type

begin group
note

name
group_welcome
welcome_note

end group
begin group
select_one operator
acknowledge

group_welcome
group_date
select_operator
informatory_note

select_one facility
integer
start
note
end group
begin group
text
text
select_one gender
date
text
select_one employer
text
end group
begin group
select_one yndkna
select_one yndkna
select_one nocxr
text
text
note
integer
integer
integer
integer
select_one facility_type
text
select_one dkdn
integer
select_one yn
end group
begin group

select_facility
number
start
start_time
group_date
group_data
first_name
last_name
gender
birth_date
job
employer
employer_specify
group_data
group_cxr
q10
q11
q12
q12_other
q13
q14
q14_km
q14_min_car
q14_min_bus
q14_min_foot
q15
q15_other
q16_teaser
q16
q17
group_cxr
group_cxr_user

select_one likert
select_one likert
select_one likert
select_one likert
select_one likert

q18
q19
q20
q21
q22

select_one likert
end group
begin group

q23
group_cxr_user
group_cxr_training

select_one yn
integer
select_one duration
integer
select_one time
integer
integer
integer
integer
integer
integer
select_one time
select_one yndkna
end group
begin group

q24
q25
q25_duration
q26
q26_time
q27
q28
q29_tandem
q29_nontandem
q30
q31
q31_time
q32
group_cxr_training
group_cxr_quality

select_one yn
select_one freq
integer
select_one yn
select_one cxr_check
text
select_one dkdn
text
integer
select_one time
select_one yn
select_one freq
integer
select_one yn
select_one cxr_check
text
select_one dkdn
text
integer
select_one time
select_one freq
integer
select_one freq
integer
select_one freq
integer
integer
select_one time
end group
begin group

q33
q34_freq
q34
q35
q36
q36_other
q37_teaser
q37
q38
q38_time
q39
q40_freq
q40
q41
q42
q42_other
q43_teaser
q43
q44
q44_time
q45_freq
q45
q46_freq
q46
q47_freq
q47
q48
q48_time
group_cxr_quality
group_cxr_logistics

select_one dkdn
integer
audio

q49_teaser
q49
q50_audio

text
integer
select_one time
select_multiple results
text
select_multiple results_told
text
select_multiple results_by
text
select_one yn
audio
text
text
text
integer
integer
integer
select_one yn
audio
text
audio
text
end group
begin group

q50
q51
q51_time
q52
q52_other
q53
q53_other
q54
q54_other
q55
q56
q56.1
q56.2
q56.3
q57_tanden
q57_nontandem
q58
q59
q60_audio
q60
q61_audio
q61

barcode
end
note
end group

barcode_test
end
end_time
group_goodbye

group_goodbye

label::English
Operational Feasibility Questionnaire
Tuberculosis screening and diagnostic tests
- Radiology staff

Data entry
Welcome,
INSTRUCTIONS
I will read the questions to you and capture your response in
the tablet. Take as much time as you need to respond. Please
answer the questions from your own perspective as it relates
to your work in the TANDEM study. INSTRUCTIONS
Facility name
Questionnaire number
Survey start time: ${start}
Interviewee information
First name:
Surname:
Gender:
Date of birth:
Job title:
Employer:
Specify:

Test 1: Chest X-ray (CXR) - RADIOGRAPHER

10. Is the CXR routinely available at this facility (outside of the TANDEM project)?
11. Is the CXR routinely prescribed for DM patients at this facility (outside of the TANDEM project)?
12. If no, why is it usually not available or prescribed?
12. If no, why is it usually not available or prescribed?
13. If no, what test is done in its place?
14. If no, how far from this facility is the closest facility at which patients would get one done?
km
minutes by car
minutes by bus
minutes on foot
15. What kind of facility is it?
15. What kind of facility is it?
16. Approximately what proportion of patients are not able to get a prescribed CXR at this facility due to the issues in 12 ab
16. Approximately what proportion of patients are not able to get a prescribed CXR at this facility due to the issues in 12 ab
17. Is an electricity supply needed to perform a CXR?
Test 1: Chest X-ray (CXR) - RADIOGRAPHER
User friendliness
18. This test is technically undemanding for you to perform
19. The amount of time needed for training in order for you to become proficient in this test is acceptable
20. The amount of time needed for you to perform this test is acceptable
21. Minimal supervision is required to perform this test
22. The CXR has a direct result reading

23. There are simple quality control checks

Test 1: Chest X-ray (CXR) - RADIOGRAPHER

Training and test performance time
24. Before the start of the TANDEM project did you already know how to perform the CXR in patients with DM?
25. If yes, how long have you been performing this test?
25. If yes, how long have you been performing this test?
26. Approximately how long did it take you to learn the method for performing the CXR in patients with DM?
26. Approximately how long did it take you to learn the method for performing the CXR in patients with DM?
27. Approximately how many times did you practice the CXR to learn the method?
28. How long does it take you, on average, to complete the paperwork (registration, insurance, payment, etc. ) for each CX
29. How many TANDEM CXR are performed each week?
29. How many nonTANDEM CXR are performed each week?
30. How long, on average, does it take you to complete the CXR on one patient (from the time the patient arrives to when t
31. How long do the results take, on average, to be sent back to the health facility or given to the patient (from the time the
31. How long do the results take, on average, to be sent back to the health facility or given to the patient (from the time the
32. Are there sufficient skilled personnel to perform CXRs if this test was rolled out into routine practice for DM patients with
Test 1: Chest X-ray (CXR) - RADIOGRAPHER
Quality control and machinery
33. Is internal quality control done for the CXR?
34. If yes, how often?
34. If yes, how often?
35. Do you perform the internal quality control?
36. If no, who performs it?
36. If no, who performs it?
37. If you do perform the quality control, please describe the process.
37. If you do perform the quality control, please describe the process.
38. How much time is spent on the internal quality control of the x-ray machine?
38. How much time is spent on the internal quality control of the x-ray machine?
39. Is the x-ray machine calibrated?
40. If yes, how often?
40. If yes, how often?
41. If yes, do you perform the x-ray machine calibration?
42. If no, who performs it?
42. If no, who performs it?
43. If you do perform the calibration, please describe the process.
43. If you do perform the calibration, please describe the process.
44. How much time is spent on the calibration of the x-ray machine?
44. How much time is spent on the calibration of the x-ray machine?
45. How often has the x-ray machine been maintained?
45. How often has the x-ray machine been maintained?
46. If never, how often should the x-ray machine be maintained?
46. If never, how often should the x-ray machine be maintained?
47. How often does the x-ray machine break down?
47. How often does the x-ray machine break down?
48. On average, how long is the machine usually not working, when it breaks down?
48. On average, how long is the machine usually not working, when it breaks down?
Test 1: Chest X-ray (CXR) - RADIOGRAPHER
Logistics and other issues
49. Approximately what proportion of patients with DM have difficulty completing a CXR?
49. Approximately what proportion of patients with DM have difficulty completing a CXR?
50. What are some of the reasons for not completing a CXR?

50. What are some of the reasons for not completing a CXR?
51. How long does it usually take to obtain the CXR film/electronic image?
51. How long does it usually take to obtain the CXR film/electronic image?
52. How are the results of the CXR returned to the DM clinic/patient?
52. How are the results of the CXR returned to the DM clinic/patient?
53. When are patients told the results of the CXR?
53. When are patients told the results of the CXR?
54. How are patients told the results?
54. How are patients told the results?
55. Has a CXR for a patient with DM ever been compromised (e. g. damaged, lost, mislabelled) in your department?
56. If yes, please indicate the top three reasons for compromised CXRs:
56.1.
56.2.
56.3.
57. How many TANDEM CXRs have you performed since the start of the TANDEM project?
57. How many non_TANDEM CXRs have you performed since the start of the TANDEM project?
58. Out of all the CXRs that you performed so far, how many have been compromised?
59. In your opinion, do you think the CXR is a useful way of screening patients with DM for TB?
60. If no, please give reasons why you think so:
60. If no, please give reasons why you think so:
61. Are there any additional comments you would like to make about the CXR?
61. Are there any additional comments you would like to make about the CXR?

Scan a barcode
Survey end time: ${end}

label::Romanian
Chestionar Fezabilitate Operaional
Screening pentruTB
Radiologie

hint::English

Introducere date
Bine ai venit,
INSTRUCIUNI
V voi citi aceste ntrebri i nota rspunsurile pe tablet. Ave i
la dispoziie att timp ct considerai dvs. suficient pentru a
rspunde. V rugm s rspundei din perspectiva personal
cu privire la munca depus de dvs. in studiul TANDEM.
Numele instituiei
Numrul chestionarului
Inceputul a acestei nregistrri: ${start}
Informaii
Prenume
Nume de familie
Sexul
Data naterii
Denumirea postului
Angajator
specificai

tside of the TANDEM project)?

at this facility (outside of the TANDEM project)?

lity at which patients would get one done?

ot able to get a prescribed CXR at this facility due to the issues in 12 above?
ot able to get a prescribed CXR at this facility due to the issues in 12 above?

for you to become proficient in this test is acceptable

this test is acceptable

already know how to perform the CXR in patients with DM?

the method for performing the CXR in patients with DM?

the method for performing the CXR in patients with DM?
e the CXR to learn the method?
plete the paperwork (registration, insurance, payment, etc. ) for each CXR? (minutes)

plete the CXR on one patient (from the time the patient arrives to when the CXR is completed)? (minutes)
sent back to the health facility or given to the patient (from the time the patient has the CXR to when the film or the report is ready)?
sent back to the health facility or given to the patient (from the time the patient has the CXR to when the film or the report is ready)?
CXRs if this test was rolled out into routine practice for DM patients with suspected TB?

scribe the process.

scribe the process.
control of the x-ray machine?
control of the x-ray machine?

be the process.
be the process.
e x-ray machine?
e x-ray machine?

e maintained?
e maintained?

ot working, when it breaks down?

ot working, when it breaks down?

DM have difficulty completing a CXR?

DM have difficulty completing a CXR?

R film/electronic image?
R film/electronic image?
DM clinic/patient?
DM clinic/patient?

mpromised (e. g. damaged, lost, mislabelled) in your department?

compromised CXRs:

d since the start of the TANDEM project?

ormed since the start of the TANDEM project?
how many have been compromised?
ul way of screening patients with DM for TB?

ke to make about the CXR?

ke to make about the CXR?
Incheierea acestei inregistrri.
Mulumesc.
Scanai un cod de bare
Incheierea acestei inregistrri: ${end}

Not required

hint::Romanian

constraint

constraint_message

when the film or the report is ready)?

when the film or the report is ready)?

Nu neaprat necesar

required

appearance
field-list

field-list

field-list

default

field-list

relevant

read_only

calculation

image

audio

image::english

media::audio::chinese

media::video

list_name

name

operator
operator
operator
operator

Riza
Cimpoeru
Cucu
Laurence
LGU

facility
facility
facility

Babe
Leamna
Calafat

facility
facility

Runcu
SCJU

gender
gender

m
f

employer
employer
employer
employer
employer

ministry
centre
TANDEM
university
other

yn
yn

y
n

yndkna
yndkna
yndkna
yndkna

y
n
dk
nap

dkdn
dkdn
dkdn
dkdn

y
ydk
dn
dndk

likert
likert
likert
likert
likert

5
4
3
2
1

time
time
time
time
time

seconds
minutes
hours
days
weeks

duration
duration
duration
duration
duration

hours
days
weeks
months
years

freq
freq
freq
freq
freq
freq

never
day
week
month
year
dk

nocxr
nocxr
nocxr
nocxr
nocxr
nocxr

nomachine
notroutine
faultymachinery
nosupplies
nostaff
other

facility_type
facility_type
facility_type

private
public
other

cxr_format
cxr_format
cxr_format

film
electronic
other

results
results
results
results
results
results

post
clinic
radiology
online
email
other

results_told
results_told
results_told
results_told
results_told
results_told

never
always
abnormal
ask
remember
other

results_by
results_by
results_by
results_by

person
phone
called
other

nosputum
nosputum
nosputum
nosputum
nosputum

notalgorithm
notstaff
notinfrastructure
notsupplies
other

facility_type2
facility_type2
facility_type2
facility_type2
facility_type2

part
privatelab
privatefacility
public
other

notst
notst
notst
notst
notst

notalgorithm
noequipment
nostaff
nosupplies
other

cxr_check
cxr_check
cxr_check

technician
external
other

label::English

label::Romanian

dr. Anca RIZA

dr. Alina CIMPOERU
dr. Mihai CUCU
Ms. Yoko Laurence
operator TANDEM LGU

dr. Anca RIZA

dr. Alina CIMPOERU
dr. Mihai CUCU
Ms. Yoko Laurence
operator TANDEM LGU

1 - Spitalul Clinic de Boli Infecioase Victor Babe", C1 - Spitalul Clinic de Boli Infecioase Victor Babe", Craiova, jud. Dol
2 - Spitalul de Pneumoftiziologie, com. Leamna, jud. 2 - Spitalul de Pneumoftiziologie, com. Leamna, jud. Dolj
3 - Spitalul Municipal Calafat, Secia exterioar TBC 3 - Spitalul Municipal Calafat, Secia exterioar TBC Pneumologie Po

4 - Spitalul de Pneumoftiziologie Tudor Vladimirescu5 - Spitalul de Pneumoftiziologie Tudor Vladimirescu", com. Runcu, j
5 - Spitalul Clinic Judeean de Urgen Craiova, secia6 - Spitalul Clinic Judeean de Urgen Craiova, secia Diabet i Boli d
male
female

brbat
femeie

Ministry of Health
Health Centre
TANDEM
University
Other

Ministerul Sanatatii
Centru Medical
TANDEM
Universitatea
Altul

Yes
No

Da
Nu

Yes
No
Don't know
Does not apply

Da
Nu
Nu tiu
Nu este cazul

This applies to me
It applies to me, but I don't know
Does not apply, but as far as I know
Does not apply, do not know

Mi se aplica
Mi se aplica, dar nu stiu
Nu mi se aplica, dar din cate
stiu
Nu mi se aplica, nu stiu

Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree

Cu totul de acord
De acord
Nici acord, nici dezacord
Dezacord
Dezacord total

seconds
minutes
hours
days
weeks

secunde
minute
ore
zile
sptmni

hours
days
weeks
months
years

ore
zile
sptmni
luni
ani

Never
times per day
times per week
times per month
times per year
I dont know

niciodat
pe zi
pe sptmn
pe lun
pe an
nu tiu

No x-ray machine
Never part of the diagnosis algorithm for patients at this clinic
Faulty machinery
Supplies unavailable
Trained staff unavailable
Other, please explain
Private
Another public health centre
Other, specify
Film
Electronic
Other, please specify
Paper results by post
Paper results by staff, clinic
Paper results by staff, radiology
Online system
E-mail
Other, please specify
Never
Always
Only when there is an abnormal reading
Only if they ask for it
If I remember
Other, please specify
In person during their next scheduled visit at the clinic
Over the phone
Called and asked to visit the clinic for the results
Other, specify
Not part of any diagnosis algorithm for DM patients
Trained staff unavailable (e.g. to instruct patients on proper sputum production techniques, etc.)
Inadequate infrastructure (e.g. no designated room for producing sputum, etc.)
Supplies unavailable (e.g. sputum pots, request forms, etc.)
Other, please explain
Another part of this facility or hospital
Private lab
Private health facility
Another public health centre
Other, specify

Never part of the diagnosis algorithm for patients at this clinic

Faulty equipment
Trained staff unavailable
Supplies unavailable
Other, please explain
Another technician from this laboratory
Supplier (external)
Other person, please explain

image

e Boli Infecioase Victor Babe", Craiova, jud. Dolj

moftiziologie, com. Leamna, jud. Dolj
al Calafat, Secia exterioar TBC Pneumologie Poiana Mare, jud. Dolj

moftiziologie Tudor Vladimirescu", com. Runcu, jud Gorj

deean de Urgen Craiova, secia Diabet i Boli de Nutri ie, jud. Dolj

uction techniques, etc.)

form_title

UMFCV_OpFeasibility_TB_CXR