BS. Biomarker

BS. Biomarker Module of SHARE 2015

item label type description
BS023 Question IWER:Start of a Non-proxy section. No proxy allowed. If the respondent is not present or not capable to give consent to participation on [ his/ her] own, please select '5'. NON PROXY MODULE
BS026 Question NURSE INTRO
BS027 Question What is the best way the nurse could contact you to arrange her visit?
BS003 Question Thank you. We will continue with the interview.
BS001 Question Before we begin, I would like to have you read this information sheet.
BS025 Question We now move on to the collection of blood samples we explained to you in our information letter.
BS002 Question Do you have any further questions?
BS006 Question MEDICAL REASONS
BS004 Question IWER:Please enter the k ind of analyses which R does not permitType "NONE" if respondent does not mention any analyses which should not be done.
BS008 Question IWER: Please be aware: if respondent takes blood thinning medication, it may take longer time to stop the bleeding. In this case make the respondent elevate his/her hand and have gauze pads available.
BS009 Question IWER:Enter barcode from barcode label into capi
BS010 Question IWER:Repeat barcodenumber
BS011 Question Thank you for your cooperation.This concludes the Dried Blood Spot portion of the interview.Before we continue with the interview, I need a moment to enter a few pieces of information in the computer.
BS012 Question IWER:What, if any, problems occured during the collection of the blood sample? {CodeAll}
BS022 Question IWER:Please specify. OTHER PROBLEMS
BS013 Question IWER:Who pricked the respondent's finger(s)? WHO PRICKED
BS014 Question IWER: How many pricks have been made? HOW MANY PRICKS
BS015 Question IWER:How many circles on the cards could be filled?
BS016 Question IWER:How compliant was R during this measurement?/
BS021 Question Do you wish to be informed [OR country-specific: Do you wish to be informed via your general practitioner] about blood results if a value lies outside the normal range?
Start of BS. Biomarker
 
BS023

IWER:Start of a Non-proxy section. No proxy allowed. If the respondent is not present or not capable to give consent to participation on [ his/ her] own, please select '5'. NON PROXY MODULE

IWER:START OF A NON-PROXY SECTION. NO PROXY ALLOWED. IF THE RESPONDENT IS NOT PRESENT OR NOT CAPABLE TO GIVE CONSENT TO PARTICIPATION ON [ HIS/ HER] OWN, PLEASE SELECT '5'. NON PROXY MODULE
expand
 
If IWER:Start of a Non-proxy section. No proxy allowed. If the respondent is not present or not capable to give consent to participation on [ his/ her] own, please select '5'. NON PROXY MODULE was answered »
 
   
 
BS026

NURSE INTRO

SINCE YOUR HEALTH IS A VERY IMPORTANT ELEMENT OF THIS INTERVIEW AND OF OUR RESEARCH PROJECT WE HAVE ARRANGEDSEVERAL MEDICAL PROCEDURES, SUCH AS MEASURING YOUR BLOOD PRESSURE AND TAKING SAMPLES OF YOUR BLOOD WHICH WOULD BE CONDUCTED BY A QUALIFIED NURSE ON A SEPARATE VISIT. WE WOULD BE VERY GRATEFUL IF YOU AGREED TO PARTICIPATE IN THIS ADDITIONAL PART OF THE PROJECT. WOULD YOU BE WILLING TO TAKE PART IN THIS PART AND AGREE TO BE VISITED BY A QUALIFIED NURSE IN THE NEXT FEW WEEKS? NURSE INTRO
expand
   
 
If NURSE INTRO = A1 Yes  »
 
     
   
BS027

What is the best way the nurse could contact you to arrange her visit?

THANK YOU VERY MUCH FOR YOUR AGREEMENT. WHAT IS THE BEST WAY THE NURSE COULD CONTACT YOU TO ARRANGE HERVISIT? COULD YOU GIVE US A TELEPHONE NUMBER SHE COULD CALL? IWER: PLEASE NOTE CONTACT DETAILS. HAND OUT INFORMATION LEAFLET TO THE RESPONDENT. THANKS
expand
     
 
Else
 
     
   
BS023

IWER:Start of a Non-proxy section. No proxy allowed. If the respondent is not present or not capable to give consent to participation on [ his/ her] own, please select '5'. NON PROXY MODULE

IWER:START OF A NON-PROXY SECTION. NO PROXY ALLOWED. IF THE RESPONDENT IS NOT PRESENT OR NOT CAPABLE TO GIVE CONSENT TO PARTICIPATION ON [ HIS/ HER] OWN, PLEASE SELECT '5'. NON PROXY MODULE
expand
     
Else
 
   
 
If MN028 = 1 »
 
     
   
BS001

Before we begin, I would like to have you read this information sheet.

TO ASSESS THE HEALTH STATUS OF THE GENERAL POPULATION AGE 50 AND ABOVE, WE WOULD LIKE TO COLLECT A FEW
DROPS OF BLOOD. THIS WILL BE DONE USING JUST A FINGER PRICK AS IT IS DONE DAILY BY MILLIONS OF PEOPLE WITH
DIABETES. WE WOULD BE VERY GRATEFUL IF YOU AGREED TO PARTICIPATE. YET, THIS BLOOD COLLECTION IS ABSOLUTELY
VOLUNTARY.
BEFORE WE BEGIN, I WOULD LIKE TO HAVE YOU READ THIS INFORMATION SHEET.
expand
     
 
Else
 
     
   
BS025

We now move on to the collection of blood samples we explained to you in our information letter.

WE NOW MOVE ON TO THE COLLECTION OF BLOOD SAMPLES WE EXPLAINED TO YOU IN OUR INFORMATION LETTER. TOASSESS THE HEALTH STATUS OF THE POPULATION, WE WOULD LIKE TO COLLECT A FEW DROPS OF BLOOD. THIS WILL BE DONE USING JUST A FINGER PRICK AS IT IS DONE DAILY BY PEOPLE WITH DIABETES. WE WOULD BE VERY GRATEFUL IF YOU AGREED TO PARTICIPATE. YET, THIS BLOOD COLLECTION IS ABSOLUTELY VOLUNTARY. BEFORE I ASK YOU TO SIGN THIS CONSENT FORM, DO YOU WANT ME TO EXPLAIN THE PROCEDURE AGAIN?
expand
     
 
BS006

MEDICAL REASONS

FROM YOUR POINT OF VIEW: ARE THERE ANY MEDICAL REASONS WHICH WOULD PREVENT YOU FROM PARTICIPATING?
MEDICAL REASONS
expand
   
 
If MEDICAL REASONS = A5 No  »
 
     
   
BS002

Do you have any further questions?

DO YOU HAVE ANY FURTHER QUESTIONS?IWER: 1. IF THE RESPONDENT HAS ANY QUESTIONS, PLEASE ANSWER THEM 2. LET RESPONDENT SIGN THE CONSENT FORMS 3. LEAVE ONE COPY OF THE CONSENT FORM WITH THE RESPONDENT CONSENT
expand
     
 
If MEDICAL REASONS = A1 Yes  »
 
     
   
BS003

Thank you. We will continue with the interview.

THANK YOU. WE WILL CONTINUE WITH THE INTERVIEW.
expand
     
 
Else
 
     
   
BS004

IWER:Please enter the k ind of analyses which R does not permitType "NONE" if respondent does not mention any analyses which should not be done.

IWER:PLEASE ENTER THE K IND OF ANALYSES WHICH R DOES NOT PERMITTYPE "NONE" IF RESPONDENT DOES NOT MENTION ANY ANALYSES WHICH SHOULD NOT BE DONE.
     
   
BS008

IWER: Please be aware: if respondent takes blood thinning medication, it may take longer time to stop the bleeding. In this case make the respondent elevate his/her hand and have gauze pads available.

IWER:
PLEASE BE AWARE: IF RESPONDENT TAKES BLOOD THINNING MEDICATION, IT MAY TAKE LONGER TIME TO STOP THE BLEEDING. IN THIS CASE MAKE THE RESPONDENT ELEVATE HIS/HER HAND AND HAVE GAUZE PADS AVAILABLE.
expand
     
   
BS009

IWER:Enter barcode from barcode label into capi

IWER:ENTER BARCODE FROM BARCODE LABEL INTO CAPI
     
   
BS010

IWER:Repeat barcodenumber

IWER:REPEAT BARCODENUMBER
     
   
If MN028 = 3 »
 
       
     
BS021

Do you wish to be informed [OR country-specific: Do you wish to be informed via your general practitioner] about blood results if a value lies outside the normal range?

DO YOU WISH TO BE INFORMED [OR COUNTRY-SPECIFIC: DO YOU WISH TO BE INFORMED VIA YOUR GENERAL
PRACTITIONER] ABOUT BLOOD RESULTS IF A VALUE LIES OUTSIDE THE NORMAL RANGE? PLEASE BE AWARE THAT A LOT OF TIME MAY PASS UNTIL THESE RESULTS ARE AVAILABLE, AND THAT THIS INFORMATION DOES NOT REPLACE CONSULTATION
WITH A PHYSICIAN.
expand
       
   
BS011

Thank you for your cooperation.This concludes the Dried Blood Spot portion of the interview.Before we continue with the interview, I need a moment to enter a few pieces of information in the computer.

THANK YOU FOR YOUR COOPERATION.THIS CONCLUDES THE DRIED BLOOD SPOT PORTION OF THE INTERVIEW.BEFORE WE CONTINUE WITH THE INTERVIEW, I NEED A MOMENT TO ENTER A FEW PIECES OF INFORMATION IN THE COMPUTER.
expand
     
   
BS012

IWER:What, if any, problems occured during the collection of the blood sample? {CodeAll}

IWER:WHAT, IF ANY, PROBLEMS OCCURED DURING THE COLLECTION OF THE BLOOD SAMPLE? {CODEALL}
expand
     
   
If A97 includes BS012 »
 
       
     
BS022

IWER:Please specify. OTHER PROBLEMS

IWER:PLEASE SPECIFY. OTHER PROBLEMS
       
   
BS013

IWER:Who pricked the respondent's finger(s)? WHO PRICKED

IWER:WHO PRICKED THE RESPONDENT'S FINGER(S)? WHO PRICKED
expand
     
   
BS014

IWER: How many pricks have been made? HOW MANY PRICKS

IWER: HOW MANY PRICKS HAVE BEEN MADE?
HOW MANY PRICKS
expand
     
   
BS015

IWER:How many circles on the cards could be filled?

IWER:HOW MANY CIRCLES ON THE CARDS COULD BE FILLED?
expand
     
End of BS. Biomarker
Start of BS. Biomarker

========================================================================
BS023
IWER:Start of a @BNon-proxy section@B. No proxy allowed. If the respondent is not present or not capable to give consent to participation on [ his/ her] own, please select '5'. NON PROXY MODULE

IWER:START OF A @BNON-PROXY SECTION@B. NO PROXY ALLOWED. IF THE RESPONDENT IS NOT PRESENT OR NOT CAPABLE TO GIVE CONSENT TO PARTICIPATION ON [ HIS/ HER] OWN, PLEASE SELECT '5'. NON PROXY MODULE
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Continue
5 Proxy-interview


If IWER:Start of a @BNon-proxy section@B. No proxy allowed. If the respondent is not present or not capable to give consent to participation on [ his/ her] own, please select '5'. NON PROXY MODULE (BS023) was answered »

| ========================================================================
BS026
NURSE INTRO

SINCE YOUR HEALTH IS A VERY IMPORTANT ELEMENT OF THIS INTERVIEW AND OF OUR RESEARCH PROJECT WE HAVE ARRANGEDSEVERAL MEDICAL PROCEDURES, SUCH AS MEASURING YOUR BLOOD PRESSURE AND TAKING SAMPLES OF YOUR BLOOD WHICH WOULD BE CONDUCTED BY A QUALIFIED NURSE ON A SEPARATE VISIT. WE WOULD BE VERY GRATEFUL IF YOU AGREED TO PARTICIPATE IN THIS ADDITIONAL PART OF THE PROJECT. WOULD YOU BE WILLING TO TAKE PART IN THIS PART AND AGREE TO BE VISITED BY A QUALIFIED NURSE IN THE NEXT FEW WEEKS? NURSE INTRO
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
5 No


If NURSE INTRO (BS026) = A1 Yes  »

| | ========================================================================
| | 
BS027
What is the best way the nurse could contact you to arrange her visit?

THANK YOU VERY MUCH FOR YOUR AGREEMENT. WHAT IS THE BEST WAY THE NURSE COULD CONTACT YOU TO ARRANGE HERVISIT? COULD YOU GIVE US A TELEPHONE NUMBER SHE COULD CALL? IWER: PLEASE NOTE CONTACT DETAILS. HAND OUT INFORMATION LEAFLET TO THE RESPONDENT. THANKS
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Continue


Else

| | ========================================================================
| | 
BS023
IWER:Start of a @BNon-proxy section@B. No proxy allowed. If the respondent is not present or not capable to give consent to participation on [ his/ her] own, please select '5'. NON PROXY MODULE

IWER:START OF A @BNON-PROXY SECTION@B. NO PROXY ALLOWED. IF THE RESPONDENT IS NOT PRESENT OR NOT CAPABLE TO GIVE CONSENT TO PARTICIPATION ON [ HIS/ HER] OWN, PLEASE SELECT '5'. NON PROXY MODULE
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Continue
5 Proxy-interview


Else

If MN028 = 1 »

| | ========================================================================
| | 
BS001
Before we begin, I would like to have you read this information sheet.

TO ASSESS THE HEALTH STATUS OF THE GENERAL POPULATION AGE 50 AND ABOVE, WE WOULD LIKE TO COLLECT A FEW
DROPS OF BLOOD. THIS WILL BE DONE USING JUST A FINGER PRICK AS IT IS DONE DAILY BY MILLIONS OF PEOPLE WITH
DIABETES. WE WOULD BE VERY GRATEFUL IF YOU AGREED TO PARTICIPATE. YET, THIS BLOOD COLLECTION IS ABSOLUTELY
VOLUNTARY.
BEFORE WE BEGIN, I WOULD LIKE TO HAVE YOU READ THIS INFORMATION SHEET.
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Continue


Else

| | ========================================================================
| | 
BS025
We now move on to the collection of blood samples we explained to you in our information letter.

WE NOW MOVE ON TO THE COLLECTION OF BLOOD SAMPLES WE EXPLAINED TO YOU IN OUR INFORMATION LETTER. TOASSESS THE HEALTH STATUS OF THE POPULATION, WE WOULD LIKE TO COLLECT A FEW DROPS OF BLOOD. THIS WILL BE DONE USING JUST A FINGER PRICK AS IT IS DONE DAILY BY PEOPLE WITH DIABETES. WE WOULD BE VERY GRATEFUL IF YOU AGREED TO PARTICIPATE. YET, THIS BLOOD COLLECTION IS ABSOLUTELY VOLUNTARY. BEFORE I ASK YOU TO SIGN THIS CONSENT FORM, DO YOU WANT ME TO EXPLAIN THE PROCEDURE AGAIN?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Continue


| ========================================================================
BS006
MEDICAL REASONS

FROM YOUR POINT OF VIEW: ARE THERE ANY MEDICAL REASONS WHICH WOULD PREVENT YOU FROM PARTICIPATING?
MEDICAL REASONS
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
5 No


If MEDICAL REASONS (BS006) = A5 No  »

| | ========================================================================
| | 
BS002
Do you have any further questions?

DO YOU HAVE ANY FURTHER QUESTIONS?IWER: 1. IF THE RESPONDENT HAS ANY QUESTIONS, PLEASE ANSWER THEM 2. LET RESPONDENT SIGN THE CONSENT FORMS 3. LEAVE ONE COPY OF THE CONSENT FORM WITH THE RESPONDENT CONSENT
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R signed the consent form
5. R did NOT sign the consent form


If MEDICAL REASONS (BS006) = A1 Yes  »

| | ========================================================================
| | 
BS003
Thank you. We will continue with the interview.

THANK YOU. WE WILL CONTINUE WITH THE INTERVIEW.
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Continue


Else

| | ========================================================================
| | 
BS004
IWER:Please enter the k ind of analyses which R does not permitType "NONE" if respondent does not mention any analyses which should not be done.

IWER:PLEASE ENTER THE K IND OF ANALYSES WHICH R DOES NOT PERMITTYPE "NONE" IF RESPONDENT DOES NOT MENTION ANY ANALYSES WHICH SHOULD NOT BE DONE.

| | ========================================================================
| | 
BS008
IWER: Please be aware: if respondent takes blood thinning medication, it may take longer time to stop the bleeding. In this case make the respondent elevate his/her hand and have gauze pads available.

IWER:
PLEASE BE AWARE: IF RESPONDENT TAKES BLOOD THINNING MEDICATION, IT MAY TAKE LONGER TIME TO STOP THE BLEEDING. IN THIS CASE MAKE THE RESPONDENT ELEVATE HIS/HER HAND AND HAVE GAUZE PADS AVAILABLE.
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Continue


| | ========================================================================
| | 
BS009
IWER:Enter barcode from barcode label into capi

IWER:ENTER BARCODE FROM BARCODE LABEL INTO CAPI

| | ========================================================================
| | 
BS010
IWER:Repeat barcodenumber

IWER:REPEAT BARCODENUMBER

| | If MN028 = 3 »

| | | ========================================================================
| | | 
BS021
Do you wish to be informed [OR country-specific: Do you wish to be informed via your general practitioner] about blood results if a value lies outside the normal range?

DO YOU WISH TO BE INFORMED [OR COUNTRY-SPECIFIC: DO YOU WISH TO BE INFORMED VIA YOUR GENERAL
PRACTITIONER] ABOUT BLOOD RESULTS IF A VALUE LIES OUTSIDE THE NORMAL RANGE? PLEASE BE AWARE THAT A LOT OF TIME MAY PASS UNTIL THESE RESULTS ARE AVAILABLE, AND THAT THIS INFORMATION DOES NOT REPLACE CONSULTATION
WITH A PHYSICIAN.
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes, R wants to be informed and signed the consent form.
5. No, R doesn't want to be informed/did not sign the consent form

| | ========================================================================
| | 
BS011
Thank you for your cooperation.This concludes the Dried Blood Spot portion of the interview.Before we continue with the interview, I need a moment to enter a few pieces of information in the computer.

THANK YOU FOR YOUR COOPERATION.THIS CONCLUDES THE DRIED BLOOD SPOT PORTION OF THE INTERVIEW.BEFORE WE CONTINUE WITH THE INTERVIEW, I NEED A MOMENT TO ENTER A FEW PIECES OF INFORMATION IN THE COMPUTER.
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Continue


| | ========================================================================
| | 
BS012
IWER:What, if any, problems occured during the collection of the blood sample? {CodeAll}

IWER:WHAT, IF ANY, PROBLEMS OCCURED DURING THE COLLECTION OF THE BLOOD SAMPLE? {CODEALL}
- - - - - - - - - - - - - - - - - - - - - - - - -
1 R became light-headed, fainted, or nauseous
2 R had difficulty getting finger to stop bleeding
3 Unable to obtain enough blood
4 Problem with equipment or supplies
96 None
97 Other


| | If A97 IN BS012 »

| | | ========================================================================
| | | 
BS022
IWER:Please specify. OTHER PROBLEMS

IWER:PLEASE SPECIFY. OTHER PROBLEMS

| | ========================================================================
| | 
BS013
IWER:Who pricked the respondent's finger(s)? WHO PRICKED

IWER:WHO PRICKED THE RESPONDENT'S FINGER(S)? WHO PRICKED
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R pricked own finger(s)
2. IWER pricked R's finger(s)
3. Both R and IWER pricked R's finger(s)
4. Someone else pricked R's finger(s)


| | ========================================================================
| | 
BS014
IWER: How many pricks have been made? HOW MANY PRICKS

IWER: HOW MANY PRICKS HAVE BEEN MADE?
HOW MANY PRICKS
- - - - - - - - - - - - - - - - - - - - - - - - -
1 One time
2 Two times


| | ========================================================================
| | 
BS015
IWER:How many circles on the cards could be filled?

IWER:HOW MANY CIRCLES ON THE CARDS COULD BE FILLED?
- - - - - - - - - - - - - - - - - - - - - - - - -
0. No circles could be filled
1. 1
2. 2
3. 3
4. 4
5. 5


End of BS. Biomarker