Version 2.78

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

Observation ID in Form

1

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL3980-1

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

Member of these Panels

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

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

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL2075-1

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

Member of these Panels

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

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

Observation ID in Form

2

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL3980-1

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

Member of these Panels

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

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

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL2075-1

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

Member of these Panels

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

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

Observation ID in Form

3

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL3980-1

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

Member of these Panels

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

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

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL2075-1

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

Member of these Panels

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

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

Observation ID in Form

4

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL3980-1

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

Member of these Panels

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

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

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL2075-1

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

Member of these Panels

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

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

Observation ID in Form

5

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL3980-1

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

Member of these Panels

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

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

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL2075-1

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

Member of these Panels

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

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

Observation ID in Form

6

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL3980-1

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

Member of these Panels

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

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

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL2075-1

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

Member of these Panels

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

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

Observation ID in Form

7

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL3980-1

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

Member of these Panels

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

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

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL2075-1

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

Member of these Panels

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

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

Observation ID in Form

8

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL3980-1

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

Member of these Panels

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

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

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL2075-1

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

Member of these Panels

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

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

Observation ID in Form

9

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL3980-1

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

Member of these Panels

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

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

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL2075-1

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

Member of these Panels

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

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

Observation ID in Form

10

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL3980-1

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

Member of these Panels

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

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

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL2075-1

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

Member of these Panels

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

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

Observation ID in Form

11

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL3980-1

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

Member of these Panels

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

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

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL2075-1

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

Member of these Panels

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

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

Observation ID in Form

12

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL3980-1

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

Member of these Panels

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

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

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL2075-1

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

Member of these Panels

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

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

Observation ID in Form

13

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL3980-1

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

Member of these Panels

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

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

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL2075-1

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

Member of these Panels

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

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

Observation ID in Form

14

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL3980-1

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

Member of these Panels

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

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

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL2075-1

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

Member of these Panels

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

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

Observation ID in Form

15

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL3980-1

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

Member of these Panels

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

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

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL2075-1

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

Member of these Panels

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

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

Observation ID in Form

16

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL3980-1

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

Member of these Panels

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

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

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL2075-1

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

Member of these Panels

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

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

Observation ID in Form

17

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL3980-1

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

Member of these Panels

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

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

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL2075-1

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

Member of these Panels

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

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

Observation ID in Form

18

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL3980-1

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

Member of these Panels

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

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

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL2075-1

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

Member of these Panels

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

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

Observation ID in Form

19

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL3980-1

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

Member of these Panels

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

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

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL2075-1

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

Member of these Panels

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

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

Observation ID in Form

20

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL3980-1

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

Member of these Panels

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

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

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL2075-1

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

Member of these Panels

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

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

Observation ID in Form

21

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL3980-1

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

Member of these Panels

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

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

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL2075-1

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

Member of these Panels

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

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

Observation ID in Form

22

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL3980-1

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

Member of these Panels

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

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

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL2075-1

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

Member of these Panels

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

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

Observation ID in Form

23

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL3980-1

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

Member of these Panels

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

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

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL2075-1

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

Member of these Panels

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

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

Observation ID in Form

24

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL3980-1

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

Member of these Panels

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

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

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL2075-1

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

Member of these Panels

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

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

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL3980-1

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

Member of these Panels

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

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

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL2075-1

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

Member of these Panels

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

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

Observation ID in Form

26

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL3980-1

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

Member of these Panels

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

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

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL2075-1

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

Member of these Panels

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

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

Observation ID in Form

27

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL3980-1

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

Member of these Panels

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

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

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL2075-1

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

Member of these Panels

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

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

Observation ID in Form

28

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL3980-1

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

Member of these Panels

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

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

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL2075-1

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

Member of these Panels

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

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

Observation ID in Form

29

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL3980-1

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

Member of these Panels

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

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

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL2075-1

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

Member of these Panels

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

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

Observation ID in Form

30

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL3980-1

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

Member of these Panels

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

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

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL2075-1

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

Member of these Panels

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

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

Observation ID in Form

31

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL3980-1

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

Member of these Panels

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

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

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL2075-1

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

Member of these Panels

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

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

Observation ID in Form

32

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL3980-1

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

Member of these Panels

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

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

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL2075-1

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

Member of these Panels

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

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

Observation ID in Form

33

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL3980-1

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

Member of these Panels

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

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

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL2075-1

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

Member of these Panels

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