Version 2.77

70982-4 Functional Assessment of Chronic Illness Therapy - Dyspnea Questionnaire - 10 items (FACIT-Dyspnea - 10)

Term Description

Functional Assessment of Chronic Illness Therapy - Dyspnea - 10 items
Source: Regenstrief LOINC

Fully-Specified Name

Component
Functional assessment of chronic illness therapy - dyspnea questionnaire - 10 items
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70971-7 How short of breath did you get dressing yourself without help?

Observation ID in Form

1

Fully-Specified Name

Component
How short of breath did you get dressing yourself without help in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get dressing yourself without help?
Source
1

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
90967-1 PROMIS short form - dyspnea functional limitations 10a - version 1.0

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70972-5 How short of breath did you get walking 50 steps-paces on flat ground at a normal speed without stopping?

Observation ID in Form

2

Fully-Specified Name

Component
How short of breath did you get walking 50 steps-paces on flat ground at a normal speed without stopping in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get walking 50 steps-paces on flat ground at a normal speed without stopping?
Source
2

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
90967-1 PROMIS short form - dyspnea functional limitations 10a - version 1.0

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70973-3 How short of breath did you get walking up 20 stairs, 2 flights, without stopping?

Observation ID in Form

3

Fully-Specified Name

Component
How short of breath did you get walking up 20 stairs - 2 flights - without stopping in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get walking up 20 stairs, 2 flights, without stopping?
Source
3

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
90967-1 PROMIS short form - dyspnea functional limitations 10a - version 1.0

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70974-1 How short of breath did you get preparing meals?

Observation ID in Form

4

Fully-Specified Name

Component
How short of breath did you get preparing meals in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get preparing meals?
Source
4

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
90967-1 PROMIS short form - dyspnea functional limitations 10a - version 1.0

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70975-8 How short of breath did you get washing dishes?

Observation ID in Form

5

Fully-Specified Name

Component
How short of breath did you get washing dishes in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get washing dishes?
Source
5

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
90967-1 PROMIS short form - dyspnea functional limitations 10a - version 1.0

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70976-6 How short of breath did you get sweeping or mopping?

Observation ID in Form

6

Fully-Specified Name

Component
How short of breath did you get sweeping or mopping in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get sweeping or mopping?
Source
6

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
90967-1 PROMIS short form - dyspnea functional limitations 10a - version 1.0

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70977-4 How short of breath did you get making a bed?

Observation ID in Form

7

Fully-Specified Name

Component
How short of breath did you get making a bed in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get making a bed?
Source
7

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
90967-1 PROMIS short form - dyspnea functional limitations 10a - version 1.0

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70978-2 How short of breath did you get lifting something weighing 10-20 lbs, about 4.5-9kg , like a large bag of groceries?

Observation ID in Form

8

Fully-Specified Name

Component
How short of breath did you get lifting something weighing 10-20 lbs, about 4.5-9kg , like a large bag of groceries, in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get lifting something weighing 10-20 lbs, about 4.5-9kg , like a large bag of groceries?
Source
8

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
90967-1 PROMIS short form - dyspnea functional limitations 10a - version 1.0

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70979-0 How short of breath did you get carrying something weighing 10-20 lbs, about 4.5-9kg, like a large bag of groceries, from one room to another?

Observation ID in Form

9

Fully-Specified Name

Component
How short of breath did you get carrying something weighing 10-20 lbs, about 4.5-9kg, like a large bag of groceries, from one room to another in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get carrying something weighing 10-20 lbs, about 4.5-9kg, like a large bag of groceries, from one room to another?
Source
9

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
90967-1 PROMIS short form - dyspnea functional limitations 10a - version 1.0

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70980-8 How short of breath did you get walking faster than your usual speed for half a mile, almost 1 km, without stopping?

Observation ID in Form

10

Fully-Specified Name

Component
How short of breath did you get walking faster than your usual speed for half a mile, almost 1 km, without stopping in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get walking faster than your usual speed for half a mile, almost 1 km, without stopping?
Source
10

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
90967-1 PROMIS short form - dyspnea functional limitations 10a - version 1.0

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70983-2 Functional Assessment of Chronic Illness Therapy - Dyspnea Questionnaire - 33 items (FACIT-Dyspnea - 33)

Term Description

Functional Assessment of Chronic Illness Therapy - Dyspnea - 33 items
Source: Regenstrief LOINC

Fully-Specified Name

Component
Functional assessment of chronic illness therapy - dyspnea questionnaire - 33 items
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70971-7 How short of breath did you get dressing yourself without help?

Observation ID in Form

1

Fully-Specified Name

Component
How short of breath did you get dressing yourself without help in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get dressing yourself without help?
Source
1

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
90967-1 PROMIS short form - dyspnea functional limitations 10a - version 1.0

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70972-5 How short of breath did you get walking 50 steps-paces on flat ground at a normal speed without stopping?

Observation ID in Form

2

Fully-Specified Name

Component
How short of breath did you get walking 50 steps-paces on flat ground at a normal speed without stopping in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get walking 50 steps-paces on flat ground at a normal speed without stopping?
Source
2

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
90967-1 PROMIS short form - dyspnea functional limitations 10a - version 1.0

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70973-3 How short of breath did you get walking up 20 stairs, 2 flights, without stopping?

Observation ID in Form

3

Fully-Specified Name

Component
How short of breath did you get walking up 20 stairs - 2 flights - without stopping in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get walking up 20 stairs, 2 flights, without stopping?
Source
3

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
90967-1 PROMIS short form - dyspnea functional limitations 10a - version 1.0

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70974-1 How short of breath did you get preparing meals?

Observation ID in Form

4

Fully-Specified Name

Component
How short of breath did you get preparing meals in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get preparing meals?
Source
4

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
90967-1 PROMIS short form - dyspnea functional limitations 10a - version 1.0

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70975-8 How short of breath did you get washing dishes?

Observation ID in Form

5

Fully-Specified Name

Component
How short of breath did you get washing dishes in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get washing dishes?
Source
5

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
90967-1 PROMIS short form - dyspnea functional limitations 10a - version 1.0

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70976-6 How short of breath did you get sweeping or mopping?

Observation ID in Form

6

Fully-Specified Name

Component
How short of breath did you get sweeping or mopping in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get sweeping or mopping?
Source
6

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
90967-1 PROMIS short form - dyspnea functional limitations 10a - version 1.0

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70977-4 How short of breath did you get making a bed?

Observation ID in Form

7

Fully-Specified Name

Component
How short of breath did you get making a bed in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get making a bed?
Source
7

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
90967-1 PROMIS short form - dyspnea functional limitations 10a - version 1.0

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70978-2 How short of breath did you get lifting something weighing 10-20 lbs, about 4.5-9kg , like a large bag of groceries?

Observation ID in Form

8

Fully-Specified Name

Component
How short of breath did you get lifting something weighing 10-20 lbs, about 4.5-9kg , like a large bag of groceries, in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get lifting something weighing 10-20 lbs, about 4.5-9kg , like a large bag of groceries?
Source
8

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
90967-1 PROMIS short form - dyspnea functional limitations 10a - version 1.0

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70979-0 How short of breath did you get carrying something weighing 10-20 lbs, about 4.5-9kg, like a large bag of groceries, from one room to another?

Observation ID in Form

9

Fully-Specified Name

Component
How short of breath did you get carrying something weighing 10-20 lbs, about 4.5-9kg, like a large bag of groceries, from one room to another in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get carrying something weighing 10-20 lbs, about 4.5-9kg, like a large bag of groceries, from one room to another?
Source
9

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
90967-1 PROMIS short form - dyspnea functional limitations 10a - version 1.0

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70980-8 How short of breath did you get walking faster than your usual speed for half a mile, almost 1 km, without stopping?

Observation ID in Form

10

Fully-Specified Name

Component
How short of breath did you get walking faster than your usual speed for half a mile, almost 1 km, without stopping in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get walking faster than your usual speed for half a mile, almost 1 km, without stopping?
Source
10

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
90967-1 PROMIS short form - dyspnea functional limitations 10a - version 1.0

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70984-0 How short of breath did you get taking a bath?

Observation ID in Form

11

Fully-Specified Name

Component
How short of breath did you get taking a bath without help in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get taking a bath?
Source
11

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70985-7 How short of breath did you get taking a shower?

Observation ID in Form

12

Fully-Specified Name

Component
How short of breath did you get taking a shower in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get taking a shower?
Source
12

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70986-5 How short of breath did you get putting on socks or stockings?

Observation ID in Form

13

Fully-Specified Name

Component
How short of breath did you get putting on socks or stockings in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get putting on socks or stockings?
Source
13

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70987-3 How short of breath did you get standing for at least 5 minutes?

Observation ID in Form

14

Fully-Specified Name

Component
How short of breath did you get standing for at least 5M in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get standing for at least 5 minutes?
Source
14

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70988-1 How short of breath did you get walking 10 steps/paces on flat ground at a normal speed without stopping?

Observation ID in Form

15

Fully-Specified Name

Component
How short of breath did you get walking 10 steps - paces on flat ground at a normal speed without stopping in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get walking 10 steps/paces on flat ground at a normal speed without stopping?
Source
15

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70989-9 How short of breath did you get walking 1/2 mile, almost 1 km, on flat ground at a normal speed, without stopping?

Observation ID in Form

16

Fully-Specified Name

Component
How short of breath did you get walking half a mile, almost 1 km, on flat ground at a normal speed, without stopping in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get walking 1/2 mile, almost 1 km, on flat ground at a normal speed, without stopping?
Source
16

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70990-7 How short of breath did you get walking up 5 stairs without stopping?

Observation ID in Form

17

Fully-Specified Name

Component
How short of breath did you get walking up 5 stairs without stopping in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get walking up 5 stairs without stopping?
Source
17

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70991-5 How short of breath did you get walking up 10 stairs, 1 flight, without stopping?

Observation ID in Form

18

Fully-Specified Name

Component
How short of breath did you get walking up 10 stairs, 1 flight, without stopping in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get walking up 10 stairs, 1 flight, without stopping?
Source
18

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70992-3 How short of breath did you get walking up 30 stairs, 3 flights, without stopping?

Observation ID in Form

19

Fully-Specified Name

Component
How short of breath did you get walking up 30 stairs, 3 flights, without stopping in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get walking up 30 stairs, 3 flights, without stopping?
Source
19

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

71006-1 How short of breath did you get scrubbing the floor or counter?

Observation ID in Form

20

Fully-Specified Name

Component
How short of breath did you get scrubbing the floor or counter in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get scrubbing the floor or counter?
Source
33

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70993-1 How short of breath did you get lifting something weighing less than 5 lbs, about 2 kg, like a houseplant?

Observation ID in Form

21

Fully-Specified Name

Component
How short of breath did you get lifting something weighing less than 5 lbs, about 2 kg, like a houseplant, in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get lifting something weighing less than 5 lbs, about 2 kg, like a houseplant?
Source
20

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70994-9 How short of breath did you get lifting something weighing 5-10 lbs, about 2-4.5 kg, like a basket of clothes?

Observation ID in Form

22

Fully-Specified Name

Component
How short of breath did you get lifting something weighing 5-10 lbs, about 2-4.5 kg, like a basket of clothes in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get lifting something weighing 5-10 lbs, about 2-4.5 kg, like a basket of clothes?
Source
21

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70995-6 How short of breath did you get lifting something weighing more than 20 lbs, about 9 kg, like a medium-sized suitcase?

Observation ID in Form

23

Fully-Specified Name

Component
How short of breath did you get lifting something weighing more than 20 lbs, about 9 kg, like a medium-sized suitcase in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get lifting something weighing more than 20 lbs, about 9 kg, like a medium-sized suitcase?
Source
22

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70996-4 How short of breath did you get carrying something weighing less than 5 lbs, about 2 kg, like a houseplant, from one room to another?

Observation ID in Form

24

Fully-Specified Name

Component
How short of breath did you get carrying something weighing less than 5 lbs, about 2 kg, like a houseplant, from one room to another in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get carrying something weighing less than 5 lbs, about 2 kg, like a houseplant, from one room to another?
Source
23

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70997-2 How short of breath did you get carrying something weighing 5-10 lbs, about 2-4.5 kg, like a basket of clothes, from one room to another

Fully-Specified Name

Component
How short of breath did you get carrying something weighing 5-10 lbs, about 2-4.5 kg, like a basket of clothes, from one room to another in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get carrying something weighing 5-10 lbs, about 2-4.5 kg, like a basket of clothes, from one room to another
Source
24

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70998-0 How short of breath did you get getting in or out of a car?

Observation ID in Form

26

Fully-Specified Name

Component
How short of breath did you get getting in or out of a car in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get getting in or out of a car?
Source
25

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70999-8 How short of breath did you get dining out?

Observation ID in Form

27

Fully-Specified Name

Component
How short of breath did you get dining out in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get dining out?
Source
26

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

71000-4 How short of breath did you get low-intensity leisure activity - gardening, etc?

Observation ID in Form

28

Fully-Specified Name

Component
How short of breath did you get low-intensity leisure activity - gardening, etc, in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get low-intensity leisure activity - gardening, etc?
Source
27

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

71001-2 How short of breath did you get moderate-intensity leisure activity - bicycling on level terrain, etc?

Observation ID in Form

29

Fully-Specified Name

Component
How short of breath did you get moderate-intensity leisure activity - bicycling on level terrain, etc, in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get moderate-intensity leisure activity - bicycling on level terrain, etc?
Source
28

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

71002-0 How short of breath did you get walking, faster than your usual speed, for 50 steps without stopping?

Observation ID in Form

30

Fully-Specified Name

Component
How short of breath did you get walking, faster than your usual speed, for 50 steps without stopping in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get walking, faster than your usual speed, for 50 steps without stopping?
Source
29

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

71003-8 How short of breath did you get walking, faster than your usual speed, for at least 1 mile, a little more than 1.5 km, without stopping?

Observation ID in Form

31

Fully-Specified Name

Component
How short of breath did you get walking, faster than your usual speed, for at least 1 mile, a little more than 1.5 km, without stopping in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get walking, faster than your usual speed, for at least 1 mile, a little more than 1.5 km, without stopping?
Source
30

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

71004-6 How short of breath did you get singing or humming?

Observation ID in Form

32

Fully-Specified Name

Component
How short of breath did you get singing or humming in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get singing or humming?
Source
31

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

71005-3 How short of breath did you get talking while walking?

Observation ID in Form

33

Fully-Specified Name

Component
How short of breath did you get talking while walking in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
How short of breath did you get talking while walking?
Source
32

Normative Answer List LL3980-1

Answer Code Score Answer ID
No shortness of breath LA26121-6
Mildly short of breath LA26122-4
Moderately short of breath LA26123-2
Severely short of breath LA26124-0
I did not do this in the past 7 days LA26125-7

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70981-6 Please indicate why you did not do this in the past 7 days

Fully-Specified Name

Component
Why you did not do this in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
Please indicate why you did not do this in the past 7 days

Normative Answer List LL2075-1

Answer Code Score Answer ID
I have stopped trying, or knew I could not do this activity because of my shortness of breath LA18538-1
I did not do this activity for some other reason (including not having a chance to do it, other health issues, etc. LA18539-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

71007-9 Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)

Term Description

Functional Assessment of Chronic Illness Therapy - Palliative Care
Source: Regenstrief LOINC

Fully-Specified Name

Component
Functional assessment of chronic illness therapy - palliative care questionnaire
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70498-1 Physical well-being [FACIT]

Fully-Specified Name

Component
Physical well being
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a lack of energy
Source
GP1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have nausea
Source
GP2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70407-2 Because of my physical condition, I have trouble meeting the needs of my family

Observation ID in Form

GP3

Fully-Specified Name

Component
Because of my physical condition, I have trouble meeting the needs of my family in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
Because of my physical condition, I have trouble meeting the needs of my family
Source
GP3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have pain
Source
GP4

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70409-8 I am bothered by side effects of treatment

Observation ID in Form

GP5

Fully-Specified Name

Component
I am bothered by side effects of treatment in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am bothered by side effects of treatment
Source
GP5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70410-6 I feel ill

Observation ID in Form

GP6

Fully-Specified Name

Component
I feel ill in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I feel ill
Source
GP6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70411-4 I am forced to spend time in bed

Observation ID in Form

GP7

Fully-Specified Name

Component
I am forced to spend time in bed in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am forced to spend time in bed
Source
GP7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70499-9 Social - family well-being [FACIT]

Fully-Specified Name

Component
Social - family well being
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70412-2 I feel close to my friends

Observation ID in Form

GS1

Fully-Specified Name

Component
I feel close to my friends in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I feel close to my friends
Source
GS1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70413-0 I get emotional support from my family

Observation ID in Form

GS2

Fully-Specified Name

Component
I get emotional support from my family in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I get emotional support from my family
Source
GS2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70414-8 I get support from my friends

Observation ID in Form

GS3

Fully-Specified Name

Component
I get support from my friends in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I get support from my friends
Source
GS3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70415-5 My family has accepted my illness

Observation ID in Form

GS4

Fully-Specified Name

Component
My family has accepted my illness in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
My family has accepted my illness
Source
GS4

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70416-3 I am satisfied with family communication about my illness

Observation ID in Form

GS5

Fully-Specified Name

Component
I am satisfied with family communication about my illness in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am satisfied with family communication about my illness
Source
GS5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70417-1 I felt close to my partner, or the person who is my main support

Observation ID in Form

GS6

Fully-Specified Name

Component
I feel close to my partner, or the person who is my main support, in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I felt close to my partner, or the person who is my main support
Source
GS6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70914-7 Regardless of your current level of sexual activity, please answer the following question. If you prefer not to answer it, please mark this box and go to the next section.

Observation ID in Form

Q1

Fully-Specified Name

Component
Would you like to answer the question referring to your sex life
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50

Survey Question

Text
Regardless of your current level of sexual activity, please answer the following question. If you prefer not to answer it, please mark this box and go to the next section.
Source
Q1

Normative Answer List LL361-7

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70418-9 I am satisfied with my sex life

Observation ID in Form

GS7

Fully-Specified Name

Component
I am satisfied with my sex life in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am satisfied with my sex life
Source
GS7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70500-4 Emotional well being [FACIT]

Fully-Specified Name

Component
Emotional well being
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70392-6 I feel sad

Observation ID in Form

GE1

Fully-Specified Name

Component
I feel sad in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I feel sad
Source
GE1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70393-4 I am satisfied with how I am coping with my illness

Observation ID in Form

GE2

Fully-Specified Name

Component
I am satisfied with how I am coping with my illness in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am satisfied with how I am coping with my illness
Source
GE2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70394-2 I am losing hope in the fight against my illness

Observation ID in Form

GE3

Fully-Specified Name

Component
I am losing hope in the fight against my illness in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am losing hope in the fight against my illness
Source
GE3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70395-9 I am nervous

Observation ID in Form

GE4

Fully-Specified Name

Component
I feel nervous in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am nervous
Source
GE4

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70396-7 I worry about dying

Observation ID in Form

GE5

Fully-Specified Name

Component
I worry about dying in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I worry about dying
Source
GE5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I worry that my condition will get worse
Source
GE6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70501-2 Functional well-being [FACIT]

Fully-Specified Name

Component
Functional well being
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70398-3 I am able to work (include work at home)

Observation ID in Form

GF1

Fully-Specified Name

Component
I am able to work - include work at home - in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am able to work (include work at home)
Source
GF1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70399-1 My work (include work at home) is fulfilling

Observation ID in Form

GF2

Fully-Specified Name

Component
My work - include work at home - is fulfilling in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
My work (include work at home) is fulfilling
Source
GF2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy life in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am able to enjoy life
Source
GF3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70401-5 I have accepted my illness

Observation ID in Form

GF4

Fully-Specified Name

Component
I have accepted my illness in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have accepted my illness
Source
GF4

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70402-3 I am sleeping well

Observation ID in Form

GF5

Fully-Specified Name

Component
I am sleeping well in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am sleeping well
Source
GF5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70403-1 I am enjoying the things I usually do for fun

Observation ID in Form

GF6

Fully-Specified Name

Component
I am enjoying the things I usually do for fun in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am enjoying the things I usually do for fun
Source
GF6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am content with the quality of my life right now
Source
GF7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

71008-7 Additional concerns - FACIT-Pal [FACIT]

Fully-Specified Name

Component
Additional concerns - FACIT-Pal
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

71009-5 I maintain contact with my friends

Observation ID in Form

PAL1

Fully-Specified Name

Component
I maintain contact with my friends in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.
Order vs. Observation
Observation

Survey Question

Text
I maintain contact with my friends
Source
PAL1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

71010-3 I have family members who will take on my responsibilities

Observation ID in Form

PAL2

Fully-Specified Name

Component
I have family members who will take on my responsibilities in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.
Order vs. Observation
Observation

Survey Question

Text
I have family members who will take on my responsibilities
Source
PAL2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

71011-1 I feel that my family appreciates me

Observation ID in Form

PAL3

Fully-Specified Name

Component
I feel that my family appreciates me in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.
Order vs. Observation
Observation

Survey Question

Text
I feel that my family appreciates me
Source
PAL3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

71012-9 I feel like a burden to my family

Observation ID in Form

PAL4

Fully-Specified Name

Component
I feel like a burden to my family in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.
Order vs. Observation
Observation

Survey Question

Text
I feel like a burden to my family
Source
PAL4

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70305-8 I have been short of breath

Observation ID in Form

B1

Fully-Specified Name

Component
I have been short of breath in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.72
Change Reason
Release 2.72: SURVEY_QUEST_TEXT: Moved to Form Data table.; METHOD_TYP: Removed Method to increase usability.; Previous Releases: Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
99357-6 COVID-19 health questions panel
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel
98520-0 PROMIS item bank - dyspnea characteristics - version 1.0

71013-7 I am constipated

Observation ID in Form

PAL5

Fully-Specified Name

Component
I am constipated in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.
Order vs. Observation
Observation

Survey Question

Text
I am constipated
Source
PAL5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70346-2 I am losing weight

Observation ID in Form

C2

Fully-Specified Name

Component
I am losing weight in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am losing weight
Source
C2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70479-1 I have been vomiting

Observation ID in Form

O2

Fully-Specified Name

Component
I have been vomiting in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have been vomiting
Source
O2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

71014-5 I have swelling in parts of my body

Observation ID in Form

PAL6

Fully-Specified Name

Component
I have swelling in parts of my body in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.
Order vs. Observation
Observation

Survey Question

Text
I have swelling in parts of my body
Source
PAL6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

71015-2 My mouth and throat are dry

Observation ID in Form

PAL7

Fully-Specified Name

Component
My mouth and throat are dry in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.
Order vs. Observation
Observation

Survey Question

Text
My mouth and throat are dry
Source
PAL7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70341-3 I feel independent

Observation ID in Form

Br7

Fully-Specified Name

Component
I feel independent in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I feel independent
Source
Br7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

71016-0 I feel useful

Observation ID in Form

PAL8

Fully-Specified Name

Component
I feel useful in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.
Order vs. Observation
Observation

Survey Question

Text
I feel useful
Source
PAL8

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

71017-8 I make each day count

Observation ID in Form

PAL9

Fully-Specified Name

Component
I make each day count in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.
Order vs. Observation
Observation

Survey Question

Text
I make each day count
Source
PAL9

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

71018-6 I have peace of mind

Observation ID in Form

PAL10

Fully-Specified Name

Component
I have peace of mind in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.
Order vs. Observation
Observation

Survey Question

Text
I have peace of mind
Source
PAL10

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

71019-4 I feel hopeful

Observation ID in Form

Sp21

Fully-Specified Name

Component
I feel hopeful in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.
Order vs. Observation
Observation

Survey Question

Text
I feel hopeful
Source
Sp21

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

71020-2 I am able to make decisions

Observation ID in Form

PAL12

Fully-Specified Name

Component
I am able to make decisions in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.
Order vs. Observation
Observation

Survey Question

Text
I am able to make decisions
Source
PAL12

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70441-1 My thinking is clear

Observation ID in Form

L1

Fully-Specified Name

Component
My thinking is clear in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
My thinking is clear
Source
L1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

71021-0 I have been able to reconcile (make peace) with other people

Observation ID in Form

PAL13

Fully-Specified Name

Component
I have been able to reconcile, make peace, with other people in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.
Order vs. Observation
Observation

Survey Question

Text
I have been able to reconcile (make peace) with other people
Source
PAL13

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

71022-8 I am able to openly discuss my concerns with the people closest to me

Observation ID in Form

PAL14

Fully-Specified Name

Component
I am able to openly discuss my concerns with the people closest to me in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.
Order vs. Observation
Observation

Survey Question

Text
I am able to openly discuss my concerns with the people closest to me
Source
PAL14

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

71439-4 Functional Assessment of Chronic Illness Therapy Spiritual Well-being Questionnaire - version 4 (FACIT-Sp)

Term Description

Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being
Source: Regenstrief LOINC

Fully-Specified Name

Component
Functional assessment of chronic illness therapy - spiritual well being questionnaire - version 4
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70498-1 Physical well-being [FACIT]

Fully-Specified Name

Component
Physical well being
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a lack of energy
Source
GP1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have nausea
Source
GP2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70407-2 Because of my physical condition, I have trouble meeting the needs of my family

Observation ID in Form

GP3

Fully-Specified Name

Component
Because of my physical condition, I have trouble meeting the needs of my family in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
Because of my physical condition, I have trouble meeting the needs of my family
Source
GP3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have pain
Source
GP4

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70409-8 I am bothered by side effects of treatment

Observation ID in Form

GP5

Fully-Specified Name

Component
I am bothered by side effects of treatment in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am bothered by side effects of treatment
Source
GP5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70410-6 I feel ill

Observation ID in Form

GP6

Fully-Specified Name

Component
I feel ill in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I feel ill
Source
GP6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70411-4 I am forced to spend time in bed

Observation ID in Form

GP7

Fully-Specified Name

Component
I am forced to spend time in bed in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am forced to spend time in bed
Source
GP7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70499-9 Social - family well-being [FACIT]

Fully-Specified Name

Component
Social - family well being
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70412-2 I feel close to my friends

Observation ID in Form

GS1

Fully-Specified Name

Component
I feel close to my friends in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I feel close to my friends
Source
GS1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70413-0 I get emotional support from my family

Observation ID in Form

GS2

Fully-Specified Name

Component
I get emotional support from my family in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I get emotional support from my family
Source
GS2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70414-8 I get support from my friends

Observation ID in Form

GS3

Fully-Specified Name

Component
I get support from my friends in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I get support from my friends
Source
GS3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70415-5 My family has accepted my illness

Observation ID in Form

GS4

Fully-Specified Name

Component
My family has accepted my illness in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
My family has accepted my illness
Source
GS4

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70416-3 I am satisfied with family communication about my illness

Observation ID in Form

GS5

Fully-Specified Name

Component
I am satisfied with family communication about my illness in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am satisfied with family communication about my illness
Source
GS5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70417-1 I felt close to my partner, or the person who is my main support

Observation ID in Form

GS6

Fully-Specified Name

Component
I feel close to my partner, or the person who is my main support, in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I felt close to my partner, or the person who is my main support
Source
GS6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70914-7 Regardless of your current level of sexual activity, please answer the following question. If you prefer not to answer it, please mark this box and go to the next section.

Observation ID in Form

Q1

Fully-Specified Name

Component
Would you like to answer the question referring to your sex life
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50

Survey Question

Text
Regardless of your current level of sexual activity, please answer the following question. If you prefer not to answer it, please mark this box and go to the next section.
Source
Q1

Normative Answer List LL361-7

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70418-9 I am satisfied with my sex life

Observation ID in Form

GS7

Fully-Specified Name

Component
I am satisfied with my sex life in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am satisfied with my sex life
Source
GS7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70500-4 Emotional well being [FACIT]

Fully-Specified Name

Component
Emotional well being
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70392-6 I feel sad

Observation ID in Form

GE1

Fully-Specified Name

Component
I feel sad in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I feel sad
Source
GE1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70393-4 I am satisfied with how I am coping with my illness

Observation ID in Form

GE2

Fully-Specified Name

Component
I am satisfied with how I am coping with my illness in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am satisfied with how I am coping with my illness
Source
GE2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70394-2 I am losing hope in the fight against my illness

Observation ID in Form

GE3

Fully-Specified Name

Component
I am losing hope in the fight against my illness in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am losing hope in the fight against my illness
Source
GE3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70395-9 I am nervous

Observation ID in Form

GE4

Fully-Specified Name

Component
I feel nervous in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am nervous
Source
GE4

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70396-7 I worry about dying

Observation ID in Form

GE5

Fully-Specified Name

Component
I worry about dying in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I worry about dying
Source
GE5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I worry that my condition will get worse
Source
GE6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70501-2 Functional well-being [FACIT]

Fully-Specified Name

Component
Functional well being
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70398-3 I am able to work (include work at home)

Observation ID in Form

GF1

Fully-Specified Name

Component
I am able to work - include work at home - in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am able to work (include work at home)
Source
GF1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70399-1 My work (include work at home) is fulfilling

Observation ID in Form

GF2

Fully-Specified Name

Component
My work - include work at home - is fulfilling in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
My work (include work at home) is fulfilling
Source
GF2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy life in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am able to enjoy life
Source
GF3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel