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ext":"EMPLOYMENT","max":0,"min":0,"questionDisplay":81372,"questionId":9047,"questionText":"Any other comments\/concerns","required":false,"responseTypeId":5,"responseTypeText":"MEMO","sequence":690},{"choiceDisplay":81351,"choiceTypeId":nu
ll,"designator":19,"hint":null,"id":9113,"instrument":309,"introDisplay":81371,"introId":2517,"introText":"PARTNER \/ FAMILY \/ CAREGIVER PERSPECTIVE","max":0,"min":0,"questionDisplay":81372,"questionId":9048,"questionText":"This is space f
229,"legacyValue":3,"sequence":4}],"choiceDisplay":81351,"choiceIdentifier":0,"choiceIdentifierIen":42358,"choiceTypeId":15113,"designator":"1a)","hint":null,"id":9044,"instrument":309,"introDisplay":81371,"introId":2499,"introText":"SYMPTO
":2},{"choiceId":5546,"choiceText":"Moderate problem; affects daily life to a certain extent","ien":109232,"legacyValue":2,"sequence":3},{"choiceId":5547,"choiceText":"Severe problem; affects all aspects of daily life; life-disturbing","ien
or your partner, family or caregiver to add anything from their perspective","required":false,"responseTypeId":5,"responseTypeText":"MEMO","sequence":700}],"display":[{"alignment":"L","columns":1,"component":"RA","fontBold":false,"fontColor
":"clWindowText","fontItalic":false,"fontName":"MS Sans Serif","fontSize":8,"fontUnderlined":false,"id":81351,"left":8,"mask":"662|||"},{"alignment":"L","columns":0,"component":null,"fontBold":false,"fontColor":"clWindowText","fontItalic":f
alse,"fontName":"MS Sans Serif","fontSize":8,"fontUnderlined":false,"id":81371,"left":3,"mask":null},{"alignment":"L","columns":0,"component":null,"fontBold":false,"fontColor":"clWindowText","fontItalic":false,"fontName":"MS Sans Serif","fo
ntSize":8,"fontUnderlined":false,"id":81372,"left":2,"mask":null},{"alignment":"L","columns":0,"component":"TR","fontBold":false,"fontColor":"clWindowText","fontItalic":false,"fontName":"MS Sans Serif","fontSize":8,"fontUnderlined":false,"i
d":81373,"left":30,"mask":"NA"}],"info":{"author":"Sivan M, et al.","auxDate":null,"auxVersion":null,"copyrightText":"University of Leeds IP Limited","copyrighted":true,"dllDate":null,"dllVersion":null,"enteredBy":"Kevin Meldrum","entryDate
":"2023-01-20","fullText":true,"id":309,"interpretiveText":null,"lastEditDate":3230808.1229,"lastEditedBy":"Kevin Meldrum","legacy":false,"licenseCurrent":false,"name":"C19-YRS","national":false,"normSample":null,"operational":"Y","printTit
le":"Modified COVID-19 Yorkshire Rehabilitation Screening (C19-YRS)","publicationDate":null,"publisher":"University of Leeds","purpose":
"Outcome measure for Long Covid or Post-COVID-19 Syndrome","reference":"Sivan M, Preston N, Parkin A, Makower S, Gee J, Ross D, Tarrant R, Davison J, Halpin S, O'Connor RJ, Horton M. The modified COVID-19 Yorkshire Rehabilitation Scale (C19
-YRSm) patient-reported outcome measure for Long Covid or Post-COVID-19 syndrome. J Med Virol. 2022 Sep;94(9):4253-4264. doi: 10.1002\/jmv.27878. Epub 2022 Jun 1. PMID: 35603810; PMCID: PMC9348420.","requireSignature":false,"requiresLicense
":"N","scoringRevision":2,"scoringRoutine":"YTSC19Y","scoringTag":"DLLSTR","staffOnly":null,"submitNational":true,"suicideriskRoutine":null,"suicideriskTag":null,"targetPopulation":null,"version":null,"wasOperational":true},"report":{"id":2
":109233,"legacyValue":3,"sequence":4},{"choiceId":5548,"choiceText":"Don't know","ien":109234,"legacyValue":4,"sequence":5}],"choiceDisplay":81351,"choiceIdentifier":0,"choiceIdentifierIen":42359,"choiceTypeId":15114,"designator":"1c)","hi
29,"instrument":309,"template":"Modified COVID-19 Yorkshire Rehabilitation Screening (C19-YRS)\r\n|\r\n| Date Given: <.Date_Given.>\r\n| Clinician: <.Staff_Ordered_By.>\r\n| Location: <.Location.>\r\n|\r\n| Veteran: <.Patient_Name
_Last_First.>\r\n| SSN: <.Patient_SSN.>\r\n| DOB: <.Patient_Date_Of_Birth.> (<.Patient_Age.>)\r\n| Gender: <.Patient_Gender.>\r\n|\r\n<*Answer_7771*>\r\n|\r\n|\r\n<*Answer_7772*>\r\n|\r\n|Information contained in this note is based on
a self-report assessment\r\n|and is not sufficient to use alone for diagnostic purposes. Assessment\r\n|results should be verified for accuracy and used in conjunction with\r\n|other diagnostic activities."},"scaleGroup":[{"grid1":0,"grid2
":0,"grid3":0,"id":367,"instrument":309,"name":"Symptom Severity","ordInc":5,"ordMax":30,"ordMin":0,"ordTitle":"Score","scale":[{"groupId":367,"id":1495,"name":"Symptom Severity Now","sequence":1,"xLabel":"SYM"},{"groupId":367,"id":1496,"na
me":"Symptom Severity Pre-COVID","sequence":2,"xLabel":"SYMPC"}],"sequence":1},{"grid1":0,"grid2":0,"grid3":0,"id":368,"instrument":309,"name":"Functional Disability","ordInc":3,"ordMax":15,"ordMin":0,"ordTitle":"Score","scale":[{"groupId":
368,"id":1497,"name":"Functional Disability Now","sequence":1,"xLabel":"DIS"},{"groupId":368,"id":1498,"name":"Functional Disability Pre-COVID","sequence":2,"xLabel":"DISPC"}],"sequence":2},{"grid1":null,"grid2":null,"grid3":null,"id":361,"
instrument":309,"name":"Additional Symptoms","ordInc":5,"ordMax":25,"ordMin":0,"ordTitle":"Score","scale":[{"groupId":361,"id":1485,"name":"Additional Symptoms","sequence":1,"xLabel":"OTHER"}],"sequence":3},{"grid1":0,"grid2":0,"grid3":0,"i
d":369,"instrument":309,"name":"Overall Health","ordInc":2,"ordMax":10,"ordMin":0,"ordTitle":"Score","scale":[{"groupId":369,"id":1499,"name":"Overall Health Now","sequence":1,"xLabel":"HLTH"},{"groupId":369,"id":1500,"name":"Overall Health
Pre-COVID","sequence":2,"xLabel":"HLTHP"}],"sequence":4}],"spec":{"entryChecksum":3733454678,"entrySpec":"{\"name\": \"C19-YRS\",\r\n \"restartDays\": 2,\r\n \"printTitle\": \"Modified COVID-19 Yorkshire Rehabilitation Screening (C19-YRS)\
",\r\n \"content\":[\r\n {\"id\": \"i2499\", \"type\": \"IntroText\",\r\n \"text\": \"<strong>SYMPTOM SEVERITY<\/strong> <br \/> <br \/><i>Please answer the questions below to the best of\r\n your knowledge. <br \/><strong>[Now]<\/stro
nt":null,"id":9049,"instrument":309,"introDisplay":81371,"introId":2499,"introText":"SYMPTOM SEVERITY\r\n|\r\n|Please answer the questions below to the best of your knowledge.\r\n|[Now] refers to how you feel now\/this week (last 7 days).\r
ng> refers to how you feel now\/this week (last 7 days).\r\n <br \/><strong>[Pre-COVID]<\/strong> refers to how you were feeling prior to contracting the\r\n illness. <br \/>If you are unable to recall this, just select <\/i>\\u0022Don't kn
ow\\u0022<i>. <br \/>\r\n <br \/>Rate the severity of each problem on a scale of 0-3:<\/i>\r\n <br \/> <hr \/>1. Breathlessness\"\r\n },\r\n {\"id\": \"q8979\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n
\"text\": \"1a. Breathlessness: At rest <i>[Now]<\/i>\",\r\n \"intro\": \"<strong>SYMPTOM SEVERITY<\/strong> <br \/> <br \/><i>Please answer the questions below to the best of\r\n your knowledge. <br \/><strong>[Now]<\/strong> refers
to how you feel now\/this week (last 7 days).\r\n <br \/><strong>[Pre-COVID]<\/strong> refers to how you were feeling prior to contracting the
\r\n illness. <br \/>If you are unable to recall this, just select <\/i>\\u0022Don't know\\u0022<i>. <br \/>\r\n <br \/>Rate the severity of each problem on a scale of 0-3:<\/i>\r\n <br \/> <hr \/>1. Breathlessness\",\r\n \"columns\": 1,
\r\n \"choices\":[\r\n {\"id\": \"c5540\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"id\": \"c5541\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5542\", \"te
xt\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\": \"c5543\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3}\r\n ]},\r\n {\"id
\": \"q8980\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"1a. Breathlessness: At rest <i>[Pre-COVID]<\/i>\",\r\n \"intro\": \"<strong>SYMPTOM SEVERITY<\/strong> <br \/> <br \/><i>Please answ
er the questions below to the best of\r\n your knowledge. <br \/><strong>[Now]<\/strong> refers to how you feel now\/this week (last 7 days).\r\n <br \/><strong>[Pre-COVID]<\/strong> refers to how you were feeling prior to contracting the\r
\n illness. <br \/>If you are unable to recall this, just select <\/i>\\u0022Don't know\\u0022<i>. <br \/>\r\n <br \/>Rate the severity of each problem on a scale of 0-3:<\/i>\r\n <br \/> <hr \/>1. Breathlessness\",\r\n \"columns\": 1,\r
\n|[Pre-COVID] refers to how you were feeling prior to contracting the illness.\r\n|If you are unable to recall this, just select \"Don't know\".\r\n|\r\n|Rate the severity of each problem on a scale of 0-3:\r\n|\r\n|Breathlessness","max":0
\n \"choices\":[\r\n {\"id\": \"c5544\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"id\": \"c5545\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5546\", \"text
\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\": \"c5547\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3},\r\n {\"id\": \"c55
48\", \"text\": \"4. Don't know\", \"quickKey\": 4}\r\n ]},\r\n {\"id\": \"q8981\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"1b. Breathlessness: Changing position e.g. from lying to sittin
g or sitting to\r\n lying <i>[Now]<\/i>\",\r\n \"intro\": \"<strong>SYMPTOM SEVERITY<\/strong> <br \/> <br \/><i>Please answer the questions below to the best of\r\n your knowledge. <br \/><strong>[Now]<\/strong> refers to how you feel
now\/this week (last 7 days).\r\n <br \/><strong>[Pre-COVID]<\/strong> refers to how you were feeling prior to contracting the\r\n illness. <br \/>If you are unable to recall this, just select <\/i>\\u0022Don't know\\u0022<i>. <br \/>\r\n <
br \/>Rate the severity of each problem on a scale of 0-3:<\/i>\r\n <br \/> <hr \/>1. Breathlessness\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5540\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"
id\": \"c5541\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5542\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\": \"c5543\
", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3}\r\n ]},\r\n {\"id\": \"q8982\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"1b. Breath
lessness: Changing position e.g. from lying to sitting or sitting to\r\n lying <i>[Pre-COVID]<\/i>\",\r\n \"intro\": \"<strong>SYMPTOM SEVERITY<\/strong> <br \/> <br \/><i>Please answer the questions below to the best of\r\n your knowle
dge. <br \/><strong>[Now]<\/strong> refers to how you feel now\/this week (last 7 days).\r\n <br \/><strong>[Pre-COVID]<\/strong> refers to how you were feeling prior to contracting the\r\n illness. <br \/>If you are unable to recall this,
,"min":0,"questionDisplay":81372,"questionId":8984,"questionText":"Breathlessness: On dressing yourself [Pre-COVID]","required":false,"responseTypeId":1,
just select <\/i>\\u0022Don't know\\u0022<i>. <br \/>\r\n <br \/>Rate the severity of each problem on a scale of 0-3:<\/i>
\r\n <br \/> <hr \/>1. Breathlessness\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5544\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"id\": \"c5545\", \"text\": \"1. Mild problem; does not affect d
aily life\", \"quickKey\": 1},\r\n {\"id\": \"c5546\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\": \"c5547\", \"text\": \"3. Severe problem; affects all aspects of daily
life; life-disturbing\", \"quickKey\": 3},\r\n {\"id\": \"c5548\", \"text\": \"4. Don't know\", \"quickKey\": 4}\r\n ]},\r\n {\"id\": \"q8983\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\":
\"1c. Breathlessness: On dressing yourself <i>[Now]<\/i>\",\r\n \"intro\": \"<strong>SYMPTOM SEVERITY<\/strong> <br \/> <br \/><i>Please answer the questions below to the best of\r\n your knowledge. <br \/><strong>[Now]<\/strong> refers
to how you feel now\/this week (last 7 days).\r\n <br \/><strong>[Pre-COVID]<\/strong> refers to how you were feeling prior to contracting the\r\n illness. <br \/>If you are unable to recall this, just select <\/i>\\u0022Don't know\\u0022<
i>. <br \/>\r\n <br \/>Rate the severity of each problem on a scale of 0-3:<\/i>\r\n <br \/> <hr \/>1. Breathlessness\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5540\", \"text\": \"0. None; no problem\", \"quickKey\"
: 0},\r\n {\"id\": \"c5541\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5542\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n
{\"id\": \"c5543\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3}\r\n ]},\r\n {\"id\": \"q8984\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"tex
t\": \"1c. Breathlessness: On dressing yourself <i>[Pre-COVID]<\/i>\",\r\n \"intro\": \"<strong>SYMPTOM SEVERITY<\/strong> <br \/> <br \/><i>Please answer the questions below to the best of\r\n your knowledge. <br \/><strong>[Now]<\/str
"responseTypeText":"MCHOICE","sequence":60},{"choice":[{"choiceId":5540,"choiceText":"None; no problem","ien":109226,"legacyValue":0,"sequence":1},{"choiceId":5541,"choiceText":"Mild problem; does not affect daily life","ien":109227,"legacy
ong> refers to how you feel now\/this week (last 7 days).\r\n <br \/><strong>[Pre-COVID]<\/strong> refers to how you were feeling prior to contracting the\r\n illness. <br \/>If you are unable to recall this, just select <\/i>\\u0022Don't k
now\\u0022<i>. <br \/>\r\n <br \/>Rate the severity of each problem on a scale of 0-3:<\/i>\r\n <br \/> <hr \/>1. Breathlessness\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5544\", \"text\": \"0. None; no problem\", \
"quickKey\": 0},\r\n {\"id\": \"c5545\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5546\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2
},\r\n {\"id\": \"c5547\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3},\r\n {\"id\": \"c5548\", \"text\": \"4. Don't know\", \"quickKey\": 4}\r\n ]},\r\n {\"id\": \"q8985
\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"1d. Breathlessness: On walking up a flight of stairs <i>[Now]<\/i>\",\r\n \"intro\": \"<strong>SYMPTOM SEVERITY<\/strong> <br \/> <br \/><i>Ple
ase answer the questions below to the best of\r\n your knowledge. <br \/><strong>[Now]<\/strong> refers to how you feel now\/this week (last 7 days).\r\n <br \/><strong>[Pre-COVID]<\/strong> refers to how you were feeling prior to contracti
ng the\r\n illness. <br \/>If you are unable to recall this, just select <\/i>\\u0022Don't know\\u0022<i>. <br \/>\r\n <br \/>Rate the severity of each problem on a scale of 0-3:<\/i>\r\n <br \/> <hr \/>1. Breathlessness\",\r\n \"columns
\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5540\", \"text\": \"0. None; no problem\", \"quickKey\": 0},
\r\n {\"id\": \"c5541\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5542\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id
\": \"c5543\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3}\r\n ]},\r\n {\"id\": \"q8986\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\":
Value":1,"sequence":2},{"choiceId":5542,"choiceText":"Moderate problem; affects daily life to a certain extent","ien":109228,"legacyValue":2,"sequence":3},{"choiceId":5543,"choiceText":"Severe problem; affects all aspects of daily life; lif
\"1d. Breathlessness: On walking up a flight of stairs <i>[Pre-COVID]<\/i>\",\r\n \"intro\": \"<strong>SYMPTOM SEVERITY<\/strong> <br \/> <br \/><i>Please answer the questions below to the best of\r\n your knowledge. <br \/><strong>[Now
]<\/strong> refers to how you feel now\/this week (last 7 days).\r\n <br \/><strong>[Pre-COVID]<\/strong> refers to how you were feeling prior to contracting the\r\n illness. <br \/>If you are unable to recall this, just select <\/i>\\u0022
Don't know\\u0022<i>. <br \/>\r\n <br \/>Rate the severity of each problem on a scale of 0-3:<\/i>\r\n <br \/> <hr \/>1. Breathlessness\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5544\", \"text\": \"0. None; no probl
em\", \"quickKey\": 0},\r\n {\"id\": \"c5545\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5546\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickK
ey\": 2},\r\n {\"id\": \"c5547\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3},\r\n {\"id\": \"c5548\", \"text\": \"4. Don't know\", \"quickKey\": 4}\r\n ]},\r\n {\"id\":
\"i2500\", \"type\": \"IntroText\",\r\n \"text\": \"2. Cough \/ throat sensitivity \/ voice change\"\r\n },\r\n {\"id\": \"q8987\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"2a. Cough \
/ throat sensitivity <i>[Now]<\/i>\",\r\n \"intro\": \"2. Cough \/ throat sensitivity \/ voice change\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5540\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n
{\"id\": \"c5541\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5542\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\": \"c5
543\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3}\r\n ]},\r\n {\"id\": \"q8988\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"2a. Co
ugh \/ throat sensitivity <i>[Pre-COVID]<\/i>\",\r\n \"intro\": \"2. Cough \/ throat sensitivity \/ voice change\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5544\", \"text\": \"0. None; no problem\", \"quickKey\":
e-disturbing","ien":109229,"legacyValue":3,"sequence":4}],"choiceDisplay":81351,"choiceIdentifier":0,"choiceIdentifierIen":42358,"choiceTypeId":15113,"designator":"1d)","hint":null,"id":9050,"instrument":309,"introDisplay":81371,"introId":2
0},\r\n {\"id\": \"c5545\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5546\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\
"id\": \"c5547\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3},\r\n {\"id\": \"c5548\", \"text\": \"4. Don't know\", \"quickKey\": 4}\r\n ]},\r\n {\"id\": \"q8989\", \"type\":
\"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"2b. Change of voice <i>[Now]<\/i>\",\r\n \"intro\": \"2. Cough \/ throat sensitivity \/ voice change\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {
\"id\": \"c5540\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"id\": \"c5541\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5542\", \"text\": \"2. Moderate problem; af
fects daily life to a certain extent\", \"quickKey\": 2},
\r\n {\"id\": \"c5543\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3}\r\n ]},\r\n {\"id\": \"q8990\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n
\"text\": \"2b. Change of voice <i>[Pre-COVID]<\/i>\",\r\n \"intro\": \"2. Cough \/ throat sensitivity \/ voice change\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5544\", \"text\": \"0. None; no problem\", \"qu
ickKey\": 0},\r\n {\"id\": \"c5545\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5546\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\
r\n {\"id\": \"c5547\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3},\r\n {\"id\": \"c5548\", \"text\": \"4. Don't know\", \"quickKey\": 4}\r\n ]},\r\n {\"id\": \"i2501\",
\"type\": \"IntroText\",\r\n \"text\": \"3. Fatigue (tiredness not improved by rest)\"\r\n },\r\n {\"id\": \"q8991\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"3. Fatigue levels in you
499,"introText":"SYMPTOM SEVERITY\r\n|\r\n|Please answer the questions below to the best of your knowledge.\r\n|[Now] refers to how you feel now\/this week (last 7 days).\r\n|[Pre-COVID] refers to how you were feeling prior to contracting t
r usual activities <i>[Now]<\/i>\",\r\n \"intro\": \"3. Fatigue (tiredness not improved by rest)\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5540\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"i
d\": \"c5541\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5542\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\": \"c5543\"
, \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3}\r\n ]},\r\n {\"id\": \"q8992\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"3. Fatigue
levels in your usual activities <i>[Pre-COVID]<\/i>\",\r\n \"intro\": \"3. Fatigue (tiredness not improved by rest)\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5544\", \"text\": \"0. None; no problem\", \"quickKey\
": 0},\r\n {\"id\": \"c5545\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5546\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n
{\"id\": \"c5547\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3},\r\n {\"id\": \"c5548\", \"text\": \"4. Don't know\", \"quickKey\": 4}\r\n ]},\r\n {\"id\": \"i2502\", \"type
\": \"IntroText\",\r\n \"text\": \"4. Smell \/ taste\"\r\n },\r\n {\"id\": \"q8993\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"4a. Altered smell <i>[Now]<\/i>\",\r\n \"intro\": \"4.
Smell \/ taste\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5540\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"id\": \"c5541\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKe
y\": 1},\r\n {\"id\": \"c5542\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\": \"c5543\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\
", \"quickKey\": 3}\r\n ]},\r\n {\"id\": \"q8994\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"4a. Altered smell <i>[Pre-COVID]<\/i>\",\r\n \"intro\": \"4. Smell \/ taste\",\r\n \"colu
he illness.\r\n|If you are unable to recall this, just select \"Don't know\".\r\n|\r\n|Rate the severity of each problem on a scale of 0-3:\r\n|\r\n|Breathlessness","max":0,"min":0,"questionDisplay":81372,"questionId":8985,"questionText":"B
mns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5544\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"id\": \"c5545\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c554
6\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},
\r\n {\"id\": \"c5547\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3},\r\n {\"id\": \"c5548\", \"text\": \"4. Don't know\", \"quickKey\": 4}\r\n ]},\r\n {\"id\": \"q8995\"
, \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"4b. Altered taste <i>[Now]<\/i>\",\r\n \"intro\": \"4. Smell \/ taste\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5540\", \
"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"id\": \"c5541\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5542\", \"text\": \"2. Moderate problem; affects daily life to
a certain extent\", \"quickKey\": 2},\r\n {\"id\": \"c5543\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3}\r\n ]},\r\n {\"id\": \"q8996\", \"type\": \"ChoiceQuestion\", \"requ
ired\": false, \"inline\": false,\r\n \"text\": \"4b. Altered taste <i>[Pre-COVID]<\/i>\",\r\n \"intro\": \"4. Smell \/ taste\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5544\", \"text\": \"0. None; no problem\"
, \"quickKey\": 0},\r\n {\"id\": \"c5545\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5546\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\"
: 2},\r\n {\"id\": \"c5547\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3},\r\n {\"id\": \"c5548\", \"text\": \"4. Don't know\", \"quickKey\": 4}\r\n ]},\r\n {\"id\": \"i2
503\", \"type\": \"IntroText\",\r\n \"text\": \"5. Pain \/ discomfort\"\r\n },\r\n {\"id\": \"q8997\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"5a. Chest pain <i>[Now]<\/i>\",\r\n \
M SEVERITY\r\n|\r\n|Please answer the questions below to the best of your knowledge.\r\n|[Now] refers to how you feel now\/this week (last 7 days).\r\n|[Pre-COVID] refers to how you were feeling prior to contracting the illness.\r\n|If you
reathlessness: On walking up a flight of stairs [Now]","required":false,"responseTypeId":1,"responseTypeText":"MCHOICE","sequence":70},{"choice":[{"choiceId":5544,"choiceText":"None; no problem","ien":109230,"legacyValue":0,"sequence":1},{"
"intro\": \"5. Pain \/ discomfort\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5540\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"id\": \"c5541\", \"text\": \"1. Mild problem; does not affect daily
life\", \"quickKey\": 1},\r\n {\"id\": \"c5542\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\": \"c5543\", \"text\": \"3. Severe problem; affects all aspects of daily life
; life-disturbing\", \"quickKey\": 3}\r\n ]},\r\n {\"id\": \"q8998\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"5a. Chest pain <i>[Pre-COVID]<\/i>\",\r\n \"intro\": \"5. Pain \/ discomfo
rt\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5544\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"id\": \"c5545\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n
{\"id\": \"c5546\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\": \"c5547\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey
\": 3},\r\n {\"id\": \"c5548\", \"text\": \"4. Don't know\", \"quickKey\": 4}\r\n ]},\r\n {\"id\": \"q8999\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"5b. Joint pain <i>[Now]<\/i>\",\r
\n \"intro\": \"5. Pain \/ discomfort\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5540\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"id\": \"c5541\", \"text\": \"1. Mild problem; does not affec
t daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5542\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\": \"c5543\", \"text\": \"3. Severe problem; affects all aspects of dai
ly life; life-disturbing\", \"quickKey\": 3}\r\n ]},\r\n {\"id\": \"q9000\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,
\r\n \"text\": \"5b. Joint Pain <i>[Pre-COVID]<\/i>\",\r\n \"intro\": \"5. Pain \/ discomfort\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5544\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"i
choiceId":5545,"choiceText":"Mild problem; does not affect daily life","ien":109231,"legacyValue":1,"sequence":2},{"choiceId":5546,"choiceText":"Moderate problem; affects daily life to a certain extent","ien":109232,"legacyValue":2,"sequenc
d\": \"c5545\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5546\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\": \"c5547\"
, \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3},\r\n {\"id\": \"c5548\", \"text\": \"4. Don't know\", \"quickKey\": 4}\r\n ]},\r\n {\"id\": \"q9001\", \"type\": \"ChoiceQuestio
n\", \"required\": false, \"inline\": false,\r\n \"text\": \"5c. Muscle pain <i>[Now]<\/i>\",\r\n \"intro\": \"5. Pain \/ discomfort\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5540\", \"text\": \"0. None; no pr
oblem\", \"quickKey\": 0},\r\n {\"id\": \"c5541\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5542\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"qui
ckKey\": 2},\r\n {\"id\": \"c5543\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3}\r\n ]},\r\n {\"id\": \"q9002\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\"
: false,\r\n \"text\": \"5c. Muscle pain <i>[Pre-COVID]<\/i>\",\r\n \"intro\": \"5. Pain \/ discomfort\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5544\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n
{\"id\": \"c5545\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5546\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\":
\"c5547\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3},\r\n {\"id\": \"c5548\", \"text\": \"4. Don't know\", \"quickKey\": 4}\r\n ]},\r\n {\"id\": \"q9003\", \"type\": \"Choi
ceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"5d. Headache <i>[Now]<\/i>\",\r\n \"intro\": \"5. Pain \/ discomfort\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5540\", \"text\": \"0. None;
no problem\", \"quickKey\": 0},\r\n {\"id\": \"c5541\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5542\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\",
e":3},{"choiceId":5547,"choiceText":"Severe problem; affects all aspects of daily life; life-disturbing","ien":109233,"legacyValue":3,"sequence":4},{"choiceId":5548,"choiceText":"Don't know","ien":109234,"legacyValue":4,"sequence":5}],"choi
\"quickKey\": 2},\r\n {\"id\": \"c5543\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3}\r\n ]},\r\n {\"id\": \"q9004\", \"type\": \"ChoiceQuestion\", \"required\": false, \"in
line\": false,\r\n \"text\": \"5d. Headache <i>[Pre-COVID]<\/i>\",\r\n \"intro\": \"5. Pain \/ discomfort\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5544\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\
r\n {\"id\": \"c5545\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5546\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\
": \"c5547\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3},\r\n {\"id\": \"c5548\", \"text\": \"4. Don't know\", \"quickKey\": 4}\r\n ]},\r\n {\"id\": \"q9005\", \"type\": \"C
hoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"5e. Abdominal pain <i>[Now]<\/i>\",\r\n \"intro\": \"5. Pain \/ discomfort\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5540\", \"text\": \
"0. None; no problem\", \"quickKey\": 0},\r\n {\"id\": \"c5541\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},
\r\n {\"id\": \"c5542\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\": \"c5543\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"qui
ckKey\": 3}\r\n ]},\r\n {\"id\": \"q9006\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"5e. Abdominal pain <i>[Pre-COVID]<\/i>\",\r\n \"intro\": \"5. Pain \/ discomfort\",\r\n \"columns
\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5544\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"id\": \"c5545\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5546\"
, \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\": \"c5547\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3},\r\n {\"id\
ceDisplay":81351,"choiceIdentifier":0,"choiceIdentifierIen":42359,"choiceTypeId":15114,"designator":"1d)","hint":null,"id":9051,"instrument":309,"introDisplay":81371,"introId":2499,"introText":"SYMPTOM SEVERITY\r\n|\r\n|Please answer the qu
": \"c5548\", \"text\": \"4. Don't know\", \"quickKey\": 4}\r\n ]},\r\n {\"id\": \"i2504\", \"type\": \"IntroText\",\r\n \"text\": \"6. Cognition\"\r\n },\r\n {\"id\": \"q9007\", \"type\": \"ChoiceQuestion\", \"required\": false
, \"inline\": false,\r\n \"text\": \"6a. Problems with concentration <i>[Now]<\/i>\",\r\n \"intro\": \"6. Cognition\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5540\", \"text\": \"0. None; no problem\", \"quickK
ey\": 0},\r\n {\"id\": \"c5541\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5542\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n
{\"id\": \"c5543\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3}\r\n ]},\r\n {\"id\": \"q9008\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \
"text\": \"6a. Problems with concentration <i>[Pre-COVID]<\/i>\",\r\n \"intro\": \"6. Cognition\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5544\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"id
\": \"c5545\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5546\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\": \"c5547\",
\"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3},\r\n {\"id\": \"c5548\", \"text\": \"4. Don't know\", \"quickKey\": 4}\r\n ]},\r\n {\"id\": \"q9009\", \"type\": \"ChoiceQuestion
\", \"required\": false, \"inline\": false,\r\n \"text\": \"6b. Problems with memory <i>[Now]<\/i>\",\r\n \"intro\": \"6. Cognition\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5540\", \"text\": \"0. None; no pro
blem\", \"quickKey\": 0},\r\n {\"id\": \"c5541\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5542\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quic
kKey\": 2},\r\n {\"id\": \"c5543\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3}\r\n ]},\r\n {\"id\": \"q9010\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\":
estions below to the best of your knowledge.\r\n|[Now] refers to how you feel now\/this week (last 7 days).\r\n|[Pre-COVID] refers to how you were feeling prior to contracting the illness.\r\n|If you are unable to recall this, just select \
false,\r\n \"text\": \"6b. Problems with memory <i>[Pre-COVID]<\/i>\",\r\n \"intro\": \"6. Cognition\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5544\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n
{\"id\": \"c5545\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5546\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\": \
"c5547\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3},
\r\n {\"id\": \"c5548\", \"text\": \"4. Don't know\", \"quickKey\": 4}\r\n ]},\r\n {\"id\": \"q9011\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"6c. Problems with planning <i>[Now]<\/i>
\",\r\n \"intro\": \"6. Cognition\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5540\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"id\": \"c5541\", \"text\": \"1. Mild problem; does not affect da
ily life\", \"quickKey\": 1},\r\n {\"id\": \"c5542\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\": \"c5543\", \"text\": \"3. Severe problem; affects all aspects of daily l
ife; life-disturbing\", \"quickKey\": 3}\r\n ]},\r\n {\"id\": \"q9012\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"6c. Problems with planning <i>[Pre-COVID]<\/i>\",\r\n \"intro\": \"6. C
ognition\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5544\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"id\": \"c5545\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1}
,\r\n {\"id\": \"c5546\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\": \"c5547\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"qu
ickKey\": 3},\r\n {\"id\": \"c5548\", \"text\": \"4. Don't know\", \"quickKey\": 4}\r\n ]},\r\n {\"id\": \"i2505\", \"type\": \"IntroText\",\r\n \"text\": \"7. Palpitations \/ dizziness\"\r\n },\r\n {\"id\": \"q9013\", \"typ
"Don't know\".\r\n|\r\n|Rate the severity of each problem on a scale of 0-3:\r\n|\r\n|Breathlessness","max":0,"min":0,"questionDisplay":81372,"questionId":8986,"questionText":"Breathlessness: On walking up a flight of stairs [Pre-COVID]","r
e\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"7a. Palpitations in certain positions, activity or at rest <i>[Now]<\/i>\",\r\n \"intro\": \"7. Palpitations \/ dizziness\",\r\n \"columns\": 1,\r\n
\"choices\":[\r\n {\"id\": \"c5540\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"id\": \"c5541\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5542\", \"text\":
\"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\": \"c5543\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3}\r\n ]},\r\n {\"id\": \"
q9014\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"7a. Palpitations in certain positions, activity or at rest <i>[Pre-COVID]<\/i>\",\r\n \"intro\": \"7. Palpitations \/ dizziness\",\r\n \
"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5544\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"id\": \"c5545\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \
"c5546\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\": \"c5547\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3},\r\n
{\"id\": \"c5548\", \"text\": \"4. Don't know\", \"quickKey\": 4}\r\n ]},\r\n {\"id\": \"q9015\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"7b. Dizziness in certain positions, activity or
at rest <i>[Now]<\/i>\",\r\n \"intro\": \"7. Palpitations \/ dizziness\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5540\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"id\": \"c5541\", \"text\":
\"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5542\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\": \"c5543\", \"text\": \"3. Severe p
roblem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3}\r\n ]},
equired":false,"responseTypeId":1,"responseTypeText":"MCHOICE","sequence":80},{"choice":[{"choiceId":5540,"choiceText":"None; no problem","ien":109226,"legacyValue":0,"sequence":1},{"choiceId":5541,"choiceText":"Mild problem; does not affec
\r\n {\"id\": \"q9016\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"7b. Dizziness in certain positions, activity or at rest <i>[Pre-COVID]<\/i>\",\r\n \"intro\": \"7. Palpitations \/ dizzin
ess\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5544\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"id\": \"c5545\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n
{\"id\": \"c5546\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\": \"c5547\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKe
y\": 3},\r\n {\"id\": \"c5548\", \"text\": \"4. Don't know\", \"quickKey\": 4}\r\n ]},\r\n {\"id\": \"i2506\", \"type\": \"IntroText\",\r\n \"text\": \"8. Post-exertional malaise (worsening of symptoms)\"\r\n },\r\n {\"id\":
\"q9017\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"8. Crashing or relapse hours or days after physical, cognitive or emotional\r\n exertion <i>[Now]<\/i>\",\r\n \"intro\": \"8. Post-exert
ional malaise (worsening of symptoms)\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5540\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"id\": \"c5541\", \"text\": \"1. Mild problem; does not affect d
aily life\", \"quickKey\": 1},\r\n {\"id\": \"c5542\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\": \"c5543\", \"text\": \"3. Severe problem; affects all aspects of daily
life; life-disturbing\", \"quickKey\": 3}\r\n ]},\r\n {\"id\": \"q9018\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"8. Crashing or relapse hours or days after physical, cognitive or emotion
al\r\n exertion <i>[Pre-COVID]<\/i>\",\r\n \"intro\": \"8. Post-exertional malaise (worsening of symptoms)\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5544\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\
n {\"id\": \"c5545\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5546\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\":
t daily life","ien":109227,"legacyValue":1,"sequence":2},{"choiceId":5542,"choiceText":"Moderate problem; affects daily life to a certain extent","ien":109228,"legacyValue":2,"sequence":3},{"choiceId":5543,"choiceText":"Severe problem; affe
\"c5547\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3},\r\n {\"id\": \"c5548\", \"text\": \"4. Don't know\", \"quickKey\": 4}\r\n ]},\r\n {\"id\": \"i2507\", \"type\": \"Int
roText\",\r\n \"text\": \"9. Anxiety \/ mood\"\r\n },\r\n {\"id\": \"q9019\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"9a. Feeling anxious <i>[Now]<\/i>\",\r\n \"intro\": \"9. Anxie
ty \/ mood\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5540\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"id\": \"c5541\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\":
1},\r\n {\"id\": \"c5542\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\": \"c5543\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"
quickKey\": 3}\r\n ]},\r\n {\"id\": \"q9020\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"9a. Feeling anxious <i>[Pre-COVID]<\/i>\",\r\n \"intro\": \"9. Anxiety \/ mood\",\r\n \"column
s\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5544\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"id\": \"c5545\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5546\
", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},
\r\n {\"id\": \"c5547\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3},\r\n {\"id\": \"c5548\", \"text\": \"4. Don't know\", \"quickKey\": 4}\r\n ]},\r\n {\"id\": \"q9021\"
, \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"9b. Feeling depressed <i>[Now]<\/i>\",\r\n \"intro\": \"9. Anxiety \/ mood\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5540
\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"id\": \"c5541\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5542\", \"text\": \"2. Moderate problem; affects daily lif
cts all aspects of daily life; life-disturbing","ien":109229,"legacyValue":3,"sequence":4}],"choiceDisplay":81351,"choiceIdentifier":0,"choiceIdentifierIen":42358,"choiceTypeId":15113,"designator":"2a)","hint":null,"id":9052,"instrument":30
e to a certain extent\", \"quickKey\": 2},\r\n {\"id\": \"c5543\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3}\r\n ]},\r\n {\"id\": \"q9022\", \"type\": \"ChoiceQuestion\", \
"required\": false, \"inline\": false,\r\n \"text\": \"9b. Feeling depressed <i>[Pre-COVID]<\/i>\",\r\n \"intro\": \"9. Anxiety \/ mood\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5544\", \"text\": \"0. None; no
problem\", \"quickKey\": 0},\r\n {\"id\": \"c5545\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5546\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"
quickKey\": 2},\r\n {\"id\": \"c5547\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3},\r\n {\"id\": \"c5548\", \"text\": \"4. Don't know\", \"quickKey\": 4}\r\n ]},\r\n {\"
id\": \"q9023\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"9c. Having unwanted memories of your illness or time in hospital <i>[Now]<\/i>\",\r\n \"intro\": \"9. Anxiety \/ mood\",\r\n \"c
olumns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5540\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"id\": \"c5541\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c
5542\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\": \"c5543\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3}\r\n ]},
\r\n {\"id\": \"q9024\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"9c. Having unwanted memories of your illness or time in hospital <i>[Pre-COVID]<\/i>\",\r\n \"intro\": \"9. Anxiety \/ mo
od\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5544\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"id\": \"c5545\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n
{\"id\": \"c5546\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\": \"c5547\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey
9,"introDisplay":81371,"introId":2500,"introText":"Cough \/ throat sensitivity \/ voice change","max":0,"min":0,"questionDisplay":81372,"questionId":8987,"questionText":"Cough \/ throat sensitivity [Now]","required":false,"responseTypeId":1
\": 3},\r\n {\"id\": \"c5548\", \"text\": \"4. Don't know\", \"quickKey\": 4}\r\n ]},\r\n {\"id\": \"q9025\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"9d. Having unpleasant dreams abou
t your illness or time in hospital <i>[Now]<\/i>\",\r\n \"intro\": \"9. Anxiety \/ mood\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5540\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"id\": \"c5
541\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5542\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\": \"c5543\", \"text\
": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3}\r\n ]},
\r\n {\"id\": \"q9026\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"9d. Having unpleasant dreams about your illness or time in hospital <i>[Pre-COVID]<\/i>\",\r\n \"intro\": \"9. Anxiety \/
mood\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5544\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"id\": \"c5545\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r
\n {\"id\": \"c5546\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\": \"c5547\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quick
Key\": 3},\r\n {\"id\": \"c5548\", \"text\": \"4. Don't know\", \"quickKey\": 4}\r\n ]},\r\n {\"id\": \"q9027\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"9e. Trying to avoid thoughts o
r feelings about your illness or time in hospital\r\n <i>[Now]<\/i>\",\r\n \"intro\": \"9. Anxiety \/ mood\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5540\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\
n {\"id\": \"c5541\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5542\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\":
are unable to recall this, just select \"Don't know\".\r\n|\r\n|Rate the severity of each problem on a scale of 0-3:\r\n|\r\n|Breathlessness","max":0,"min":0,"questionDisplay":81372,"questionId":8979,"questionText":"Breathlessness: At rest
,"responseTypeText":"MCHOICE","sequence":90},{"choice":[{"choiceId":5544,"choiceText":"None; no problem","ien":109230,"legacyValue":0,"sequence":1},{"choiceId":5545,"choiceText":"Mild problem; does not affect daily life","ien":109231,"legac
\"c5543\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3}\r\n ]},\r\n {\"id\": \"q9028\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"9
e. Trying to avoid thoughts or feelings about your illness or time in hospital\r\n <i>[Pre-COVID]<\/i>\",\r\n \"intro\": \"9. Anxiety \/ mood\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5544\", \"text\": \"0. None;
no problem\", \"quickKey\": 0},\r\n {\"id\": \"c5545\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5546\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\",
\"quickKey\": 2},\r\n {\"id\": \"c5547\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3},\r\n {\"id\": \"c5548\", \"text\": \"4. Don't know\", \"quickKey\": 4}\r\n ]},\r\n
{\"id\": \"i2508\", \"type\": \"IntroText\",\r\n \"text\": \"10. Sleep\"\r\n },\r\n {\"id\": \"q9029\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"10. Sleep problems, such as difficulty
falling asleep, staying asleep or\r\n oversleeping <i>[Now]<\/i>\",\r\n \"intro\": \"10. Sleep\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5540\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"id\
": \"c5541\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5542\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\": \"c5543\",
\"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3}\r\n ]},\r\n {\"id\": \"q9030\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"10. Sleep pro
blems, such as difficulty falling asleep, staying asleep or\r\n oversleeping <i>[Pre-COVID]<\/i>\",\r\n \"intro\": \"10. Sleep\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5544\", \"text\": \"0. None; no problem\",
\"quickKey\": 0},\r\n {\"id\": \"c5545\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5546\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\":
yValue":1,"sequence":2},{"choiceId":5546,"choiceText":"Moderate problem; affects daily life to a certain extent","ien":109232,"legacyValue":2,"sequence":3},{
2},\r\n {\"id\": \"c5547\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3},
\r\n {\"id\": \"c5548\", \"text\": \"4. Don't know\", \"quickKey\": 4}\r\n ]},\r\n {\"id\": \"i2509\", \"type\": \"IntroText\",\r\n \"text\": \"<strong>FUNCTIONAL ABILITY<\/strong> <br \/><br \/>11. Communication\"\r\n },\r\n
{\"id\": \"q9031\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"11. Difficulty with communication \/ word finding difficulty \/ understanding\r\n others <i>[Now]<\/i>\",\r\n \"intro\": \"<st
rong>FUNCTIONAL ABILITY<\/strong> <br \/><br \/>11. Communication\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5540\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"id\": \"c5541\", \"text\": \"1. Mil
d problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5542\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\": \"c5543\", \"text\": \"3. Severe problem; a
ffects all aspects of daily life; life-disturbing\", \"quickKey\": 3}\r\n ]},\r\n {\"id\": \"q9032\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"11. Difficulty with communication\/word findi
ng difficulty\/understanding others\r\n <i>[Pre-COVID]<\/i>\",\r\n \"intro\": \"<strong>FUNCTIONAL ABILITY<\/strong> <br \/><br \/>11. Communication\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5544\", \"text\": \"0
. None; no problem\", \"quickKey\": 0},\r\n {\"id\": \"c5545\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5546\", \"text\": \"2. Moderate problem; affects daily life to a certain ex
tent\", \"quickKey\": 2},\r\n {\"id\": \"c5547\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3},\r\n {\"id\": \"c5548\", \"text\": \"4. Don't know\", \"quickKey\": 4}\r\n ]},
\r\n {\"id\": \"i2510\", \"type\": \"IntroText\",\r\n \"text\": \"12. Walking or moving around\"\r\n },\r\n {\"id\": \"q9033\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"12. Difficult
"choiceId":5547,"choiceText":"Severe problem; affects all aspects of daily life; life-disturbing","ien":109233,"legacyValue":3,"sequence":4},{"choiceId":5548,"choiceText":"Don't know","ien":109234,"legacyValue":4,"sequence":5}],"choiceDispl
ies with walking or moving around <i>[Now]<\/i>\",\r\n \"intro\": \"12. Walking or moving around\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5540\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"i
d\": \"c5541\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5542\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\": \"c5543\"
, \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3}\r\n ]},\r\n {\"id\": \"q9034\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"12. Difficu
lties with walking or moving around <i>[Pre-COVID]<\/i>\",\r\n \"intro\": \"12. Walking or moving around\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5544\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n
{\"id\": \"c5545\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5546\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\": \
"c5547\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3},\r\n {\"id\": \"c5548\", \"text\": \"4. Don't know\", \"quickKey\": 4}\r\n ]},\r\n {\"id\": \"i2511\", \"type\": \"Intro
Text\",\r\n \"text\": \"13. Personal Care\"\r\n },\r\n {\"id\": \"q9035\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"13. Difficulties with personal tasks such as using the toilet or get
ting washed\r\n and dressed <i>[Now]<\/i>\",\r\n \"intro\": \"13. Personal Care\",\r\n \"columns\": 1,\r\n \"choices\":[
\r\n {\"id\": \"c5540\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"id\": \"c5541\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5542\", \"text\": \"2. Moderate p
roblem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\": \"c5543\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3}\r\n ]},\r\n {\"id\": \"q9036\", \"type
ay":81351,"choiceIdentifier":0,"choiceIdentifierIen":42359,"choiceTypeId":15114,"designator":"2a)","hint":null,"id":9053,"instrument":309,"introDisplay":81371,"introId":2500,"introText":"Cough \/ throat sensitivity \/ voice change","max":0,
\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"13. Difficulties with personal tasks such as using the toilet or getting washed\r\n and dressed <i>[Pre-COVID]<\/i>\",\r\n \"intro\": \"13. Personal Care\
",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5544\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"id\": \"c5545\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n
{\"id\": \"c5546\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\": \"c5547\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\":
3},\r\n {\"id\": \"c5548\", \"text\": \"4. Don't know\", \"quickKey\": 4}\r\n ]},\r\n {\"id\": \"i2512\", \"type\": \"IntroText\",\r\n \"text\": \"14. Other activities of Daily Living\"\r\n },\r\n {\"id\": \"q9037\", \"type
\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"14. Difficulty doing wider activities, such as household work, leisure\/sporting\r\n activities, paid\/unpaid work, study or shopping <i>[Now]<\/i>\",\r\n
\"intro\": \"14. Other activities of Daily Living\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5540\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"id\": \"c5541\", \"text\": \"1. Mild problem; does
not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5542\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\": \"c5543\", \"text\": \"3. Severe problem; affects all aspe
cts of daily life; life-disturbing\", \"quickKey\": 3}\r\n ]},\r\n {\"id\": \"q9038\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"14. Difficulty doing wider activities, such as household wor
k, leisure\/sporting\r\n activities, paid\/unpaid work, study or shopping <i>[Pre-COVID]<\/i>\",\r\n \"intro\": \"14. Other activities of Daily Living\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5544\", \"text\": \
"0. None; no problem\", \"quickKey\": 0},\r\n {\"id\": \"c5545\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5546\", \"text\": \"2. Moderate problem; affects daily life to a certain
"min":0,"questionDisplay":81372,"questionId":8988,"questionText":"Cough \/ throat sensitivity [Pre-COVID]","required":false,"responseTypeId":1,"responseTypeText":"MCHOICE","sequence":100},{"choice":[{"choiceId":5540,"choiceText":"None; no p
extent\", \"quickKey\": 2},\r\n {\"id\": \"c5547\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3},\r\n {\"id\": \"c5548\", \"text\": \"4. Don't know\", \"quickKey\": 4}\r\n ]
},\r\n {\"id\": \"i2513\", \"type\": \"IntroText\",\r\n \"text\": \"15. Social role\"\r\n },\r\n {\"id\": \"q9039\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"15. Problems with social
izing \/ interacting with friends* or caring for\r\n dependants <i>[Now]<\/i><br \/>* related to your illness and not due to social distancing \/\r\n lockdown measures\",\r\n \"intro\": \"15. Social role\",\r\n \"columns\": 1,\r\n
\"choices\":[\r\n {\"id\": \"c5540\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"id\": \"c5541\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\": 1},\r\n {\"id\": \"c5542\", \"text\": \"
2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},
\r\n {\"id\": \"c5543\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\", \"quickKey\": 3}\r\n ]},\r\n {\"id\": \"q9040\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": false,\r\n
\"text\": \"15. Problems with socializing \/ interacting with friends* or caring for\r\n dependants <i>[Pre-COVID]<\/i><br \/>* related to your illness and not due to social distancing \/\r\n lockdown measures\",\r\n \"intro\": \"15.
Social role\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5544\", \"text\": \"0. None; no problem\", \"quickKey\": 0},\r\n {\"id\": \"c5545\", \"text\": \"1. Mild problem; does not affect daily life\", \"quickKey\"
: 1},\r\n {\"id\": \"c5546\", \"text\": \"2. Moderate problem; affects daily life to a certain extent\", \"quickKey\": 2},\r\n {\"id\": \"c5547\", \"text\": \"3. Severe problem; affects all aspects of daily life; life-disturbing\",
\"quickKey\": 3},\r\n {\"id\": \"c5548\", \"text\": \"4. Don't know\", \"quickKey\": 4}\r\n ]},\r\n {\"id\": \"i2514\", \"type\": \"IntroText\",\r\n \"text\": \"<strong>OTHER SYMPTOMS<\/strong>\"\r\n },\r\n {\"id\": \"q9041\
roblem","ien":109226,"legacyValue":0,"sequence":1},{"choiceId":5541,"choiceText":"Mild problem; does not affect daily life","ien":109227,"legacyValue":1,"sequence":2},{"choiceId":5542,"choiceText":"Moderate problem; affects daily life to a
", \"type\": \"CheckQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"16a. Please select any of the following symptoms you have experienced since your\r\n illness in the last 7 days. Please also select any previous prob
lems that have\r\n worsened for you following your illness.\",\r\n \"intro\": \"<strong>OTHER SYMPTOMS<\/strong>\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5549\", \"text\": \" Fever\"},\r\n {\"id\": \"c5550\"
, \"text\": \" Skin rash \/ discoloration of skin\"},\r\n {\"id\": \"c5551\", \"text\": \" New allergy such as medication, food etc.\"},\r\n {\"id\": \"c5552\", \"text\": \" Hair loss\"},\r\n {\"id\": \"c5553\", \"text\": \" Ski
n sensation (numbness \/ tingling \/ itching \/ nerve pain)\"},\r\n {\"id\": \"c5554\", \"text\": \" Dry eyes \/ redness of eyes\"},\r\n {\"id\": \"c5555\", \"text\": \" Swelling of feet \/ swelling of hands\"},\r\n {\"id\": \"c
5556\", \"text\": \" Easy bruising \/ bleeding\"},\r\n {\"id\": \"c5557\", \"text\": \" Visual changes\"},\r\n {\"id\": \"c5558\", \"text\": \" Difficulty swallowing solids\"},\r\n {\"id\": \"c5559\", \"text\": \" Difficulty swa
llowing liquids\"},\r\n {\"id\": \"c5560\", \"text\": \" Balance problems or falls\"},\r\n {\"id\": \"c5561\", \"text\": \" Weakness or movement problems or coordination problems in limbs\"},\r\n {\"id\": \"c5562\", \"text\": \"
Tinnitus\"},\r\n {\"id\": \"c5563\", \"text\": \" Nausea\"},\r\n {\"id\": \"c5564\", \"text\": \" Dry mouth \/ mouth ulcers\"},\r\n {\"id\": \"c5565\", \"text\": \" Acid Reflux \/ heartburn\"},\r\n {\"id\": \"c5566\", \"tex
t\": \" Change in appetite\"},\r\n {\"id\": \"c5567\", \"text\": \" Unintentional weight loss\"},\r\n {\"id\": \"c5568\", \"text\": \" Unintentional weight gain\"},\r\n {\"id\": \"c5569\", \"text\": \" Bladder frequency, urgency
or incontinence\"},\r\n {\"id\": \"c5570\", \"text\": \" Constipation, diarrhea or bowel incontinence\"},\r\n {\"id\": \"c5571\", \"text\": \" Change in menstrual cycles or flow\"},\r\n {\"id\": \"c5572\", \"text\": \" Waking u
p at night gasping for air (also called sleep apnea)\"},\r\n {\"id\": \"c5573\", \"text\": \" Thoughts about harming yourself\"}\r\n ]},\r\n {\"id\": \"q9042\", \"type\": \"MemoQuestion\", \"required\": false,\r\n \"text\": \"16b
certain extent","ien":109228,"legacyValue":2,"sequence":3},{"choiceId":5543,"choiceText":"Severe problem; affects all aspects of daily life; life-disturbing","ien":109229,"legacyValue":3,"sequence":4}],"choiceDisplay":81351,"choiceIdentifie
. Other symptoms - free text\",\r\n \"intro\": \"<strong>OTHER SYMPTOMS<\/strong>\",\r\n \"controlWidth\": 662},\r\n {\"id\": \"i2515\", \"type\": \"IntroText\",\r\n \"text\": \"<strong>OVERALL HEALTH<\/strong> <br \/><br \/>For
this question, a score of 10 means the BEST health\r\n you can imagine. 0 means the WORST health you can imagine.\"\r\n },
\r\n {\"id\": \"q9043\", \"type\": \"SliderQuestion\", \"required\": false,\r\n \"text\": \"17a. How good or bad is your health overall in the last 7 days? <i>[Now]<\/i>\",\r\n \"intro\": \"<strong>OVERALL HEALTH<\/strong> <br \/><b
r \/>For this question, a score of 10 means the BEST health\r\n you can imagine. 0 means the WORST health you can imagine.\",\r\n \"min\": 0, \"max\": 10,\r\n \"legend\":[\"WORST HEALTH\", \"BEST HEALTH\"]},\r\n {\"id\": \"q9044\",
\"type\": \"SliderQuestion\", \"required\": false,\r\n \"text\": \"17b. How good or bad is your health overall in the last 7 days? <i>[Pre-COVID]<\/i>\",\r\n \"intro\": \"<strong>OVERALL HEALTH<\/strong> <br \/><br \/>For this questio
n, a score of 10 means the BEST health\r\n you can imagine. 0 means the WORST health you can imagine.\",\r\n \"min\": 0, \"max\": 10,\r\n \"legend\":[\"WORST HEALTH\", \"BEST HEALTH\"]},\r\n {\"id\": \"i2516\", \"type\": \"IntroText
\",\r\n \"text\": \"<strong>EMPLOYMENT<\/strong>\"\r\n },\r\n {\"id\": \"q9045\", \"type\": \"StringQuestion\", \"required\": false,\r\n \"text\": \"18a. Occupation\",\r\n \"intro\": \"<strong>EMPLOYMENT<\/strong>\",\r\n \"
controlWidth\": 662, \"min\": 0, \"max\": 0},\r\n {\"id\": \"q9046\", \"type\": \"CheckQuestion\", \"required\": false, \"inline\": false,\r\n \"text\": \"18b. Has your COVID-19 illness affected your work?\",\r\n \"intro\": \"<stron
g>EMPLOYMENT<\/strong>\",\r\n \"columns\": 1,\r\n \"choices\":[\r\n {\"id\": \"c5576\", \"text\": \" No change\"},\r\n {\"id\": \"c5577\", \"text\": \" On reduced working hours\"},\r\n {\"id\": \"c5578\", \"text\": \" On s
ickness leave\"},\r\n {\"id\": \"c5579\", \"text\": \" Changes made to role \/ working arrangements (such as working from home or lighter\r\n duties)\"},\r\n {\"id\": \"c5580\", \"text\": \" Had to retire \/ change job\"},\r\n {
r":0,"choiceIdentifierIen":42358,"choiceTypeId":15113,"designator":"2b)","hint":null,"id":9054,"instrument":309,"introDisplay":81371,"introId":2500,"introText":"Cough \/ throat sensitivity \/ voice change","max":0,"min":0,"questionDisplay":
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