Version 2.78

75820-1 Over the last week, were you able to dress yourself, including shoelaces and buttons

Observation ID in Form

1a.

Fully-Specified Name

Component
Over the past W, are you able to dress yourself, including shoelaces and buttons
Property
Find
Time
1W
System
^Patient
Scale
Ord
Method
HAQ

Basic Attributes

Class
SURVEY.HAQ
Type
Surveys
First Released
Version 2.50
Last Updated
Version 2.54
Order vs. Observation
Observation

Survey Question

Text
Over the past week, are you able to dress yourself, including shoelaces and buttons?

Normative Answer List LL3066-9

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

Member of these Panels

LOINC Long Common Name
71950-0 Health Assessment Questionnaire [HAQ]
75877-1 Patient activity scale [PAS]
90028-2 Routine Assessment of Patient Index Data 3 [RAPID3]

75823-5 Over the last week, were you able to get in and out of bed

Observation ID in Form

1b.

Fully-Specified Name

Component
Over the past W, are you able to get in and out of bed
Property
Find
Time
1W
System
^Patient
Scale
Ord
Method
HAQ

Basic Attributes

Class
SURVEY.HAQ
Type
Surveys
First Released
Version 2.50
Last Updated
Version 2.54
Order vs. Observation
Observation

Survey Question

Text
Over the past week, are you able to get in and out of bed?

Normative Answer List LL3066-9

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

Member of these Panels

LOINC Long Common Name
71950-0 Health Assessment Questionnaire [HAQ]
75877-1 Patient activity scale [PAS]
90028-2 Routine Assessment of Patient Index Data 3 [RAPID3]

75825-0 Over the last week, were you able to lift a full cup or glass to your mouth

Observation ID in Form

1c.

Fully-Specified Name

Component
Over the past W, are you able to lift a full cup or glass to your mouth
Property
Find
Time
1W
System
^Patient
Scale
Ord
Method
HAQ

Basic Attributes

Class
SURVEY.HAQ
Type
Surveys
First Released
Version 2.50
Last Updated
Version 2.54
Order vs. Observation
Observation

Survey Question

Text
Over the past week, are you able to lift a full cup or glass to your mouth?

Normative Answer List LL3066-9

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

Member of these Panels

LOINC Long Common Name
71950-0 Health Assessment Questionnaire [HAQ]
75877-1 Patient activity scale [PAS]
90028-2 Routine Assessment of Patient Index Data 3 [RAPID3]

75827-6 Over the last week, were you able to walk outdoors on flat ground

Observation ID in Form

1d.

Fully-Specified Name

Component
Over the past W, are you able to walk outdoors on flat ground
Property
Find
Time
1W
System
^Patient
Scale
Ord
Method
HAQ

Basic Attributes

Class
SURVEY.HAQ
Type
Surveys
First Released
Version 2.50
Last Updated
Version 2.54
Order vs. Observation
Observation

Survey Question

Text
Over the past week, are you able to walk outdoors on flat ground?

Normative Answer List LL3066-9

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

Member of these Panels

LOINC Long Common Name
71950-0 Health Assessment Questionnaire [HAQ]
75877-1 Patient activity scale [PAS]
75876-3 Patient activity scale II [PASII]
90028-2 Routine Assessment of Patient Index Data 3 [RAPID3]

75829-2 Over the last week, were are you able to wash and dry your entire body

Observation ID in Form

1e.

Fully-Specified Name

Component
Over the past W, are you able to wash and dry your body
Property
Find
Time
1W
System
^Patient
Scale
Ord
Method
HAQ

Basic Attributes

Class
SURVEY.HAQ
Type
Surveys
First Released
Version 2.50
Last Updated
Version 2.54
Order vs. Observation
Observation

Survey Question

Text
Over the past week, are you able to wash and dry your body?

Normative Answer List LL3066-9

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

Member of these Panels

LOINC Long Common Name
71950-0 Health Assessment Questionnaire [HAQ]
75877-1 Patient activity scale [PAS]
90028-2 Routine Assessment of Patient Index Data 3 [RAPID3]

75833-4 Over the last week, were are you able to bend down and pick up clothing from the floor

Observation ID in Form

1f.

Fully-Specified Name

Component
Over the past W, are you able to bend down and pick up clothing from the floor
Property
Find
Time
1W
System
^Patient
Scale
Ord
Method
HAQ

Basic Attributes

Class
SURVEY.HAQ
Type
Surveys
First Released
Version 2.50
Last Updated
Version 2.54
Order vs. Observation
Observation

Survey Question

Text
Over the past week, are you able to bend down and pick up clothing from the floor?

Normative Answer List LL3066-9

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

Member of these Panels

LOINC Long Common Name
71950-0 Health Assessment Questionnaire [HAQ]
75877-1 Patient activity scale [PAS]
90028-2 Routine Assessment of Patient Index Data 3 [RAPID3]

75836-7 Over the last week, were are you able to turn faucets on and off

Observation ID in Form

1g.

Fully-Specified Name

Component
Over the past W, are you able to turn faucets on and off
Property
Find
Time
1W
System
^Patient
Scale
Ord
Method
HAQ

Basic Attributes

Class
SURVEY.HAQ
Type
Surveys
First Released
Version 2.50
Last Updated
Version 2.54
Order vs. Observation
Observation

Survey Question

Text
Over the past week, are you able to turn faucets on and off?

Normative Answer List LL3066-9

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

Member of these Panels

LOINC Long Common Name
71950-0 Health Assessment Questionnaire [HAQ]
75877-1 Patient activity scale [PAS]
90028-2 Routine Assessment of Patient Index Data 3 [RAPID3]

90030-8 Over the last week, were you able to get in and out of a car, bus, train, or airplane

Observation ID in Form

1h.

Fully-Specified Name

Component
Over the past W, are you able to get in and out of a car, bus, train, or airplane
Property
Find
Time
1W
System
^Patient
Scale
Ord
Method
HAQ

Basic Attributes

Class
SURVEY.HAQ
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
Over the last week, were you able to get in and out of a car, bus, train, or airplane?

Normative Answer List LL3066-9

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

Member of these Panels

LOINC Long Common Name
90028-2 Routine Assessment of Patient Index Data 3 [RAPID3]

90031-6 Over the last week, were you able to walk two miles or three kilometers, if you wish

Observation ID in Form

1i.

Fully-Specified Name

Component
Over the past W, are you able to walk two miles or three kilometers, if you wish
Property
Find
Time
1W
System
^Patient
Scale
Ord
Method
HAQ

Basic Attributes

Class
SURVEY.HAQ
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
Over the last week, were you able to walk two miles or three kilometers, if you wish?

Normative Answer List LL3066-9

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

Member of these Panels

LOINC Long Common Name
90028-2 Routine Assessment of Patient Index Data 3 [RAPID3]

Member of these Groups Get Info

LOINC Group Group Name
LG41761-4 Exercise/Activity

90032-4 Over the last week, were you able to participate in recreational activities and sports as you would like, if you wish

Observation ID in Form

1j.

Fully-Specified Name

Component
Over the past W, are you able to participate in recreational activities and sports as you would like, if you wish
Property
Find
Time
1W
System
^Patient
Scale
Ord
Method
HAQ

Basic Attributes

Class
SURVEY.HAQ
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
Over the last week, were you able to participate in recreational activities and sports as you would like, if you wish?

Normative Answer List LL3066-9

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

Member of these Panels

LOINC Long Common Name
90028-2 Routine Assessment of Patient Index Data 3 [RAPID3]

Member of these Groups Get Info

LOINC Group Group Name
LG41761-4 Exercise/Activity

90033-2 Over the last week, were you able to get a good night's sleep

Observation ID in Form

1k.

Fully-Specified Name

Component
Over the past W, are you able to get a good night's sleep
Property
Find
Time
1W
System
^Patient
Scale
Ord
Method
HAQ

Basic Attributes

Class
SURVEY.HAQ
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
Over the last week, were you able to get a good night's sleep?

Normative Answer List LL5123-6

Answer Code Score Answer ID
Without any difficulty 0 LA13921-4
With some difficulty 1.1 LA13920-6
With much difficulty 2.2 LA13919-8
Unable to do 3.3 LA13912-3

Member of these Panels

LOINC Long Common Name
90028-2 Routine Assessment of Patient Index Data 3 [RAPID3]

90034-0 Over the last week, were you able to deal with feelings of anxiety or being nervous

Observation ID in Form

1l.

Fully-Specified Name

Component
Over the past W, are you able to deal with feelings of anxiety or being nervous
Property
Find
Time
1W
System
^Patient
Scale
Ord
Method
HAQ

Basic Attributes

Class
SURVEY.HAQ
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
Over the last week, were you able to deal with feelings of anxiety or being nervous?

Normative Answer List LL5123-6

Answer Code Score Answer ID
Without any difficulty 0 LA13921-4
With some difficulty 1.1 LA13920-6
With much difficulty 2.2 LA13919-8
Unable to do 3.3 LA13912-3

Member of these Panels

LOINC Long Common Name
90028-2 Routine Assessment of Patient Index Data 3 [RAPID3]

90035-7 Over the last week, were you able to deal with feelings of depression or feeling blue

Observation ID in Form

1m.

Fully-Specified Name

Component
Over the past W, are you able to deal with feelings of depression or feeling blue
Property
Find
Time
1W
System
^Patient
Scale
Ord
Method
HAQ

Basic Attributes

Class
SURVEY.HAQ
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
Over the last week, were you able to deal with feelings of depression or feeling blue?

Normative Answer List LL5123-6

Answer Code Score Answer ID
Without any difficulty 0 LA13921-4
With some difficulty 1.1 LA13920-6
With much difficulty 2.2 LA13919-8
Unable to do 3.3 LA13912-3

Member of these Panels

LOINC Long Common Name
90028-2 Routine Assessment of Patient Index Data 3 [RAPID3]

90036-5 How much pain have you had because of your condition OVER THE PAST WEEK? Please indicate below how severe your pain has been:

Term Description

The patient is asked to indicate his/her level of pain in the past week on a scale of 0-10 with 0.5 increments and where 0 is no pain and 10 is severe pain.
Source: Regenstrief LOINC

Form Coding Instructions

Please indicate below how severe your pain has been:

Source: Dr. Theodore Pincus

Fully-Specified Name

Component
Pain severity in the past W - 0-10 (0.5 increments) numeric rating
Property
Score
Time
1W
System
^Patient
Scale
Ord
Method
Reported

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Example Answer List LL5120-2

Answer Code Score Answer ID
0 - no pain LA19102-5
0.5 LA16632-4
1 LA6112-2
1.5 LA15765-3
2 or more LA6113-0
2.5 LA15766-1
3 LA6114-8
3.5 LA15767-9
4 LA6115-5
4.5 LA15768-7
5 LA10137-0
5.5 LA15769-5
6 LA10138-8
6.5 LA15770-3
7 LA10139-6
7.5 LA21653-3
8 LA10140-4
8.5 LA21654-1
9 LA10141-2
9.5 LA21655-8
10 - Pain as bad as it could be LA29463-9

Member of these Panels

LOINC Long Common Name
90028-2 Routine Assessment of Patient Index Data 3 [RAPID3]

90037-3 Considering all the ways in which illness and health conditions may affect you at this time, please indicate below how you are doing:

Term Description

The patient is asked to consider all the ways in which illness and health conditions may affect them and indicate their overall assessment of their global health on a scale of 0-10 with 0.5 increments where 0 is very well and 10 is very poorly.
Source: Regenstrief LOINC

Form Coding Instructions

At this time, please indicate below how you are doing:

Source: Dr. Theodore Pincus

Fully-Specified Name

Component
Assessment of global health - 0-10 (0.5 increments) numeric rating
Property
Score
Time
Pt
System
^Patient
Scale
Ord
Method
Reported

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Example Answer List LL5119-4

Answer Code Score Answer ID
0 - Very well LA21651-7
0.5 LA16632-4
1 LA6112-2
1.5 LA15765-3
2 or more LA6113-0
2.5 LA15766-1
3 LA6114-8
3.5 LA15767-9
4 LA6115-5
4.5 LA15768-7
5 LA10137-0
5.5 LA15769-5
6 LA10138-8
6.5 LA15770-3
7 LA10139-6
7.5 LA21653-3
8 LA10140-4
8.5 LA21654-1
9 LA10141-2
9.5 LA21655-8
10 - Very poorly LA29462-1

Member of these Panels

LOINC Long Common Name
90028-2 Routine Assessment of Patient Index Data 3 [RAPID3]

90038-1 Weighted score [RAPID3]

Term Description

The RAPID3® is an index to assess and monitor patients with rheumatoid arthritis, without formal joint counts. PMID: 19962621 The weighted RAPID3® score corresponds to disease activity level[LOINC: 90094-4]. It is based on the individual scores for each of the three sections of the RAPID3®, which together represent the RAPID3® cumulative score that is converted to the weighted score.
Source: Regenstrief LOINC

Reference Information

Type Source Reference
Citation Dr. Theodore PincusCopyright RAPID3 © 2008 - All rights reserved. Pincus, T., (2008), RAPID3 (Routine Assessment of Patient Index Data 3), a rheumatoid arthritis index without formal joint counts for routine care: proposed severity categories compared to disease activity score and clinical disease activity index categories. J Rheumatol. 2008 Nov;35(11):2136-47. Epub 2008 Sep 15.

Fully-Specified Name

Component
Weighted score
Property
Score
Time
Pt
System
^Patient
Scale
Qn
Method
RAPID3

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Member of these Panels

LOINC Long Common Name
90028-2 Routine Assessment of Patient Index Data 3 [RAPID3]

Example Units

Unit Source
{score} Example UCUM Units

90094-4 Rheumatoid arthritis disease severity level [RAPID3]

Term Description

The RAPID3® is an index to assess and monitor patients with rheumatoid arthritis, without formal joint counts. PMID: 19962621 The cumulative score is the sum of the results of the 10 physical function questions reduced to a score between 0 and 10, the score for pain severity [LOINC: 90036-5], and the patient's global assessment of overall health [LOINC: 90037-3]. The cumulative score is converted to a weighted score that is interpreted as follows: 0-1.0 is near remission (NR); 1.3-2.0 as low severity (LS); 2.3-4.0 as moderate severity (MS); and 4.3-10.0 as high severity (HS). Alternatively, the activity level may be based on the RAPID3 cumulative score as follows: 1-3 is near remission; 4-6 as low severity; 7-12 as moderate severity; and 13-30 as high severity.[https://www.rheumatology.org/Portals/0/Files/RAPID3%20Form.pdf]
Source: Regenstrief LOINC

Reference Information

Type Source Reference
Citation Dr. Theodore PincusCopyright RAPID3 © 2008 - All rights reserved. Pincus, T., (2008), RAPID3 (Routine Assessment of Patient Index Data 3), a rheumatoid arthritis index without formal joint counts for routine care: proposed severity categories compared to disease activity score and clinical disease activity index categories. J Rheumatol. 2008 Nov;35(11):2136-47. Epub 2008 Sep 15.

Fully-Specified Name

Component
Rheumatoid arthritis disease severity level
Property
Imp
Time
Pt
System
^Patient
Scale
Ord
Method
RAPID3

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL5129-3

Answer Code Score Answer ID
Near remission LA29471-2
Low severity LA29472-0
Moderate severity LA29473-8
High severity LA29474-6

Member of these Panels

LOINC Long Common Name
90028-2 Routine Assessment of Patient Index Data 3 [RAPID3]