Version 2.78

70676-2 Functional Assessment of Anorexia-Cachexia Treatment Questionnaire - version 4 (FAACT) [FACIT]

Term Description

Functional Assessment of Anorexia/CachexiaTreatment
Source: Regenstrief LOINC

Form Coding Instructions

Please circle or mark one number per line to indicate your response as it applies to the past 7 days

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of anorexia-cachexia treatment 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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom 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

70893-3 Additional concerns - FAACT [FACIT]

Fully-Specified Name

Component
Additional concerns - FAACT
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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70350-4 I have a good appetite

Observation ID in Form

C6

Fully-Specified Name

Component
I have a good appetite 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 good appetite
Source
C6

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
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70677-0 The amount I eat is sufficient to meet my needs

Observation ID in Form

ACT1

Fully-Specified Name

Component
The amount I eat is sufficient to meet my needs 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
The amount I eat is sufficient to meet my needs
Source
ACT1

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70678-8 I am worried about my weight

Observation ID in Form

ACT2

Fully-Specified Name

Component
I am worried about my 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 worried about my weight
Source
ACT2

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
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

70679-6 Most food tastes unpleasant to me

Observation ID in Form

ACT3

Fully-Specified Name

Component
Most food tastes unpleasant 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 2.66
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
Most food tastes unpleasant to me
Source
ACT3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70680-4 I am concerned about how thin I look

Observation ID in Form

ACT4

Fully-Specified Name

Component
I am concerned about how thin I look 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 concerned about how thin I look
Source
ACT4

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70681-2 My interest in food drops as soon as I try to eat

Observation ID in Form

ACT6

Fully-Specified Name

Component
My interest in food drops as soon as I try to eat 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 interest in food drops as soon as I try to eat
Source
ACT6

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70682-0 I have difficulty eating rich or heavy foods

Observation ID in Form

ACT7

Fully-Specified Name

Component
I have difficulty eating rich or heavy foods 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 difficulty eating rich or heavy foods
Source
ACT7

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70683-8 My family or friends are pressuring me to eat

Observation ID in Form

ACT9

Fully-Specified Name

Component
My family or friends are pressuring me to eat 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 or friends are pressuring me to eat
Source
ACT9

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom 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

70684-6 When I eat, I seem to get full quickly

Observation ID in Form

ACT10

Fully-Specified Name

Component
When I eat, I seem to get full quickly 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
When I eat, I seem to get full quickly
Source
ACT10

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
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

70301-7 I have a pain in my stomach area

Observation ID in Form

ACT11

Fully-Specified Name

Component
I have pain in my stomach area 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 pain in my stomach area
Source
ACT11

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70685-3 My general health is improving

Observation ID in Form

ACT13

Fully-Specified Name

Component
My general health is improving 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 general health is improving
Source
ACT13

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70686-1 Functional Assessment of Chronic Illness Therapy for patients with abdominal symptoms questionnaire - version 4 (FACIT-AD)

Term Description

For patients with Abdominal symptoms
Source: Regenstrief LOINC

Form Coding Instructions

Please circle or mark one number per line to indicate your response as it applies to the past 7 days

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of chronic illness therapy for patients with abdominal symptoms 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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom 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

70904-8 Additional concerns - FACIT-AD [FACIT]

Fully-Specified Name

Component
Additional concerns - FACIT-AD
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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70480-9 I have cramps in my stomach area

Observation ID in Form

O3

Fully-Specified Name

Component
I have cramps in my stomach area 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 cramps in my stomach area
Source
O3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70301-7 I have a pain in my stomach area

Observation ID in Form

ACT11

Fully-Specified Name

Component
I have pain in my stomach area 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 pain in my stomach area
Source
ACT11

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70687-9 Stomach pain interferes with my daily functioning

Observation ID in Form

AD1

Fully-Specified Name

Component
Stomach pain interferes with my daily functioning 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
Stomach pain interferes with my daily functioning
Source
AD1

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70688-7 Functional Assessment of Chronic Illness Therapy for patients with ascites questionnaire (FACIT-AI)

Term Description

For patients with Ascites
Source: Regenstrief LOINC

Fully-Specified Name

Component
Functional assessment of chronic illness therapy for patients with ascites 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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70350-4 I have a good appetite

Observation ID in Form

C6

Fully-Specified Name

Component
I have a good appetite 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 good appetite
Source
C6

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
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

70320-7 I am able to get around by myself

Observation ID in Form

BMT5

Fully-Specified Name

Component
I am able to get around by myself 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 get around by myself
Source
BMT5

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
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

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

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

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

70301-7 I have a pain in my stomach area

Observation ID in Form

ACT11

Fully-Specified Name

Component
I have pain in my stomach area 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 pain in my stomach area
Source
ACT11

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70478-3 I have swelling in my stomach area

Observation ID in Form

O1

Fully-Specified Name

Component
I have swelling in my stomach area 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 swelling in my stomach area
Source
O1

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom 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

70684-6 When I eat, I seem to get full quickly

Observation ID in Form

ACT10

Fully-Specified Name

Component
When I eat, I seem to get full quickly 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
When I eat, I seem to get full quickly
Source
ACT10

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
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

70315-7 I urinate more frequently than usual

Observation ID in Form

BL2

Fully-Specified Name

Component
I urinate more frequently than usual 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 urinate more frequently than usual
Source
BL2

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70365-2 I am bothered by constipation

Observation ID in Form

Cx6

Fully-Specified Name

Component
I am bothered by constipation 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 constipation
Source
Cx6

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70689-5 I have been emotionally distressed

Observation ID in Form

AI1

Fully-Specified Name

Component
I have been emotionally distressed 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 emotionally distressed
Source
AI1

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70690-3 Functional Assessment of Chronic Illness Therapy for patients with cervical dysplasia questionnaire - version 4 (FACIT-CD)

Term Description

For patients with Cervical Dysplasia
Source: Regenstrief LOINC

Form Coding Instructions

Please circle or mark one number per line to indicate your response as it applies to the past 7 days

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of chronic illness therapy for patients with cervical dysplasia 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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70905-5 Physical well-being - FACIT-CD [FACIT]

Fully-Specified Name

Component
Physical well being - FACIT-CD
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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70841-2 I have discomfort in my pelvic area

Observation ID in Form

CD1

Fully-Specified Name

Component
I have discomfort in my pelvic area 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 discomfort in my pelvic area
Source
CD1

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70842-0 I have pain in my pelvic area

Observation ID in Form

CD2

Fully-Specified Name

Component
I have pain in my pelvic area 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 in my pelvic area
Source
CD2

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70843-8 I have cramping in my pelvic area

Observation ID in Form

CD3

Fully-Specified Name

Component
I have cramping in my pelvic area 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 cramping in my pelvic area
Source
CD3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70360-3 I am bothered by discharge or bleeding from my vagina

Observation ID in Form

Cx1

Fully-Specified Name

Component
I am bothered by discharge or bleeding from my vagina 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 discharge or bleeding from my vagina
Source
Cx1

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom 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

70844-6 Are you sexually active or would you like to be sexually active?

Observation ID in Form

Q8

Fully-Specified Name

Component
Are you sexually active or would you like to be sexually active
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
Are you sexually active or would you like to be sexually active?
Source
Q8

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70382-7 I have pain or discomfort with intercourse

Observation ID in Form

ES8

Fully-Specified Name

Component
I have pain or discomfort with intercourse 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 or discomfort with intercourse
Source
ES8

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70694-5 I have to limit my sexual activity because of the infection

Observation ID in Form

CD4

Fully-Specified Name

Component
I have to limit my sexual activity because of the infection 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 to limit my sexual activity because of the infection
Source
CD4

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70695-2 I worry about spreading the infection

Observation ID in Form

CD5

Fully-Specified Name

Component
I worry about spreading the infection 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 spreading the infection
Source
CD5

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70691-1 Treatment satisfaction [FACIT]

Fully-Specified Name

Component
Treatment satisfaction
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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70845-3 I have confidence in my doctors

Observation ID in Form

GR1

Fully-Specified Name

Component
I have confidence in my doctors 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 confidence in my doctors
Source
GR1

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70846-1 I feel that I received the treatment that was right for me

Observation ID in Form

CD6

Fully-Specified Name

Component
I feel that I received the treatment that was right for 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 2.66
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 that I received the treatment that was right for me
Source
CD6

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70847-9 My doctor gave me explanations that I could understand

Observation ID in Form

CD7

Fully-Specified Name

Component
My doctor gave me explanations that I could understand 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 doctor gave me explanations that I could understand
Source
CD7

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70848-7 My doctor explained the possible benefits of my treatmen

Observation ID in Form

CD8

Fully-Specified Name

Component
My doctor explained the possible benefits of my 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
My doctor explained the possible benefits of my treatmen
Source
CD8

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70692-9 General perceptions [FACIT]

Fully-Specified Name

Component
General perceptions
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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom 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

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

70696-0 I am hopeful about the future

Observation ID in Form

HI11

Fully-Specified Name

Component
I am hopeful about the future 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 hopeful about the future
Source
HI11

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70697-8 I find comfort in my faith or spiritual beliefs

Observation ID in Form

Sp9

Fully-Specified Name

Component
I find comfort in my faith or spiritual beliefs 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 find comfort in my faith or spiritual beliefs
Source
Sp9

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom 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

70698-6 I feel that I can manage things that come up around this infection

Observation ID in Form

CD9

Fully-Specified Name

Component
I feel that I can manage things that come up around this infection 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 that I can manage things that come up around this infection
Source
CD9

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70699-4 I have accepted that I have this infection

Observation ID in Form

CD10

Fully-Specified Name

Component
I have accepted that I have this infection 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 that I have this infection
Source
CD10

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70906-3 Emotional well being - FACIT-CD [FACIT]

Fully-Specified Name

Component
Emotional well being - FACIT-CD
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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70700-0 I worry that the infection will get worse

Observation ID in Form

CD11

Fully-Specified Name

Component
I worry that the infection 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 the infection will get worse
Source
CD11

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70701-8 I have hidden this problem so others will not notice

Observation ID in Form

CD12

Fully-Specified Name

Component
I have hidden this problem so others will not notice 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 hidden this problem so others will not notice
Source
CD12

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70702-6 I have concerns about my ability to become pregnant

Observation ID in Form

CD13

Fully-Specified Name

Component
I have concerns about my ability to become pregnant 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 concerns about my ability to become pregnant
Source
CD13

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70648-1 The cost of my treatment is a burden on me or my family

Observation ID in Form

BMT18

Fully-Specified Name

Component
The cost of my treatment is a burden on me or 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
The cost of my treatment is a burden on me or my family
Source
BMT18

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
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

70703-4 I worry about other peoples attitudes towards me

Observation ID in Form

CD14

Fully-Specified Name

Component
I worry about other peoples attitudes towards 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 2.66
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 other peoples attitudes towards me
Source
CD14

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70704-2 I feel embarrassed about the infection

Observation ID in Form

CD15

Fully-Specified Name

Component
I feel embarrassed about the infection 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 embarrassed about the infection
Source
CD15

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70705-9 I tend to blame myself for the infection

Observation ID in Form

CD16

Fully-Specified Name

Component
I tend to blame myself for the infection 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 tend to blame myself for the infection
Source
CD16

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70706-7 I was careful who I told about the infection

Observation ID in Form

CD17

Fully-Specified Name

Component
I was careful who I told about the infection 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 was careful who I told about the infection
Source
CD17

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70707-5 I have had difficulty telling my partner/spouse about the infection

Observation ID in Form

CD18

Fully-Specified Name

Component
I have had difficulty telling my partner - spouse about the infection 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 had difficulty telling my partner/spouse about the infection
Source
CD18

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70708-3 I am frustrated by the infection

Observation ID in Form

CD19

Fully-Specified Name

Component
I am frustrated by the infection 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 frustrated by the infection
Source
CD19

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70709-1 I am depressed about the infection

Observation ID in Form

CD20

Fully-Specified Name

Component
I am depressed about the infection 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 depressed about the infection
Source
CD20

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70693-7 Relationships [FACIT]

Fully-Specified Name

Component
Relationships
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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70710-9 I have told my partner/spouse about my infection

Observation ID in Form

Q9

Fully-Specified Name

Component
I have told my partner - spouse about my infection 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 2.54

Survey Question

Text
I have told my partner/spouse about my infection
Source
Q9

Normative Answer List LL251-0

Answer Code Score Answer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 0 LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6

Member of these Panels

LOINC Long Common Name
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70711-7 I get emotional support from my partner/spouse

Observation ID in Form

CD21

Fully-Specified Name

Component
I get emotional support from my partner - spouse 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 partner/spouse
Source
CD21

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70712-5 I have told family members about my infection

Observation ID in Form

Q10

Fully-Specified Name

Component
I have told family members about my infection 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 2.54

Survey Question

Text
I have told family members about my infection
Source
Q10

Normative Answer List LL251-0

Answer Code Score Answer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 0 LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6

Member of these Panels

LOINC Long Common Name
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70713-3 I get emotional support from family members

Observation ID in Form

CD22

Fully-Specified Name

Component
I get emotional support from family members 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 family members
Source
CD22

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom 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

70714-1 I have people to help me if I need it

Observation ID in Form

HI3

Fully-Specified Name

Component
I have people to help me if I need it 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 people to help me if I need it
Source
HI3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70715-8 Functional Assessment of Chronic Illness Therapy-Diarrhea Questionnaire - version 4 (FACIT-D)

Term Description

Functional Assessment of Chronic Illness Therapy-Diarrhea
Source: Regenstrief LOINC

Form Coding Instructions

Please circle or mark one number per line to indicate your response as it applies to the past 7 days

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of chronic illness therapy - diarrhea 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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom 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

70894-1 Additional concerns - FACIT-D [FACIT]

Fully-Specified Name

Component
Additional concerns - FACIT-D
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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70347-0 I have control of my bowels

Observation ID in Form

C3

Fully-Specified Name

Component
I have control of my bowels 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 control of my bowels
Source
C3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70716-6 I move my bowels more frequently than usual

Observation ID in Form

ITF1

Fully-Specified Name

Component
I move my bowels more frequently than usual 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 move my bowels more frequently than usual
Source
ITF1

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70717-4 I am afraid to be far from a toilet

Observation ID in Form

ITU2

Fully-Specified Name

Component
I am afraid to be far from a toilet 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 afraid to be far from a toilet
Source
ITU2

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70718-2 I have to limit my social activity because of diarrhea

Observation ID in Form

D1

Fully-Specified Name

Component
I have to limit my social activity because of diarrhea 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 to limit my social activity because of diarrhea
Source
D1

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70719-0 I have to limit my physical activity because of diarrhea

Observation ID in Form

D2

Fully-Specified Name

Component
I have to limit my physical activity because of diarrhea 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 to limit my physical activity because of diarrhea
Source
D2

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70720-8 I have to limit my sexual activity because of diarrhea

Observation ID in Form

D3

Fully-Specified Name

Component
I have to limit my sexual activity because of diarrhea 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 to limit my sexual activity because of diarrhea
Source
D3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70721-6 I am embarrassed by having diarrhea

Observation ID in Form

D4

Fully-Specified Name

Component
I am embarrassed by having diarrhea 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 embarrassed by having diarrhea
Source
D4

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70722-4 I have abdominal cramps or discomfort due to my diarrhea

Observation ID in Form

D5

Fully-Specified Name

Component
I have abdominal cramps or discomfort due to my diarrhea 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 abdominal cramps or discomfort due to my diarrhea
Source
D5

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70723-2 My problem with diarrhea keeps/wakes me up at night

Observation ID in Form

D6

Fully-Specified Name

Component
My problem with diarrhea keeps - wakes - me up at night 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 problem with diarrhea keeps/wakes me up at night
Source
D6

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70724-0 I must move my bowels frequently to avoid accidents

Observation ID in Form

ITF3

Fully-Specified Name

Component
I must move my bowels frequently to avoid accidents 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 must move my bowels frequently to avoid accidents
Source
ITF3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70725-7 I wear protection for soiling of stool

Observation ID in Form

ITF5

Fully-Specified Name

Component
I wear protection for soiling of stool 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 wear protection for soiling of stool
Source
ITF5

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70726-5 Functional Assessment of Chronic Illness Therapy-Fatigue Questionnaire - version 4 (FACIT-F)

Term Description

Functional Assessment of Chronic Illness Therapy-Fatigue
Source: Regenstrief LOINC

Form Coding Instructions

Please circle or mark one number per line to indicate your response as it applies to the past 7 days

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of chronic illness therapy - fatigue 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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom 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

70895-8 Additional concerns - FACIT-F [FACIT]

Fully-Specified Name

Component
Additional concerns - FACIT-F
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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70426-2 I feel fatigued

Observation ID in Form

HI7

Fully-Specified Name

Component
I feel fatigued 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 fatigued
Source
HI7

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

70425-4 I feel weak all over

Observation ID in Form

HI12

Fully-Specified Name

Component
I feel weak all over 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
Release 2.67: SURVEY_QUEST_TEXT: Corrected the omission of "over" from Survey Question Text; Previous Releases: 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 weak all over
Source
HI12

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
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70727-3 I feel listless ("washed out")

Observation ID in Form

An1

Fully-Specified Name

Component
I feel listless - washed 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 2.66
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 listless ("washed out")
Source
An1

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70304-1 I feel tired

Observation ID in Form

An2

Fully-Specified Name

Component
I feel tired 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 tired
Source
An2/pF1

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
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

70728-1 I have trouble starting things because I am tired

Observation ID in Form

An3

Fully-Specified Name

Component
I have trouble starting things because I am tired 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 trouble starting things because I am tired
Source
An3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70729-9 I have trouble finishing things because I am tired

Observation ID in Form

An4

Fully-Specified Name

Component
I have trouble finishing things because I am tired 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 trouble finishing things because I am tired
Source
An4

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70730-7 I have energy

Observation ID in Form

An5

Fully-Specified Name

Component
I have 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 energy
Source
An5

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

61890-0 During the past 7 days - I am able to do my usual activities

Observation ID in Form

An7

Fully-Specified Name

Component
I am able to do my usual activities in past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.34
Last Updated
Version 2.54

Survey Question

Text
During the past 7 days - I am able to do my usual activities
Source
An7

Normative Answer List LL1017-4

Answer Code Score Answer ID
Not at all 1 LA6568-5
A little bit 2 LA13863-8
Somewhat 3 LA13909-9
Quite a bit 4 LA13902-4
Very much 5 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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
61795-1 PROMIS item bank - fatigue - version 1.0

70731-5 I need to sleep during the day

Observation ID in Form

An8

Fully-Specified Name

Component
I need to sleep during the day 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 need to sleep during the day
Source
An8

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70732-3 I am too tired to eat

Observation ID in Form

An12

Fully-Specified Name

Component
I am too tired to eat 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 too tired to eat
Source
An12

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70303-3 I need help doing my usual activities

Observation ID in Form

An14

Fully-Specified Name

Component
I need help doing my usual activities 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 need help doing my usual activities
Source
An14

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70733-1 I am frustrated by being too tired to do the things I want to do

Observation ID in Form

An15

Fully-Specified Name

Component
I am frustrated by being too tired to do the things I want to do 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 frustrated by being too tired to do the things I want to do
Source
An15

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70734-9 I have to limit my social activity because I am tired

Observation ID in Form

An16

Fully-Specified Name

Component
I have to limit my social activity because I am tired 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 to limit my social activity because I am tired
Source
An16

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70735-6 Functional Assessment of Chronic Illness Therapy-Fatigue Questionnaire -13 items - version 4 (FACIT - fatigue 13)

Term Description

Functional Assessment of Chronic Illness Therapy-Fatigue; a 13-item FACIT Fatigue Scale
Source: Regenstrief LOINC

Form Coding Instructions

Please circle or mark one number per line to indicate your response as it applies to the past 7 days

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of chronic illness therapy - fatigue questionnaire -13 items - 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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70426-2 I feel fatigued

Observation ID in Form

HI7

Fully-Specified Name

Component
I feel fatigued 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 fatigued
Source
HI7

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

70425-4 I feel weak all over

Observation ID in Form

HI12

Fully-Specified Name

Component
I feel weak all over 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
Release 2.67: SURVEY_QUEST_TEXT: Corrected the omission of "over" from Survey Question Text; Previous Releases: 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 weak all over
Source
HI12

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
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70727-3 I feel listless ("washed out")

Observation ID in Form

An1

Fully-Specified Name

Component
I feel listless - washed 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 2.66
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 listless ("washed out")
Source
An1

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70304-1 I feel tired

Observation ID in Form

An2

Fully-Specified Name

Component
I feel tired 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 tired
Source
An2/pF1

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
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

70728-1 I have trouble starting things because I am tired

Observation ID in Form

An3

Fully-Specified Name

Component
I have trouble starting things because I am tired 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 trouble starting things because I am tired
Source
An3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70729-9 I have trouble finishing things because I am tired

Observation ID in Form

An4

Fully-Specified Name

Component
I have trouble finishing things because I am tired 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 trouble finishing things because I am tired
Source
An4

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70730-7 I have energy

Observation ID in Form

An5

Fully-Specified Name

Component
I have 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 energy
Source
An5

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

61890-0 During the past 7 days - I am able to do my usual activities

Observation ID in Form

An7

Fully-Specified Name

Component
I am able to do my usual activities in past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.34
Last Updated
Version 2.54

Survey Question

Text
During the past 7 days - I am able to do my usual activities
Source
An7

Normative Answer List LL1017-4

Answer Code Score Answer ID
Not at all 1 LA6568-5
A little bit 2 LA13863-8
Somewhat 3 LA13909-9
Quite a bit 4 LA13902-4
Very much 5 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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
61795-1 PROMIS item bank - fatigue - version 1.0

70731-5 I need to sleep during the day

Observation ID in Form

An8

Fully-Specified Name

Component
I need to sleep during the day 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 need to sleep during the day
Source
An8

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70732-3 I am too tired to eat

Observation ID in Form

An12

Fully-Specified Name

Component
I am too tired to eat 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 too tired to eat
Source
An12

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70303-3 I need help doing my usual activities

Observation ID in Form

An14

Fully-Specified Name

Component
I need help doing my usual activities 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 need help doing my usual activities
Source
An14

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70733-1 I am frustrated by being too tired to do the things I want to do

Observation ID in Form

An15

Fully-Specified Name

Component
I am frustrated by being too tired to do the things I want to do 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 frustrated by being too tired to do the things I want to do
Source
An15

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70734-9 I have to limit my social activity because I am tired

Observation ID in Form

An16

Fully-Specified Name

Component
I have to limit my social activity because I am tired 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 to limit my social activity because I am tired
Source
An16

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70736-4 Functional Assessment of Cancer Therapy for patients with anemia - fatigue questionnaire - version 4 (FACT-An) [FACIT]

Term Description

For patients with Anemia/Fatigue
Source: Regenstrief LOINC

Form Coding Instructions

Please circle or mark one number per line to indicate your response as it applies to the past 7 days

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of cancer therapy for patients with anemia - fatigue 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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom 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

70896-6 Additional concerns - FACT-An [FACIT]

Fully-Specified Name

Component
Additional concerns - FACT-An
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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70426-2 I feel fatigued

Observation ID in Form

HI7

Fully-Specified Name

Component
I feel fatigued 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 fatigued
Source
HI7

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

70425-4 I feel weak all over

Observation ID in Form

HI12

Fully-Specified Name

Component
I feel weak all over 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
Release 2.67: SURVEY_QUEST_TEXT: Corrected the omission of "over" from Survey Question Text; Previous Releases: 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 weak all over
Source
HI12

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
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70727-3 I feel listless ("washed out")

Observation ID in Form

An1

Fully-Specified Name

Component
I feel listless - washed 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 2.66
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 listless ("washed out")
Source
An1

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70304-1 I feel tired

Observation ID in Form

An2

Fully-Specified Name

Component
I feel tired 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 tired
Source
An2/pF1

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
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

70728-1 I have trouble starting things because I am tired

Observation ID in Form

An3

Fully-Specified Name

Component
I have trouble starting things because I am tired 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 trouble starting things because I am tired
Source
An3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70729-9 I have trouble finishing things because I am tired

Observation ID in Form

An4

Fully-Specified Name

Component
I have trouble finishing things because I am tired 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 trouble finishing things because I am tired
Source
An4

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70730-7 I have energy

Observation ID in Form

An5

Fully-Specified Name

Component
I have 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 energy
Source
An5

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70632-5 I have trouble walking

Observation ID in Form

An6

Fully-Specified Name

Component
I have trouble 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 2.66
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 trouble walking
Source
An6

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
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

61890-0 During the past 7 days - I am able to do my usual activities

Observation ID in Form

An7

Fully-Specified Name

Component
I am able to do my usual activities in past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.34
Last Updated
Version 2.54

Survey Question

Text
During the past 7 days - I am able to do my usual activities
Source
An7

Normative Answer List LL1017-4

Answer Code Score Answer ID
Not at all 1 LA6568-5
A little bit 2 LA13863-8
Somewhat 3 LA13909-9
Quite a bit 4 LA13902-4
Very much 5 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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
61795-1 PROMIS item bank - fatigue - version 1.0

70731-5 I need to sleep during the day

Observation ID in Form

An8

Fully-Specified Name

Component
I need to sleep during the day 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 need to sleep during the day
Source
An8

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70560-8 I feel light-headed (dizzy)

Observation ID in Form

An9

Fully-Specified Name

Component
I feel light-headed, dizzy 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 light-headed (dizzy)
Source
An9

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
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70302-5 I get headaches

Observation ID in Form

An10

Fully-Specified Name

Component
I get headaches 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 headaches
Source
An10

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom 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

70737-2 I have pain in my chest

Observation ID in Form

An11

Fully-Specified Name

Component
I have pain in my chest 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 in my chest
Source
An11

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70732-3 I am too tired to eat

Observation ID in Form

An12

Fully-Specified Name

Component
I am too tired to eat 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 too tired to eat
Source
An12

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70317-3 I am interested in sex

Observation ID in Form

BL4

Fully-Specified Name

Component
I am interested in sex 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 interested in sex
Source
BL4

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
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

70738-0 I am motivated to do my usual activities

Observation ID in Form

An13

Fully-Specified Name

Component
I am motivated to do my usual activities 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 motivated to do my usual activities
Source
An13

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70303-3 I need help doing my usual activities

Observation ID in Form

An14

Fully-Specified Name

Component
I need help doing my usual activities 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 need help doing my usual activities
Source
An14

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70733-1 I am frustrated by being too tired to do the things I want to do

Observation ID in Form

An15

Fully-Specified Name

Component
I am frustrated by being too tired to do the things I want to do 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 frustrated by being too tired to do the things I want to do
Source
An15

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70734-9 I have to limit my social activity because I am tired

Observation ID in Form

An16

Fully-Specified Name

Component
I have to limit my social activity because I am tired 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 to limit my social activity because I am tired
Source
An16

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70739-8 Functional Assessment of Cancer Therapy for Patients with lymphedema questionnaire - version 4 (FACT-B + 4) [FACIT]

Term Description

For patients with Lymphedema (to be used with FACT-B)
Source: Regenstrief LOINC

Form Coding Instructions

Please circle or mark one number per line to indicate your response as it applies to the past 7 days

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of cancer therapy for patients with lymphedema 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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom 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

70897-4 Additional concerns - FACT-B+4 [FACIT]

Fully-Specified Name

Component
Additional concerns - FACT-B+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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom 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

70306-6 I am self-conscious about the way I dress

Observation ID in Form

B2

Fully-Specified Name

Component
I am self-conscious about the way I dress 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 self-conscious about the way I dress
Source
B2

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70307-4 One or more of my arms are swollen or tender

Observation ID in Form

B3

Fully-Specified Name

Component
One or more of my arms are swollen or tender 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
One or more of my arms are swollen or tender
Source
B3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70308-2 I feel sexually attractive

Observation ID in Form

B4

Fully-Specified Name

Component
I feel sexually attractive 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 sexually attractive
Source
B4

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70309-0 I am bothered by hair loss

Observation ID in Form

B5

Fully-Specified Name

Component
I am bothered by hair loss 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 hair loss
Source
B5

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
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

70310-8 I worry that other members of my family might someday get the same illness I have

Observation ID in Form

B6

Fully-Specified Name

Component
I worry that other members of my family might someday get the same illness I have 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 other members of my family might someday get the same illness I have
Source
B6

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70311-6 I worry about the effect of stress on my illness

Observation ID in Form

B7

Fully-Specified Name

Component
I worry about the effect of stress on 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 worry about the effect of stress on my illness
Source
B7

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70312-4 I am bothered by a change in weight

Observation ID in Form

B8

Fully-Specified Name

Component
I am bothered by a change in 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 bothered by a change in weight
Source
B8

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70313-2 I am able to feel like a woman

Observation ID in Form

B9

Fully-Specified Name

Component
I am able to feel like a woman 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 feel like a woman
Source
B9

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70481-7 I have certain parts of my body where I experience pain

Observation ID in Form

P2

Fully-Specified Name

Component
I have certain parts of my body where I experience 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 certain parts of my body where I experience pain
Source
P2

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70740-6 On which side was your breast operation

Observation ID in Form

Q6

Fully-Specified Name

Component
On which side was your breast operation
Property
Find
Time
Pt
System
^Patient
Scale
Nom
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.52

Survey Question

Text
On which side was your breast operation
Source
Q6

Normative Answer List LL1973-8

Answer Code Score Answer ID
Left LA4585-1
Right LA4306-2

Member of these Panels

LOINC Long Common Name
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70741-4 Movement of my arm on this side is painful

Observation ID in Form

B10

Fully-Specified Name

Component
Movement of my arm on this side is painful 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
Movement of my arm on this side is painful
Source
B10

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70742-2 I have a poor range of arm movements on this side

Observation ID in Form

B11

Fully-Specified Name

Component
I have a poor range of arm movements on this side 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 poor range of arm movements on this side
Source
B11

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70743-0 My arm on this side feels numb

Observation ID in Form

B12

Fully-Specified Name

Component
My arm on this side feels numb 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 arm on this side feels numb
Source
B12

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70744-8 I have stiffness of my arm on this side

Observation ID in Form

B13

Fully-Specified Name

Component
I have stiffness of my arm on this side 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 stiffness of my arm on this side
Source
B13

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70745-5 Functional Assessment of Cancer Therapy for patients with bone pain questionnaire (FACT-BP) [FACIT]

Term Description

For patients with Bone Pain
Source: Regenstrief LOINC

Form Coding Instructions

Please circle or mark one number per line to indicate your response as it applies to the past 7 days

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of cancer therapy for patients with bone pain 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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70746-3 In how many places in your body have you felt bone pain

Observation ID in Form

Q7

Fully-Specified Name

Component
In how many places in your body have you felt bone pain
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
In how many places in your body have you felt bone pain
Source
Q7

Normative Answer List LL2042-1

Answer Code Score Answer ID
0 LA6111-4
1 LA6112-2
2 or more LA6113-0
3 LA6114-8
4+ LA11844-0

Member of these Panels

LOINC Long Common Name
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom 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

70481-7 I have certain parts of my body where I experience pain

Observation ID in Form

P2

Fully-Specified Name

Component
I have certain parts of my body where I experience 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 certain parts of my body where I experience pain
Source
P2

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70322-3 I have bone pain

Observation ID in Form

BP1

Fully-Specified Name

Component
I have bone 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 bone pain
Source
BP1

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70747-1 It hurts when I put weight or pressure on the place where I have bone pain

Observation ID in Form

BP2

Fully-Specified Name

Component
It hurts when I put weight or pressure on the place where I have bone 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
It hurts when I put weight or pressure on the place where I have bone pain
Source
BP2

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70748-9 I have bone pain even when I sit or lie still

Observation ID in Form

BP3

Fully-Specified Name

Component
I have bone pain even when I sit or lie still 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 bone pain even when I sit or lie still
Source
BP3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70749-7 I need help doing my usual activities because of bone pain

Observation ID in Form

BP4

Fully-Specified Name

Component
I need help doing my usual activities because of bone 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 need help doing my usual activities because of bone pain
Source
BP4

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70750-5 I am forced to rest during the day because of bone pain

Observation ID in Form

BP5

Fully-Specified Name

Component
I am forced to rest during the day because of bone 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 am forced to rest during the day because of bone pain
Source
BP5

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70751-3 I have trouble walking because of bone pain

Observation ID in Form

BP6

Fully-Specified Name

Component
I have trouble walking because of bone 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 trouble walking because of bone pain
Source
BP6

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70752-1 Bone pain interferes with my ability to care for myself (bathing, dressing, eating, etc.)

Observation ID in Form

BP7

Fully-Specified Name

Component
Bone pain interferes with my ability to care for myself - bathing, dressing, eating, 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 2.66
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
Bone pain interferes with my ability to care for myself (bathing, dressing, eating, etc.)
Source
BP7

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70753-9 Bone pain interferes with my social activities

Observation ID in Form

BP8

Fully-Specified Name

Component
Bone pain interferes with my social activities 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
Bone pain interferes with my social activities
Source
BP8

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70754-7 Bone pain wakes me up at night

Observation ID in Form

BP9

Fully-Specified Name

Component
Bone pain wakes me up at night 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
Bone pain wakes me up at night
Source
BP9

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70755-4 I am frustrated by my bone pain

Observation ID in Form

BP10

Fully-Specified Name

Component
I am frustrated by my bone 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 am frustrated by my bone pain
Source
BP10

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70756-2 I feel depressed about my bone pain

Observation ID in Form

BP11

Fully-Specified Name

Component
I feel depressed about my bone 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 feel depressed about my bone pain
Source
BP11

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70757-0 I worry that my bone pain will get worse

Observation ID in Form

BP12

Fully-Specified Name

Component
I worry that my bone pain 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 bone pain will get worse
Source
BP12

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70758-8 My family has trouble understanding when my bone pain interferes with my activity

Observation ID in Form

BP13

Fully-Specified Name

Component
My family has trouble understanding when my bone pain interferes with my activity 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 trouble understanding when my bone pain interferes with my activity
Source
BP13

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70759-6 Functional Assessment of Cancer Therapy for patients with cognitive function issues questionnaire - version 3 (FACT-Cog) [FACIT]

Term Description

For patients with Cognitive function issues
Source: Regenstrief LOINC

Form Coding Instructions

Please circle or mark one number per line to indicate your response as it applies to the past 7 days

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of cancer therapy for patients with cognitive function issues questionnaire - version 3
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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70849-5 Perceived cognitive impairments [FACIT]

Fully-Specified Name

Component
Perceived cognitive impairments
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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70760-4 I have had trouble forming thoughts

Observation ID in Form

CogA1

Fully-Specified Name

Component
I have had trouble forming thoughts 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 had trouble forming thoughts
Source
CogA1

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70761-2 My thinking has been slow

Observation ID in Form

CogA3

Fully-Specified Name

Component
My thinking has been slow 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 has been slow
Source
CogA3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70762-0 I have had trouble concentrating

Observation ID in Form

CogC7

Fully-Specified Name

Component
I have had trouble concentrating 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 had trouble concentrating
Source
CogC7

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70763-8 I have had trouble finding my way to a familiar place

Observation ID in Form

CogM9

Fully-Specified Name

Component
I have had trouble finding my way to a familiar place 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 had trouble finding my way to a familiar place
Source
CogM9

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70764-6 I have had trouble remembering where I put things, like my keys or my wallet

Observation ID in Form

CogM10

Fully-Specified Name

Component
I have had trouble remembering where I put things, like my keys or my wallet 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 had trouble remembering where I put things, like my keys or my wallet
Source
CogM10

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70765-3 I have had trouble remembering new information, like phone numbers or simple instructions

Observation ID in Form

CogM12

Fully-Specified Name

Component
I have had trouble remembering new information, like phone numbers or simple instructions 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 had trouble remembering new information, like phone numbers or simple instructions
Source
CogM12

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70766-1 I have had trouble recalling the name of an object while talking to someone

Observation ID in Form

CogV13

Fully-Specified Name

Component
I have had trouble recalling the name of an object while talking to someone 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 had trouble recalling the name of an object while talking to someone
Source
CogV13

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70767-9 I have had trouble finding the right words to express myself

Observation ID in Form

CogV15

Fully-Specified Name

Component
I have had trouble finding the right words to express myself 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 had trouble finding the right words to express myself
Source
CogV15

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70768-7 I have used the wrong word when I referred to an object

Observation ID in Form

CogV16

Fully-Specified Name

Component
I have used the wrong word when I referred to an object 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 used the wrong word when I referred to an object
Source
CogV16

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70769-5 I have had trouble saying what I mean in conversations with others

Observation ID in Form

CogV17b

Fully-Specified Name

Component
I have had trouble saying what I mean in conversations with others 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 had trouble saying what I mean in conversations with others
Source
CogV17b

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70770-3 I have walked into a room and forgotten what I meant to get or do there

Observation ID in Form

CogF19

Fully-Specified Name

Component
I have walked into a room and forgotten what I meant to get or do there 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 walked into a room and forgotten what I meant to get or do there
Source
CogF19

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70771-1 I have had to work really hard to pay attention or I would make a mistake

Observation ID in Form

CogF23

Fully-Specified Name

Component
I have had to work really hard to pay attention or I would make a mistake 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 had to work really hard to pay attention or I would make a mistake
Source
CogF23

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70772-9 I have forgotten names of people soon after being introduced

Observation ID in Form

CogF24

Fully-Specified Name

Component
I have forgotten names of people soon after being introduced 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 forgotten names of people soon after being introduced
Source
CogF24

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70773-7 My reactions in everyday situations have been slow

Observation ID in Form

CogF25

Fully-Specified Name

Component
My reactions in everyday situations have been slow 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 reactions in everyday situations have been slow
Source
CogF25

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70776-0 I have had to work harder than usual to keep track of what I was doing

Observation ID in Form

CogC31

Fully-Specified Name

Component
I have had to work harder than usual to keep track of what I was doing 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 had to work harder than usual to keep track of what I was doing
Source
CogC31

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70777-8 My thinking has been slower than usual

Observation ID in Form

CogC32

Fully-Specified Name

Component
My thinking has been slower than usual 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 has been slower than usual
Source
CogC32

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70778-6 I have had to work harder than usual to express myself clearly

Observation ID in Form

CogC33a

Fully-Specified Name

Component
I have had to work harder than usual to express myself clearly 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 had to work harder than usual to express myself clearly
Source
CogC33a

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70779-4 I have had to use written lists more often than usual so I would not forget things

Observation ID in Form

CogC33c

Fully-Specified Name

Component
I have had to use written lists more often than usual so I would not forget things 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 had to use written lists more often than usual so I would not forget things
Source
CogC33c

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70781-0 I have trouble shifting back and forth between different activities that require thinking

Observation ID in Form

CogMT2

Fully-Specified Name

Component
I have trouble shifting back and forth between different activities that require thinking 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 trouble shifting back and forth between different activities that require thinking
Source
CogMT2

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70774-5 Comments from others [FACIT]

Fully-Specified Name

Component
Comments from others
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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70775-2 Other people have told me I seemed to have trouble remembering information

Observation ID in Form

CogO1

Fully-Specified Name

Component
Other people have told me I seemed to have trouble remembering information 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
Other people have told me I seemed to have trouble remembering information
Source
CogO1

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70782-8 Other people have told me I seemed to have trouble speaking clearly

Observation ID in Form

CogO2

Fully-Specified Name

Component
Other people have told me I seemed to have trouble speaking clearly 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
Other people have told me I seemed to have trouble speaking clearly
Source
CogO2

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70783-6 Other people have told me I seemed to have trouble thinking clearly

Observation ID in Form

CogO3

Fully-Specified Name

Component
Other people have told me I seemed to have trouble thinking clearly 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
Other people have told me I seemed to have trouble thinking clearly
Source
CogO3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70784-4 Other people have told me I seemed confused

Observation ID in Form

CogO4

Fully-Specified Name

Component
Other people have told me I seemed confused 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
Other people have told me I seemed confused
Source
CogO4

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70785-1 Perceived cognitive abilities [FACIT]

Fully-Specified Name

Component
Perceived cognitive abilities
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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70786-9 I have been able to concentrate

Observation ID in Form

CogPC1

Fully-Specified Name

Component
I have been able to concentrate 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 able to concentrate
Source
CogPC1

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70787-7 I have been able to bring to mind words that I wanted to use while talking to someone

Observation ID in Form

CogPV1

Fully-Specified Name

Component
I have been able to bring to mind words that I wanted to use while talking to someone 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 able to bring to mind words that I wanted to use while talking to someone
Source
CogPV1

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70788-5 I have been able to remember things, like where I left my keys or wallet

Observation ID in Form

CogPM1

Fully-Specified Name

Component
I have been able to remember things, like where I left my keys or wallet, 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 able to remember things, like where I left my keys or wallet
Source
CogPM1

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70789-3 I have been able to remember to do things, like take medicine or buy something I needed

Observation ID in Form

CogPM2

Fully-Specified Name

Component
I have been able to remember to do things, like take medicine or buy something I needed, 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 able to remember to do things, like take medicine or buy something I needed
Source
CogPM2

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70790-1 I am able to pay attention and keep track of what I am doing without extra effort

Observation ID in Form

CogPF1

Fully-Specified Name

Component
I am able to pay attention and keep track of what I am doing without extra effort 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 pay attention and keep track of what I am doing without extra effort
Source
CogPF1

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70791-9 My mind is as sharp as it has always been

Observation ID in Form

CogPCH1

Fully-Specified Name

Component
My mind is as sharp as it has always been 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 mind is as sharp as it has always been
Source
CogPCH1

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70792-7 My memory is as good as it has always been

Observation ID in Form

CogPCH2

Fully-Specified Name

Component
My memory is as good as it has always been 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 memory is as good as it has always been
Source
CogPCH2

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70793-5 I am able to shift back and forth between two activities that require thinking

Observation ID in Form

CogPMT1

Fully-Specified Name

Component
I am able to shift back and forth between two activities that require thinking 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 shift back and forth between two activities that require thinking
Source
CogPMT1

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70794-3 I am able to keep track of what I am doing, even if I am interrupted

Observation ID in Form

CogPMT2

Fully-Specified Name

Component
I am able to keep track of what I am doing, even if I am interrupted 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 keep track of what I am doing, even if I am interrupted
Source
CogPMT2

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70795-0 Impact on quality of life [FACIT]

Fully-Specified Name

Component
Impact on quality of life
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.69
Change Reason
Release 2.69: PROPERTY: Updated the Property and Scale to dash to reflect that this is a panel term;
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70796-8 I have been upset about these problems

Observation ID in Form

CogQ35

Fully-Specified Name

Component
I have been upset about these problems 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 upset about these problems
Source
CogQ35

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70797-6 These problems have interfered with my ability to work

Observation ID in Form

CogQ37

Fully-Specified Name

Component
These problems have interfered with my ability to work 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
These problems have interfered with my ability to work
Source
CogQ37

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70798-4 These problems have interfered with my ability to do things I enjoy

Observation ID in Form

CogQ38

Fully-Specified Name

Component
These problems have interfered with my ability to do things I enjoy 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
These problems have interfered with my ability to do things I enjoy
Source
CogQ38

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70799-2 These problems have interfered with the quality of my life

Observation ID in Form

CogQ41

Fully-Specified Name

Component
These problems have interfered with the quality of my 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
These problems have interfered with the quality of my life
Source
CogQ41

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70800-8 Functional Assessment of Cancer Therapy for patients with endocrine symptoms questionnaire - version 4 (FACT-ES) [FACIT]

Term Description

For patients with Endocrine Symptoms
Source: Regenstrief LOINC

Form Coding Instructions

Please circle or mark one number per line to indicate your response as it applies to the past 7 days

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of cancer therapy for patients with endocrine symptoms 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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom 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

70898-2 Additional concerns - FACT-ES [FACIT]

Fully-Specified Name

Component
Additional concerns - FACT-ES
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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70376-9 I have hot flashes

Observation ID in Form

ES1

Fully-Specified Name

Component
I have hot flashes 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 hot flashes
Source
ES1

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70378-5 I have cold sweats

Observation ID in Form

ES2

Fully-Specified Name

Component
I have cold sweats 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 cold sweats
Source
ES2

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70379-3 I have night sweats

Observation ID in Form

ES3

Fully-Specified Name

Component
I have night sweats 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 night sweats
Source
ES3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70380-1 I have vaginal discharge

Observation ID in Form

ES4

Fully-Specified Name

Component
I have vaginal discharge 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 vaginal discharge
Source
ES4

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70801-6 I have vaginal itching/irritation

Observation ID in Form

ES5

Fully-Specified Name

Component
I have vaginal itching - irritation - 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 vaginal itching/irritation
Source
ES5

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70381-9 I have vaginal bleeding or spotting

Observation ID in Form

ES6

Fully-Specified Name

Component
I have vaginal bleeding or spotting 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 vaginal bleeding or spotting
Source
ES6

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70802-4 I have vaginal dryness

Observation ID in Form

ES7

Fully-Specified Name

Component
I have vaginal dryness 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 vaginal dryness
Source
ES7

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70382-7 I have pain or discomfort with intercourse

Observation ID in Form

ES8

Fully-Specified Name

Component
I have pain or discomfort with intercourse 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 or discomfort with intercourse
Source
ES8

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70803-2 I have lost interest in sex

Observation ID in Form

ES9

Fully-Specified Name

Component
I have lost interest in sex 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 lost interest in sex
Source
ES9

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70377-7 I have gained weight

Observation ID in Form

ES10

Fully-Specified Name

Component
I have gained 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 have gained weight
Source
ES10

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70560-8 I feel light-headed (dizzy)

Observation ID in Form

An9

Fully-Specified Name

Component
I feel light-headed, dizzy 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 light-headed (dizzy)
Source
An9

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
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom 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

70349-6 I have diarrhea

Observation ID in Form

C5

Fully-Specified Name

Component
I have diarrhea 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 diarrhea
Source
C5

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70302-5 I get headaches

Observation ID in Form

An10

Fully-Specified Name

Component
I get headaches 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 headaches
Source
An10

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70656-4 I feel bloated

Observation ID in Form

Tax1

Fully-Specified Name

Component
I feel bloated 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 bloated
Source
Tax1

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
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

70804-0 I have breast sensitivity/tenderness

Observation ID in Form

ES11

Fully-Specified Name

Component
I have breast sensitivity - tenderness - 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 breast sensitivity/tenderness
Source
ES11

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70805-7 I have mood swings

Observation ID in Form

ES12

Fully-Specified Name

Component
I have mood swings 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 mood swings
Source
ES12

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70806-5 I am irritable

Observation ID in Form

ES13

Fully-Specified Name

Component
I am irritable 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 irritable
Source
ES13

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70670-5 I have pain in my joints

Observation ID in Form

BRM1

Fully-Specified Name

Component
I have pain in my joints 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 in my joints
Source
BRM1

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
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

70807-3 Functional assessment of cancer therapy for patients with neutropenia questionnaire - version 4 (FACT-N) [FACIT]

Term Description

For patients with Neutropenia
Source: Regenstrief LOINC

Form Coding Instructions

Please circle or mark one number per line to indicate your response as it applies to the past 7 days

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of cancer therapy for patients with neutropenia 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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom 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

70899-0 Additional concerns - FACT-N [FACIT]

Fully-Specified Name

Component
Additional concerns - FACT-N
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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70808-1 I worry about getting sick due to low blood counts

Observation ID in Form

N1

Fully-Specified Name

Component
I worry about getting sick due to low blood counts 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 getting sick due to low blood counts
Source
N1

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70809-9 I avoid public places for fear of getting an infection

Observation ID in Form

N2

Fully-Specified Name

Component
I avoid public places for fear of getting an infection 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 avoid public places for fear of getting an infection
Source
N2

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70810-7 I get aches and pains that bother me

Observation ID in Form

P1

Fully-Specified Name

Component
I get aches and pains that bother 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 2.66
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 aches and pains that bother me
Source
P1

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70303-3 I need help doing my usual activities

Observation ID in Form

An14

Fully-Specified Name

Component
I need help doing my usual activities 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 need help doing my usual activities
Source
An14

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70470-0 I worry about getting infections

Observation ID in Form

N3

Fully-Specified Name

Component
I worry about getting infections 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 getting infections
Source
N3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70811-5 I worry my condition will not improve if my treatment is delayed

Observation ID in Form

N4

Fully-Specified Name

Component
I worry my condition will not improve if my treatment is delayed 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 my condition will not improve if my treatment is delayed
Source
N4

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70730-7 I have energy

Observation ID in Form

An5

Fully-Specified Name

Component
I have 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 energy
Source
An5

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70344-7 I am bothered by fevers (episodes of high body temperature)

Observation ID in Form

BRM3

Fully-Specified Name

Component
I am bothered by fevers - episodes of high body temperature - 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 fevers (episodes of high body temperature)
Source
BRM3

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
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70527-7 I am bothered by the chills

Observation ID in Form

BRM2

Fully-Specified Name

Component
I am bothered by the chills 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 the chills
Source
BRM2

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
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

70379-3 I have night sweats

Observation ID in Form

ES3

Fully-Specified Name

Component
I have night sweats 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 night sweats
Source
ES3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70734-9 I have to limit my social activity because I am tired

Observation ID in Form

An16

Fully-Specified Name

Component
I have to limit my social activity because I am tired 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 to limit my social activity because I am tired
Source
An16

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70815-6 I need to rest during the day

Observation ID in Form

MS10

Fully-Specified Name

Component
I need to rest during the day 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 need to rest during the day
Source
MS10

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70727-3 I feel listless ("washed out")

Observation ID in Form

An1

Fully-Specified Name

Component
I feel listless - washed 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 2.66
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 listless ("washed out")
Source
An1

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70738-0 I am motivated to do my usual activities

Observation ID in Form

An13

Fully-Specified Name

Component
I am motivated to do my usual activities 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 motivated to do my usual activities
Source
An13

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70561-6 I have mouth sores

Observation ID in Form

N6

Fully-Specified Name

Component
I have mouth sores 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 mouth sores
Source
N6

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
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70812-3 My partner worries about me when my blood counts are low

Observation ID in Form

N7

Fully-Specified Name

Component
My partner worries about me when my blood counts are low 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 partner worries about me when my blood counts are low
Source
N7

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70813-1 My low blood counts interfere with my intimate relationships

Observation ID in Form

N8

Fully-Specified Name

Component
My low blood counts interfere with my intimate relationships 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 low blood counts interfere with my intimate relationships
Source
N8

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70728-1 I have trouble starting things because I am tired

Observation ID in Form

An3

Fully-Specified Name

Component
I have trouble starting things because I am tired 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 trouble starting things because I am tired
Source
An3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70814-9 I am bothered by headaches

Observation ID in Form

MS3

Fully-Specified Name

Component
I am bothered by headaches 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 headaches
Source
MS3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70816-4 Functional Assessment of Cancer Therapy for patients with thrombocytopenia questionnaire -11 items - version 4 (FACT-Th11) [FACIT]

Term Description

For patients with Thrombocytopenia-11itmes
Source: Regenstrief LOINC

Form Coding Instructions

Please circle or mark one number per line to indicate your response as it applies to the past 7 days

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of cancer therapy for patients with thrombocytopenia questionnaire - 11 items - 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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom 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

70900-6 Additional concerns - FACT-Th11 [FACIT]

Fully-Specified Name

Component
Additional concerns - FACT-Th11
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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70730-7 I have energy

Observation ID in Form

An5

Fully-Specified Name

Component
I have 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 energy
Source
An5

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

61890-0 During the past 7 days - I am able to do my usual activities

Observation ID in Form

An7

Fully-Specified Name

Component
I am able to do my usual activities in past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.34
Last Updated
Version 2.54

Survey Question

Text
During the past 7 days - I am able to do my usual activities
Source
An7

Normative Answer List LL1017-4

Answer Code Score Answer ID
Not at all 1 LA6568-5
A little bit 2 LA13863-8
Somewhat 3 LA13909-9
Quite a bit 4 LA13902-4
Very much 5 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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
61795-1 PROMIS item bank - fatigue - version 1.0

70484-1 I bleed easily

Observation ID in Form

TH1

Fully-Specified Name

Component
I bleed easily 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 bleed easily
Source
TH1

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70485-8 I bruise easily

Observation ID in Form

TH2

Fully-Specified Name

Component
I bruise easily 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 bruise easily
Source
TH2

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70817-2 I worry about problems with bruising or bleeding

Observation ID in Form

TH3

Fully-Specified Name

Component
I worry about problems with bruising or bleeding 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 problems with bruising or bleeding
Source
TH3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70818-0 I am bothered by nosebleeds

Observation ID in Form

TH5

Fully-Specified Name

Component
I am bothered by nosebleeds 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 nosebleeds
Source
TH5

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70819-8 I am bothered by pinpoint bruising beneath my skin

Observation ID in Form

TH7

Fully-Specified Name

Component
I am bothered by pinpoint bruising beneath my skin 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 pinpoint bruising beneath my skin
Source
TH7

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70820-6 I am bothered by blood in my urine or stool

Observation ID in Form

TH8

Fully-Specified Name

Component
I am bothered by blood in my urine or stool 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 blood in my urine or stool
Source
TH8

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70821-4 I avoid or limit physical activity, because of concern with bleeding or bruising

Observation ID in Form

TH10

Fully-Specified Name

Component
I avoid or limit physical activity, because of concern with bleeding or bruising, 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 avoid or limit physical activity, because of concern with bleeding or bruising
Source
TH10

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70822-2 I am frustrated by not being able to do my usual activities

Observation ID in Form

TH12

Fully-Specified Name

Component
I am frustrated by not being able to do my usual activities 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 frustrated by not being able to do my usual activities
Source
TH12

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70823-0 I worry that my treatment will be delayed, because of low blood counts

Observation ID in Form

TH13

Fully-Specified Name

Component
I worry that my treatment will be delayed, because of low blood counts, 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 treatment will be delayed, because of low blood counts
Source
TH13

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70824-8 Functional Assessment of Cancer Therapy for patients with thrombocytopenia questionnaire -18 items - version 4 (FACT-Th18) [FACIT]

Term Description

For patients with Thrombocytopenia-18 items
Source: Regenstrief LOINC

Form Coding Instructions

Please circle or mark one number per line to indicate your response as it applies to the past 7 days

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of cancer therapy for patients with thrombocytopenia questionnaire - 18 items - 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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom 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

70901-4 Additional concerns - FACT-Th18 [FACIT]

Fully-Specified Name

Component
Additional concerns - FACT-Th18
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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70730-7 I have energy

Observation ID in Form

An5

Fully-Specified Name

Component
I have 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 energy
Source
An5

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

61890-0 During the past 7 days - I am able to do my usual activities

Observation ID in Form

An7

Fully-Specified Name

Component
I am able to do my usual activities in past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.34
Last Updated
Version 2.54

Survey Question

Text
During the past 7 days - I am able to do my usual activities
Source
An7

Normative Answer List LL1017-4

Answer Code Score Answer ID
Not at all 1 LA6568-5
A little bit 2 LA13863-8
Somewhat 3 LA13909-9
Quite a bit 4 LA13902-4
Very much 5 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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
61795-1 PROMIS item bank - fatigue - version 1.0

70484-1 I bleed easily

Observation ID in Form

TH1

Fully-Specified Name

Component
I bleed easily 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 bleed easily
Source
TH1

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70485-8 I bruise easily

Observation ID in Form

TH2

Fully-Specified Name

Component
I bruise easily 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 bruise easily
Source
TH2

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70817-2 I worry about problems with bruising or bleeding

Observation ID in Form

TH3

Fully-Specified Name

Component
I worry about problems with bruising or bleeding 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 problems with bruising or bleeding
Source
TH3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70825-5 I worry about the possibility of serious bleeding

Observation ID in Form

TH4

Fully-Specified Name

Component
I worry about the possibility of serious bleeding 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 the possibility of serious bleeding
Source
TH4

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70818-0 I am bothered by nosebleeds

Observation ID in Form

TH5

Fully-Specified Name

Component
I am bothered by nosebleeds 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 nosebleeds
Source
TH5

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70826-3 I am bothered by bleeding in my gums or mouth

Observation ID in Form

TH6

Fully-Specified Name

Component
I am bothered by bleeding in my gums or mouth 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 bleeding in my gums or mouth
Source
TH6

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70819-8 I am bothered by pinpoint bruising beneath my skin

Observation ID in Form

TH7

Fully-Specified Name

Component
I am bothered by pinpoint bruising beneath my skin 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 pinpoint bruising beneath my skin
Source
TH7

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70820-6 I am bothered by blood in my urine or stool

Observation ID in Form

TH8

Fully-Specified Name

Component
I am bothered by blood in my urine or stool 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 blood in my urine or stool
Source
TH8

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70827-1 I am inconvenienced by platelet transfusions

Observation ID in Form

TH9

Fully-Specified Name

Component
I am inconvenienced by platelet transfusions 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 inconvenienced by platelet transfusions
Source
TH9

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70426-2 I feel fatigued

Observation ID in Form

HI7

Fully-Specified Name

Component
I feel fatigued 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 fatigued
Source
HI7

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

70821-4 I avoid or limit physical activity, because of concern with bleeding or bruising

Observation ID in Form

TH10

Fully-Specified Name

Component
I avoid or limit physical activity, because of concern with bleeding or bruising, 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 avoid or limit physical activity, because of concern with bleeding or bruising
Source
TH10

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70828-9 I avoid or limit social activity, because of concern with bleeding or bruising

Observation ID in Form

TH11

Fully-Specified Name

Component
I avoid or limit social activity, because of concern with bleeding or bruising, 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 avoid or limit social activity, because of concern with bleeding or bruising
Source
TH11

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70822-2 I am frustrated by not being able to do my usual activities

Observation ID in Form

TH12

Fully-Specified Name

Component
I am frustrated by not being able to do my usual activities 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 frustrated by not being able to do my usual activities
Source
TH12

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70823-0 I worry that my treatment will be delayed, because of low blood counts

Observation ID in Form

TH13

Fully-Specified Name

Component
I worry that my treatment will be delayed, because of low blood counts, 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 treatment will be delayed, because of low blood counts
Source
TH13

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70829-7 I worry that my treatment dose will be reduced, because of low blood counts

Observation ID in Form

TH14

Fully-Specified Name

Component
I worry that my treatment dose will be reduced, because of low blood counts, 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 treatment dose will be reduced, because of low blood counts
Source
TH13

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70830-5 (For women only) I am bothered by vaginal bleeding

Observation ID in Form

TH15

Fully-Specified Name

Component
For women only - I am bothered by vaginal bleeding 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
(For women only) I am bothered by vaginal bleeding
Source
TH15

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70831-3 Functional Assessment of Incontinence Therapy - Fecal Questionnaire - version 4 ( [FACIT]

Term Description

Functional Assessment of Incontinence Therapy - Fecal
Source: Regenstrief LOINC

Form Coding Instructions

Please circle or mark one number per line to indicate your response as it applies to the past 7 days

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of incontinence therapy - fecal 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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom 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

70902-2 Additional concerns - FAIT-F [FACIT]

Fully-Specified Name

Component
Additional concerns - FAIT-F
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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70832-1 I am comfortable discussing my condition with friends

Fully-Specified Name

Component
I am comfortable discussing my condition with 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 am comfortable discussing my condition with friends
Source
ITU1

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70347-0 I have control of my bowels

Observation ID in Form

C3

Fully-Specified Name

Component
I have control of my bowels 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 control of my bowels
Source
C3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70716-6 I move my bowels more frequently than usual

Observation ID in Form

ITF1

Fully-Specified Name

Component
I move my bowels more frequently than usual 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 move my bowels more frequently than usual
Source
ITF1

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70717-4 I am afraid to be far from a toilet

Observation ID in Form

ITU2

Fully-Specified Name

Component
I am afraid to be far from a toilet 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 afraid to be far from a toilet
Source
ITU2

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70439-5 I have to limit my social activity because of my condition

Observation ID in Form

ITU3

Fully-Specified Name

Component
I have to limit my social activity because of my condition 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 to limit my social activity because of my condition
Source
ITU3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70440-3 I have to limit my physical activity because of my condition

Observation ID in Form

ITU4

Fully-Specified Name

Component
I have to limit my physical activity because of my condition 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 to limit my physical activity because of my condition
Source
ITU4

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70833-9 I have to limit my sexual activity because of my condition

Observation ID in Form

ITU5

Fully-Specified Name

Component
I have to limit my sexual activity because of my condition 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 to limit my sexual activity because of my condition
Source
ITU5

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70834-7 I am embarrassed by my condition

Observation ID in Form

ITU6

Fully-Specified Name

Component
I am embarrassed by my condition 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 embarrassed by my condition
Source
ITU6

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70835-4 My condition wakes or keeps me up at night

Observation ID in Form

ITF2

Fully-Specified Name

Component
My condition wakes or keeps me up at night 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 condition wakes or keeps me up at night
Source
ITF2

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70724-0 I must move my bowels frequently to avoid accidents

Observation ID in Form

ITF3

Fully-Specified Name

Component
I must move my bowels frequently to avoid accidents 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 must move my bowels frequently to avoid accidents
Source
ITF3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70836-2 I can be far from home/work without fearing soilage

Observation ID in Form

ITF4

Fully-Specified Name

Component
I can be far from home - work without fearing soilage 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 can be far from home/work without fearing soilage
Source
ITF4

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70725-7 I wear protection for soiling of stool

Observation ID in Form

ITF5

Fully-Specified Name

Component
I wear protection for soiling of stool 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 wear protection for soiling of stool
Source
ITF5

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70837-0 Functional Assessment of Incontinence Therapy - Urinary Questionnaire - version 4 (FAIT-U) [FACIT]

Term Description

Functional Assessment of Incontinence Therapy - Urinary
Source: Regenstrief LOINC

Form Coding Instructions

Please circle or mark one number per line to indicate your response as it applies to the past 7 days

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of incontinence therapy - urinary 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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom 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

70903-0 Additional concerns - FAIT-U [FACIT]

Fully-Specified Name

Component
Additional concerns - FAIT-U
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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70314-0 I have trouble controlling my urine

Observation ID in Form

BL1

Fully-Specified Name

Component
I have trouble controlling my urine 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 trouble controlling my urine
Source
BL1

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

70832-1 I am comfortable discussing my condition with friends

Fully-Specified Name

Component
I am comfortable discussing my condition with 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 am comfortable discussing my condition with friends
Source
ITU1

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70315-7 I urinate more frequently than usual

Observation ID in Form

BL2

Fully-Specified Name

Component
I urinate more frequently than usual 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 urinate more frequently than usual
Source
BL2

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70717-4 I am afraid to be far from a toilet

Observation ID in Form

ITU2

Fully-Specified Name

Component
I am afraid to be far from a toilet 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 afraid to be far from a toilet
Source
ITU2

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70439-5 I have to limit my social activity because of my condition

Observation ID in Form

ITU3

Fully-Specified Name

Component
I have to limit my social activity because of my condition 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 to limit my social activity because of my condition
Source
ITU3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70440-3 I have to limit my physical activity because of my condition

Observation ID in Form

ITU4

Fully-Specified Name

Component
I have to limit my physical activity because of my condition 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 to limit my physical activity because of my condition
Source
ITU4

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70833-9 I have to limit my sexual activity because of my condition

Observation ID in Form

ITU5

Fully-Specified Name

Component
I have to limit my sexual activity because of my condition 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 to limit my sexual activity because of my condition
Source
ITU5

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70834-7 I am embarrassed by my condition

Observation ID in Form

ITU6

Fully-Specified Name

Component
I am embarrassed by my condition 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 embarrassed by my condition
Source
ITU6

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70838-8 My condition wakes me up at night

Observation ID in Form

ITU7

Fully-Specified Name

Component
My condition wakes me up at night 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 condition wakes me up at night
Source
ITU7

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70839-6 I must urinate frequently to avoid leaking

Observation ID in Form

ITU8

Fully-Specified Name

Component
I must urinate frequently to avoid leaking 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 must urinate frequently to avoid leaking
Source
ITU8

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70840-4 I wear protection for leakage of urine

Fully-Specified Name

Component
I wear protection for leakage of urine 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 wear protection for leakage of urine
Source
ITU9

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel