Version 2.78

61623-5 Are you able to turn a key in a lock?

Fully-Specified Name

Component
Are you able to turn a key in a lock
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.34
Last Updated
Version 2.65

Survey Question

Text
Are you able to turn a key in a lock?
Source
Mobility-FA40

Normative Answer List LL1022-4

Answer Code Score Answer ID
Without any difficulty 5 LA13921-4
With a little difficulty 4 LA13918-0
With some difficulty 3 LA13920-6
With much difficulty 2 LA13919-8
Unable to do 1 LA13912-3

Member of these Panels

LOINC Long Common Name
67892-0 Neuro-Qol item bank - upper extremity - version 1.0
67906-8 Neuro-Qol short form - upper extremity - version 1.0
61587-2 PROMIS item bank - physical function - version 1.0
91722-9 PROMIS item bank - physical function - version 2.0
79062-6 PROMIS item bank - physical function w mobility aids - version 1.0
91611-4 PROMIS item bank - upper extremity - version 2.0

61632-6 Are you able to brush your teeth?

Fully-Specified Name

Component
Are you able to brush your teeth
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.34
Last Updated
Version 2.65

Survey Question

Text
Are you able to brush your teeth?
Source
Mobility-FA50

Normative Answer List LL1022-4

Answer Code Score Answer ID
Without any difficulty 5 LA13921-4
With a little difficulty 4 LA13918-0
With some difficulty 3 LA13920-6
With much difficulty 2 LA13919-8
Unable to do 1 LA13912-3

Member of these Panels

LOINC Long Common Name
67892-0 Neuro-Qol item bank - upper extremity - version 1.0
67906-8 Neuro-Qol short form - upper extremity - version 1.0
61587-2 PROMIS item bank - physical function - version 1.0
91722-9 PROMIS item bank - physical function - version 2.0
91611-4 PROMIS item bank - upper extremity - version 2.0

67936-5 Are you able to make a phone call using a touch tone key-pad?

Fully-Specified Name

Component
Are you able to make a phone call using a touch tone key-pad
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
NeuroQol

Basic Attributes

Class
SURVEY.NEUROQ
Type
Surveys
First Released
Version 2.38
Last Updated
Version 2.50

Survey Question

Text
Are you able to make a phone call using a touch tone key-pad?
Source
NQUEX44

Normative Answer List LL1022-4

Answer Code Score Answer ID
Without any difficulty 5 LA13921-4
With a little difficulty 4 LA13918-0
With some difficulty 3 LA13920-6
With much difficulty 2 LA13919-8
Unable to do 1 LA13912-3

Member of these Panels

LOINC Long Common Name
67892-0 Neuro-Qol item bank - upper extremity - version 1.0
67906-8 Neuro-Qol short form - upper extremity - version 1.0

61656-5 Are you able to pick up coins from a table top?

Fully-Specified Name

Component
Are you able to pick up coins from a table top
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.34
Last Updated
Version 2.65

Survey Question

Text
Are you able to pick up coins from a table top?
Source
PFB21

Normative Answer List LL1022-4

Answer Code Score Answer ID
Without any difficulty 5 LA13921-4
With a little difficulty 4 LA13918-0
With some difficulty 3 LA13920-6
With much difficulty 2 LA13919-8
Unable to do 1 LA13912-3

Member of these Panels

LOINC Long Common Name
67892-0 Neuro-Qol item bank - upper extremity - version 1.0
67906-8 Neuro-Qol short form - upper extremity - version 1.0
61587-2 PROMIS item bank - physical function - version 1.0
91722-9 PROMIS item bank - physical function - version 2.0
79062-6 PROMIS item bank - physical function w mobility aids - version 1.0
91611-4 PROMIS item bank - upper extremity - version 2.0

61626-8 Are you able to write with a pen or pencil?

Fully-Specified Name

Component
Are you able to write with a pen or pencil
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.34
Last Updated
Version 2.65

Survey Question

Text
Are you able to write with a pen or pencil?
Source
Mobility-FA43

Normative Answer List LL1022-4

Answer Code Score Answer ID
Without any difficulty 5 LA13921-4
With a little difficulty 4 LA13918-0
With some difficulty 3 LA13920-6
With much difficulty 2 LA13919-8
Unable to do 1 LA13912-3

Member of these Panels

LOINC Long Common Name
67892-0 Neuro-Qol item bank - upper extremity - version 1.0
67906-8 Neuro-Qol short form - upper extremity - version 1.0
61587-2 PROMIS item bank - physical function - version 1.0
91722-9 PROMIS item bank - physical function - version 2.0
79062-6 PROMIS item bank - physical function w mobility aids - version 1.0
91611-4 PROMIS item bank - upper extremity - version 2.0

61618-5 Are you able to open and close a zipper?

Fully-Specified Name

Component
Are you able to open and close a zipper
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.34
Last Updated
Version 2.65

Survey Question

Text
Are you able to open and close a zipper?
Source
Mobility-FA35

Normative Answer List LL1022-4

Answer Code Score Answer ID
Without any difficulty 5 LA13921-4
With a little difficulty 4 LA13918-0
With some difficulty 3 LA13920-6
With much difficulty 2 LA13919-8
Unable to do 1 LA13912-3

Member of these Panels

LOINC Long Common Name
67892-0 Neuro-Qol item bank - upper extremity - version 1.0
67906-8 Neuro-Qol short form - upper extremity - version 1.0
61587-2 PROMIS item bank - physical function - version 1.0
91722-9 PROMIS item bank - physical function - version 2.0
79062-6 PROMIS item bank - physical function w mobility aids - version 1.0
91611-4 PROMIS item bank - upper extremity - version 2.0

61637-5 Are you able to wash and dry your body?

Fully-Specified Name

Component
Are you able to wash and dry your body
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.34
Last Updated
Version 2.65

Survey Question

Text
Are you able to wash and dry your body?
Source
Mobility-FA55

Normative Answer List LL1022-4

Answer Code Score Answer ID
Without any difficulty 5 LA13921-4
With a little difficulty 4 LA13918-0
With some difficulty 3 LA13920-6
With much difficulty 2 LA13919-8
Unable to do 1 LA13912-3

Member of these Panels

LOINC Long Common Name
67892-0 Neuro-Qol item bank - upper extremity - version 1.0
67906-8 Neuro-Qol short form - upper extremity - version 1.0
61587-2 PROMIS item bank - physical function - version 1.0
91722-9 PROMIS item bank - physical function - version 2.0
79062-6 PROMIS item bank - physical function w mobility aids - version 1.0
62199-5 PROMIS short form - physical function 10a - version 1.0
92580-0 PROMIS short form - physical function 10a - version 2.0
76702-0 PROMIS short form - physical function 20a - version 1.0

61661-5 Are you able to shampoo your hair?

Fully-Specified Name

Component
Are you able to shampoo your hair
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.34
Last Updated
Version 2.65

Survey Question

Text
Are you able to shampoo your hair?
Source
PFB26

Normative Answer List LL1022-4

Answer Code Score Answer ID
Without any difficulty 5 LA13921-4
With a little difficulty 4 LA13918-0
With some difficulty 3 LA13920-6
With much difficulty 2 LA13919-8
Unable to do 1 LA13912-3

Member of these Panels

LOINC Long Common Name
67892-0 Neuro-Qol item bank - upper extremity - version 1.0
67906-8 Neuro-Qol short form - upper extremity - version 1.0
61587-2 PROMIS item bank - physical function - version 1.0
91722-9 PROMIS item bank - physical function - version 2.0
91611-4 PROMIS item bank - upper extremity - version 2.0
62199-5 PROMIS short form - physical function 10a - version 1.0
92580-0 PROMIS short form - physical function 10a - version 2.0
76702-0 PROMIS short form - physical function 20a - version 1.0

67937-3 How much DIFFICULTY do you currently have using a spoon to eat a meal?

Fully-Specified Name

Component
How much difficulty do you currently have using a spoon to eat a meal
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
NeuroQol

Basic Attributes

Class
SURVEY.NEUROQ
Type
Surveys
First Released
Version 2.38
Last Updated
Version 2.50

Survey Question

Text
How much DIFFICULTY do you currently have using a spoon to eat a meal?
Source
NQUEX03

Normative Answer List LL1879-7

Answer Code Score Answer ID
No difficulty 5 LA15227-4
A little difficulty 4 LA15725-7
Some difficulty 3 LA13950-3
A lot of difficulty 2 LA13951-1
Can't do 1 LA17824-6

Member of these Panels

LOINC Long Common Name
67892-0 Neuro-Qol item bank - upper extremity - version 1.0

67938-1 How much DIFFICULTY do you currently have putting on a pullover shirt?

Fully-Specified Name

Component
How much difficulty do you currently have putting on a pullover shirt
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
NeuroQol

Basic Attributes

Class
SURVEY.NEUROQ
Type
Surveys
First Released
Version 2.38
Last Updated
Version 2.50

Survey Question

Text
How much DIFFICULTY do you currently have putting on a pullover shirt?
Source
NQUEX04

Normative Answer List LL1879-7

Answer Code Score Answer ID
No difficulty 5 LA15227-4
A little difficulty 4 LA15725-7
Some difficulty 3 LA13950-3
A lot of difficulty 2 LA13951-1
Can't do 1 LA17824-6

Member of these Panels

LOINC Long Common Name
67892-0 Neuro-Qol item bank - upper extremity - version 1.0

67939-9 How much DIFFICULTY do you currently have taking off a pullover shirt?

Fully-Specified Name

Component
How much difficulty do you currently have taking off a pullover shirt
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
NeuroQol

Basic Attributes

Class
SURVEY.NEUROQ
Type
Surveys
First Released
Version 2.38
Last Updated
Version 2.50

Survey Question

Text
How much DIFFICULTY do you currently have taking off a pullover shirt?
Source
NQUEX05

Normative Answer List LL1879-7

Answer Code Score Answer ID
No difficulty 5 LA15227-4
A little difficulty 4 LA15725-7
Some difficulty 3 LA13950-3
A lot of difficulty 2 LA13951-1
Can't do 1 LA17824-6

Member of these Panels

LOINC Long Common Name
67892-0 Neuro-Qol item bank - upper extremity - version 1.0

67940-7 How much DIFFICULTY do you currently have removing wrappings from small objects?

Fully-Specified Name

Component
How much difficulty do you currently have removing wrappings from small objects
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
NeuroQol

Basic Attributes

Class
SURVEY.NEUROQ
Type
Surveys
First Released
Version 2.38
Last Updated
Version 2.50

Survey Question

Text
How much DIFFICULTY do you currently have removing wrappings from small objects?
Source
NQUEX06

Normative Answer List LL1879-7

Answer Code Score Answer ID
No difficulty 5 LA15227-4
A little difficulty 4 LA15725-7
Some difficulty 3 LA13950-3
A lot of difficulty 2 LA13951-1
Can't do 1 LA17824-6

Member of these Panels

LOINC Long Common Name
67892-0 Neuro-Qol item bank - upper extremity - version 1.0

67941-5 How much DIFFICULTY do you currently have opening medications or vitamin containers (e.g., childproof containers, small bottles)?

Fully-Specified Name

Component
How much difficulty do you currently have opening medications or vitamin containers, like childproof containers, small bottles
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
NeuroQol

Basic Attributes

Class
SURVEY.NEUROQ
Type
Surveys
First Released
Version 2.38
Last Updated
Version 2.50

Survey Question

Text
How much DIFFICULTY do you currently have opening medications or vitamin containers (e.g., childproof containers, small bottles)?
Source
NQUEX15

Normative Answer List LL1879-7

Answer Code Score Answer ID
No difficulty 5 LA15227-4
A little difficulty 4 LA15725-7
Some difficulty 3 LA13950-3
A lot of difficulty 2 LA13951-1
Can't do 1 LA17824-6

Member of these Panels

LOINC Long Common Name
67892-0 Neuro-Qol item bank - upper extremity - version 1.0

61608-6 Are you able to open previously opened jars?

Fully-Specified Name

Component
Are you able to open previously opened jars
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.34
Last Updated
Version 2.65

Survey Question

Text
Are you able to open previously opened jars?
Source
Mobility-FA22

Normative Answer List LL1022-4

Answer Code Score Answer ID
Without any difficulty 5 LA13921-4
With a little difficulty 4 LA13918-0
With some difficulty 3 LA13920-6
With much difficulty 2 LA13919-8
Unable to do 1 LA13912-3

Member of these Panels

LOINC Long Common Name
67892-0 Neuro-Qol item bank - upper extremity - version 1.0
61587-2 PROMIS item bank - physical function - version 1.0
79062-6 PROMIS item bank - physical function w mobility aids - version 1.0

61657-3 Are you able to hold a plate full of food?

Fully-Specified Name

Component
Are you able to hold a plate full of food
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.34
Last Updated
Version 2.65

Survey Question

Text
Are you able to hold a plate full of food?
Source
PFB22

Normative Answer List LL1022-4

Answer Code Score Answer ID
Without any difficulty 5 LA13921-4
With a little difficulty 4 LA13918-0
With some difficulty 3 LA13920-6
With much difficulty 2 LA13919-8
Unable to do 1 LA13912-3

Member of these Panels

LOINC Long Common Name
67892-0 Neuro-Qol item bank - upper extremity - version 1.0
61587-2 PROMIS item bank - physical function - version 1.0
91722-9 PROMIS item bank - physical function - version 2.0
91611-4 PROMIS item bank - upper extremity - version 2.0
76702-0 PROMIS short form - physical function 20a - version 1.0

61629-2 Are you able to pull on trousers?

Fully-Specified Name

Component
Are you able to pull on trousers
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.34
Last Updated
Version 2.65

Survey Question

Text
Are you able to pull on trousers?
Source
Mobility-FA47

Normative Answer List LL1022-4

Answer Code Score Answer ID
Without any difficulty 5 LA13921-4
With a little difficulty 4 LA13918-0
With some difficulty 3 LA13920-6
With much difficulty 2 LA13919-8
Unable to do 1 LA13912-3

Member of these Panels

LOINC Long Common Name
67892-0 Neuro-Qol item bank - upper extremity - version 1.0
61587-2 PROMIS item bank - physical function - version 1.0
91722-9 PROMIS item bank - physical function - version 2.0

61636-7 Are you able to button your shirt?

Fully-Specified Name

Component
Are you able to button your shirt
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.34
Last Updated
Version 2.65

Survey Question

Text
Are you able to button your shirt?
Source
Mobility-FA54

Normative Answer List LL1022-4

Answer Code Score Answer ID
Without any difficulty 5 LA13921-4
With a little difficulty 4 LA13918-0
With some difficulty 3 LA13920-6
With much difficulty 2 LA13919-8
Unable to do 1 LA13912-3

Member of these Panels

LOINC Long Common Name
67892-0 Neuro-Qol item bank - upper extremity - version 1.0
61587-2 PROMIS item bank - physical function - version 1.0
91722-9 PROMIS item bank - physical function - version 2.0
91611-4 PROMIS item bank - upper extremity - version 2.0

61674-8 Are you able to trim your fingernails?

Fully-Specified Name

Component
Are you able to trim your fingernails
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.34
Last Updated
Version 2.65

Survey Question

Text
Are you able to trim your fingernails?
Source
PFB41

Normative Answer List LL1022-4

Answer Code Score Answer ID
Without any difficulty 5 LA13921-4
With a little difficulty 4 LA13918-0
With some difficulty 3 LA13920-6
With much difficulty 2 LA13919-8
Unable to do 1 LA13912-3

Member of these Panels

LOINC Long Common Name
67892-0 Neuro-Qol item bank - upper extremity - version 1.0
61587-2 PROMIS item bank - physical function - version 1.0
91722-9 PROMIS item bank - physical function - version 2.0
79062-6 PROMIS item bank - physical function w mobility aids - version 1.0
91611-4 PROMIS item bank - upper extremity - version 2.0

61595-5 Are you able to bend down and pick up clothing from the floor?

Fully-Specified Name

Component
Are you able to bend down and pick up clothing from the floor
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.34
Last Updated
Version 2.65

Survey Question

Text
Are you able to bend down and pick up clothing from the floor?
Source
Mobility-FA9

Normative Answer List LL1022-4

Answer Code Score Answer ID
Without any difficulty 5 LA13921-4
With a little difficulty 4 LA13918-0
With some difficulty 3 LA13920-6
With much difficulty 2 LA13919-8
Unable to do 1 LA13912-3

Member of these Panels

LOINC Long Common Name
67892-0 Neuro-Qol item bank - upper extremity - version 1.0
89689-4 PROMIS cancer item bank - physical function - version 1.1
61587-2 PROMIS item bank - physical function - version 1.0
91722-9 PROMIS item bank - physical function - version 2.0
92579-2 PROMIS short form - physical function 10b - version 2.0