Survey Text

2007
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2007
Survey form view entire document:  text  image
Question ID: : ALT.146_00.000

Instrument Variable Name: CHE_COND
Question Text:
?[F1]
For what health problems or conditions did you use chelation therapy?
*Enter all that apply, separate with commas.
01 Acid reflux or heartburn
02 Angina
03 Anxiety
04 Asthma
05 Arthritis
06 Attention Deficit Disorder/Hyperactivity
07 Autism
08 Benign tumors, cysts
09 Bipolar Disorder
10 Birth defect
11 Cancer
12 Cholesterol
13 Chronic Bronchitis
14 Circulation problems (other than in the legs)
15 Constipation severe enough to require medication
16 Coronary heart disease
17 Dementia, including Alzheimer's Disease
18 Dental pain
19 Depression
20 Diabetes
21 Emphysema
22 Excessive sleepiness during the day
23 Excessive use of alcohol or tobacco
24 Fibromyalgia
25 Fracture, bone/joint injury
26 Gout
27 Gum disease
28 Gynecologic problem
29 Hay fever
30 Hearing problem
31 Heart attack
32 Other heart condition or disease
33 Hernia
34 Hypertension
35 Inflammatory bowel disease
36 Influenza or pneumonia
37 Insomnia or trouble sleeping
38 Irritable bowel
39 Jaw pain
40 Joint pain or stiffness/other joint condition
41 Knee problems (not arthritis, not joint injury)
42 Liver problem
43 Lung/breathing problem (not already listed)
44 Lupus
45 Mania or psychosis
46 Memory loss or loss of other cognitive function
47 Menopause
48 Menstrual problems
49 Mental retardation
50 Missing limbs (fingers, toes or digits), amputee
51 Osteoporosis, tendinitis
52 Other developmental problem
53 Other injury
54 Other nerve damage, including carpal tunnel syndrome
55 Phobia or fears
56 Polio (myelitis), paralysis, para/quadriplegia
57 Poor circulation in legs
58 Prostate trouble or impotence
59 Regular headaches
60 Rheumatoid arthritis
61 Schizophrenia
62 Seizures
63 Senility
64 Sinusitis
65 Skin problems
66 Sprain or strain
67 Stroke
68 Substance abuse, other than alcohol or tobacco
69 Filled problem
70 Filled problem
71 Ulcer
72 Urinary problem
73 Varicose veins, hemorrhoids
74 Vision problem
75 Weak or failing kidneys
76 Weight problem
77 Back pain or problem
78 Head or chest cold
79 Neck pain or problem
80 Severe headache or migraine
81 Stomach or intestinal illness
82 Other - specify
97 Refused
99 Don't know
Universe Text: Sample adults 18+ who use chelation therapy for a specific condition
Skip Instructions:
(1-81) If more than one condition selected, [goto CHE_MOST], elseif only one condition selected, [goto
CHE_MED]
(82) [goto CHE_SPEC]
(Refused,Don't know) goto CHE_ENG
Question ID: : ALT.147_00.000

Instrument Variable Name: CHE_SPEC
Question Text:
*Enter condition for which chelation therapy was used. If respondent gives more than one condition, probe for condition
most important for using chelation therapy.
97 Refused
99 Don't know
Verbatim Verbatim response
Universe Text: Sample adults 18+ who used chelation therapy to treat other health problem or condition
Skip Instructions:
(Allow 75) if more than one condition selected [goto CHE_MOST]; else if only one condition selected [goto
CHE_MED]
(R,D) [if more than one condition (1-81) selected [goto CHE_MOST]; elseif only one condition (1-81) selected
[goto CHE_MED]; else [goto CHE_ENG]

Survey form view entire document:  text  image
Question ID: : CAL.135_00.000

Instrument Variable Name: CCH_COND
Question Text:
?[F1]
DURING THE PAST 12 MONTHS, for what health problems or conditions did [fill: S.C. name] use chelation therapy?
*Enter all that apply, separate with commas.
01 Abdominal pain
02 Acid reflux or heartburn
03 Allergies other than hay fever, respiratory allergies, food or digestive allergies, or skin allergies
04 Anemia
05 Anxiety or stress
06 Arthritis
07 Asthma
08 Attention Deficit Hyperactivity Disorder (ADHD)/Attention Deficit Disorder (ADD)
09 Autism
10 Back or neck pain
11 Cancer
12 Cerebral palsy
13 Chickenpox
14 Congenital heart disease
15 Cystic fibrosis
16 Depression
17 Diabetes
18 Down syndrome
19 Eczema or skin allergy
20 Fatigue or lack of energy
21 Fever
22 Food or digestive allergy
23 Frequent or repeated diarrhea or colitis
24 Migraine headaches
25 Gum disease
26 Hay Fever
27 Head or chest cold
28 Hearing problem
29 Incontinence, including bed wetting
30 Influenza or pneumonia
31 Insomnia or trouble sleeping
32 Lung or breathing problem, other than Asthma
33 Mental Retardation
34 Menstrual problems
35 Muscular dystrophy
36 Nausea and/or vomiting
37 Neurological problems
38 Other chronic pain
39 Other developmental delay
40 Other heart condition
41 Phobia or fears
42 Problems with being overweight
43 Non-migraine headaches
44 Recurring constipation
45 Respiratory allergy
46 Seizures
47 Severe acne
48 Sickle cell anemia
49 Sinusitis
50 Skin problems other than eczema, acne, or warts
51 Sore throat other than strep or tonsillitis
52 Strep throat or tonsillitis
53 Stuttering or stammering
54 Three or more ear infections
55 Urinary problems, including urinary tract infection
56 Vision problem
57 Warts
58 Other specify
97 Refused
99 Don't know
Universe Text: Sample children LT 18 who used chelation therapy for a problem or condition
Skip Instructions:
(1-57,R,D) Cycle through modalities, if CCO
_USEM = 1 [goto CCO_TRET];
else [goto next selected modality.] If no more modalities selected [goto TRD]
(58) [goto CCH_SPEC]
Question ID: : CAL.136_00.000

Instrument Variable Name: CCH_SPEC

Question Text:
*Enter condition for which chelation therapy was used. If respondent gives more than one condition, probe for condition most important for using chelation therapy.
97 Refused
99 Don't know
Verbatim Verbatim response
Universe Text: Sample children LT 18 who used chelation therapy for othe
r problem or condition
Skip Instructions:
(allow 75,R,D) Cycle through modalities, if CCO_USEM = 1 [goto CCO_TRET];
else [goto next selected modality.] If no more modalities selected [goto TRD]