| ENTRY SPECIFICATION |
{"name": "NSI FOR TBI",
},
track symptoms over time. Please do not attempt to score.",
"columns": 1,
"choices":[
{"id": "c6175", "text": "0. None - Rarely if ever present; not a problem at all", "quickKey": 0},
{"id": "c6176", "text": "1. Mild - Occasionally present, but it does not disrupt my activities; I can
usually continue what I'm doing; doesn't really concern me.", "quickKey": 1},
{"id": "c6177", "text": "2. Moderate - Often present, occasionally disrupts my activities; I can usually
continue what I'm doing with some effort; I feel somewhat concerned.", "quickKey": 2},
{"id": "c6178", "text": "3. Severe - Frequently present and disrupts activities; I can only do things
that are fairly simple or take little effort; I feel I need help.", "quickKey": 3},
{"id": "q9567", "type": "ChoiceQuestion", "required": true, "inline": false,
{"id": "c6179", "text": "4. Very Severe - Almost always present and I have been unable to perform at work,
school or home due to this.", "quickKey": 4}
]},
{"id": "q9573", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "7. Sensitivity to light",
"intro": "Symptom Report <br />Please rate the following symptoms with regard to how much
they have disturbed you SINCE YOUR INJURY. The purpose of this inventory is to
track symptoms over time. Please do not attempt to score.",
"columns": 1,
"choices":[
"text": "1. Feeling dizzy",
{"id": "c6175", "text": "0. None - Rarely if ever present; not a problem at all", "quickKey": 0},
{"id": "c6176", "text": "1. Mild - Occasionally present, but it does not disrupt my activities; I can
usually continue what I'm doing; doesn't really concern me.", "quickKey": 1},
{"id": "c6177", "text": "2. Moderate - Often present, occasionally disrupts my activities; I can usually
continue what I'm doing with some effort; I feel somewhat concerned.", "quickKey": 2},
{"id": "c6178", "text": "3. Severe - Frequently present and disrupts activities; I can only do things
that are fairly simple or take little effort; I feel I need help.", "quickKey": 3},
{"id": "c6179", "text": "4. Very Severe - Almost always present and I have been unable to perform at work,
school or home due to this.", "quickKey": 4}
]},
"intro": "Symptom Report <br />Please rate the following symptoms with regard to how much
{"id": "q9574", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "8. Hearing difficulty",
"intro": "Symptom Report <br />Please rate the following symptoms with regard to how much
they have disturbed you SINCE YOUR INJURY. The purpose of this inventory is to
track symptoms over time. Please do not attempt to score.",
"columns": 1,
"choices":[
{"id": "c6175", "text": "0. None - Rarely if ever present; not a problem at all", "quickKey": 0},
{"id": "c6176", "text": "1. Mild - Occasionally present, but it does not disrupt my activities; I can
usually continue what I'm doing; doesn't really concern me.", "quickKey": 1},
they have disturbed you SINCE YOUR INJURY. The purpose of this inventory is to
{"id": "c6177", "text": "2. Moderate - Often present, occasionally disrupts my activities; I can usually
continue what I'm doing with some effort; I feel somewhat concerned.", "quickKey": 2},
{"id": "c6178", "text": "3. Severe - Frequently present and disrupts activities; I can only do things
that are fairly simple or take little effort; I feel I need help.", "quickKey": 3},
{"id": "c6179", "text": "4. Very Severe - Almost always present and I have been unable to perform at work,
school or home due to this.", "quickKey": 4}
]},
{"id": "q9575", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "9. Sensitivity to noise",
"intro": "Symptom Report <br />Please rate the following symptoms with regard to how much
track symptoms over time. Please do not attempt to score.",
they have disturbed you SINCE YOUR INJURY. The purpose of this inventory is to
track symptoms over time. Please do not attempt to score.",
"columns": 1,
"choices":[
{"id": "c6175", "text": "0. None - Rarely if ever present; not a problem at all", "quickKey": 0},
{"id": "c6176", "text": "1. Mild - Occasionally present, but it does not disrupt my activities; I can
usually continue what I'm doing; doesn't really concern me.", "quickKey": 1},
{"id": "c6177", "text": "2. Moderate - Often present, occasionally disrupts my activities; I can usually
continue what I'm doing with some effort; I feel somewhat concerned.", "quickKey": 2},
{"id": "c6178", "text": "3. Severe - Frequently present and disrupts activities; I can only do things
"columns": 1,
that are fairly simple or take little effort; I feel I need help.", "quickKey": 3},
{"id": "c6179", "text": "4. Very Severe - Almost always present and I have been unable to perform at work,
school or home due to this.", "quickKey": 4}
]},
{"id": "q9576", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "10. Numbness or tingling on parts of my body",
"intro": "Symptom Report <br />Please rate the following symptoms with regard to how much
they have disturbed you SINCE YOUR INJURY. The purpose of this inventory is to
track symptoms over time. Please do not attempt to score.",
"columns": 1,
"choices":[
"choices":[
{"id": "c6175", "text": "0. None - Rarely if ever present; not a problem at all", "quickKey": 0},
{"id": "c6176", "text": "1. Mild - Occasionally present, but it does not disrupt my activities; I can
usually continue what I'm doing; doesn't really concern me.", "quickKey": 1},
{"id": "c6177", "text": "2. Moderate - Often present, occasionally disrupts my activities; I can usually
continue what I'm doing with some effort; I feel somewhat concerned.", "quickKey": 2},
{"id": "c6178", "text": "3. Severe - Frequently present and disrupts activities; I can only do things
that are fairly simple or take little effort; I feel I need help.", "quickKey": 3},
{"id": "c6179", "text": "4. Very Severe - Almost always present and I have been unable to perform at work,
school or home due to this.", "quickKey": 4}
{"id": "c6175", "text": "0. None - Rarely if ever present; not a problem at all", "quickKey": 0},
]},
{"id": "q9577", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "11. Change in taste and/or smell",
"intro": "Symptom Report <br />Please rate the following symptoms with regard to how much
they have disturbed you SINCE YOUR INJURY. The purpose of this inventory is to
track symptoms over time. Please do not attempt to score.",
"columns": 1,
"choices":[
{"id": "c6175", "text": "0. None - Rarely if ever present; not a problem at all", "quickKey": 0},
{"id": "c6176", "text": "1. Mild - Occasionally present, but it does not disrupt my activities; I can
{"id": "c6176", "text": "1. Mild - Occasionally present, but it does not disrupt my activities; I can
usually continue what I'm doing; doesn't really concern me.", "quickKey": 1},
{"id": "c6177", "text": "2. Moderate - Often present, occasionally disrupts my activities; I can usually
continue what I'm doing with some effort; I feel somewhat concerned.", "quickKey": 2},
{"id": "c6178", "text": "3. Severe - Frequently present and disrupts activities; I can only do things
that are fairly simple or take little effort; I feel I need help.", "quickKey": 3},
{"id": "c6179", "text": "4. Very Severe - Almost always present and I have been unable to perform at work,
school or home due to this.", "quickKey": 4}
]},
{"id": "q9578", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "12. Loss of appetite or increased appetite",
"copyright": "Used with permission: Cicerone,KD: J Head Tr Rehabil 1995;10(3):1-17",
usually continue what I'm doing; doesn't really concern me.", "quickKey": 1},
"intro": "Symptom Report <br />Please rate the following symptoms with regard to how much
they have disturbed you SINCE YOUR INJURY. The purpose of this inventory is to
track symptoms over time. Please do not attempt to score.",
"columns": 1,
"choices":[
{"id": "c6175", "text": "0. None - Rarely if ever present; not a problem at all", "quickKey": 0},
{"id": "c6176", "text": "1. Mild - Occasionally present, but it does not disrupt my activities; I can
usually continue what I'm doing; doesn't really concern me.", "quickKey": 1},
{"id": "c6177", "text": "2. Moderate - Often present, occasionally disrupts my activities; I can usually
continue what I'm doing with some effort; I feel somewhat concerned.", "quickKey": 2},
{"id": "c6177", "text": "2. Moderate - Often present, occasionally disrupts my activities; I can usually
{"id": "c6178", "text": "3. Severe - Frequently present and disrupts activities; I can only do things
that are fairly simple or take little effort; I feel I need help.", "quickKey": 3},
{"id": "c6179", "text": "4. Very Severe - Almost always present and I have been unable to perform at work,
school or home due to this.", "quickKey": 4}
]},
{"id": "q9579", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "13. Poor concentration, can't pay attention, easily distracted",
"intro": "Symptom Report <br />Please rate the following symptoms with regard to how much
they have disturbed you SINCE YOUR INJURY. The purpose of this inventory is to
track symptoms over time. Please do not attempt to score.",
continue what I'm doing with some effort; I feel somewhat concerned.", "quickKey": 2},
"columns": 1,
"choices":[
{"id": "c6175", "text": "0. None - Rarely if ever present; not a problem at all", "quickKey": 0},
{"id": "c6176", "text": "1. Mild - Occasionally present, but it does not disrupt my activities; I can
usually continue what I'm doing; doesn't really concern me.", "quickKey": 1},
{"id": "c6177", "text": "2. Moderate - Often present, occasionally disrupts my activities; I can usually
continue what I'm doing with some effort; I feel somewhat concerned.", "quickKey": 2},
{"id": "c6178", "text": "3. Severe - Frequently present and disrupts activities; I can only do things
that are fairly simple or take little effort; I feel I need help.", "quickKey": 3},
{"id": "c6179", "text": "4. Very Severe - Almost always present and I have been unable to perform at work,
{"id": "c6178", "text": "3. Severe - Frequently present and disrupts activities; I can only do things
school or home due to this.", "quickKey": 4}
]},
{"id": "q9580", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "14. Forgetfulness, can't remember things",
"intro": "Symptom Report <br />Please rate the following symptoms with regard to how much
they have disturbed you SINCE YOUR INJURY. The purpose of this inventory is to
track symptoms over time. Please do not attempt to score.",
"columns": 1,
"choices":[
{"id": "c6175", "text": "0. None - Rarely if ever present; not a problem at all", "quickKey": 0},
that are fairly simple or take little effort; I feel I need help.", "quickKey": 3},
{"id": "c6176", "text": "1. Mild - Occasionally present, but it does not disrupt my activities; I can
usually continue what I'm doing; doesn't really concern me.", "quickKey": 1},
{"id": "c6177", "text": "2. Moderate - Often present, occasionally disrupts my activities; I can usually
continue what I'm doing with some effort; I feel somewhat concerned.", "quickKey": 2},
{"id": "c6178", "text": "3. Severe - Frequently present and disrupts activities; I can only do things
that are fairly simple or take little effort; I feel I need help.", "quickKey": 3},
{"id": "c6179", "text": "4. Very Severe - Almost always present and I have been unable to perform at work,
school or home due to this.", "quickKey": 4}
]},
{"id": "q9581", "type": "ChoiceQuestion", "required": true, "inline": false,
{"id": "c6179", "text": "4. Very Severe - Almost always present and I have been unable to perform at work,
"text": "15. Difficulty making decisions",
"intro": "Symptom Report <br />Please rate the following symptoms with regard to how much
they have disturbed you SINCE YOUR INJURY. The purpose of this inventory is to
track symptoms over time. Please do not attempt to score.",
"columns": 1,
"choices":[
{"id": "c6175", "text": "0. None - Rarely if ever present; not a problem at all", "quickKey": 0},
{"id": "c6176", "text": "1. Mild - Occasionally present, but it does not disrupt my activities; I can
usually continue what I'm doing; doesn't really concern me.", "quickKey": 1},
{"id": "c6177", "text": "2. Moderate - Often present, occasionally disrupts my activities; I can usually
school or home due to this.", "quickKey": 4}
continue what I'm doing with some effort; I feel somewhat concerned.", "quickKey": 2},
{"id": "c6178", "text": "3. Severe - Frequently present and disrupts activities; I can only do things
that are fairly simple or take little effort; I feel I need help.", "quickKey": 3},
{"id": "c6179", "text": "4. Very Severe - Almost always present and I have been unable to perform at work,
school or home due to this.", "quickKey": 4}
]},
{"id": "q9582", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "16. Slowed thinking, difficulty getting organized, can't finish things",
"intro": "Symptom Report <br />Please rate the following symptoms with regard to how much
they have disturbed you SINCE YOUR INJURY. The purpose of this inventory is to
]},
track symptoms over time. Please do not attempt to score.",
"columns": 1,
"choices":[
{"id": "c6175", "text": "0. None - Rarely if ever present; not a problem at all", "quickKey": 0},
{"id": "c6176", "text": "1. Mild - Occasionally present, but it does not disrupt my activities; I can
usually continue what I'm doing; doesn't really concern me.", "quickKey": 1},
{"id": "c6177", "text": "2. Moderate - Often present, occasionally disrupts my activities; I can usually
continue what I'm doing with some effort; I feel somewhat concerned.", "quickKey": 2},
{"id": "c6178", "text": "3. Severe - Frequently present and disrupts activities; I can only do things
that are fairly simple or take little effort; I feel I need help.", "quickKey": 3},
{"id": "q9568", "type": "ChoiceQuestion", "required": true, "inline": false,
{"id": "c6179", "text": "4. Very Severe - Almost always present and I have been unable to perform at work,
school or home due to this.", "quickKey": 4}
]},
{"id": "q9583", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "17. Fatigue, loss of energy, getting tired easily",
"intro": "Symptom Report <br />Please rate the following symptoms with regard to how much
they have disturbed you SINCE YOUR INJURY. The purpose of this inventory is to
track symptoms over time. Please do not attempt to score.",
"columns": 1,
"choices":[
"text": "2. Loss of balance",
{"id": "c6175", "text": "0. None - Rarely if ever present; not a problem at all", "quickKey": 0},
{"id": "c6176", "text": "1. Mild - Occasionally present, but it does not disrupt my activities; I can
usually continue what I'm doing; doesn't really concern me.", "quickKey": 1},
{"id": "c6177", "text": "2. Moderate - Often present, occasionally disrupts my activities; I can usually
continue what I'm doing with some effort; I feel somewhat concerned.", "quickKey": 2},
{"id": "c6178", "text": "3. Severe - Frequently present and disrupts activities; I can only do things
that are fairly simple or take little effort; I feel I need help.", "quickKey": 3},
{"id": "c6179", "text": "4. Very Severe - Almost always present and I have been unable to perform at work,
school or home due to this.", "quickKey": 4}
]},
"restartDays": 2,
"intro": "Symptom Report <br />Please rate the following symptoms with regard to how much
{"id": "q9584", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "18. Difficulty falling or staying asleep",
"intro": "Symptom Report <br />Please rate the following symptoms with regard to how much
they have disturbed you SINCE YOUR INJURY. The purpose of this inventory is to
track symptoms over time. Please do not attempt to score.",
"columns": 1,
"choices":[
{"id": "c6175", "text": "0. None - Rarely if ever present; not a problem at all", "quickKey": 0},
{"id": "c6176", "text": "1. Mild - Occasionally present, but it does not disrupt my activities; I can
usually continue what I'm doing; doesn't really concern me.", "quickKey": 1},
they have disturbed you SINCE YOUR INJURY. The purpose of this inventory is to
{"id": "c6177", "text": "2. Moderate - Often present, occasionally disrupts my activities; I can usually
continue what I'm doing with some effort; I feel somewhat concerned.", "quickKey": 2},
{"id": "c6178", "text": "3. Severe - Frequently present and disrupts activities; I can only do things
that are fairly simple or take little effort; I feel I need help.", "quickKey": 3},
{"id": "c6179", "text": "4. Very Severe - Almost always present and I have been unable to perform at work,
school or home due to this.", "quickKey": 4}
]},
{"id": "q9585", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "19. Feeling anxious or tense",
"intro": "Symptom Report <br />Please rate the following symptoms with regard to how much
track symptoms over time. Please do not attempt to score.",
they have disturbed you SINCE YOUR INJURY. The purpose of this inventory is to
track symptoms over time. Please do not attempt to score.",
"columns": 1,
"choices":[
{"id": "c6175", "text": "0. None - Rarely if ever present; not a problem at all", "quickKey": 0},
{"id": "c6176", "text": "1. Mild - Occasionally present, but it does not disrupt my activities; I can
usually continue what I'm doing; doesn't really concern me.", "quickKey": 1},
{"id": "c6177", "text": "2. Moderate - Often present, occasionally disrupts my activities; I can usually
continue what I'm doing with some effort; I feel somewhat concerned.", "quickKey": 2},
{"id": "c6178", "text": "3. Severe - Frequently present and disrupts activities; I can only do things
"columns": 1,
that are fairly simple or take little effort; I feel I need help.", "quickKey": 3},
{"id": "c6179", "text": "4. Very Severe - Almost always present and I have been unable to perform at work,
school or home due to this.", "quickKey": 4}
]},
{"id": "q9586", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "20. Feeling depressed or sad",
"intro": "Symptom Report <br />Please rate the following symptoms with regard to how much
they have disturbed you SINCE YOUR INJURY. The purpose of this inventory is to
track symptoms over time. Please do not attempt to score.",
"columns": 1,
"choices":[
"choices":[
{"id": "c6175", "text": "0. None - Rarely if ever present; not a problem at all", "quickKey": 0},
{"id": "c6176", "text": "1. Mild - Occasionally present, but it does not disrupt my activities; I can
usually continue what I'm doing; doesn't really concern me.", "quickKey": 1},
{"id": "c6177", "text": "2. Moderate - Often present, occasionally disrupts my activities; I can usually
continue what I'm doing with some effort; I feel somewhat concerned.", "quickKey": 2},
{"id": "c6178", "text": "3. Severe - Frequently present and disrupts activities; I can only do things
that are fairly simple or take little effort; I feel I need help.", "quickKey": 3},
{"id": "c6179", "text": "4. Very Severe - Almost always present and I have been unable to perform at work,
school or home due to this.", "quickKey": 4}
{"id": "c6175", "text": "0. None - Rarely if ever present; not a problem at all", "quickKey": 0},
]},
{"id": "q9587", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "21. Irritability, easily annoyed",
"intro": "Symptom Report <br />Please rate the following symptoms with regard to how much
they have disturbed you SINCE YOUR INJURY. The purpose of this inventory is to
track symptoms over time. Please do not attempt to score.",
"columns": 1,
"choices":[
{"id": "c6175", "text": "0. None - Rarely if ever present; not a problem at all", "quickKey": 0},
{"id": "c6176", "text": "1. Mild - Occasionally present, but it does not disrupt my activities; I can
{"id": "c6176", "text": "1. Mild - Occasionally present, but it does not disrupt my activities; I can
usually continue what I'm doing; doesn't really concern me.", "quickKey": 1},
{"id": "c6177", "text": "2. Moderate - Often present, occasionally disrupts my activities; I can usually
continue what I'm doing with some effort; I feel somewhat concerned.", "quickKey": 2},
{"id": "c6178", "text": "3. Severe - Frequently present and disrupts activities; I can only do things
that are fairly simple or take little effort; I feel I need help.", "quickKey": 3},
{"id": "c6179", "text": "4. Very Severe - Almost always present and I have been unable to perform at work,
school or home due to this.", "quickKey": 4}
]},
{"id": "q9588", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "22. Poor frustration tolerance, feeling easily overwhelmed by things",
usually continue what I'm doing; doesn't really concern me.", "quickKey": 1},
"intro": "Symptom Report <br />Please rate the following symptoms with regard to how much
they have disturbed you SINCE YOUR INJURY. The purpose of this inventory is to
track symptoms over time. Please do not attempt to score.",
"columns": 1,
"choices":[
{"id": "c6175", "text": "0. None - Rarely if ever present; not a problem at all", "quickKey": 0},
{"id": "c6176", "text": "1. Mild - Occasionally present, but it does not disrupt my activities; I can
usually continue what I'm doing; doesn't really concern me.", "quickKey": 1},
{"id": "c6177", "text": "2. Moderate - Often present, occasionally disrupts my activities; I can usually
continue what I'm doing with some effort; I feel somewhat concerned.", "quickKey": 2},
{"id": "c6177", "text": "2. Moderate - Often present, occasionally disrupts my activities; I can usually
{"id": "c6178", "text": "3. Severe - Frequently present and disrupts activities; I can only do things
that are fairly simple or take little effort; I feel I need help.", "quickKey": 3},
{"id": "c6179", "text": "4. Very Severe - Almost always present and I have been unable to perform at work,
school or home due to this.", "quickKey": 4}
]}]
}
continue what I'm doing with some effort; I feel somewhat concerned.", "quickKey": 2},
"printTitle": "Neurobehavioral Symptom Inventory for Traumatic Brain Injury",
{"id": "c6178", "text": "3. Severe - Frequently present and disrupts activities; I can only do things
that are fairly simple or take little effort; I feel I need help.", "quickKey": 3},
{"id": "c6179", "text": "4. Very Severe - Almost always present and I have been unable to perform at work,
school or home due to this.", "quickKey": 4}
]},
{"id": "q9569", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "3. Poor coordination, clumsy",
"intro": "Symptom Report <br />Please rate the following symptoms with regard to how much
they have disturbed you SINCE YOUR INJURY. The purpose of this inventory is to
track symptoms over time. Please do not attempt to score.",
"content":[
"columns": 1,
"choices":[
{"id": "c6175", "text": "0. None - Rarely if ever present; not a problem at all", "quickKey": 0},
{"id": "c6176", "text": "1. Mild - Occasionally present, but it does not disrupt my activities; I can
usually continue what I'm doing; doesn't really concern me.", "quickKey": 1},
{"id": "c6177", "text": "2. Moderate - Often present, occasionally disrupts my activities; I can usually
continue what I'm doing with some effort; I feel somewhat concerned.", "quickKey": 2},
{"id": "c6178", "text": "3. Severe - Frequently present and disrupts activities; I can only do things
that are fairly simple or take little effort; I feel I need help.", "quickKey": 3},
{"id": "c6179", "text": "4. Very Severe - Almost always present and I have been unable to perform at work,
{"id": "i2617", "type": "IntroText",
school or home due to this.", "quickKey": 4}
]},
{"id": "q9570", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "4. Headaches",
"intro": "Symptom Report <br />Please rate the following symptoms with regard to how much
they have disturbed you SINCE YOUR INJURY. The purpose of this inventory is to
track symptoms over time. Please do not attempt to score.",
"columns": 1,
"choices":[
{"id": "c6175", "text": "0. None - Rarely if ever present; not a problem at all", "quickKey": 0},
"text": "Symptom Report <br />Please rate the following symptoms with regard to how much
{"id": "c6176", "text": "1. Mild - Occasionally present, but it does not disrupt my activities; I can
usually continue what I'm doing; doesn't really concern me.", "quickKey": 1},
{"id": "c6177", "text": "2. Moderate - Often present, occasionally disrupts my activities; I can usually
continue what I'm doing with some effort; I feel somewhat concerned.", "quickKey": 2},
{"id": "c6178", "text": "3. Severe - Frequently present and disrupts activities; I can only do things
that are fairly simple or take little effort; I feel I need help.", "quickKey": 3},
{"id": "c6179", "text": "4. Very Severe - Almost always present and I have been unable to perform at work,
school or home due to this.", "quickKey": 4}
]},
{"id": "q9571", "type": "ChoiceQuestion", "required": true, "inline": false,
they have disturbed you SINCE YOUR INJURY. The purpose of this inventory is to
"text": "5. Nausea",
"intro": "Symptom Report <br />Please rate the following symptoms with regard to how much
they have disturbed you SINCE YOUR INJURY. The purpose of this inventory is to
track symptoms over time. Please do not attempt to score.",
"columns": 1,
"choices":[
{"id": "c6175", "text": "0. None - Rarely if ever present; not a problem at all", "quickKey": 0},
{"id": "c6176", "text": "1. Mild - Occasionally present, but it does not disrupt my activities; I can
usually continue what I'm doing; doesn't really concern me.", "quickKey": 1},
{"id": "c6177", "text": "2. Moderate - Often present, occasionally disrupts my activities; I can usually
track symptoms over time. Please do not attempt to score."
continue what I'm doing with some effort; I feel somewhat concerned.", "quickKey": 2},
{"id": "c6178", "text": "3. Severe - Frequently present and disrupts activities; I can only do things
that are fairly simple or take little effort; I feel I need help.", "quickKey": 3},
{"id": "c6179", "text": "4. Very Severe - Almost always present and I have been unable to perform at work,
school or home due to this.", "quickKey": 4}
]},
{"id": "q9572", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "6. Vision problems, blurring, trouble seeing",
"intro": "Symptom Report <br />Please rate the following symptoms with regard to how much
they have disturbed you SINCE YOUR INJURY. The purpose of this inventory is to
|
