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The Surgeon's Certificates Variables
A fundamental challenge in making the information gathered from surgeon's
certificates available for public use was the development of adequate data collection instruments, or disease
screens. The collection screens are the result of extensive analysis of the original surgeons'
certificates, led by the medical experts on the research team of the Early Indicators
(EI) project. The screens were designed to give some basic
structure to the data while still allowing later modifications as more experience was amassed in
the collection process. They constitute the format used by the data inputters, and also provide an initial
classification scheme that organized the data for further standardization and classification.
The structure of the disease screens is motivated by three primary factors. First, the data are
grouped, where possible, according to physiological systems. For example, there are individual screens for
the cardiovascular, respiratory, genito-urinary, and gastro-intestinal systems. Variables are named in a way
that identifies to which system (collection screen) they belong. For instance, variables such
as c_murmur
and c_enlarg are identified as cardiovascular variables because of the
prefix "c_" that precedes the variables.
Second, the form of the certificates themselves dictate the design of the screens. Examining
physicians tended to group their observations according to disease systems.
Some of these, such as
cardiovascular and genito-urinary, are
consistent with modern classification. Other groupings used by the
physicians, however, were
determined by the specific purpose of the examination, namely, to identify what
were considered to be disabling conditions. Therefore, there were individual screens
for diarrhea, hernias,
hemorrhoids, rheumatism, and varicose veins. Organizing the screens according
to the groupings typically
used by the examining physicians considerably simplified the collection process.
Finally, the grouping of different conditions is highly correlated with the
disability ratings given to
conditions. In general, the disease screens represented the level of
detail that was commonly found in the
ratings. For instance, ratings were usually given for the
cardiovascular system as a whole without
differentiating between different cardiovascular conditions
even though additional detail was often
provided about the cardiovascular system. The physicians typically stated something like "$8
for disease of
heart". On the other hand, conditions such as hernias, chronic diarrhea, or varicose veins
were given
individual disease ratings. On each disease screen there is a field for the data
inputter to enter the disability
rating for that disease screen. Sometimes diseases from different screens are
grouped together under a
single rating amount, at other times the only rating information provided is a single
disability rating that
gave the overall amount the physicians recommended the applicant receive.
The following table provides a listing of the disease screens, each with its
respective variable group number (VG #) and identifying character. The screens are still
being revised and updated, under the supervision of
Dr. Louis Nguyen
of Brigham and Women's Hospital at Harvard University in Boston.
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