Name | Value |
---|---|
INSTRUMENT | PROMIS29 |
LAST UPDATE | 2022-04-08 09:18:33 |
ENTRY CHECKSUM | 3063151347 |
ENTRY SPECIFICATION | {"name": "PROMIS29", "text": "1. Physical Functioning: Are you able to do chores such as vacuuming or yard "text": "9. Depression: IN THE PAST 7 DAYS I felt worthless.", "intro": "For each question or statement below, please mark one answer.", "columns": 1, "choices":[ {"id": "c3942", "text": "1. Never", "quickKey": 1}, {"id": "c3943", "text": "2. Rarely", "quickKey": 2}, {"id": "c3944", "text": "3. Sometimes", "quickKey": 3}, {"id": "c3945", "text": "4. Often", "quickKey": 4}, {"id": "c3946", "text": "5. Always", "quickKey": 5} ]}, work?", {"id": "q8299", "type": "ChoiceQuestion", "required": true, "inline": false, "text": "10. Depression: IN THE PAST 7 DAYS I felt helpless.", "intro": "For each question or statement below, please mark one answer.", "columns": 1, "choices":[ {"id": "c3942", "text": "1. Never", "quickKey": 1}, {"id": "c3943", "text": "2. Rarely", "quickKey": 2}, {"id": "c3944", "text": "3. Sometimes", "quickKey": 3}, {"id": "c3945", "text": "4. Often", "quickKey": 4}, {"id": "c3946", "text": "5. Always", "quickKey": 5} "intro": "For each question or statement below, please mark one answer.", ]}, {"id": "q8300", "type": "ChoiceQuestion", "required": true, "inline": false, "text": "11. Depression: IN THE PAST 7 DAYS I felt depressed.", "intro": "For each question or statement below, please mark one answer.", "columns": 1, "choices":[ {"id": "c3942", "text": "1. Never", "quickKey": 1}, {"id": "c3943", "text": "2. Rarely", "quickKey": 2}, {"id": "c3944", "text": "3. Sometimes", "quickKey": 3}, {"id": "c3945", "text": "4. Often", "quickKey": 4}, "columns": 1, {"id": "c3946", "text": "5. Always", "quickKey": 5} ]}, {"id": "q8301", "type": "ChoiceQuestion", "required": true, "inline": false, "text": "12. Depression: IN THE PAST 7 DAYS I felt hopeless.", "intro": "For each question or statement below, please mark one answer.", "columns": 1, "choices":[ {"id": "c3942", "text": "1. Never", "quickKey": 1}, {"id": "c3943", "text": "2. Rarely", "quickKey": 2}, {"id": "c3944", "text": "3. Sometimes", "quickKey": 3}, "choices":[ {"id": "c3945", "text": "4. Often", "quickKey": 4}, {"id": "c3946", "text": "5. Always", "quickKey": 5} ]}, {"id": "q8302", "type": "ChoiceQuestion", "required": true, "inline": false, "text": "13. Fatigue: DURING THE PAST 7 DAYS I feel fatigued.", "intro": "For each question or statement below, please mark one answer.", "columns": 1, "choices":[ {"id": "c3947", "text": "1. Not at all", "quickKey": 1}, {"id": "c3948", "text": "2. A little bit", "quickKey": 2}, {"id": "c3937", "text": "1. Without any difficulty", "quickKey": 1}, {"id": "c3949", "text": "3. Somewhat", "quickKey": 3}, {"id": "c3950", "text": "4. Quite a bit", "quickKey": 4}, {"id": "c3951", "text": "5. Very much", "quickKey": 5} ]}, {"id": "q8303", "type": "ChoiceQuestion", "required": true, "inline": false, "text": "14. Fatigue: DURING THE PAST 7 DAYS I have trouble STARTING things because I am tired.", "intro": "For each question or statement below, please mark one answer.", "columns": 1, "choices":[ {"id": "c3938", "text": "2. With a little difficulty", "quickKey": 2}, {"id": "c3947", "text": "1. Not at all", "quickKey": 1}, {"id": "c3948", "text": "2. A little bit", "quickKey": 2}, {"id": "c3949", "text": "3. Somewhat", "quickKey": 3}, {"id": "c3950", "text": "4. Quite a bit", "quickKey": 4}, {"id": "c3951", "text": "5. Very much", "quickKey": 5} ]}, {"id": "q8304", "type": "ChoiceQuestion", "required": true, "inline": false, "text": "15. Fatigue: IN THE PAST 7 DAYS - How run down did you feel on average?", "intro": "For each question or statement below, please mark one answer.", "columns": 1, {"id": "c3939", "text": "3. With some difficulty", "quickKey": 3}, "choices":[ {"id": "c3947", "text": "1. Not at all", "quickKey": 1}, {"id": "c3948", "text": "2. A little bit", "quickKey": 2}, {"id": "c3949", "text": "3. Somewhat", "quickKey": 3}, {"id": "c3950", "text": "4. Quite a bit", "quickKey": 4}, {"id": "c3951", "text": "5. Very much", "quickKey": 5} ]}, {"id": "q8305", "type": "ChoiceQuestion", "required": true, "inline": false, "text": "16. Fatigue: IN THE PAST 7 DAYS - How fatigued were you on average?", "intro": "For each question or statement below, please mark one answer.", {"id": "c3940", "text": "4. With much difficulty", "quickKey": 4}, "columns": 1, "choices":[ {"id": "c3947", "text": "1. Not at all", "quickKey": 1}, {"id": "c3948", "text": "2. A little bit", "quickKey": 2}, {"id": "c3949", "text": "3. Somewhat", "quickKey": 3}, {"id": "c3950", "text": "4. Quite a bit", "quickKey": 4}, {"id": "c3951", "text": "5. Very much", "quickKey": 5} ]}, {"id": "q8306", "type": "ChoiceQuestion", "required": true, "inline": false, "text": "17. Sleep Disturbance: IN THE PAST 7 DAYS my sleep quality was,", {"id": "c3941", "text": "5. Unable to do", "quickKey": 5} "intro": "For each question or statement below, please mark one answer.", "columns": 1, "choices":[ {"id": "c3952", "text": "1. Very poor", "quickKey": 1}, {"id": "c3953", "text": "2. Poor", "quickKey": 2}, {"id": "c3954", "text": "3. Fair", "quickKey": 3}, {"id": "c3955", "text": "4. Good", "quickKey": 4}, {"id": "c3956", "text": "5. Very good", "quickKey": 5} ]}, {"id": "q8307", "type": "ChoiceQuestion", "required": true, "inline": false, "copyright": " 2008-2016 PROMIS Health Organization and PROMIS Cooperative Group", ]}, "text": "18. Sleep Disturbance: IN THE PAST 7 DAYS my sleep was refreshing,", "intro": "For each question or statement below, please mark one answer.", "columns": 1, "choices":[ {"id": "c4060", "text": "1. Not at all", "quickKey": 1}, {"id": "c4061", "text": "2. A little bit", "quickKey": 2}, {"id": "c4062", "text": "3. Somewhat", "quickKey": 3}, {"id": "c4063", "text": "4. Quite a bit", "quickKey": 4}, {"id": "c4064", "text": "5. Very much", "quickKey": 5} ]}, {"id": "q8291", "type": "ChoiceQuestion", "required": true, "inline": false, {"id": "q8308", "type": "ChoiceQuestion", "required": true, "inline": false, "text": "19. Sleep Disturbance: IN THE PAST 7 DAYS I had a problem with sleep,", "intro": "For each question or statement below, please mark one answer.", "columns": 1, "choices":[ {"id": "c3947", "text": "1. Not at all", "quickKey": 1}, {"id": "c3948", "text": "2. A little bit", "quickKey": 2}, {"id": "c3949", "text": "3. Somewhat", "quickKey": 3}, {"id": "c3950", "text": "4. Quite a bit", "quickKey": 4}, {"id": "c3951", "text": "5. Very much", "quickKey": 5} "text": "2. Physical Functioning: Are you able to go up and down stairs at a normal pace?", ]}, {"id": "q8309", "type": "ChoiceQuestion", "required": true, "inline": false, "text": "20. Sleep Disturbance: IN THE PAST 7 DAYS I had difficulty falling asleep,", "intro": "For each question or statement below, please mark one answer.", "columns": 1, "choices":[ {"id": "c3947", "text": "1. Not at all", "quickKey": 1}, {"id": "c3948", "text": "2. A little bit", "quickKey": 2}, {"id": "c3949", "text": "3. Somewhat", "quickKey": 3}, {"id": "c3950", "text": "4. Quite a bit", "quickKey": 4}, "intro": "For each question or statement below, please mark one answer.", {"id": "c3951", "text": "5. Very much", "quickKey": 5} ]}, {"id": "q8310", "type": "ChoiceQuestion", "required": true, "inline": false, "text": "21. Satisfaction with Social Role: IN THE PAST 7 DAYS I am satisfied with how much work I can do (include work at home).", "intro": "For each question or statement below, please mark one answer.", "columns": 1, "choices":[ {"id": "c3947", "text": "1. Not at all", "quickKey": 1}, {"id": "c3948", "text": "2. A little bit", "quickKey": 2}, "columns": 1, {"id": "c3949", "text": "3. Somewhat", "quickKey": 3}, {"id": "c3950", "text": "4. Quite a bit", "quickKey": 4}, {"id": "c3951", "text": "5. Very much", "quickKey": 5} ]}, {"id": "q8311", "type": "ChoiceQuestion", "required": true, "inline": false, "text": "22. Satisfaction with Social Role: IN THE PAST 7 DAYS I am satisfied with my ability to work (include work at home).", "intro": "For each question or statement below, please mark one answer.", "columns": 1, "choices":[ "choices":[ {"id": "c3947", "text": "1. Not at all", "quickKey": 1}, {"id": "c3948", "text": "2. A little bit", "quickKey": 2}, {"id": "c3949", "text": "3. Somewhat", "quickKey": 3}, {"id": "c3950", "text": "4. Quite a bit", "quickKey": 4}, {"id": "c3951", "text": "5. Very much", "quickKey": 5} ]}, {"id": "q8312", "type": "ChoiceQuestion", "required": true, "inline": false, "text": "23. Satisfaction with Social Role: IN THE PAST 7 DAYS I am satisfied with my ability to do regular personal and household responsibilities.", "intro": "For each question or statement below, please mark one answer.", {"id": "c3937", "text": "1. Without any difficulty", "quickKey": 1}, "columns": 1, "choices":[ {"id": "c3947", "text": "1. Not at all", "quickKey": 1}, {"id": "c3948", "text": "2. A little bit", "quickKey": 2}, {"id": "c3949", "text": "3. Somewhat", "quickKey": 3}, {"id": "c3950", "text": "4. Quite a bit", "quickKey": 4}, {"id": "c3951", "text": "5. Very much", "quickKey": 5} ]}, {"id": "q8313", "type": "ChoiceQuestion", "required": true, "inline": false, "text": "24. Satisfaction with Social Role: IN THE PAST 7 DAYS I am satisfied with my {"id": "c3938", "text": "2. With a little difficulty", "quickKey": 2}, ability to perform my daily routines.", "intro": "For each question or statement below, please mark one answer.", "columns": 1, "choices":[ {"id": "c3947", "text": "1. Not at all", "quickKey": 1}, {"id": "c3948", "text": "2. A little bit", "quickKey": 2}, {"id": "c3949", "text": "3. Somewhat", "quickKey": 3}, {"id": "c3950", "text": "4. Quite a bit", "quickKey": 4}, {"id": "c3951", "text": "5. Very much", "quickKey": 5} ]}, {"id": "c3939", "text": "3. With some difficulty", "quickKey": 3}, {"id": "q8314", "type": "ChoiceQuestion", "required": true, "inline": false, "text": "25. Pain Interference: IN THE PAST 7 DAYS - How much did pain interfere in your day to day activities?", "intro": "For each question or statement below, please mark one answer.", "columns": 1, "choices":[ {"id": "c3947", "text": "1. Not at all", "quickKey": 1}, {"id": "c3948", "text": "2. A little bit", "quickKey": 2}, {"id": "c3949", "text": "3. Somewhat", "quickKey": 3}, {"id": "c3950", "text": "4. Quite a bit", "quickKey": 4}, {"id": "c3940", "text": "4. With much difficulty", "quickKey": 4}, {"id": "c3951", "text": "5. Very much", "quickKey": 5} ]}, {"id": "q8315", "type": "ChoiceQuestion", "required": true, "inline": false, "text": "26. Pain Interference: IN THE PAST 7 DAYS - How much did pain interfere with your work around the house?", "intro": "For each question or statement below, please mark one answer.", "columns": 1, "choices":[ {"id": "c3947", "text": "1. Not at all", "quickKey": 1}, {"id": "c3948", "text": "2. A little bit", "quickKey": 2}, "restartDays": 2, {"id": "c3941", "text": "5. Unable to do", "quickKey": 5} {"id": "c3949", "text": "3. Somewhat", "quickKey": 3}, {"id": "c3950", "text": "4. Quite a bit", "quickKey": 4}, {"id": "c3951", "text": "5. Very much", "quickKey": 5} ]}, {"id": "q8316", "type": "ChoiceQuestion", "required": true, "inline": false, "text": "27. Pain Interference: IN THE PAST 7 DAYS - How much did pain interfere with your ability to participate in social activities?", "intro": "For each question or statement below, please mark one answer.", "columns": 1, "choices":[ ]}, {"id": "c3947", "text": "1. Not at all", "quickKey": 1}, {"id": "c3948", "text": "2. A little bit", "quickKey": 2}, {"id": "c3949", "text": "3. Somewhat", "quickKey": 3}, {"id": "c3950", "text": "4. Quite a bit", "quickKey": 4}, {"id": "c3951", "text": "5. Very much", "quickKey": 5} ]}, {"id": "q8317", "type": "ChoiceQuestion", "required": true, "inline": false, "text": "28. Pain Interference: IN THE PAST 7 DAYS - How much did pain interfere with your household chores?", "intro": "For each question or statement below, please mark one answer.", {"id": "q8292", "type": "ChoiceQuestion", "required": true, "inline": false, "columns": 1, "choices":[ {"id": "c3947", "text": "1. Not at all", "quickKey": 1}, {"id": "c3948", "text": "2. A little bit", "quickKey": 2}, {"id": "c3949", "text": "3. Somewhat", "quickKey": 3}, {"id": "c3950", "text": "4. Quite a bit", "quickKey": 4}, {"id": "c3951", "text": "5. Very much", "quickKey": 5} ]}, {"id": "q8318", "type": "SliderQuestion", "required": true, "text": "29. Pain Intensity: How would you rate your pain on average? ", "text": "3. Physical Functioning: Are you able to go for a walk of at least 15 minutes?", "intro": "For each question or statement below, please mark one answer.", "min": 0, "max": 10, "legend":["No Pain", "Worst Imaginable Pain"]}] } "intro": "For each question or statement below, please mark one answer.", "columns": 1, "choices":[ {"id": "c3937", "text": "1. Without any difficulty", "quickKey": 1}, {"id": "c3938", "text": "2. With a little difficulty", "quickKey": 2}, {"id": "c3939", "text": "3. With some difficulty", "quickKey": 3}, "printTitle": "Patient Reported Outcome Measurement Information System (PROMIS) 29 Profile v2.0", {"id": "c3940", "text": "4. With much difficulty", "quickKey": 4}, {"id": "c3941", "text": "5. Unable to do", "quickKey": 5} ]}, {"id": "q8293", "type": "ChoiceQuestion", "required": true, "inline": false, "text": "4. Physical Functioning: Are you able to run errands and shop?", "intro": "For each question or statement below, please mark one answer.", "columns": 1, "choices":[ {"id": "c3937", "text": "1. Without any difficulty", "quickKey": 1}, {"id": "c3938", "text": "2. With a little difficulty", "quickKey": 2}, "content":[ {"id": "c3939", "text": "3. With some difficulty", "quickKey": 3}, {"id": "c3940", "text": "4. With much difficulty", "quickKey": 4}, {"id": "c3941", "text": "5. Unable to do", "quickKey": 5} ]}, {"id": "q8294", "type": "ChoiceQuestion", "required": true, "inline": false, "text": "5. Anxiety: IN THE PAST 7 DAYS I felt fearful.", "intro": "For each question or statement below, please mark one answer.", "columns": 1, "choices":[ {"id": "c3942", "text": "1. Never", "quickKey": 1}, {"id": "i2386", "type": "IntroText", {"id": "c3943", "text": "2. Rarely", "quickKey": 2}, {"id": "c3944", "text": "3. Sometimes", "quickKey": 3}, {"id": "c3945", "text": "4. Often", "quickKey": 4}, {"id": "c3946", "text": "5. Always", "quickKey": 5} ]}, {"id": "q8295", "type": "ChoiceQuestion", "required": true, "inline": false, "text": "6. Anxiety: IN THE PAST 7 DAYS I found it hard to focus on anything other than my anxiety.", "intro": "For each question or statement below, please mark one answer.", "columns": 1, "text": "For each question or statement below, please mark one answer." "choices":[ {"id": "c3942", "text": "1. Never", "quickKey": 1}, {"id": "c3943", "text": "2. Rarely", "quickKey": 2}, {"id": "c3944", "text": "3. Sometimes", "quickKey": 3}, {"id": "c3945", "text": "4. Often", "quickKey": 4}, {"id": "c3946", "text": "5. Always", "quickKey": 5} ]}, {"id": "q8296", "type": "ChoiceQuestion", "required": true, "inline": false, "text": "7. Anxiety: IN THE PAST 7 DAYS my worries overwhelmed me.", "intro": "For each question or statement below, please mark one answer.", }, "columns": 1, "choices":[ {"id": "c3942", "text": "1. Never", "quickKey": 1}, {"id": "c3943", "text": "2. Rarely", "quickKey": 2}, {"id": "c3944", "text": "3. Sometimes", "quickKey": 3}, {"id": "c3945", "text": "4. Often", "quickKey": 4}, {"id": "c3946", "text": "5. Always", "quickKey": 5} ]}, {"id": "q8297", "type": "ChoiceQuestion", "required": true, "inline": false, "text": "8. Anxiety: IN THE PAST 7 DAYS I felt uneasy.", {"id": "q8290", "type": "ChoiceQuestion", "required": true, "inline": false, "intro": "For each question or statement below, please mark one answer.", "columns": 1, "choices":[ {"id": "c3942", "text": "1. Never", "quickKey": 1}, {"id": "c3943", "text": "2. Rarely", "quickKey": 2}, {"id": "c3944", "text": "3. Sometimes", "quickKey": 3}, {"id": "c3945", "text": "4. Often", "quickKey": 4}, {"id": "c3946", "text": "5. Always", "quickKey": 5} ]}, {"id": "q8298", "type": "ChoiceQuestion", "required": true, "inline": false, |