Att8_Data Dictionary

OMB 0920-0307

Attachment 8

GISP Data Dictionary and Data Elements

Demographic/Clinical Data (Form 1 or CDC 73.60A)

Variable Name	Type/Length		Description	Values
CLINIC YRMO TOTYRMO EPFEM EPMALE TOTEP ID CLINID SEX ETHNIC AMIND ASIAN BLACK NAHAW WHITE ORACE DATEVIS	[Char, 3] [Char, 6] [Char, 6] [Num, 3] [Num, 3] [Num, 3] [Char, 2] [Char, 1] [Char, 1] [Char, 1] [Char, 1] [Char, 1] [Char, 1] [Char, 1] [Char, 1] [Char, 1] [Date, 10]		Sentinel site code Year/Month of patient’s visit Year/Month of clinic totals for gonorrhea total monthly female gonorrhea episodes total monthly male gonorrhea episodes total monthly gonorrhea episodes patient or isolate number clinic identifier number gender Hispanic origin American Indian/ Alaskan Native Asian Black Native Hawaiian/ Pacific Islander White Other race date of clinic visit	ALB=Albuquerque, ATL=Atlanta, BAL=Baltimore, BHM=Birmingham, CHI=Chicago, CIN=Cincinnati, CLE=Cleveland, DAL=Dallas, DEN=Denver, DTR=Detroit, GRB=Greensboro, HON=Honolulu, KCY=Kansas City, LAX=Los Angeles, LBC=Long Beach, LVG=Las Vegas, MIA=Miami, MIN=Minneapolis, NOR=New Orleans, NYC=New York City, OKC=Oklahoma City, ORA=Orange County, PHI=Philadelphia, PHX=Phoenix, POR=Portland, RIC=Richmond, SDG=San Diego, SEA=Seattle, SFO=San Francisco, TRP=Tripler Army Medical Center YYYYMM YYYYMM 01, 02, 03, ... 30 or higher 1=male, 2=female, 9=unknown 1=Hispanic, 2=non-Hispanic, 9=Unknown 1= yes, 2= no 1= yes, 2= no 1= yes, 2= no 1= yes, 2= no 1= yes, 2= no 1= yes, 2= no MM/DD/YYYY
DOB AGE SEXOR SYMP REASON HISTORY EPSDS ZIP HIVSTAT TRAVEL SEXWK ANTIBIOT IDU NONIDU	[Date, 10] [Num, 2] [Char, 1] [Char, 1] [Char, 1] [Char, 1] [Num, 2] [Char, 5] [Char, 1] [Char, 1] [Char, 1] [Char, 1] [Char, 1] [Char, 1]	date of birth age in years sexual orientation symptoms of gonorrhea reason for clinic visit previous history of gonorrhea number of previous episodes within the past 12 months zip code (residential) most recent known HIV status at clinic visit for gonorrhea travel to Hawaii or outside U.S. in the previous 60 days history of giving or receiving drugs/money for sex in the previous 60 days any antibiotic use during the previous 60 days history of injection drug use in previous 60 days history of noninjection recreational drug use (excluding alcohol) in the previous 60 days		MM/DD/YYYY 1= heterosexual, 2= homosexual, 3=bisexual, 9= unknown 1= discharge and/or dysuria, 2= no discharge or dysuria, 9= symptoms unknown 1=volunteer, 2=contact of gonorrhea patient, 3=test of cure, 8=other, 9=unknown 1=yes, 2=no, 9=unknown 0=no documented previous episodes in the past 12 months 99=unknown (patient record not available) 00000=homeless, 99999=unknown 1=positive, 2=negative, 3=indeterminate, 9=unknown 1=yes, 2=no, 9=unknown 1=yes, 2=no, 9=unknown 1=yes, 2=no, 9=unknown 1=yes, 2=no, 9=unknown 1=yes, 2=no, 9=unknown
TRMT1 OTHTRMT1 TRMT2	[Char, 2] [Char, 15] [Char, 2]	primary treatment for gonorrhea alternative primary therapy for gonorrhea treatment for presumptive chlamydial coinfection		00=none, 03=spectinomycin (Trobicin) 2 g, 04=ceftriaxone (Rocephin) 250 mg, 05=ceftriaxone (Rocephin) 125 mg, 06=ciprofloxacin (Cipro) 500 mg, 07=cefoxitin (Mefoxin) 2 g, 12=cefixime (Suprax) 400 mg, 14=cefpodoxime proxetil (Vantin) 200 mg, 15=ofloxacin (Floxin) 400 mg, 17=ceftizoxime (Cefizox) 500 mg, 18=cefotaxime (Claforan) 500 mg, 21=azithromycin (Zithromax) 2 g, 22=levofloxacin (Levaquin) 250 mg, 23=cefpodoxime proxetil (Vantin) 400 mg, 24=ceftibuten (Cedax) 400 mg, 25=cefdinir (Omnicef) 300 mg, 26=cefdinir (Omnicef) 600 mg, 88=other (please indicate in othtrmt1), 99=unknown If code 88 was entered for Treatment 1, write in the name of the alternative 00=none, 01=ampicillin/amoxicillin, 09=doxycycline (Vibramycin)/tetracycline, 10=erythromycin, 11=azithromycin (Zithromax) 1 gm, 15=ofloxacin (Floxin), 88=other, 99=unknown

GISP Data Elements

Antimicrobial Susceptibility Testing (Form 2 or CDC 73.60B)

Variable Name	Type/Length	Description	Values
CLINIC YRMO ID B_LAC PEN TETRACY SPCTINO CFX CRO CIPRO CPD AZI DATETEST CONTROL	[Char, 3] [Char, 6] [Char, 2] [Char, 1] [Num, 6] [Num, 6] [Char, 1] [Num, 6] [Num, 6] [Num, 6] [Num, 6] [Num, 6] [Date, 10] [Char, 1]	Sentinel site code Year/ Month of patient's visit patient or isolate number beta-lactamase test penicillin MIC tetracycline MIC spectinomycin sensitivity cefixime MIC ceftriaxone MIC ciprofloxacin MIC cefpodoxime MIC azithromycin MIC date isolate tested Control ID	ALB=Albuquerque, ATL=Atlanta, BAL=Baltimore, BHM=Birmingham, CHI=Chicago, CIN=Cincinnati, CLE=Cleveland, DAL=Dallas, DEN=Denver, DTR=Detroit, GRB=Greensboro, HON=Honolulu, KCY=Kansas City, LAX=Los Angeles, LBC=Long Beach, LVG=Las Vegas, MIA=Miami, MIN=Minneapolis, NOR=New Orleans, NYC=New York City, OKC=Oklahoma City, ORA=Orange County, PHI=Philadelphia, PHX=Phoenix, POR=Portland, RIC=Richmond, SDG=San Diego, SEA=Seattle, SFO=San Francisco, TRP=Tripler Army Medical Center YYYYMM 01, 02, 03, ... 30 or higher 1=positive, 2=negative 0.0008; 0.015; 0.03; 0.06; 0.125; 0.25; 0.5; 1.0; 2.0; 4.0; 8.0; 16.0; 32.0; 64.0 0.06; 0.125; 0.25; 0.5; 1.0; 2.0; 4.0; 8.0; 16.0; 32.0; 64.0 1=sensitive; 2=resistant 0.002; 0004; 0.008; 0.015; 0.03; 0.06; 0.125; 0.25; 0.5; 1.0; 2.0 0.001; 0.002; 0.004; 0.008; 0.015; 0.03; 0.06; 0.125; 0.25; 0.5; 1.0; 2.0 0.001; 0.002; 0.004; 0.008; 0.015; 0.03; 0.06; 0.125; 0.25; 0.5; 1.0; 2.0; 4.0; 8.0; 16.0; 32.0 0.008; 0.015; 0.03; 0.06; 0.125; 0.25; 0.5; 1.0; 2.0; 4.0; 8.0 0.008; 0.015; 0.03; 0.06; 0.125; 0.25; 0.5; 1.0; 2.0; 4.0; 8.0; 16.0 MM/DD/YYYY A, B, C, D

GISP Data Elements

Control Strain Susceptibility Testing (Form 3 or CDC 73.60C)

Variable Name	Type/Length	Description	Values
LAB CONTROL STRAIN B_LAC PEN TETRACY SPCTINO CFX CRO CIPRO CPD AZI DATETEST	[Char, 3] [Char, 1] [Char, 9] [Char, 1] [Num, 6] [Num, 6] [Char, 1] [Num, 6] [Num, 6] [Num, 6] [Num, 6] [Num, 6] [Date, 10]	Regional laboratory Control ID strain number beta-lactamase test penicillin MIC tetracycline MIC spectinomycin sensitivity cefixime MIC ceftriaxone MIC ciprofloxacin MIC cefpodoxime MIC azithromycin MIC date of isolate testing	EMO=Atlanta regional lab UAB=Birmingham regional lab CLV=Cleveland regional lab UCO=Denver regional lab UWA=Seattle regional lab A, B, C, D F-18 F-28 SPL-4 P681E CDC 10328 CDC 10329 SPJ-15 1=positive, 2=negative 0.0008; 0.015; 0.03; 0.06; 0.125; 0.25; 0.5; 1.0; 2.0; 4.0; 8.0; 16.0; 32.0; 64.0 0.06; 0.125; 0.25; 0.5; 1.0; 2.0; 4.0; 8.0; 16.0; 32.0; 64.0 1=sensitive; 2=resistant 0.002; 0004; 0.008; 0.015; 0.03; 0.06; 0.125; 0.25; 0.5; 1.0; 2.0 0.001; 0.002; 0.004; 0.008; 0.015; 0.03; 0.06; 0.125; 0.25; 0.5; 1.0; 2.0 0.001; 0.002; 0.004; 0.008; 0.015; 0.03; 0.06; 0.125; 0.25; 0.5; 1.0; 2.0; 4.0; 8.0; 16.0; 32.0 0.008; 0.015; 0.03; 0.06; 0.125; 0.25; 0.5; 1.0; 2.0; 4.0; 8.0; 16.0 0.008; 0.015; 0.03; 0.06; 0.125; 0.25; 0.5; 1.0; 2.0; 4.0; 8.0; 16.0 MM/DD/YYYY

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