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=== EXAMPLES === === SIDE-BY-SIDE (RADIO GRID + DROPDOWN) === <unit> <source_text> 6. Please select all the vaccines you typically schedule at each month below. If the month you schedule a particular vaccine or dose is not listed, please select that month from the drop-down in the last column. [SHOW DROP DOWN IN OTHER MONTH: 3,5,7,8,10,11,13,14,16,17] COLUMNS: 2 months, 4 months, 6 months, 9 months, 12 months, 15 months, 18 months or later, Other Month [DROPDOWN] ROWS: Hep B 1st, Hep B 2nd, Rotavirus 1st </source_text> <decipher_xml> <radio label="Q6" optional="1" ss:listDisplay="0" surveyDisplay="desktop"> <title>Please select all the vaccines you <b><u>typically schedule</u></b> at each month below.</title> <group label="g1" builder:axis="col"><b>Vaccines Typically Scheduled</b></group> <col label="c2" groups="g1"><b>2 months</b></col> <col label="c4" groups="g1"><b>4 months</b></col> <col label="c6" groups="g1"><b>6 months</b></col> <col label="c9" groups="g1"><b>9 months</b></col> <col label="c12" groups="g1"><b>12 months</b></col> <col label="c15" groups="g1"><b>15 months</b></col> <col label="c18" groups="g1"><b>18 months or later</b></col> <row label="r1">Hep B 1<sup>st</sup> dose</row> <row label="r2">Hep B 2<sup>nd</sup> dose</row> <row label="r4">Rotavirus 1<sup>st</sup> dose</row> </radio> <select label="Q6c8" keepWith="Q6" rightOf="Q6"> <title> </title> <alt>Other Month</alt> <group label="g1" builder:axis="col"> </group> <col label="c99" groups="g1" optional="1"><b>Other Month</b></col> <choice label="ch3" value="3">3 months</choice> <choice label="ch5" value="5">5 months</choice> <choice label="ch7" value="7">7 months</choice> <choice label="ch8" value="8">8 months</choice> <choice label="ch10" value="10">10 months</choice> <row label="r1">Hep B 1<sup>st</sup> dose</row> <row label="r2">Hep B 2<sup>nd</sup> dose</row> <row label="r4">Rotavirus 1<sup>st</sup> dose</row> </select> <suspend/> </decipher_xml> </unit> === RANKING VIA NUMBER (UNIQUE VALIDATION) === <unit> <source_text> 22. What are the reasons some children don’t get their scheduled doses of a pneumococcal conjugate vaccine on time? Select the top five reasons for children with vaccines covered by private insurance. A rank of 1 occurs most often, rank of 2 is second most often, rank of 3 is third most often, etc. 1. Missed the scheduled well or vaccine visit 2. Child is sick at the time of the appointment 3. Cannot afford or lack insurance coverage 4. Don’t understand the importance 91. Other (Please specify) 98. Don’t know </source_text> <decipher_xml> <number label="Q22_private" shuffle="rows" size="3" unique="1" verify="range(1,5)"> <title>Select the <b><u>top</u></b> five reasons for children with vaccines covered by <b>private insurance</b>.</title> <validate> if not this.any: error("Please provide your answer.") if not(Q22_private.r98): if Q22_private.count != 5: error("Please rank top five reasons.") </validate> <row label="r1">Missed the scheduled well or vaccine visit</row> <row label="r2">Child is sick at the time of the appointment</row> <row label="r3">Cannot afford or lack insurance coverage</row> <row label="r4">Don't understand the importance</row> <row label="r91" open="1" openSize="25" randomize="0">Other (Please specify)</row> <noanswer label="r98">Don't know</noanswer> <style name="question.after"><![CDATA[ <script> const rankconfig = {minRank: 5,maxRank: 5, isDKnewLine: 1, maxRankErrorMessage: "Please rank top five reasons only."} $(document).ready(function(){rankingComponent(rankconfig);}); </script> ]]></style> </number> <suspend/> </decipher_xml> </unit> === TEXT GRID QUESTIONS (GROUPED ROWS) === <unit> <source_text> A6. We are interested in understanding the diagnostic code you would assign to each of the cough descriptions below. Please type your answer below and be as specific as possible. ROWS: 1. Patient has NO identified medical condition causing the chronic cough despite thorough investigation 2. Patient was diagnosed with an underlying medical condition associated with chronic cough 3. Patient’s cough is caused by an underlying medical condition, which is not properly controlled COLUMNS/FIELDS: Diagnostic Code / Number: ______ Condition/symptoms: ______ 99. I’m not sure [EXCLUSIVE] </source_text> <decipher_xml> <text label="A6" size="50" surveyDisplay="desktop"> <title>We are interested in understanding the diagnostic code you would assign to each of the cough descriptions below.</title> <group label="g1" builder:axis="row">Patient has <b>NO identified medical condition causing the chronic cough</b> despite thorough investigation</group> <group label="g2" builder:axis="row">Patient was diagnosed with an <b>underlying medical condition associated with chronic cough</b></group> <group label="g3" builder:axis="row">Patient’s cough is caused by an <b>underlying medical condition, which is not properly controlled</b></group> <row label="r1_c1" groups="g1">Diagnostic Code / Number:</row> <row label="r1_c2" groups="g1">Condition/symptoms:</row> <row label="rdum1" groups="g1">I’m not sure</row> <row label="r2_c1" groups="g2">Diagnostic Code / Number:</row> <row label="r2_c2" groups="g2">Condition/symptoms:</row> <row label="rdum2" groups="g2">I’m not sure</row> <row label="r3_c1" groups="g3">Diagnostic Code / Number:</row> <row label="r3_c2" groups="g3">Condition/symptoms:</row> <row label="rdum3" groups="g3">I’m not sure</row> </text> <checkbox label="A6c99" optional="1"> <title> </title> <col label="c1" alt="I'm not sure for Group 1"> </col> <col label="c2" alt="I'm not sure for Group 2"> </col> <col label="c3" alt="I'm not sure for Group 3"> </col> </checkbox> <suspend/> </decipher_xml> </unit> === SEMANTIC DIFFERENTIAL SLIDER (GRID) === <unit> <source_text> D1. The following statements about Refractory or Unexplained Chronic Cough are presented in pairs, with the two opposing statements on either side of the scale. Please select any point on the scale that best represents your opinion. 0 to 100. STATEMENT A: I have a strong interest in managing Refractory or Unexplained Chronic Cough patients STATEMENT B: Managing Refractory or Unexplained Chronic Cough is not of interest to me </source_text> <decipher_xml> <number label="D1" optional="0" shuffle="rows" size="10" slidernumber:sliderPosition="Middle" uses="slidernumber.6" verify="range(0,100)"> <title>The following statements about Refractory or Unexplained Chronic Cough are presented in pairs... Please select any point on the scale that best represents your opinion.</title> <row label="r1" alt="Statement 1" legend="both" rightLegend="Managing Refractory or Unexplained Chronic Cough is not of interest to me">I have a strong interest in managing Refractory or Unexplained Chronic Cough patients</row> </number> <suspend/> </decipher_xml> </unit> === NUMERIC GRID (PIPED/DISABLED COLUMN + AUTOSUM) === <unit> <source_text> 50. Thinking ahead 6 months from now, for what percent of children under two years of age do you anticipate you will recommend/administer each vaccine below, in a typical month? As a reference, the allocations you provided earlier are displayed below. Total must sum to 100%. COLUMNS: In PAST MONTH [PIPE IN FROM Q44] In SIX MONTHS from now ROWS: 1. Vaxneuvance 2. Prevnar 20 </source_text> <decipher_xml> <number label="Q50" autosumdq:ignoreLabels="c1" autosumdq:postText="%" autosumdq:sumToVal="100,100" grouping="cols" optional="0" shuffle="rows" size="3" uses="autosumdq.6"> <title><b>Thinking ahead 6 months from now</b>, for what percent of children under two years of age do you <b>anticipate</b> you will recommend/administer each vaccine below, in a typical month?</title> <exec> if S17.r2.c1: Q50.r1.c1.ival = Q44.r1.c1.ival if S17.r1.c1: Q50.r2.c1.ival = Q44.r2.c1.ival autoSumEvalPrevResponses(this) </exec> <validate> autoSumValidate(this) </validate> <group label="g1">% Under 2 recommend/administer each vaccine</group> <col label="c1" groups="g1" optional="1" ss:colClassNames="disable-column-on">In <u>PAST MONTH</u></col> <col label="c2" groups="g1">In <u>SIX MONTHS</u> from now</col> <row label="r1">Vaxneuvance</row> <row label="r2">Prevnar 20</row> <style name="question.after" wrap="ready"><![CDATA[ $(document).ready(function(){ $column_tds = $('.disable-column-on').find('.input').disable(); $('.disable-column-on').find('.input').css('background-color',''); }); ]]></style> </number> <suspend/> </decipher_xml> </unit> === CHECKBOX GRID (GROUPED COLUMNS) === <unit> <source_text> C10. Now, how did you learn about each of the following drug(s) in clinical development or recently approved for Refractory or Unexplained Chronic Cough? Please select all that apply in each column. COLUMNS: A. Lyfnua (gefapixant) B. Sivopixant (S-600918) C. Camlipixant (BLU-5937) ROWS: 1. Manufacturer representative [ANCHOR AT TOP] 2. Communication with experts in the field 3. Press releases 99. Not sure [ANCHOR; MUTUALLY EXCLUSIVE PER COLUMN] </source_text> <decipher_xml> <checkbox label="C10" atleast="1" grouping="cols" shuffle="rows,cols" ss:listDisplay="0"> <title>Now, how did you learn about each of the following drug(s) in <u>clinical development or recently approved</u>?</title> <col label="c1"><b>Lyfnua (gefapixant)</b></col> <col label="c2"><b>Sivopixant (S-600918)</b></col> <col label="c3"><b>Camlipixant (BLU-5937)</b></col> <row label="r1" randomize="0">Manufacturer representative</row> <row label="r2">Communication with experts in the field</row> <row label="r3">Press releases</row> <row label="r99" exclusive="1" randomize="0">Not sure</row> </checkbox> <suspend/> </decipher_xml> </unit> === NUMERIC WITH DYNAMIC SUM VALIDATION === <unit> <source_text> S8. Among the [INSERT RESPONSE FROM S7] adult patients you saw in the past 3-month period, how many did you see for the following conditions? Please enter a whole number per row. 1. Chronic Cough 2. Asthma 3. Community-acquired pneumonia 4. COPD [MUST SUM TO S7] </source_text> <decipher_xml> <number label="S8" cond="S7.ival gt 0" autosumdq:operator="le" autosumdq:sumToVal="S7.ival" grouping="cols" optional="0" shuffle="rows" size="3" uses="autosumdq.6" verify="range(0,999)"> <title>Among the <b>${S7.val}</b> adult patients you saw in the past 3-month period, how many did you see for the following conditions?</title> <exec> autoSumEvalPrevResponses(this) </exec> <validate> autoSumValidate(this) </validate> <row label="r1">Chronic Cough</row> <row label="r2">Asthma</row> <row label="r3">Community-acquired pneumonia</row> <row label="r4">COPD</row> </number> <suspend/> </decipher_xml> </unit> === HIDDEN VARIABLES === <unit> <source_text> S3a. HIDDEN VARIABLE – Pulmonologist Type 1. General Pulmonologist (PUNCH IF S3 IS NOT 1) 2. Chronic Cough Specialist (PUNCH IF S3=1) </source_text> <decipher_xml> <exec> if (S3.r1): hS3a.val = hS3a.r2.index elif (not S3.r1): hS3a.val = hS3a.r1.index </exec> <radio label="hS3a" optional="1" translateable="0" where="execute,survey,report"> <title>HIDDEN VARIABLE – Pulmonologist Type</title> <row label="r1" value="1">General Pulmonologist</row> <row label="r2" value="2">Chronic Cough Specialist</row> </radio> <suspend/> </decipher_xml> </unit> <unit> <source_text> SCR_S3. Which, if any, of the following conditions have you been diagnosed with by a healthcare provider? Please select only the conditions that have been professionally diagnosed by a healthcare provider. [RANDOMIZE] 1 Anxiety 2 Chronic Fatigue 3 Chronic / Frequent Headaches 4 Chronic Migraine 5 Migraine with or without aura 6 Depression 7 Diabetes 8 Fibromyalgia 9 High Blood Pressure / Hypertension 10 High Cholesterol 11 Arthritis 12 Asthma 13 Osteoporosis 14 Rheumatoid Arthritis 15 Sinusitis / Allergies 16 Sleep Disorders (e.g., insomnia, narcolepsy, sleep apnea) 17 Multiple Sclerosis 18 Seizures / Epilepsy 19 Obesity 20 Renal conditions (e.g., chronic kidney disease, hypertensive nephropathy) 21 Constipation 22 Irritable Bowel Syndrome 23 Inflammatory Bowel Disease (i.e., Crohn’s disease, ulcerative colitis) 24 Liver conditions (e.g., hepatitis, nonalcoholic fatty liver disease) 98 Other (Please specify: _____) [ANCHOR] 99 None of the above [ANCHOR TO BOTTOM] [ENSURE ANSWERS 3,4, AND 5 ARE SHOWN NEXT TO EACH OTHER IN THE LIST] [TERMINATE IMMEDIATELY IF S3 DOES NOT EQUAL 3,4, OR 5] [DO NOT ALLOW RESPONDENT TO MAKE OTHER SELECTIONS IF S3=99] </source_text> <decipher_xml> <checkbox label="SCR_S3" atleast="1" atm1d:showInput="1" cs:ref="055c12b5" cs:section_ref="a7d90947" shuffle="rows" uses="atm1d.10"> <title>Which, if any, of the following conditions have you been diagnosed with by a healthcare provider? <br /><br /><i>Please select only the conditions that have been professionally diagnosed by a healthcare provider.</i></title> <comment>[res INS_M]</comment> <exec> group_rows(SCR_S3,['r3','r4','r5']) </exec> <row label="r1">Anxiety</row> <row label="r2">Chronic Fatigue</row> <row label="r3">Chronic / Frequent Headaches</row> <row label="r4">Chronic Migraine</row> <row label="r5">Migraine with or without aura</row> <row label="r6">Depression</row> <row label="r7">Diabetes</row> <row label="r8">Fibromyalgia</row> <row label="r9">High Blood Pressure / Hypertension</row> <row label="r10">High Cholesterol</row> <row label="r11">Arthritis</row> <row label="r12">Asthma</row> <row label="r13">Osteoporosis</row> <row label="r14">Rheumatoid Arthritis</row> <row label="r15">Sinusitis / Allergies</row> <row label="r16">Sleep Disorders (e.g., insomnia, narcolepsy, sleep apnea)</row> <row label="r17">Multiple Sclerosis</row> <row label="r18">Seizures / Epilepsy</row> <row label="r19">Obesity</row> <row label="r20">Renal conditions (e.g., chronic kidney disease, hypertensive nephropathy)</row> <row label="r21">Constipation</row> <row label="r22">Irritable Bowel Syndrome</row> <row label="r23">Inflammatory Bowel Disease (i.e., Crohn’s disease, ulcerative colitis)</row> <row label="r24">Liver conditions (e.g., hepatitis, nonalcoholic fatty liver disease)</row> <row label="r98" open="1" openSize="25" randomize="0">Other (Please specify:)</row> <row label="r99" exclusive="1" randomize="0">None of the above</row> </checkbox> <suspend/> <term label="SCR_S3term" cond="not (SCR_S3.r3 or SCR_S3.r4 or SCR_S3.r5)" cs:ref="51652150" cs:section_ref="a7d90947">Term: SCR_S3</term> <suspend/> </decipher_xml> </unit>
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