SUDORS - screenshots

Attachment E

Screens Retrieving and Refileing Records

State Unintentional Drug Overdose Reporting System (SUDORS)

Form Approved

OMB No. xxx-xxx

Exp. Date: x/xx/xxxx

Public Reporting burden of this collection of information is estimated at 30 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer, 1600 Clifton Road NW, MS D-74, Atlanta, GA 30333; Attn: PRA (0920-XXXX).

Introduction

This document displays the screens that abstractors use to enter required data elements. The variable name associated with each data entry field is provided to help users interpret and analyze the data.

1.0 Demographic Variables

1.1 Demographics, Race, and Ethnicity

1	PersonType			9	AgeUnit		17	RaceWhite
2	BirthDayofMonth			10	HeightFeet		18	RaceBlack
3	LastNameFirstInitial			11	HeightInches		19	RaceAsian
4	CMENumberLastFour			12	Weight		20	RacePacificIslander
5	DCNumberLastFour			13	MaritalStatus		21	RaceAmericanIndian
6	Sex			14	Pregnant		22	RaceOther
7	Transgender			15	SexualOrientation		23	RaceUnspecified
8	Age			16	Military		24	Ethnicity

1.2 Place of Residence, Birthplace, Industry, Occupation, and Education

1	Country					10	BirthPlace
2	ResidenceState					11	BirthCountryOther
3	ResidenceCounty					12	UsualOccupation
4	ResidenceCity					13	OccupationText
5	ResidenceZip					14	OccupationCurrentText
6	ResidenceCensusTract					15	Homeless
7	ResidenceCensusBlock					16	EducationLevel
8	Industry					17	EducationYears
9	IndustryText

2.0 Injury and Death

2.1 Injury Locations, Time, and Events

1	DeathMannerAbstractor			9	InjuryLocationType		17	VictimInCustody
2	DeathMannerDC			10	CensusTract		18	RecentRelease
3	DeathMannerCME			11	CensusBlock		19	AlcoholUseSuspected
4	DeathMannerLE			12	InjuryDate		20	SurvivalTime
5	InjuryState			13	InjuryTime		21	SurvivalTimeUnit
6	InjuryCounty			14	InjuredAtWork
7	InjuryCity			15	InjuredAtVictimHome
8	InjuryZip			16	EMSPresent

2.2 Hospital Codes

1	EmergencyDepartment
2	HospitalAdmit
3	ExternalCause1ICD9
4	ExternalCause2ICD9
5	ExternalCause1ICD10
6	ExternalCause2ICD10

2.3 Underlying Cause of Death & Location of Death

1	UnderlyingCauseCode	8	DatePronouncedDate
2	UnderlyingCauseCode4thDigit	9	DeathDate
3	UnderlyingCauseCode5thDigit	10	DeathCause1
4	DeathPlace	11	DeathCause2
5	DeathPlaceText	12	DeathCause3
6	AutopsyPerformed	13	DeathCause4
7	DeathState

3.0 Circumstances 3.1 Mental, Health, Substance Abuse, and Other Addiction & Relationship and Life Stressors

CRISIS VARIABLE NAMES

Whenever a circumstance was a crisis (i.e., occurred within two weeks of the fatal overdose), the CME variable is stored in a separate variable from the circumstance in the export file. Specifically, crisis variables will have the word “crisis” inserted between the data source (i.e., CME) and the circumstance name in the variable label variable (e.g., CME_CrisisVariableName,). For example, the crisis variables for “Stalking” will be CME_CrisisStalking.

CIRCUMSTANCE VARIABLE NAMES BY DATA SOURCE (CME AND LE)

NUDORS only uses variables abstracted from coroner and medical examiners. If the CME report is the source, CME variable names are preceded by “CME_” (e.g., “CME_VariableName”).

1	MentalHealthProblem	11	CME_MentalHealthDiagnosis1	20	InterpersonalViolencePerpetrator
2	DepressedMood	12	CME_MentalHealthDiagnosis2	21	InterpersonalViolenceVictim
3	MentalIllnessTreatmentCurrent	13	CME_MentalHealthDiagnosisOther	22	FightBetweenTwoPeople
4	HistoryMentalIllnessTreatment	14	IntimatePartnerViolence	23	Argument
5	AlcoholProblem	15	IntimatePartnerProblem	25	CME_ArgumentTiming
6	SubstanceAbuseOther	16	FamilyStressors	26	CME_CircumstancesKnown
7	OtherAddiction	17	RelationshipProblemOther

17

RelationshipProblemOther

3.2 Manner Specific Circumstances for Suicide Deaths

13	SuicideAttemptHistory	22	JobProblem	29	DisasterExposure
14	SuicideIntentDisclosed	23	FinancialProblem
16	CME_DisclosedIntentToWhom	24	SchoolProblem
17	SuicideNote	25	EvictionorLossofHome
18	SuicideThoughtHistory	26	RecentSuicideFriendFamily
19	RecentCriminalLegalProblem	27	DeathFriendorFamilyOther
20	LegalProblemOther	28	TraumaticAnniversary
21	PhysicalHealthProblem	22	JobProblem

3.3 Other Circumstances

1	CrisisRecent
2	LE_CircumstancesOtherText
3	CME_CircumstancesOtherText

4.0 Toxicology

4.1 Toxicology Specimen Date & Toxicology Findings

1	No Toxicology Available			7	SubstanceCausedDeath
2	SpecimensTime			8	DrugObtainedFor
3	Comments			9	SubstanceClass
4	SubstanceName
5	SubstanceTested
6	SubstanceResult

4.2 Toxicology Summary

1 AlcoholTested	9	AnticonvulsantsTested	17	BenzodiazepinesTested	25	OpiateTested
2 AlcoholResult	10	AnticonvulsantsResult	18	BenzodiazepinesResult	26	OpiateResult
3 AlcoholLevel	11	AntiDepressantTested	19	CocaineTested
4 CarbonMonoxideTested	12	AntiDepressantResult	20	Cocaine test result
5 CarbonMonoxideResult	13	AntipsychoticTested	21	MarijuanaTested
6 CarbonMonoxideSource	14	AntipsychoticResult	22	MarijuanaResult
7 AmphetamineTested	15	BarbituratesTested	23	MuscleRelaxantTested
8 AmphetamineResult	16	BarbituratesResult	24	MuscleRelaxantResult

5.0 Document

1	DocumentUnavailable	5	Date record re-requested
2	DocumentType	6	Date record received
3	AgencySource	7	AbstractedDate
4	Date record requested	8	Date entered data checked
		9	DocumentNotes

6.0 Incident

6.1 Incident Overview

1 IncidentType	8	CompleteToxicology	15	LastUpdateDate
2 NumberOfDocuments	9	CompleteLE	16	DateDeleted
3 NumberofVictims	10	AbstractorName	17	DateMerged
4 NumberNonfatallyShot	11	SupervisorCheckedDate	18	NumberOfWeapons
5 FollowUp	12	SupervisorRecheckedDate	19	NumberOfSuspects
6 CompleteDC	13	CompleteIncident
7 CompleteCME	14	CreateDate

6.2 CME Incident Narratives

2	NarrativeCME

7.0 Unintentional Drug Overdose Questions

7.1 Type of Poisoning, Substance Abuse, Response to Drug Overdose, and Other Questions

1	TypeOfPoisoning	5	Scene (None, DrugPar, Tracks, Illicit drugs, Burpenorphine, Prescription, Other)
2	PreviousOverdose	6	NaloxoneAdministered
3	TreatForSubstanceAbuse	7	BystandersPresent
4	HistoryOpioid	8	Route of Exposure (Inject, Snort, Ingest, suppository, Unknown)
		9	TreatedforPain

7.2 Type of Poisoning, Substance Abuse, Response to Drug Overdose, and Other Questions

1	PrescriptionMorphine	4	NumPharmaciesPast30Days
2	MorphineNarrative	5	NumDoctorsPrescribing30Days
3	NumScripsPast30Days

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