ID INFORMATION
ASKER INFORMATION
QUESTION INFORMATION
PATIENT INFORMATION
LOCAL SOURCE INFORMATION

Local Source

Submission: Required
Allowable responses: 1
Controlled vocabulary: No
Definition: The local source from which the question originated.

Submission: Required
Allowable responses: 1
Controlled vocabulary: No
Definition: The local source collection/group identifier that identifies a set of questions.

Submission: Optional
Allowable responses: 1
Controlled vocabulary: No
Definition: The local source unique question identifier number.

ASKER INFORMATON

Healthcare Occupation

Submission: Required
Allowable responses: 1
Controlled vocabulary: Yes
Definition: The profession of the individual asking the question. Choices offered are MeSH terms from which only one may be chosen. These choices include the following options:

• Allied Health Occupations
• Dentistry
• Medicine
• Nursing
• Pharmacy
• Podiatry

Submission: Required data element if "Medicine" is chosen in asker's Healthcare Occupation
Allowable responses: 1
Controlled vocabulary: Yes
Definition: This refers to the asker's field of specialization. It is a required field for physicians, and optional for other professions. Choices offered are MeSH terms from which only one may be chosen. These choices include the following options:

• Anesthesiology
• Dermatology
• Emergency Medicine
• Family Practice
• Gynecology
• Internal Medicine
• Neurology
• Obstetrics
• Ophthalmology
• Osteopathic Medicine
• Pathology
• Pediatrics
• Psychiatry
• Radiology
• Surgery
• Student, Medical

Submission: Required
Allowable responses: 1
Controlled vocabulary: Yes
Definition: This deals with the level of professional advancement of the asker. Only one of the following non-MeSH terms may be chosen:

• Licensed/Credentialed- not Resident or Fellow
• Resident/Fellow
• Student

Submission: Optional
Allowable responses: 1
Controlled vocabulary: Yes
Definition: The years of professional school training. This would only be applicable to the asker if "Student" had been chosen in asker's Professional Status. Only one of the following may be chosen:

• First Year Student
• Second Year Student
• Third Year Student
• Fourth Year Student
• Fifth Year Student

Submission: Optional
Allowable responses: 1
Controlled vocabulary: No- Positive whole numbers only
Definition: The age of the asker in years.

Submission: Optional
Allowable responses: 1
Controlled vocabulary: Yes
Definition: The gender of the asker. Options are "Male" or "Female"

QUESTION INFORMATION

Original Question

Submission: Required
Allowable responses: One free text question
Controlled vocabulary: No
Definition: The original, free text version of the question.
Example: "I have a 72-year-old man with idiopathic cardiomyopathy who had six, four beat runs of ventricular tachycardia on a 24-hour holter monitor without any symptoms. Should I do anything?"

Submission: Optional
Allowable responses: 1
Controlled vocabulary: Yes (response may be "Yes" or "No")
Definition: If the original question contains multiple (i.e. more than one) sub-questions, the data element should be "Yes."
Example: Original Question: "I suspect that the patient has a gastro-esophageal tear. What are the symptoms of this condition and how would I treat the condition?" This question has two sub-questions. One deals with the symptoms (diagnosis) of a gastro-esophageal tear and the other sub-question relates to the treatment of such a condition.

Submission: Optional
Allowable responses: One free text question
Controlled vocabulary: No
Definition: Modification of the original question. This modification may be performed to improve grammar or clarify the question.
Example: (modification of the example above): "What is the management of asymptomatic four beat runs of ventricular tachycardia in elderly men?"

Submission: Optional
Allowable responses: One free text question
Controlled vocabulary: No
Definition: Modification of the original question or the short question so that its answer may be generalized to other questions.
Example (modification of the example above): "What is the management of asymptomatic, non-sustained ventricular tachycardia in elderly patients with idiopathic cardiomyopathy?"

Submission: Optional
Allowable responses: 1
Controlled vocabulary: No- Valid year
Definition: The year in which the question was asked (i.e. the year the asker asked the question).

Submission: Required
Allowable responses: 1
Controlled vocabulary: Yes
Definition: The purpose of a question will fall into one of three general categories from which one must be chosen:

• For Administrative Purposes- deals with purely administrative concerns such as insurance coverage, legal issues, or hospital policy. Example: "Does a patient need to be admitted to the intensive care unit to receive conscious sedation?" or "What proton pump inhibitors does this patient's insurance formulary cover?" or "If my clinic patient dies at home, am I obligated to sign the death certificate if requested by the funeral director?"
• To Deliver Healthcare To A Specific Patient- deals with providing care directly or indirectly to patients. Example: "What is the best way to perform a lumbar puncture on a combative patient" or "What is the best acid suppressing medicine for a patient with gastritis" or "What are the main causes of sudden death in outpatients with diagnosed prostate cancer?"
• To Increase General Medical Knowledge, Independent Of A Specific Patient- deals with gaining knowledge not related to a specific patient or to increase the asker's fund of knowledge independent of its immediate utilization in patient care. Example: "How does conscious sedation differ from general anesthesia?" or "Does enteric coated aspirin decrease the risk of gastritis or peptic ulcer disease?" or "Is there a consensus about how to treat incidentally diagnosed, asymptomatic prostate cancer in men older than 65 years old?"

Submission: Required if response to Purpose of Question was "Delivery of Healthcare" otherwise, it is optional.
Allowable responses: Multiple
Controlled vocabulary: Yes
Definition: This data element deals with the emphasis of the question's content. The asker may drill down as deep into the tree as she/he would like, but must chose at least one of the four main topics (Epidemiology, Etiology, Management, Prognosis). The options include:

• Epidemiology
• Etiology
• Management
•       Diagnosis
•           History
•           Physical Finding
•           Test
•       Treatment & Prevention
•           Device
•           Pharmacological
•           Procedure
• Prognosis

PATIENT INFORMATION

Patient Type: Is the Question Related to a Specific Patient or a "Hypothetical Patient"?

Submission: Optional
Allowable responses: 1
Controlled vocabulary: Yes ("Specific Patient" or "Hypothetical Patient")
Definition: Was the question in reference a specific patient?

Submission: Optional
Allowable responses: 1
Controlled vocabulary: Yes
Definition: The age of the patient when the question was asked using the following MeSH age categories listed below. Obstetrical patients will be reported as the age of the mother while the age of the fetus is reported separately (see Trimester of Pregnancy). MeSH terms for patient's age:

• Infant, Newborn (0-1 month)
• Infant (1-23 months)
• Child, Preschool (2-5 years)
• Child (5-12 years)
• Adolescence (13-18 years)
• Adult (19-44 years)
• Middle Age (45-65 years)
• Aged (65+ years)

Submission: Optional
Allowable response: 1
Controlled vocabulary: Yes
Definition: Choose from "Male", or "Female"

Submission: Optional
Allowable response: 1
Controlled vocabulary: Yes
Definition: The trimester of the woman's pregnancy. Allowable options include (MeSH terms):

• First Trimester
• Second Trimester
• Third Trimester
• Pregnant, Unknown Gestation

Submission: Optional
Allowable response: 1
Controlled vocabulary: Yes
Definition: The location where the patient was located when the question was asked. Choose from one of the following MeSH terms:

Community Dwelling

• House Call
• Office Visit
• Surgicenter
• Telemedicine
• Prisons

Acute Care

• Emergency Medical Services (including Emergency Department visits)
• Hospital (excluding specialty hospitals)
• Psychiatric Hospital
• Intensive Care Unit
• Patient Transfer (including transportation of patients between healthcare facilities but excluding emergency patient transfer which would fall under Emergency Medical Services)

Long-term Care Facility

• Chronic Disease Hospital (including chronic ventilator facilities)
• Hospice
• Nursing Home
• Rehabilitation Center

Submission: Optional
Allowable response: Multiple
Controlled vocabulary: Yes
Definition: The reason for the interaction with the patient. In most cases this would be the reason for the office or clinic visit or hospital admission diagnosis. Restrict responses to MeSH terms. Most reasons for interaction can be found under: "Disease Categories" (the "C" MeSH tree headings) and "Psychiatry and Psychology" (the "F" MeSH tree headings) and all sibling categories. Additionally, two other MeSH terms may be useful to describe the reason for patient interaction:

• Physical Exam
• Medical History Taking

Submission: Optional
Allowable responses: 1
Controlled vocabulary: No
Definition: Other annotations regarding the patient interaction- but avoiding abbreviations.
Example: "Patient lives in the same dormitory complex of recent case of meningitis."

Submission: Optional
Allowable responses: Multiple
Controlled vocabulary: Yes
Definition: The specific disease category relevant to the question, and not the specialty of the physician who would treat the condition. Options include the following MeSH terms from the "Disease Categories" and "Psychiatry and Psychology".

Disease Categories

• Animal Diseases
• Bacterial Infections and Mycoses
• Cardiovascular Diseases
• Digestive System Diseases
• Disorders of Environmental Origin
• Endocrine Diseases
• Eye Diseases
• Female Genital Diseases and Pregnancy Complications
• Hemic and Lymphatic Diseases
• Immunologic Diseases
• Musculoskeletal Diseases
• Neonatal Diseases and Abnormalities
• Neoplasms
• Nervous System Diseases
• Nutritional and Metabolic Diseases
• Otorhinolaryngologic Diseases
• Parasitic Diseases
• Respiratory Tract Diseases
• Skin and Connective Tissue Diseases
• Stomatognathic Diseases
• Urologic and Male Genital Diseases
• Virus Diseases

Psychiatry and Psychology

• Behavior and Behavior Mechanisms
• Behavioral Disciplines and Activities
• Mental Disorders
• Psychological Phenomena and Processes

Submission: Optional
Allowable responses: 1
Controlled vocabulary: No
Definition: Additional free text annotations related to the question.

Submission: Optional
Allowable responses: Multiple
Controlled vocabulary: No
Definition: The keywords that describe or are germane to the question. Although it would be preferable that these keywords be MeSH terms, they may be non-MeSH terms. Abbreviations are also strongly discouraged.

LOCAL SOURCE INFORMATION

References and Links:

Definition: References and Links provide access to information related to the question, background, or the local source. If local source fields (see below) are provided at least one Reference or Link is required to explain the interpretation/meaning of the local source field values. References are citations of publications and links provide pointers to web pages directly relevant to the question or the local source fields.

Reference

Submission: Optional (Required if local source fields are populated)
Allowable responses: Multiple
Controlled vocabulary: No- Citation format followed.
Definition: The reference is a bibliographic citation of the journal article, which explains the local source fields. Contains Citation Text and PubMed Identifier.

Citation Text

Definition: The Citation Text is textual reference to citation.
Example: BMJ 1999;319:358-361 (explains local indexing scheme)

PubMed Identifier

Definition: The PubMed unique identification number of the journal article.
Example: PubMed Identifier 10435959 refers to above Citation Text "BMJ 1999;319:358-361"

Link

Submission: Optional (Required if local source fields are populated)
Allowable responses: Multiple
Controlled vocabulary: No- Valid URL format
Definition: The URL to a web page that is related to the question or local source. Contains URL and URL Description.

URL

Definition: The valid URL to web page.
Example: http://bmj.com/cgi/content/full/319/7206/358?view=full&pmid=10435959 (from the BMJ site)

URL Description

Definition: A description of the URL (see above).
Example: BMJ article entitled Analysis of questions asked by family doctors regarding patient care (Description for URL above)

Definition: These elements are unstructured fields that submitters may choose to populate with their own data. Although these fields will support free text, it is highly recommended that they contain structured data to improve searching. A local indexing scheme or field description must be publicly available for inclusion in the database, and public access to this must be documented in either a Reference or Link (see above).

Local Source Field1

Submission: Optional
Allowable responses: Multiple
Controlled vocabulary: No
Definition: Any local source data terms.

Local Source Field2

Submission: Optional
Allowable responses: Multiple
Controlled vocabulary: No
Definition: Any local source data terms.

Local Source Field3

Submission: Optional
Allowable responses: Multiple
Controlled vocabulary: No
Definition: Any local source data terms.

Local Source Field4

Submission: Optional
Allowable responses: Multiple
Controlled vocabulary: No
Definition: Any local source data terms.

Local Source Field5

Submission: Optional
Allowable responses: Multiple
Controlled vocabulary: No
Definition: Any local source data terms.

Submission: Optional
Allowable responses: 1
Controlled vocabulary: No- Valid date
Definition: The date that the local editor evaluated the question.
Example: An intern may have asked a question in the Emergency Department on January 1, 2001, but because of the holidays and vacation, the local editor may not have evaluated the question until January 8, 2001. The Date Asked would be January 1, 2001 while the Local Editor's Date would be January 8, 2001.