Survey Text

2016
2008
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2016

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2008
Survey form view entire document:  text  image

Question ID:BAL.060_01.000

Instrument Variable Name:BTYPE_01
QuestionText:
This next question is about symptoms of dizziness or balance problems. Please tell me if you have had any of these problems in the past 12 months. Please say yes or no to each....A spinning or vertigo sensation, a rocking of yourself or your surroundings
*Read if necessary: Vertigo is an illusion of rotation or other motion, as if riding a carousel.
* Read if necessary: Do not include times when drinking alcohol.
1 Yes
2 No
7 Refused
9 Don't know
UniverseText:Sample adults 18+ who have had a problem(s) with dizziness or balance
SkipInstructions:
(1,2,R,D) [goto BTYPE_02]
Question ID:BAL.060_02.000

Instrument Variable Name:BTYPE_02
QuestionText:
* Read if necessary. This next question is about symptoms of dizziness or balance problems. Please tell me if you have had any of these problems in the past 12 months. Please say yes or no to each....A floating, spacey, or tilting sensation
* Read if necessary: Do not include times when drinking alcohol.
1 Yes
2 No
7 Refused
9 Don't know
UniverseText:Sample adults 18+ who have had a problem(s) with dizziness or balance
SkipInstructions:
(1,2,R,D) [goto BTYPE_03]
Question ID:BAL.060_03.000

Instrument Variable Name:BTYPE_03
QuestionText:
* Read if necessary. This next question is about symptoms of dizziness or balance problems. Please tell me if you have had any of these problems in the past 12 months. Please say yes or no to each....Feeling lightheaded, without a sense of motion
* Read if necessary: Do not include times when drinking alcohol.
1 Yes
2 No
7 Refused
9 Don't know
UniverseText:Sample adults 18+ who have had a problem(s) with dizziness or balance
SkipInstructions:
(1,2,R,D) [goto BTYPE_04]
Question ID:BAL.060_04.000

Instrument Variable Name:BTYPE_04
QuestionText:
* Read if necessary. This next question is about symptoms of dizziness or balance problems. Please tell me if you have had any of these problems in the past 12 months. Please say yes or no to each...Feeling as if you are going to pass out or faint
* Read if necessary: Do not include times when drinking alcohol.
1 Yes
2 No
7 Refused
9 Don't know
UniverseText:Sample adults 18+ who have had a problem(s) with dizziness or balance
SkipInstructions:
(1,2,R,D) [goto BTYPE_05]
Question ID:BAL.060_05.000

Instrument Variable Name:BTYPE_05
QuestionText:
* Read if necessary. This next question is about symptoms of dizziness or balance problems. Please tell me if you have had any of these problems in the past 12 months. Please say yes or no to each....Blurring of your vision when you move your head
* Read if necessary: Do not include times when drinking alcohol.
1 Yes
2 No
7 Refused
9 Don't know
UniverseText:Sample adults 18+ who have had a problem(s) with dizziness or balance
SkipInstructions:
(1,2,R,D) [goto BTYPE_06]
Question ID:BAL.060_06.000

Instrument Variable Name:BTYPE_06
QuestionText:
* Read if necessary. This next question is about symptoms of dizziness or balance problems. Please tell me if you have had any of these problems in the past 12 months. Please say yes or no to each....Feeling off-balance or unsteady
* Read if necessary: Do not include times when drinking alcohol.
1 Yes
2 No
7 Refused
9 Don't know
UniverseText:Sample adults 18+ who have had a problem(s) with dizziness or balance
SkipInstructions:
if (all BTYPE_01 -BTYPE_06 = 2,R,D) and (BDIZZ = 2,R,D) [goto BMEDIC];
else if two or more BTYPE_01 - BTYPE_06 = 1 then [goto BBOTH];
else if (only one BTYPE_01-BTYPE_06=1,R,D) or (all BTYPE_01 -BTYPE_06 = 2,R,D and (BDIZZ = 1) [goto
BAGE]