| ENTRY SPECIFICATION |
{"name": "COPD",
healthcare professional to help improve the management of your COPD and get the
{"id": "c4077", "text": " 3", "quickKey": 3},
{"id": "c4078", "text": " 4", "quickKey": 4},
{"id": "c4147", "text": " 5 Very Limited", "quickKey": 5}
]},
{"id": "q8356", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "6. Rate your confidence: 0 - I am confident leaving my home despite my lung
condition TO 5 - I am not at all confident leaving my home because of my lung
condition",
"intro": "This questionnaire will help you and your healthcare professional measure the
impact COPD (Chronic Obstructive Pulmonary Disease) is having on your well-being
greatest benefit from treatment.<br /><br /> For each item below, select the
and daily life. Your answers, and test score, can be used by you and your
healthcare professional to help improve the management of your COPD and get the
greatest benefit from treatment.<br /><br /> For each item below, select the
number that best describes you currently.",
"columns": 6,
"choices":[
{"id": "c4148", "text": " 0 Confident", "quickKey": 0},
{"id": "c4075", "text": " 1", "quickKey": 1},
{"id": "c4076", "text": " 2", "quickKey": 2},
{"id": "c4077", "text": " 3", "quickKey": 3},
number that best describes you currently."
{"id": "c4078", "text": " 4", "quickKey": 4},
{"id": "c4149", "text": " 5 Not Confident", "quickKey": 5}
]},
{"id": "q8357", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "7. Rate your sleep: 0 - I sleep soundly TO 5 - I don't sleep soundly because of
my lung condition",
"intro": "This questionnaire will help you and your healthcare professional measure the
impact COPD (Chronic Obstructive Pulmonary Disease) is having on your well-being
and daily life. Your answers, and test score, can be used by you and your
healthcare professional to help improve the management of your COPD and get the
},
greatest benefit from treatment.<br /><br /> For each item below, select the
number that best describes you currently.",
"columns": 6,
"choices":[
{"id": "c4150", "text": " 0 Sleep Soundly", "quickKey": 0},
{"id": "c4075", "text": " 1", "quickKey": 1},
{"id": "c4076", "text": " 2", "quickKey": 2},
{"id": "c4077", "text": " 3", "quickKey": 3},
{"id": "c4078", "text": " 4", "quickKey": 4},
{"id": "c4151", "text": " 5 Don't Sleep Soundly", "quickKey": 5}
{"id": "q8351", "type": "ChoiceQuestion", "required": false, "inline": true,
]},
{"id": "q8379", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "8. Rate your energy: 0 - I have lots of energy TO 5 - I have no energy at all",
"intro": "This questionnaire will help you and your healthcare professional measure the
impact COPD (Chronic Obstructive Pulmonary Disease) is having on your well-being
and daily life. Your answers, and test score, can be used by you and your
healthcare professional to help improve the management of your COPD and get the
greatest benefit from treatment.<br /><br /> For each item below, select the
number that best describes you currently.",
"columns": 6,
"text": "1. Rate your cough: 0 - I never cough TO 5 - I cough all the time",
"choices":[
{"id": "c4152", "text": " 0 Lots of Energy", "quickKey": 0},
{"id": "c4075", "text": " 1", "quickKey": 1},
{"id": "c4076", "text": " 2", "quickKey": 2},
{"id": "c4077", "text": " 3", "quickKey": 3},
{"id": "c4078", "text": " 4", "quickKey": 4},
{"id": "c4153", "text": " 5 No Energy", "quickKey": 5}
]}]
}
"intro": "This questionnaire will help you and your healthcare professional measure the
impact COPD (Chronic Obstructive Pulmonary Disease) is having on your well-being
and daily life. Your answers, and test score, can be used by you and your
healthcare professional to help improve the management of your COPD and get the
"copyright": "Copyright 2009 GlaxoSmithKline group of companies. ",
greatest benefit from treatment.<br /><br /> For each item below, select the
number that best describes you currently.",
"columns": 6,
"choices":[
{"id": "c4074", "text": " 0 Never", "quickKey": 0},
{"id": "c4075", "text": " 1", "quickKey": 1},
{"id": "c4076", "text": " 2", "quickKey": 2},
{"id": "c4077", "text": " 3", "quickKey": 3},
{"id": "c4078", "text": " 4", "quickKey": 4},
{"id": "c4079", "text": " 5 All the Time", "quickKey": 5}
"restartDays": 2,
]},
{"id": "q8352", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "2. Rate your phlegm: 0 - I have no phlegm (mucus) in my chest at all TO 5 - My
chest is completely fully of phlegm (mucus)",
"intro": "This questionnaire will help you and your healthcare professional measure the
impact COPD (Chronic Obstructive Pulmonary Disease) is having on your well-being
and daily life. Your answers, and test score, can be used by you and your
healthcare professional to help improve the management of your COPD and get the
greatest benefit from treatment.<br /><br /> For each item below, select the
number that best describes you currently.",
"printTitle": "COPD Assessment Test (CAT)",
"columns": 6,
"choices":[
{"id": "c4130", "text": " 0 No Phlegm", "quickKey": 0},
{"id": "c4075", "text": " 1", "quickKey": 1},
{"id": "c4076", "text": " 2", "quickKey": 2},
{"id": "c4077", "text": " 3", "quickKey": 3},
{"id": "c4078", "text": " 4", "quickKey": 4},
{"id": "c4131", "text": " 5 Full of Phlegm", "quickKey": 5}
]},
{"id": "q8353", "type": "ChoiceQuestion", "required": false, "inline": true,
"content":[
"text": "3. Rate the tightness of your chest: 0 - My chest does not feel tight at all TO 5
- My chest feels very tight",
"intro": "This questionnaire will help you and your healthcare professional measure the
impact COPD (Chronic Obstructive Pulmonary Disease) is having on your well-being
and daily life. Your answers, and test score, can be used by you and your
healthcare professional to help improve the management of your COPD and get the
greatest benefit from treatment.<br /><br /> For each item below, select the
number that best describes you currently.",
"columns": 6,
"choices":[
{"id": "i2392", "type": "IntroText",
{"id": "c4132", "text": " 0 Not Tight", "quickKey": 0},
{"id": "c4075", "text": " 1", "quickKey": 1},
{"id": "c4076", "text": " 2", "quickKey": 2},
{"id": "c4077", "text": " 3", "quickKey": 3},
{"id": "c4078", "text": " 4", "quickKey": 4},
{"id": "c4133", "text": " 5 Very Tight", "quickKey": 5}
]},
{"id": "q8354", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "4. Rate your breathlessness: 0 - When I walk up a hill or one flight of stairs I
am not breathless TO 5 - When I walk up a hill or one flight of stairs I am
"text": "This questionnaire will help you and your healthcare professional measure the
very breathless",
"intro": "This questionnaire will help you and your healthcare professional measure the
impact COPD (Chronic Obstructive Pulmonary Disease) is having on your well-being
and daily life. Your answers, and test score, can be used by you and your
healthcare professional to help improve the management of your COPD and get the
greatest benefit from treatment.<br /><br /> For each item below, select the
number that best describes you currently.",
"columns": 6,
"choices":[
{"id": "c4144", "text": " 0 Not Breathless", "quickKey": 0},
impact COPD (Chronic Obstructive Pulmonary Disease) is having on your well-being
{"id": "c4075", "text": " 1", "quickKey": 1},
{"id": "c4076", "text": " 2", "quickKey": 2},
{"id": "c4077", "text": " 3", "quickKey": 3},
{"id": "c4078", "text": " 4", "quickKey": 4},
{"id": "c4145", "text": " 5 Very Breathless", "quickKey": 5}
]},
{"id": "q8355", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "5. Rate your activity limitation: 0 - I am not limited doing any activities at
home TO 5 - I am very limited doing activities at home",
"intro": "This questionnaire will help you and your healthcare professional measure the
and daily life. Your answers, and test score, can be used by you and your
impact COPD (Chronic Obstructive Pulmonary Disease) is having on your well-being
and daily life. Your answers, and test score, can be used by you and your
healthcare professional to help improve the management of your COPD and get the
greatest benefit from treatment.<br /><br /> For each item below, select the
number that best describes you currently.",
"columns": 6,
"choices":[
{"id": "c4146", "text": " 0 Not Limited", "quickKey": 0},
{"id": "c4075", "text": " 1", "quickKey": 1},
{"id": "c4076", "text": " 2", "quickKey": 2},
|
