CRF3B - isaric4c/wiki GitHub Wiki

Variable / Field Name Section Header Field Type Field Label Choices or Calculations
crf3b_version radio CRF3 Version Completed 1, Unversioned ; 2, 1.0 ; 3, 1.1 ; 4, 1.2 ; 5, 1.3 ; 6, 1.4 ; 7, 1.5 ; 8, 1.6 ; 9, 2.0
crf3b_date_consent text Date of consent
crf3b_ongoing_consent_done yesno Ongoing consent confirmed verbally? 1, Yes ; 0, No
crf3b_date_visit text Date of visit
crf3b_visit radio Type of this visit 1, 3 months visit ; 2, 12 months visit
crf3b_rest_spo2_done Resting observations (If no corresponding clinical visit) radio a) Pulse Oximetry (SpO2) 1, Yes ; 0, No
crf3b_rest_hr_done radio b) Heart rate 1, Yes ; 0, No
crf3b_rest_bp_done radio c) Blood pressure 1, Yes ; 0, No
crf3b_rest_temp_done radio d) Temperature 1, Yes ; 0, No
crf3b_rest_height_done radio e) Height (cm) 1, Yes ; 0, No
crf3b_rest_weight_done radio f) Weight (kg) 1, Yes ; 0, No
crf3b_rest_spo2 text a) Resting Pulse Oximetry (SpO2):
crf3b_rest_hr text b) Resting heart rate:
crf3b_rest_bp_sys text c) Resting blood pressure (systolic):
crf3b_rest_bp_dia text c) Resting blood pressure (diastolic):
crf3b_rest_temp text d) Temperature:
crf3b_rest_height text e) Height (cm):
crf3b_rest_weight text f) Weight (kg):
crf3b_base_ecg_done Basic investigations (If no corresponding clinical visit) radio ECG 1, Completed ; 0, Not done
crf3b_ecg radio ECG result: 1, Sinus rhythm ; 2, Atrial fibrillation/flutter ; 3, ST segment/T wave changes ; 4, RBBB ; 5, LBBB
crf3b_base_ecg_hr text ECG heart rate:
crf3b_hcare_ehv Healthcare utilisation radio Emergency hospital visit 1, Yes ; 0, No
crf3b_hcare_pacr radio Planned additional COVID-related review 1, Yes ; 0, No
crf3b_hcare_cgp radio Contacts with GP for a clinical review 1, Yes ; 0, No
crf3b_hcare_med radio Any changes in regular medication 1, Yes ; 0, No
crf3b_crfev_done yesno Have you completed Emergency Visit CRF for any unplanned emergency visits? 1, Yes ; 0, No
crf3b_crf4_done yesno Have you completed CRF4 for any additional planned COVID-related clinical visits? 1, Yes ; 0, No
crf3b_medlog_done yesno Have you completed or updated medication log? 1, Yes ; 0, No
crf3b_eq5d_done yesno Have you completed a EQ-5D-5L form (Pre-COVID)? 1, Yes ; 0, No
crf3b_mrc_done yesno Have you completed a MRC dyspnoea scale form (Before COVID)? 1, Yes ; 0, No
crf3b_social_history_done yesno Have you completed a Social History form? 1, Yes ; 0, No
crf3b_new_prob yesno Are you experiencing any new problems that we haven't mentioned? 1, Yes ; 0, No
crf3b_new_prob_detail notes Please provide details for these new problems
crf3b_info_dis notes What information would have been helpful to receive at discharge?
crf3b_spost_livewell Signposting radio https://www.nhs.uk/live-well/ 1, Yes ; 0, No ; 2, Unsure
crf3b_spost_iapt radio Improving Access to Psychological Therapies (IAPT) 1, Yes ; 0, No ; 2, Unsure
crf3b_spost_shyg radio Sleep hygiene 1, Yes ; 0, No ; 2, Unsure
crf3b_spost_mental radio Mental wellbeing - Daylight app/weblink 1, Yes ; 0, No ; 2, Unsure
crf3b_spost_drinkfree radio Alcohol - 'Drink free days' 1, Yes ; 0, No ; 2, Unsure
crf3b_spost_phyinac radio Physical inactivity - 'couch to 5K' or 'Active 10' 1, Yes ; 0, No ; 2, Unsure
crf3b_spost_smkadv radio Smoking Advice https://www.nhs.uk/live-well/quit-smoking/ 1, Yes ; 0, No ; 2, Unsure
crf3b_spost_smkref radio Smoking cessation referral 1, Yes ; 0, No ; 2, Unsure
crf3b_spost_smkapp radio 'Smoke free' app 1, Yes ; 0, No ; 2, Unsure
crf3b_spost_wmgmt radio Weight management: http://www.nhs.uk/live-well/healthyweight/start-the-nhs-weight-loss-plan/ 1, Yes ; 0, No ; 2, Unsure
crf3b_spost_heat radio Healthy eating: 1, Yes ; 0, No ; 2, Unsure
crf3b_inv_assess Investigator completed assessments checkbox Investigator completed assessments 1, Montreal Cognitive Assessment (MoCA) ; 2, Clinical Frailty Scale ; 3, Fried Frailty assessment
crf3b_assess_moca yesno 1. Have you completed a MoCA form? 1, Yes ; 0, No
crf3b_assess_cfs yesno 2. Have you completed a Rockwood Clinical Frailty Scale form? 1, Yes ; 0, No
crf3b_truecolours_check Questionnaires yesno Is the participant completing questionnaires using True Colours? 1, Yes ; 0, No
crf3b_quests checkbox Questionnaires 12, Pre-COVID Patient Symptom Questionnaire (Only to be completed once during study) ; 13, Patient Symptom Questionnaire ; 1, MRC dyspnoea scale ; 2, EQ-5D-5L ; 3, Generalised Anxiety Disorder Assessment (GAD-7) ; 4, Patient Health Questionnaire (PHQ-9) ; 5, Sarcopenia screen (SARC-F) ; 6, General Practice Physical Activity Questionnaire (GPPAQ) ; 7, Dyspnoea-12 ; 8, Fatigue (FACIT) ; 9, Brief Pain Inventory (BPI) ; 10, Post-Traumatic Stress Disorder (PTSD) checklist (PCL-5) ; 11, Nottingham extended activity of daily living (NEADL)
crf3b_quest_pre_psq yesno 1. Have you completed a Pre-COVID Patient Symptom Questionnaire form? 1, Yes ; 0, No
crf3b_quest_psq yesno 2. Have you completed a Patient Symptom Questionnaire form? 1, Yes ; 0, No
crf3b_quest_mrc yesno 3. Have you completed a MRC dyspnoea scale form (Since COVID)? 1, Yes ; 0, No
crf3b_quest_eq5d5l yesno 4. Have you completed a EQ-5D-5L form (Current visit)? 1, Yes ; 0, No
crf3b_quest_gad7 yesno 5. Have you completed a GAD-7 form? 1, Yes ; 0, No
crf3b_quest_phq9 yesno 6. Have you completed a PHQ-9 form? 1, Yes ; 0, No
crf3b_quest_sarcf yesno 7. Have you completed a SARC-F form? 1, Yes ; 0, No
crf3b_quest_gppaq yesno 8. Have you completed a GPPAQ form? 1, Yes ; 0, No
crf3b_quest_dys12 yesno 9. Have you completed a Dyspnoea-12 form? 1, Yes ; 0, No
crf3b_quest_facit yesno 10. Have you completed a FACIT form? 1, Yes ; 0, No
crf3b_quest_bpi yesno 11. Have you completed a BPI form? 1, Yes ; 0, No
crf3b_quest_pcl5 yesno 12. Have you completed a PCL-5 form? 1, Yes ; 0, No
crf3b_quest_neadl yesno 13. Have you completed a NEADL form? 1, Yes ; 0, No
crf3b_fried_date Fried's Frailty Assessment Questions text Date completed
crf3b_fried_shrink yesno 1. Shrinking: In the last year, has the patient lost more than 10lb (4.5 kilograms) unintentionally? 1, Yes ; 0, No
crf3b_fried_energy yesno 2. Exhaustion - Q1: Do they feel full of energy? 1, Yes ; 0, No
crf3b_fried_rest_day radio 2. Exhaustion - Q2: During the last 4 weeks how often have they rested in bed during the day? 1, Every day ; 2, Every week ; 3, Once ; 4, Not at all
crf3b_t2_core Tier 2 Core Tests yesno Have you completed a Tier 2 Core Tests Checklist? 1, Yes ; 0, No
crf3b_t2_research Tier 2 Biological Research Samples yesno Have you completed a Tier 2 Biological Research Samples Checklist? 1, Yes ; 0, No
crf3b_pft Pulmonary Function Tests (PFTs) yesno Have you completed Pulmonary function tests (PFTs) forms? 1, Yes ; 0, No
crf3b_qrisk3 QRISK®3 yesno Have you completed a QRISK®3 form? 1, Yes ; 0, No
cr3b_waist_done yesno Waist circumference measurement: Completed 1, Yes ; 0, No
cr3b_waist_result text Waist circumference measurement: Result
crf3b_rehab_q1 Post-discharge Rehabilitation Programme radio 1. Has the patient been referred to a rehabilitation programme after their hospital admission with COVID-19? 1, Yes ; 0, No ; 2, Not sure
crf3b_rehab_q2 radio 2. Did they attend any rehabilitation session(s)? 1, Yes ; 0, No ; 2, Not sure
crf3b_rehab_q3 radio 3. What was the nature of the session(s)? 1, Face-to-face ; 2, Virtual/remote ; 3, Both
crf3b_rehab_q4_yn yesno 4. Is the total number of sessions attended by the patient so far known? 1, Yes ; 0, No
crf3b_rehab_q4 text 4. Total number of sessions attended by the patient so far
crf3b_rehab_q5 radio 5. Has the patient completed the programme & attended the discharge assessment? 1, Yes ; 0, No ; 2, Not sure
crf3b_rehab_q6 radio 6. Did they find the programme helpful? 1, Yes ; 0, No ; 2, Not sure
crf3b_psych_q1 Post-discharge Psychology Services Review radio 1. Has the patient been referred to any psychology service after their hospital admission with COVID-19? 1, Yes ; 0, No ; 2, Not sure
crf3b_psych_q2 checkbox 2. Please select all that apply. 1, Post ICU psychology service ; 2, Psychiatric liaison service ; 3, Improving Access to Psychological Therapies (IAPT) ; 4, Acute Hospital Clinical Health Psychology service ; 5, Community Mental Health Team (adult) ; 6, Community Mental Health Team (older adult) ; 7, Psychological Therapies service for serious mental illness (SMI) ; 8, Mental health Crisis Resolution and Home Treatment service ; 9, In patient mental health service ; 10, Counselling services (Third sector or primary care based) ; 11, Private providers of psychological therapy ; 12, Other ; 13, Not known
crf3b_psych_q2_other notes 2. Other post-discharge psychology services - Please specify
crf3b_psych_q3 radio 3. What was the nature of the session(s)? 1, Face-to-face ; 2, Virtual/remote ; 3, Both
crf3b_psych_q4 radio 4. Did they find the service(s) helpful? 1, Yes ; 0, No ; 2, Not sure
crf3b_bodycom_bia Body composition measurements (BIA and DXA) radio Have you completed a BIA form? 1, Yes ; 0, No
crf3b_bodycom_dxa radio Have you completed a DXA form? 1, Yes ; 0, No
crf3b_muscle_strength Muscle Strength yesno Have you completed a muscle strength form? 1, Yes ; 0, No
crf3b_iswt_1 Incremental shuttle walk test (ISWT) Modified 15 level radio ISWT measurement 1 1, Yes ; 0, No
crf3b_iswt_2 radio ISWT measurement 2 1, Yes ; 0, No
crf3b_sppb Short Physical Performance Battery (SPPB) yesno Have you completed a short physical performance battery (SPPB)  form? 1, Yes ; 0, No
crf3b_amc_inform Activity Monitor checklist yesno 1. Has the participant been informed about the activity monitor? 1, Yes ; 0, No
crf3b_amc_happy yesno 2. Is the participant happy to receive and wear the activity monitor? 1, Yes ; 0, No
crf3b_amc_location radio 3. Wear location 1, Wrist ; 2, Upper Arm
crf3b_amc_strap radio 4. Strap Type 1, Plastic ; 2, Velcro
crf3b_amc_notes notes 5. Activity Monitor checklist - Notes
crf3b_future_studies Future studies yesno Is the participant happy to be contacted about future studies? 1, Yes ; 0, No