Survey Text

Survey form view entire document:  text  image
Question ID: BAL.250_00.000

Instrument Variable Name: BCAUS1
Questionnaire File Name: Sample Adult
Question Text:
What did the doctor(s) or health care professional(s) tell you was the cause or causes of your dizziness or balance problem(s)?
* Enter all that apply, separate with commas.
*Read the list if necessary.
01 Allergies
02 Anxiety or depression
03 Benign positional vertigo (BPV or BPPV)
04 Crystals-loose or dislodged in ear
05 Diabetes
06 Headache or migraines
07 Head or neck trauma or concussion
08 Heart disease
09 Inner ear infection, viral labrynthitis
10 Méniêre?s (Men-e-AIRZ) disease
11 Neurological-multiple sclerosis (MS), seizures, etc.
12 Side effects from medications (antibiotics, cancer treatments, etc.)
13 Stroke
14 Other health problem(s)
97 Refused
99 Don't know
Universe Text: Sample adults 18+ who were told cause of dizziness or balance problem
Skip Instructions:
(1-14,R,D) [goto BTRET1]

No questionnaire text is available for this sample.

Survey form view entire document:  text  image
Question ID:: CBL.045_00.000

Instrument Variable Name:: CBALDGHP
Did a doctor or other health professional EVER tell you a diagnosis or reason for {fill1: S.C. name}'s dizziness or balance problems?
1 Yes
2 No
7 Refused
9 Don't know
UniverseText: Sample children 3+ who have had episodes of balance problems or dizziness in the past 12 months
(1) [goto CBALDIGN]
(2,R,D) [goto CBALPART]
Question ID:: CBL.050_00.000

Instrument Variable Name:: CBALDIGN
What diagnoses or reasons were you told caused {fill1: S.C. name}'s balance or dizziness problems?
*Enter all that apply, separate with commas.
01 Ear infections (inner ear infection, otitis media, fluid in ears)
02 Vision problems/Blurred vision
03 Positional dizziness or vertigo (BPPV)
04 Severe headaches or migraine
05 Head or neck injury or concussion
06 Neurologic disorders including seizures, stroke, or brain tumors
07 Developmental motor coordination disorder ("clumsy" child)
08 Malformation of the ear
09 Other genetic cause (Asperger Syndrome, Usher's Syndrome, etc.)
10 Metabolic problem, such as "low blood sugar" (hypoglycemia)
11 Prescription medication or drugs
12 Other
97 Refused
99 Don't Know
UniverseText: Sample children 3+ who have ever been told a diagnosis for their balance problem or dizziness
(1-12,R,D) [goto CBALPART]