Form:	NOD Baseline Medications v5.0

CDE ID	CDE Description
* 421	EDRN Participant ID (Go To: 1832)
1832	Participant initials: (Go To: 423)
* 423	EDRN Protocol ID (Go To: 422)
* 422	EDRN Site ID (Go To: 929)
* 929	EDRN Staff ID of the person who collected the data: (Go To: 1219)
* 1219	Date of contact (MM/DD/YYYY): (Go To: 2980)
* 2980	Currently taking any medications or supplements (including herbal or nutrient supplements)? (Go To: 1097)
	Permissible Values (value): No (0)
	Yes (1) (Go To: 3892)
	Unknown (99)
* 3892	Source of information, 2nd source (Go To: 3144)
	Permissible Values (value): Patient self-report (1)
	Electronic medical record (4)
	Other (95)
* 3144	Number of loops: (Go To: 3200)
	Permissible Values (value): 0 (0)
	1 (1)
	2 (2)
	3 (3)
	4 (4)
	5 (5)
	6 (6)
	7 (7)
	8 (8)
	9 (9)
	10 (10)
	11 (11)
	12 (12)
	13 (13)
	14 (14)
	15 (15)
	16 (16)
	17 (17)
	18 (18)
	19 (19)
	20 (20)
* 3200	Line number or identifier (system-generated): (Go To: 1873)
* 1873	Medication Name: (Go To: 4862)
* 4862	Medication dose (Go To: 4938)
* 4938	Medication units (Go To: 4937)
* 4937	Medication category (Go To: 5278)
	Permissible Values (value): Anti-DM (1)
	Steroid (2)
	Insulin (5)
	Other (95)
5278	Drug descriptor ID (auto-entered) (Go To: 5437)
* 5437	Medication frequency (Go To: 3163)
	Permissible Values (value): 1 per day (1)
	2 per day (2)
	3 per day (3)
	4 per day (4)
	PRN (20)
	Other, specify: (97) (Go To: 5438)
	Unknown (99)
* 5438	Medication frequency, other, specify (Go To: 3163)
3163	Loop-specific comments 2: (Go To: 1097)
1097	Comments (do not include any participant identifiers) (Go To: End of Form)