CRF3A

Variable / Field Name	Section Header	Field Type	Field Label	Choices or Calculations
crf3a_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
crf3a_consent_date		text	Date of consent
crf3a_visit_date		text	Date of consultation
crf3a_visit		radio	With which research visit does this clinical visit align?	3_months_arm_1, 3 months visit ; 12_months_arm_1, 12 months visit
crf3a_rest_spo2_done	Resting observations	radio	a) Pulse Oximetry (SpO2)	1, Yes ; 0, No
crf3a_rest_hr_done		radio	b) Heart rate	1, Yes ; 0, No
crf3a_rest_bp_done		radio	c) Blood pressure	1, Yes ; 0, No
crf3a_rest_temp_done		radio	d) Temperature	1, Yes ; 0, No
crf3a_rest_height_done		radio	e) Height (cm)	1, Yes ; 0, No
crf3a_rest_weight_done		radio	f) Weight (kg)	1, Yes ; 0, No
crf3a_rest_spo2		text	a) Resting Pulse Oximetry (SpO2):
crf3a_rest_hr		text	b) Resting heart rate:
crf3a_rest_bp_sys		text	c) Resting blood pressure (systolic):
crf3a_rest_bp_dia		text	c) Resting blood pressure (diastolic):
crf3a_rest_temp		text	d) Temperature:
crf3a_rest_height		text	e) Height (cm):
crf3a_rest_weight		text	f) Weight (kg):
crf3a_base_cxr_done	Basic investigations	radio	a) Chest XR	1, Completed ; 2, Not done
crf3a_base_ecg_done		radio	b) ECG	1, Completed ; 2, Not done
crf3a_base_cxr		radio	a) Chest XR result:	1, Normal ; 2, Extensive persistent changes >1/3 lung involvement ; 3, Suggestive of fibrotic lung disease ; 4, Indeterminate ; 5, Other
crf3a_ecg		radio	b) ECG result:	1, Sinus rhythm ; 2, Atrial fibrillation/flutter ; 3, ST segment/T wave changes ; 4, RBBB ; 5, LBBB
crf3a_base_ecg_hr		text	b) ECG heart rate:
crf3a_outcome_fup	Clinical review Outcome	radio	1. Further follow up	1, Yes ; 0, No
crf3a_outcome_ras		radio	2. Referred to another speciality	1, Yes ; 0, No
crf3a_outcome_rtc		radio	3. Referred to a tertiary centre for specialised care	1, Yes ; 0, No
crf3a_outcome_rpc		radio	4. Referred/discharged to palliative care	1, Yes ; 0, No
crf3a_outcome_rmhs		radio	5. Referred to mental health services including IAPT	1, Yes ; 0, No
crf3a_outcome_rrh		radio	6. Referred to Rehabilitation	1, Yes ; 0, No
crf3a_outcome_rdt		radio	7. Referred to Dietician or similar	1, Yes ; 0, No
crf3a_outcome_rsss		radio	8. Referred to a Stop Smoking Service	1, Yes ; 0, No
crf3a_outcome_dis		radio	9. Discharged from clinical review	1, Yes ; 0, No
crf3a_tier		radio	4. Tier allocation	1, Tier 1 ; 2, Tier 2
crf3a_blood_done	Blood tests	yesno	Were any blood tests requested?	1, Yes ; 0, No
crf3a_blood_fbc		radio	FBC	1, Yes ; 0, No
crf3a_blood_ue		radio	U&Es	1, Yes ; 0, No
crf3a_blood_egfr		radio	eGFR	1, Yes ; 0, No
crf3a_blood_lfts		radio	LFTs	1, Yes ; 0, No
crf3a_blood_crp		radio	CRP	1, Yes ; 0, No
crf3a_blood_bp		radio	Bone profile	1, Yes ; 0, No
crf3a_blood_25oh		radio	25-Hydroxyvitamin D (25-OH)	1, Yes ; 0, No
crf3a_blood_bnp		radio	BNP/Pro-NT BNP	1, Yes ; 0, No
crf3a_blood_trop		radio	Troponin	1, Yes ; 0, No
crf3a_blood_ddim		radio	D Dimer	1, Yes ; 0, No
crf3a_blood_fib		radio	Fibrinogen	1, Yes ; 0, No
crf3a_blood_inr		radio	INR	1, Yes ; 0, No
crf3a_blood_fer		radio	Ferritin	1, Yes ; 0, No
crf3a_blood_hba1c		radio	HbA1C	1, Yes ; 0, No
crf3a_blood_lp		radio	Lipid profile (non-fasting)	1, Yes ; 0, No
crf3a_blood_covid19		radio	SARS-Cov-2 Serology	1, Yes ; 0, No
crf3a_link_routine_blood		yesno	If any blood tests performed, please enter results in the Laboratory Results Collection Log - Routine blood tests	1, Yes ; 0, No
crf3a_link_add_blood_sars		yesno	If Sars-CoV-2 Serology performed, please enter results in the Laboratory Results Collection Log - Additional blood tests	1, Yes ; 0, No
crf3a_inv_resp	Additional investigations/procedures	checkbox	Respiratory	1, Spirometry ; 2, Full pulmonary function tests ; 3, Fractional exhaled nitric oxide (FeNO) ; 4, Nijmegen questionnaire ; 5, Incremental shuttle walk test (ISWT) ; 6, Six-minute walk test ; 7, Cardio-pulmonary exercise test ; 8, CT chest with contrast ; 9, HRCT ; 10, CTPA ; 11, Pulmonary perfusion scan
crf3a_inv_cardiac		checkbox	Cardiac	1, Cardiac MRI ; 2, Echocardiogram ; 3, 24/48 hrs tape ; 4, Right heart catheterisation ; 5, Coronary angiogram/CT angiogram ; 6, Cardiac perfusion scan
crf3a_inv_haema		checkbox	Haematological	1, Thyroid function tests ; 2, Blood borne viruses (BBV) screen ; 3, Haematinics
crf3a_link_add_blood_haema		yesno	If Thyroid Function Tests or Haematinics (Haematological Profile) performed, please enter results in the Laboratory Results Collection Log - Additional Blood Tests. If BBV Screen performed, please enter results in the Laboratory Results Collection Log - Immunological Profile.	1, Yes ; 0, No
crf3a_inv_renal		checkbox	Renal	1, USS abdomen ; 2, USS Kidneys ; 3, CT abdomen/pelvis ; 4, Urinalysis ; 5, Urine albumin: creatinine ratio ; 6, Urine protein: creatinine ratio ; 7, Renal biopsy
crf3a_link_blood_urine		yesno	If Urinalysis, Urine albumin : creatinine ratio or Urine protein : creatinine ratio performed, please enter results in the Laboratory Results Collection Log - Urine Profile.	1, Yes ; 0, No
crf3a_inv_immu		checkbox	Immunological	1, Vasculitis screen ; 2, Complements factors ; 3, Immunoglobulins ; 4, Rheumatoid factor/Anti-CCP
crf3a_link_blood_immun		yesno	If any immunological procedures performed, please enter results in the Laboratory Results Collection Log - Immunological Profile.	1, Yes ; 0, No
crf3a_inv_neuro		checkbox	Neurology/Mental health	1, CT brain ; 2, MRI brain ; 3, Nerve conduction studies ; 4, Mini-International Neuro-psychiatric Interview (M.I.N.I.) ; 5, Columbia-Suicide Severity Rating Scale ; 6, Sleep Condition Indicator
crf3a_inv_other		notes	Other, please specify
crf3a_quest	Questionnaires	checkbox	Questionnaires completed	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)
crf3a_quest_mrc		yesno	1. Have you completed a MRC dyspnoea scale form?	1, Yes ; 0, No
crf3a_quest_eq5d5l		yesno	2. Have you completed a EQ-5D-5L form?	1, Yes ; 0, No
crf3a_quest_gad7		yesno	3. Have you completed a GAD-7 form?	1, Yes ; 0, No
crf3a_quest_phq9		yesno	4. Have you completed a PHQ-9 form?	1, Yes ; 0, No
crf3a_quest_sarcf		yesno	5. Have you completed a SARC-F form?	1, Yes ; 0, No
crf3a_quest_gppaq		yesno	6. Have you completed a GPPAQ form?	1, Yes ; 0, No
crf3a_quest_dys12		yesno	7. Have you completed a Dyspnoea-12 form?	1, Yes ; 0, No
crf3a_quest_facit		yesno	8. Have you completed a FACIT form?	1, Yes ; 0, No
crf3a_quest_bpi		yesno	9. Have you completed a BPI form?	1, Yes ; 0, No
crf3a_quest_pcl5		yesno	10. Have you completed a PCL-5 form?	1, Yes ; 0, No
crf3a_quest_neadl		yesno	11. Have you completed a NEADL form?	1, Yes ; 0, No
crf3a_inv_quest	Investigator completed assessments	checkbox	Assessments completed	1, Montreal Cognitive Assessment (MoCA) ; 2, Clinical Frailty Scale
crf3a_quest_moca		yesno	1. Have you completed a MoCA form?	1, Yes ; 0, No
crf3a_quest_rcfs		yesno	2. Have you completed a Rockwood Clinical Frailty Scale form?	1, Yes ; 0, No
crf3a_pft_done	Pulmonary function tests	yesno	Have you completed a PFTs form?	1, Yes ; 0, No
crf3a_echo_date	Additional investigations/procedures results	text	Echocardiogram: Date performed
crf3a_echo_right		radio	Echocardiogram: Results - Right ventricle	1, Normal ; 2, Mild dysfunction ; 3, Moderate dysfunction ; 4, Severe dysfunction ; 5, Unable to visualise
crf3a_echo_left		radio	Echocardiogram: Results - Left ventricle	1, Normal ; 2, Mild dysfunction ; 3, Moderate dysfunction ; 4, Severe dysfunction ; 5, Unable to visualise
crf3a_echo_pap		text	Echocardiogram: Estimated PAP
crf3a_tape_done		yesno	24/48 hours tape: Symptom diary completed	1, Yes ; 0, No
crf3a10_tape_date		text	24/48 hours tape: Date performed
crf3a_tape_finding		checkbox	24/48 hours tape: Findings	1, Sinus rhythm ; 2, Atrial flutter/fibrillation ; 3, Significant bradycardia ; 4, Significant tachycardia ; 5, Heart block ; 6, Sinus pause > 3 seconds ; 7, Burden of ectopic > 10%
crf3a10_tape_heartblock		text	24/48 hours tape: Heart block details
crf3a_nijm_date		text	Nijmegen questionnaire: Date performed
crf3a_nijm_result		text	Nijmegen questionnaire: Result
crf3a_cpet_date		text	Cardio-pulmonary exercise test: Date performed
crf3a_cpet_result		text	Cardio-pulmonary exercise test: Result (Peak Vo2)
crf3a_feno_date		text	Fractional exhaled nitric oxide (FeNO): Date performed
crf3a_feno_result		text	Fractional exhaled nitric oxide (FeNO): Result
crf3a_6mwt_done	6 Minute Walk Test	yesno	Have you completed a Walk Test form?	1, Yes ; 0, No