| ENTRY SPECIFICATION |
{"name": "PROMIS29 V2.1",
"text": "1. Physical Function: Are you able to do chores such as vacuuming or yard work?",
"intro": "Please respond to each question or statement by selecting one answer.",
"columns": 1,
"choices":[
{"id": "c5168", "text": "1. Never", "quickKey": 1},
{"id": "c5169", "text": "2. Rarely", "quickKey": 2},
{"id": "c5170", "text": "3. Sometimes", "quickKey": 3},
{"id": "c5171", "text": "4. Often", "quickKey": 4},
{"id": "c5172", "text": "5. Always", "quickKey": 5}
]},
{"id": "q8592", "type": "ChoiceQuestion", "required": true, "inline": false,
"intro": "Please respond to each question or statement by selecting one answer.",
"text": "10. Depression: IN THE PAST 7 DAYS I felt helpless.",
"intro": "Please respond to each question or statement by selecting one answer.",
"columns": 1,
"choices":[
{"id": "c5168", "text": "1. Never", "quickKey": 1},
{"id": "c5169", "text": "2. Rarely", "quickKey": 2},
{"id": "c5170", "text": "3. Sometimes", "quickKey": 3},
{"id": "c5171", "text": "4. Often", "quickKey": 4},
{"id": "c5172", "text": "5. Always", "quickKey": 5}
]},
"columns": 1,
{"id": "q8593", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "11. Depression: IN THE PAST 7 DAYS I felt depressed.",
"intro": "Please respond to each question or statement by selecting one answer.",
"columns": 1,
"choices":[
{"id": "c5168", "text": "1. Never", "quickKey": 1},
{"id": "c5169", "text": "2. Rarely", "quickKey": 2},
{"id": "c5170", "text": "3. Sometimes", "quickKey": 3},
{"id": "c5171", "text": "4. Often", "quickKey": 4},
{"id": "c5172", "text": "5. Always", "quickKey": 5}
"choices":[
]},
{"id": "q8594", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "12. Depression: IN THE PAST 7 DAYS I felt hopeless.",
"intro": "Please respond to each question or statement by selecting one answer.",
"columns": 1,
"choices":[
{"id": "c5168", "text": "1. Never", "quickKey": 1},
{"id": "c5169", "text": "2. Rarely", "quickKey": 2},
{"id": "c5170", "text": "3. Sometimes", "quickKey": 3},
{"id": "c5171", "text": "4. Often", "quickKey": 4},
{"id": "c5163", "text": "1. Without any difficulty", "quickKey": 1},
{"id": "c5172", "text": "5. Always", "quickKey": 5}
]},
{"id": "q8595", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "13. Fatigue: DURING THE PAST 7 DAYS I feel fatigued.",
"intro": "Please respond to each question or statement by selecting one answer.",
"columns": 1,
"choices":[
{"id": "c5173", "text": "1. Not at all", "quickKey": 1},
{"id": "c5174", "text": "2. A little bit", "quickKey": 2},
{"id": "c5175", "text": "3. Somewhat", "quickKey": 3},
{"id": "c5164", "text": "2. With a little difficulty", "quickKey": 2},
{"id": "c5176", "text": "4. Quite a bit", "quickKey": 4},
{"id": "c5177", "text": "5. Very much", "quickKey": 5}
]},
{"id": "q8596", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "14. Fatigue: DURING THE PAST 7 DAYS I have trouble starting things because I am
tired.",
"intro": "Please respond to each question or statement by selecting one answer.",
"columns": 1,
"choices":[
{"id": "c5173", "text": "1. Not at all", "quickKey": 1},
{"id": "c5165", "text": "3. With some difficulty", "quickKey": 3},
{"id": "c5174", "text": "2. A little bit", "quickKey": 2},
{"id": "c5175", "text": "3. Somewhat", "quickKey": 3},
{"id": "c5176", "text": "4. Quite a bit", "quickKey": 4},
{"id": "c5177", "text": "5. Very much", "quickKey": 5}
]},
{"id": "q8597", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "15. Fatigue: DURING THE PAST 7 DAYS how run-down did you feel on average?",
"intro": "Please respond to each question or statement by selecting one answer.",
"columns": 1,
"choices":[
{"id": "c5166", "text": "4. With much difficulty", "quickKey": 4},
{"id": "c5173", "text": "1. Not at all", "quickKey": 1},
{"id": "c5174", "text": "2. A little bit", "quickKey": 2},
{"id": "c5175", "text": "3. Somewhat", "quickKey": 3},
{"id": "c5176", "text": "4. Quite a bit", "quickKey": 4},
{"id": "c5177", "text": "5. Very much", "quickKey": 5}
]},
{"id": "q8598", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "16. Fatigue: DURING THE PAST 7 DAYS how fatigued were you on average?",
"intro": "Please respond to each question or statement by selecting one answer.",
"columns": 1,
{"id": "c5167", "text": "5. Unable to do", "quickKey": 5}
"choices":[
{"id": "c5173", "text": "1. Not at all", "quickKey": 1},
{"id": "c5174", "text": "2. A little bit", "quickKey": 2},
{"id": "c5175", "text": "3. Somewhat", "quickKey": 3},
{"id": "c5176", "text": "4. Quite a bit", "quickKey": 4},
{"id": "c5177", "text": "5. Very much", "quickKey": 5}
]},
{"id": "q8599", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "17. Sleep Disturbance: IN THE PAST 7 DAYS my sleep quality was",
"intro": "Please respond to each question or statement by selecting one answer.",
]},
"columns": 1,
"choices":[
{"id": "c5178", "text": "1. Very Poor", "quickKey": 1},
{"id": "c5179", "text": "2. Poor", "quickKey": 2},
{"id": "c5180", "text": "3. Fair", "quickKey": 3},
{"id": "c5181", "text": "4. Good", "quickKey": 4},
{"id": "c5182", "text": "5. Very good", "quickKey": 5}
]},
{"id": "q8600", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "18. Sleep Disturbance: IN THE PAST 7 DAYS my sleep was refreshing.",
"copyright": "2008-2020 PROMIS Health Organization (PHO)",
{"id": "q8584", "type": "ChoiceQuestion", "required": true, "inline": false,
"intro": "Please respond to each question or statement by selecting one answer.",
"columns": 1,
"choices":[
{"id": "c5183", "text": "1. Not at all", "quickKey": 1},
{"id": "c5184", "text": "2. A little bit", "quickKey": 2},
{"id": "c5185", "text": "3. Somewhat", "quickKey": 3},
{"id": "c5186", "text": "4. Quite a bit", "quickKey": 4},
{"id": "c5187", "text": "5. Very much", "quickKey": 5}
]},
{"id": "q8601", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "2. Physical Function: Are you able to go up and down stairs at a normal pace?",
"text": "19. Sleep Disturbance: IN THE PAST 7 DAYS I had a problem with my sleep.",
"intro": "Please respond to each question or statement by selecting one answer.",
"columns": 1,
"choices":[
{"id": "c5173", "text": "1. Not at all", "quickKey": 1},
{"id": "c5174", "text": "2. A little bit", "quickKey": 2},
{"id": "c5175", "text": "3. Somewhat", "quickKey": 3},
{"id": "c5176", "text": "4. Quite a bit", "quickKey": 4},
{"id": "c5177", "text": "5. Very much", "quickKey": 5}
]},
"intro": "Please respond to each question or statement by selecting one answer.",
{"id": "q8602", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "20. Sleep Disturbance: IN THE PAST 7 DAYS I had difficulty falling asleep.",
"intro": "Please respond to each question or statement by selecting one answer.",
"columns": 1,
"choices":[
{"id": "c5173", "text": "1. Not at all", "quickKey": 1},
{"id": "c5174", "text": "2. A little bit", "quickKey": 2},
{"id": "c5175", "text": "3. Somewhat", "quickKey": 3},
{"id": "c5176", "text": "4. Quite a bit", "quickKey": 4},
{"id": "c5177", "text": "5. Very much", "quickKey": 5}
"columns": 1,
]},
{"id": "q8603", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "21. Ability to Participate in Social Roles and Activities: I have trouble doing
all of my regular leisure activities with others.",
"intro": "Please respond to each question or statement by selecting one answer.",
"columns": 1,
"choices":[
{"id": "c5188", "text": "1. Never", "quickKey": 1},
{"id": "c5189", "text": "2. Rarely", "quickKey": 2},
{"id": "c5190", "text": "3. Sometimes", "quickKey": 3},
"choices":[
{"id": "c5191", "text": "4. Usually", "quickKey": 4},
{"id": "c5192", "text": "5. Always", "quickKey": 5}
]},
{"id": "q8604", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "22. Ability to Participate in Social Roles and Activities: I have trouble doing
all of the family activities that I want to do.",
"intro": "Please respond to each question or statement by selecting one answer.",
"columns": 1,
"choices":[
{"id": "c5188", "text": "1. Never", "quickKey": 1},
{"id": "c5163", "text": "1. Without any difficulty", "quickKey": 1},
{"id": "c5189", "text": "2. Rarely", "quickKey": 2},
{"id": "c5190", "text": "3. Sometimes", "quickKey": 3},
{"id": "c5191", "text": "4. Usually", "quickKey": 4},
{"id": "c5192", "text": "5. Always", "quickKey": 5}
]},
{"id": "q8605", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "23. Ability to Participate in Social Roles and Activities: I have trouble doing
all of my usual work (include work at home).",
"intro": "Please respond to each question or statement by selecting one answer.",
"columns": 1,
{"id": "c5164", "text": "2. With a little difficulty", "quickKey": 2},
"choices":[
{"id": "c5188", "text": "1. Never", "quickKey": 1},
{"id": "c5189", "text": "2. Rarely", "quickKey": 2},
{"id": "c5190", "text": "3. Sometimes", "quickKey": 3},
{"id": "c5191", "text": "4. Usually", "quickKey": 4},
{"id": "c5192", "text": "5. Always", "quickKey": 5}
]},
{"id": "q8606", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "24. Ability to Participate in Social Roles and Activities: I have trouble doing
all of the activities with friends that I want to do.",
{"id": "c5165", "text": "3. With some difficulty", "quickKey": 3},
"intro": "Please respond to each question or statement by selecting one answer.",
"columns": 1,
"choices":[
{"id": "c5188", "text": "1. Never", "quickKey": 1},
{"id": "c5189", "text": "2. Rarely", "quickKey": 2},
{"id": "c5190", "text": "3. Sometimes", "quickKey": 3},
{"id": "c5191", "text": "4. Usually", "quickKey": 4},
{"id": "c5192", "text": "5. Always", "quickKey": 5}
]},
{"id": "q8607", "type": "ChoiceQuestion", "required": true, "inline": false,
{"id": "c5166", "text": "4. With much difficulty", "quickKey": 4},
"text": "25. Pain Interference: IN THE PAST 7 DAYS how much did pain interfere with your
day to day activities?",
"intro": "Please respond to each question or statement by selecting one answer.",
"columns": 1,
"choices":[
{"id": "c5173", "text": "1. Not at all", "quickKey": 1},
{"id": "c5174", "text": "2. A little bit", "quickKey": 2},
{"id": "c5175", "text": "3. Somewhat", "quickKey": 3},
{"id": "c5176", "text": "4. Quite a bit", "quickKey": 4},
{"id": "c5177", "text": "5. Very much", "quickKey": 5}
{"id": "c5167", "text": "5. Unable to do", "quickKey": 5}
]},
{"id": "q8608", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "26. Pain Interference: IN THE PAST 7 DAYS how much did pain interfere with work
around the home?",
"intro": "Please respond to each question or statement by selecting one answer.",
"columns": 1,
"choices":[
{"id": "c5173", "text": "1. Not at all", "quickKey": 1},
{"id": "c5174", "text": "2. A little bit", "quickKey": 2},
{"id": "c5175", "text": "3. Somewhat", "quickKey": 3},
"restartDays": 2,
]},
{"id": "c5176", "text": "4. Quite a bit", "quickKey": 4},
{"id": "c5177", "text": "5. Very much", "quickKey": 5}
]},
{"id": "q8609", "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": "Please respond to each question or statement by selecting one answer.",
"columns": 1,
"choices":[
{"id": "c5173", "text": "1. Not at all", "quickKey": 1},
{"id": "q8585", "type": "ChoiceQuestion", "required": true, "inline": false,
{"id": "c5174", "text": "2. A little bit", "quickKey": 2},
{"id": "c5175", "text": "3. Somewhat", "quickKey": 3},
{"id": "c5176", "text": "4. Quite a bit", "quickKey": 4},
{"id": "c5177", "text": "5. Very much", "quickKey": 5}
]},
{"id": "q8610", "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": "Please respond to each question or statement by selecting one answer.",
"columns": 1,
"text": "3. Physical Function: Are you able to go for a walk of at least 15 minutes?",
"choices":[
{"id": "c5173", "text": "1. Not at all", "quickKey": 1},
{"id": "c5174", "text": "2. A little bit", "quickKey": 2},
{"id": "c5175", "text": "3. Somewhat", "quickKey": 3},
{"id": "c5176", "text": "4. Quite a bit", "quickKey": 4},
{"id": "c5177", "text": "5. Very much", "quickKey": 5}
]},
{"id": "q8613", "type": "SliderQuestion", "required": true,
"text": "29. Pain Intensity: IN THE PAST 7 DAYS how would you rate your pain on average?",
"intro": "Please respond to each question or statement by selecting one answer.",
"intro": "Please respond to each question or statement by selecting one answer.",
"min": 0, "max": 10,
"legend":["No pain", "Worst pain imaginable"]}]
}
"columns": 1,
"choices":[
{"id": "c5163", "text": "1. Without any difficulty", "quickKey": 1},
{"id": "c5164", "text": "2. With a little difficulty", "quickKey": 2},
{"id": "c5165", "text": "3. With some difficulty", "quickKey": 3},
{"id": "c5166", "text": "4. With much difficulty", "quickKey": 4},
"printTitle": "Patient Reported Outcome Measurement Information System (PROMIS) 29 Profile v2.1",
{"id": "c5167", "text": "5. Unable to do", "quickKey": 5}
]},
{"id": "q8586", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "4. Physical Function: Are you able to run errands and shop?",
"intro": "Please respond to each question or statement by selecting one answer.",
"columns": 1,
"choices":[
{"id": "c5163", "text": "1. Without any difficulty", "quickKey": 1},
{"id": "c5164", "text": "2. With a little difficulty", "quickKey": 2},
{"id": "c5165", "text": "3. With some difficulty", "quickKey": 3},
"content":[
{"id": "c5166", "text": "4. With much difficulty", "quickKey": 4},
{"id": "c5167", "text": "5. Unable to do", "quickKey": 5}
]},
{"id": "q8587", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "5. Anxiety: IN THE PAST 7 DAYS I felt fearful.",
"intro": "Please respond to each question or statement by selecting one answer.",
"columns": 1,
"choices":[
{"id": "c5168", "text": "1. Never", "quickKey": 1},
{"id": "c5169", "text": "2. Rarely", "quickKey": 2},
{"id": "i2455", "type": "IntroText",
{"id": "c5170", "text": "3. Sometimes", "quickKey": 3},
{"id": "c5171", "text": "4. Often", "quickKey": 4},
{"id": "c5172", "text": "5. Always", "quickKey": 5}
]},
{"id": "q8588", "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": "Please respond to each question or statement by selecting one answer.",
"columns": 1,
"choices":[
"text": "Please respond to each question or statement by selecting one answer."
{"id": "c5168", "text": "1. Never", "quickKey": 1},
{"id": "c5169", "text": "2. Rarely", "quickKey": 2},
{"id": "c5170", "text": "3. Sometimes", "quickKey": 3},
{"id": "c5171", "text": "4. Often", "quickKey": 4},
{"id": "c5172", "text": "5. Always", "quickKey": 5}
]},
{"id": "q8589", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "7. Anxiety: IN THE PAST 7 DAYS my worries overwhelmed me.",
"intro": "Please respond to each question or statement by selecting one answer.",
"columns": 1,
},
"choices":[
{"id": "c5168", "text": "1. Never", "quickKey": 1},
{"id": "c5169", "text": "2. Rarely", "quickKey": 2},
{"id": "c5170", "text": "3. Sometimes", "quickKey": 3},
{"id": "c5171", "text": "4. Often", "quickKey": 4},
{"id": "c5172", "text": "5. Always", "quickKey": 5}
]},
{"id": "q8590", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "8. Anxiety: IN THE PAST 7 DAYS I felt uneasy.",
"intro": "Please respond to each question or statement by selecting one answer.",
{"id": "q8583", "type": "ChoiceQuestion", "required": true, "inline": false,
"columns": 1,
"choices":[
{"id": "c5168", "text": "1. Never", "quickKey": 1},
{"id": "c5169", "text": "2. Rarely", "quickKey": 2},
{"id": "c5170", "text": "3. Sometimes", "quickKey": 3},
{"id": "c5171", "text": "4. Often", "quickKey": 4},
{"id": "c5172", "text": "5. Always", "quickKey": 5}
]},
{"id": "q8591", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "9. Depression: IN THE PAST 7 DAYS I felt worthless.",
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