MONICA Manual, Part IV, Section 3

Event Registration Data
TEST CASE HISTORY FORM
ACUTE CORONARY CARE
Form:L
Version: 6         30.11.89		 FOR MQC (Dundee) USE ONLY
A,B Form, version, MONICA Collaborating centre |_9|_2|_6| MCC |__|__|
C Form coded by: name |__|__|
D Test case serial number |__|__|__|__|__|
E Date of starting to code record (day,month,year) |__|__||__|__||__|__|
6 DBIRTH |__|__||__|__||__|__| 24 SMOKE |__| 42 ACEB |__| 61 FINTD3 |__|
7 TIME |__| 25 CUNIT |__| 43-44 HSTAY |__|__| 62 FINTD4 |__|
8 ACTIME |__|__|__||__|__| 26 CSTAY |__|__| 45 ANTARD |__| 63 ANTARP |__|
9 INITC |__| 27 ANTARB |__| 46 ANTCOD |__| 64 ANTCOP |__|
10 CAROUT |__| 28 ANTCOB |__| 47 ANTPLD |__| 65 ANTPLP |__|
11 RESOUT |__| 29 ANTPLB |__| 48 BBLOKD |__| 66 BBLOKP |__|
12 RESARR |__| 30 BBLOKB |__| 49 CABLOD |__| 67 CABLOP |__|
13 CARIN |__| 31 CABLOB |__| 50 DIURD |__| 68 DIURP |__|
14 RESIN |__| 32 DIURB |__| 51 HYPOTD |__| 69 HYPOTP |__|
15 SYSBP |__|__|__| 33 HYPOTB |__| 52 INOD |__| 70 INOP |__|
16 PULSE |__|__|__| 34 INOB |__| 53 NITRD |__| 71 NITROP |__|
17 ECGSTE |__| 35 NITROB |__| 54 STREPD |__| 72 STREPP |__|
18 ECGSTD |__| 36 STREPB |__| 55 CORAND |__| 73 PACEP |__|
19 ECGEVO |__| 37 CORANB |__| 56 CORBYD |__| 74 HYPOLP |__|
20 ECGANT |__| 38 CORBYB |__| 57 ANGPLD |__| 75 ACEP |__|
21 CPK |__|__|__|__| 39 ANGPLB |__| 58 PACED |__| 76 FINTP3 |__|
22 AST |__|__|__|__| 40 PACEB |__| 59 HYPOLD |__| 77 PLOD |__|
23 HBD |__|__|__|__| 41 HYPOLB |__| 60 ACED |__| 78 REHABP |__|

General and specific instructions

This test case history form has exactly the same format as the Core Data Transfer Format - Acute Coronary Care with the exception of items A,B,C,D,E which replace items 1,2,3,4,5 in the latter. However, it is designed for coding test case histories directly onto paper forms without the use of magnetic tape. These should be sent directly to the MONICA Quality Control Centre in Dundee according to the instructions provided with the test case histories or other enquiry. By these means small quantities of coded data can be sent at one time, particularly for quality control tests.

When using this form the coding instructions for items 6 - 78 should be taken from the Specific Instructions for the Core Data Transfer Format - Acute Coronary Care. In addition item B should be coded as for item 3, CENTRE. Local codes should be used for item C, coder and Item D, Test Case Serial Number, should be that on the test material. Item E, Date of Starting to Code Record is as stated. Test case histories for Acute Coronary Care will normally be coded onto Coronary Event forms at the same time.

Blanks are not allowed in any field on this form and all boxes should be filled only with permissible characters which are 0,1,2,3,4,5,6,7,8,9.

Before sending off coded forms:

  1. make sure that all codes are legible.
  2. make sure that all fields have been filled.
  3. ensure that any corrections are clear. These should be done with a horizontal line through the incorrect item - and the correct answer written alongside and not on top.
  4. ensure that you have photostats of what is sent, but send the originals for analysis as photostats can be too faint or badly aligned.
  5. complete the packing list supplied with the test cases and make sure that both what is sent and what is retained is a complete set of coded forms.
  6. ensure that a Coronary Event test case history form is completed and sent for each event at the same time and that the serial numbers for the same case are the same. This rule will apply unless you are specifically asked not to code a Coronary Event form at the same time.