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Tree: Skin Acne Assessment
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#1 1 Welcome
Q: How old are you ?
12-17 #2 (+2)   18-40 #2 (+1)   Above 40 #2 (+3)  
Variables: grade
#2 3 (no title)
Q: For how long have you had acne?
Less than 6 months #3    6 months - 2 years #3    More than 2 years #3   
#3 3 Have you tried any treatment for a significant (at least a month or more) period of time? (Multiple Choice can be selected)
Continue #4   
Data Entry Fields: H, H, H, H, H, H
#4 1 (no title)
Q: Do you have sensitive skin?
Yes #5 (+3)   No #5 (+1)   I Don't Know #5 (+2)  
3 Variables: skin
#5 3 (no title)
Q: What is your skin type?
Dry #6 (+1)   Regular #6    Oily #6 (+3)   Combination (T-Zone) #6 (+2)   I'm Not Sure #6 (+1)  
Variables: skin
#6 5 (no title)
Q: How many times do you wash your face per day with soap/facewash?
1-2 times #7 (+1)   3-5 times #7 (+2)   More than 5 times #7 (+2)  
Variables: habits
#7 3 (no title)
Q: Do you have dandruff?
Yes #8 (+3)   No #8 (+1)   I'm not sure #8 (+2)  
Variables: skin
#8 3 Describe your acne
Only Blackheads #38    Mild #9 (+1)   Moderate #9 (+3)   Severe #9 (+5)  
Variables: acne
#9 3 Which of the following best describes your acne?
Continue #10   
Data Entry Fields: Acne_1, Acne_2, Acne_3, Acne_4, Acne_5
Variables: acne, acne, acne, acne, acne
#10 1 (no title)
Q: Do you experience pain?
Yes #11 (+2)   No #11 (+1)  
Variables: acne
#11 2 (no title)
Q: Where is your face most affected by acne?
Concentrated in some areas #12 (+5)   More than Half #13 (+3)   Less than half #13 (+2)   Scattered #13 (+1)  
Variables: acne
#12 1 Select all that apply (Multiple choice can be selected)
Continue #13   
Data Entry Fields: Face_1, Face_2, Face_3, Face_4, Face_5, Face_6
Variables: acne, acne, acne, acne, acne, acne
#13 4 (no title)
Q: What would be the approximate no. of acne on your face?
0-5 #49 (+1)   5-10 #49 (+2)   10-20 #49 (+3)   20-30 #49 (+4)   More than 30 #49 (+5)  
Variables: acne
#16 2 (no title)
Q: Does your acne leave behind
Pigmentation #17 (+2)   Scars #17 (+3)   No marks #17 (+1)  
Variables: acne
#17 3 (no title)
Q: Does anyone else in your immediate family have acne ?
Yes #18 (+2)   No #18 (+1)  
Variables: cause
#18 2 (no title)
Q: Do you notice acne breakouts prior to periods?
Yes #19 (+3)   No #19 (+1)   I'm not sure #19 (+2)  
Variables: cause
#19 3 (no title)
Q: How are your periods?
Mostly Regular #20 (+1)   Mostly Irregular #20 (+3)  
Variables: cause
#20 2 PolyCystic Ovary Syndrome (PCOS) is a condition that affects women's hormonal levels.
Q: Have you been diagnosed with PCOS?
Yes #26 (+3)   No #26 (+1)   I'm not sure #26 (+2)  
Variables: cause
#21 1 (no title)
Q: Now tell us a little about your nutrition and habits ! This helps us in suggesting better treatment methods :)
Continue #27   
#22 1 (no title)
Q: Now tell us a little about your nutrition and habits ! This helps us in suggesting better treatment methods :)
Continue #27   
#23 1 (no title)
Q: Now tell us a little about your nutrition and habits ! This helps us in suggesting better treatment methods :)
Continue #27   
#24 1 (no title)
Q: Now tell us a little about your nutrition and habits ! This helps us in suggesting better treatment methods :)
Continue #27   
#25 1 (no title)
Q: Now tell us a little about your nutrition and habits ! This helps us in suggesting better treatment methods :)
Continue #27   
#26 3 Logic:
acne ≤ 14 #21  acne ≤ 24 #22  acne ≤ 34 #23  acne ≤ 44 #24  acne ≥ 45 #25  default #1 
Variables: acne
#27 5 (no title)
Q: How much of plain water do you drink per day?
2-4 glasses #28 (+2)   4-8 glasses #28 (+1)   More than 8 glasses #28 (+1)  
Variables: food
#28 3 (no title)
Q: How often do you consume dairy products?
Never #29    2-3 times a week #29 (+1)   More than 3 times a week #29 (+1)   Once a day #29 (+3)   Twice a day or more #29 (+3)  
Variables: food
#29 5 (no title)
Q: How often do you consume oily/fried/fast/sugary foods at home or out?
Everyday #30 (+3)   3-4 times a week #30 (+2)   1-2 times a week #30 (+1)   Never #30   
Variables: food
#30 4 (no title)
Q: How is your bowel movement?
Mostly Constipated #31 (+3)   Mostly Regular #31 (+1)  
Variables: food
#31 2 (no title)
Q: What is the frequency of passing the stool?
Everyday #33 (+1)   Once in 2 days #33 (+2)   Once in more than 2 days #33 (+3)  
Variables: food
#33 3 Do you regularly experience any of the following symptoms?
Continue #39   
Data Entry Fields: Sym, Sym1, Sym2, Sym3, Sym5
Variables: food, food, food, food
#38 1 (no title)
#39 1 (no title)
Q: Do you regularly smoke or use tobacco products?
Yes #40 (+3)   No #40 (+1)  
Variables: habits
#40 2 (no title)
Q: Do you regularly consume alcohol?
Yes #41 (+3)   No #41 (+1)  
Variables: habits
#41 2 (no title)
Q: Over the last 12 weeks (at most times) what has been your state of mind?
Generally Happy #42 (+1)   Mood Swings #42 (+3)   Stressed #42 (+3)   Depressed #42 (+3)   Anxious #42 (+3)  
Variables: mood
#42 5 (no title)
Q: Any known allergies or sensitivities?
Yes #43 (+3)   No #43 (+1)   I'm not sure #43 (+2)  
Variables: cause
#43 3 (no title)
Declaration #47   
#47 1 (no title)
#49 5 (no title)
Q: Do you have acne on other parts of your body ?
Yes #50    No #16   
#50 1 Select all that apply (Multiple choice can be selected)
Continue #16   
Data Entry Fields: Body_1, Body_2, Body_3, Back_4
Variables: acne, acne, acne, acne
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