| ENTRY SPECIFICATION |
{"name": "PHQ-15",
{"id": "q5191", "type": "ChoiceQuestion", "required": false, "inline": true,
{"id": "q5304", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "j. Shortness of breath",
"intro": "During the past 4 weeks, how much have you been bothered by any of the following
problems? ",
"columns": 3,
"choices":[
{"id": "c2933", "text": "0. Not bothered at all", "quickKey": 0},
{"id": "c2934", "text": "1. Bothered a little", "quickKey": 1},
{"id": "c2935", "text": "2. Bothered a lot", "quickKey": 2}
]},
"text": "a. Stomach pain",
{"id": "q5305", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "k. Pain or problems during sexual intercourse",
"intro": "During the past 4 weeks, how much have you been bothered by any of the following
problems? ",
"columns": 3,
"choices":[
{"id": "c2933", "text": "0. Not bothered at all", "quickKey": 0},
{"id": "c2934", "text": "1. Bothered a little", "quickKey": 1},
{"id": "c2935", "text": "2. Bothered a lot", "quickKey": 2}
]},
"intro": "During the past 4 weeks, how much have you been bothered by any of the following
{"id": "q5306", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "l. Constipation, loose bowels, or diarrhea",
"intro": "During the past 4 weeks, how much have you been bothered by any of the following
problems? ",
"columns": 3,
"choices":[
{"id": "c2933", "text": "0. Not bothered at all", "quickKey": 0},
{"id": "c2934", "text": "1. Bothered a little", "quickKey": 1},
{"id": "c2935", "text": "2. Bothered a lot", "quickKey": 2}
]},
problems? ",
{"id": "q5307", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "m. Nausea, gas, or indigestion",
"intro": "During the past 4 weeks, how much have you been bothered by any of the following
problems? ",
"columns": 3,
"choices":[
{"id": "c2933", "text": "0. Not bothered at all", "quickKey": 0},
{"id": "c2934", "text": "1. Bothered a little", "quickKey": 1},
{"id": "c2935", "text": "2. Bothered a lot", "quickKey": 2}
]},
"columns": 3,
{"id": "q5308", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "n. Feeling tired or having low energy",
"intro": "During the past 4 weeks, how much have you been bothered by any of the following
problems? ",
"columns": 3,
"choices":[
{"id": "c2933", "text": "0. Not bothered at all", "quickKey": 0},
{"id": "c2934", "text": "1. Bothered a little", "quickKey": 1},
{"id": "c2935", "text": "2. Bothered a lot", "quickKey": 2}
]},
"choices":[
{"id": "q5400", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "o. Trouble sleeping",
"intro": "During the past 4 weeks, how much have you been bothered by any of the following
problems? ",
"columns": 3,
"choices":[
{"id": "c2933", "text": "0. Not bothered at all", "quickKey": 0},
{"id": "c2934", "text": "1. Bothered a little", "quickKey": 1},
{"id": "c2935", "text": "2. Bothered a lot", "quickKey": 2}
]}]
{"id": "c2933", "text": "0. Not bothered at all", "quickKey": 0},
}
{"id": "c2934", "text": "1. Bothered a little", "quickKey": 1},
{"id": "c2935", "text": "2. Bothered a lot", "quickKey": 2}
]},
"copyright": "Copyright (c) Pfizer Inc. All rights reserved. Reproduced with permission.",
{"id": "q5192", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "b. Back pain",
"intro": "During the past 4 weeks, how much have you been bothered by any of the following
problems? ",
"columns": 3,
"choices":[
{"id": "c2933", "text": "0. Not bothered at all", "quickKey": 0},
{"id": "c2934", "text": "1. Bothered a little", "quickKey": 1},
{"id": "c2935", "text": "2. Bothered a lot", "quickKey": 2}
]},
"restartDays": 2,
{"id": "q5297", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "c. Pain in your arms, legs, or joints (knees, hips, etc.)",
"intro": "During the past 4 weeks, how much have you been bothered by any of the following
problems? ",
"columns": 3,
"choices":[
{"id": "c2933", "text": "0. Not bothered at all", "quickKey": 0},
{"id": "c2934", "text": "1. Bothered a little", "quickKey": 1},
{"id": "c2935", "text": "2. Bothered a lot", "quickKey": 2}
]},
"printTitle": "Patient Health Questionnaire 15-Item Somatic Symptom Severity Scale",
{"id": "q5298", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "d. Menstrual cramps or other problems with your periods [Women only]",
"intro": "During the past 4 weeks, how much have you been bothered by any of the following
problems? ",
"columns": 3,
"choices":[
{"id": "c2933", "text": "0. Not bothered at all", "quickKey": 0},
{"id": "c2934", "text": "1. Bothered a little", "quickKey": 1},
{"id": "c2935", "text": "2. Bothered a lot", "quickKey": 2}
]},
"content":[
{"id": "q5299", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "e. Headaches",
"intro": "During the past 4 weeks, how much have you been bothered by any of the following
problems? ",
"columns": 3,
"choices":[
{"id": "c2933", "text": "0. Not bothered at all", "quickKey": 0},
{"id": "c2934", "text": "1. Bothered a little", "quickKey": 1},
{"id": "c2935", "text": "2. Bothered a lot", "quickKey": 2}
]},
{"id": "i599", "type": "IntroText",
{"id": "q5300", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "f. Chest pain",
"intro": "During the past 4 weeks, how much have you been bothered by any of the following
problems? ",
"columns": 3,
"choices":[
{"id": "c2933", "text": "0. Not bothered at all", "quickKey": 0},
{"id": "c2934", "text": "1. Bothered a little", "quickKey": 1},
{"id": "c2935", "text": "2. Bothered a lot", "quickKey": 2}
]},
"text": "During the past 4 weeks, how much have you been bothered by any of the following
{"id": "q5301", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "g. Dizziness",
"intro": "During the past 4 weeks, how much have you been bothered by any of the following
problems? ",
"columns": 3,
"choices":[
{"id": "c2933", "text": "0. Not bothered at all", "quickKey": 0},
{"id": "c2934", "text": "1. Bothered a little", "quickKey": 1},
{"id": "c2935", "text": "2. Bothered a lot", "quickKey": 2}
]},
problems? "
{"id": "q5302", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "h. Fainting spells",
"intro": "During the past 4 weeks, how much have you been bothered by any of the following
problems? ",
"columns": 3,
"choices":[
{"id": "c2933", "text": "0. Not bothered at all", "quickKey": 0},
{"id": "c2934", "text": "1. Bothered a little", "quickKey": 1},
{"id": "c2935", "text": "2. Bothered a lot", "quickKey": 2}
]},
},
{"id": "q5303", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "i. Feeling your heart pound or race",
"intro": "During the past 4 weeks, how much have you been bothered by any of the following
problems? ",
"columns": 3,
"choices":[
{"id": "c2933", "text": "0. Not bothered at all", "quickKey": 0},
{"id": "c2934", "text": "1. Bothered a little", "quickKey": 1},
{"id": "c2935", "text": "2. Bothered a lot", "quickKey": 2}
]},
|
