CDE Detailed Report
Disease: Sickle Cell Disease
Sub-Domain: Additional Proposed Instruments
CRF: PhenX Toolkit: Functionality After Stroke
Sub-Domain: Additional Proposed Instruments
CRF: PhenX Toolkit: Functionality After Stroke
| CDE ID | CDE Name | Variable Name | Definition | Short Description | Additional Notes (Question Text) | Permissible Values | Description | Data Type | Disease Specific Instructions | Disease Specific Reference | Population | Classification (e.g., Core) | Version Number | Version Date | CRF Name (CRF Module / Guideline) | Sub Domain Name | Domain Name | Size | Input Restrictions | Min Value | Max Value | Measurement Type | Source | Form Set | Form | Field | Domain | CDASH Variable | CDASH Definition | CDASH Label | Controlled Terminology | Prompt | Essentiality | Question Text | CDASH imp guidance | SDTM IG target | csDSR | PhenX | Data Type | CRF Completion Inst | SDTMIG Target Var | SDTMIG Target Map | Codelist Name | PVs | Pre Pop Value | Query Display | List Style |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C59458 | Difficult clip toenail past 2 week scale | DifClpTonailPst2WkScl | Scale of the difficulty the subject/participant had over the past 2 weeks clipping his or her toenails | Scale of the difficulty the subject/participant had over the past 2 weeks clipping his or her toenails | In the past 2 weeks, how difficult was it to clip your toenails? | 2;3;4;5;1 | Very difficult;Somewhat difficult;A little difficult;Not difficult at all;Could not do at all | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 15:25:21.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 5d | ||||||||||||||||||||||||||
| C59435 | Difficult think quickly past week scale | DifThnkQuickPstWkScl | Scale of the difficulty the subject/participant has had thinking quickly in the past week | Scale of the difficulty the subject/participant has had thinking quickly in the past week | In the past week, how difficult was it for you to think quickly? | 1;2;3;4;5 | Extremely difficult;Very difficult;Somewhat difficult;A little difficult;Not difficult at all | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 12:24:55.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 2f | ||||||||||||||||||||||||||
| C59470 | Difficult walk one block past 2 week scale | DifWalk1BlockPst2WkScl | Scale of the difficulty the subject/participant had over the past 2 weeks to walk one block | Scale of the difficulty the subject/participant had over the past 2 weeks to walk one block | In the past 2 weeks, how difficult was it to walk one block? | 2;3;4;5;1 | Very difficult;Somewhat difficult;A little difficult;Not difficult at all;Could not do at all | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 15:25:21.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 6e | ||||||||||||||||||||||||||
| C59448 | Difficult say name person in front past week scale | DifSayNamPrsnInFrtPstWkScl | Scale for the difficulty over the past week that the subject/participant has had saying the name of someone in front of him or her | Scale for the difficulty over the past week that the subject/participant has had saying the name of someone in front of him or her | In the past week, how difficult was it to say the name of someone who was in front of you? | 1;2;3;4;5 | Extremely difficult;Very difficult;Somewhat difficult;A little difficult;Not difficult at all | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 14:50:26.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 4a | ||||||||||||||||||||||||||
| C59481 | Limited social activity past 4 week scale | LtdSocActPst4WkScl | Scale of the amount of time over the past 4 weeks that the subject/participant has been limited in his or her social activities | Scale of the amount of time over the past 4 weeks that the subject/participant has been limited in his or her social activities | During the past 4 weeks, how much of the time have you been limited in your social activities? | 1;2;3;4;5;1;2;3;4;5 | All of the time;Most of the time;Some of the time;A little of the time;None of the time;All of the time;Most of the time;Some of the time;A little of the time;None of the time | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-05 12:23:41.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 8b | ||||||||||||||||||||||||||
| C59459 | Difficult reach toilet in time past 2 week scale | DifRchTltInTimPst2WkScl | Scale of the difficulty the subject/participant had over the past 2 weeks reaching the toilet in time to use it | Scale of the difficulty the subject/participant had over the past 2 weeks reaching the toilet in time to use it | In the past 2 weeks, how difficult was it to get to the toilet on time? | 2;3;4;5;1 | Very difficult;Somewhat difficult;A little difficult;Not difficult at all;Could not do at all | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 15:25:21.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 5e | ||||||||||||||||||||||||||
| C59436 | Difficult solve everyday problem past week scale | DifSlvEvydyProbPstWkScl | Scale of the difficulty the subject/participant has had solving everyday problems in the past week | Scale of the difficulty the subject/participant has had solving everyday problems in the past week | In the past week, how difficult was it for you to solve everyday problems? | 1;2;3;4;5 | Extremely difficult;Very difficult;Somewhat difficult;A little difficult;Not difficult at all | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 12:24:55.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 2g | ||||||||||||||||||||||||||
| C59471 | Difficult walk fast past 2 week scale | DifWalkFastPst2WkScl | Scale of the difficulty the subject/participant had over the past 2 weeks to walk fast | Scale of the difficulty the subject/participant had over the past 2 weeks to walk fast | In the past 2 weeks, how difficult was it to walk fast? | 2;3;4;5;1 | Very difficult;Somewhat difficult;A little difficult;Not difficult at all;Could not do at all | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 15:25:21.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 6f | ||||||||||||||||||||||||||
| C59449 | Difficult understand conversation past week scale | DifUnstdCnvrstnPstWkScl | Scale for the difficulty over the past week that the subject/participant has had understanding what is said to him or her in conversation | Scale for the difficulty over the past week that the subject/participant has had understanding what is said to him or her in conversation | In the past week, how difficult was it to understand what was being said to you in a conversation? | 1;2;3;4;5 | Extremely difficult;Very difficult;Somewhat difficult;A little difficult;Not difficult at all | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 14:50:26.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 4b | ||||||||||||||||||||||||||
| C59482 | Limited quiet recreation past 4 week scale | LtdQuietRecrtnPst4WkScl | Scale of the amount of time over the past 4 weeks that the subject/participant has been limited in his or her quiet recreational activities | Scale of the amount of time over the past 4 weeks that the subject/participant has been limited in his or her quiet recreational activities | During the past 4 weeks, how much of the time have you been limited in your quiet recreation (crafts, reading)? | 1;2;3;4;5;1;2;3;4;5 | All of the time;Most of the time;Some of the time;A little of the time;None of the time;All of the time;Most of the time;Some of the time;A little of the time;None of the time | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-05 12:23:41.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 8c | ||||||||||||||||||||||||||
| C59426 | Strength arm most affect stroke past week scale | StrgthArmMostAffctStrkPstWkScl | Strength over the past week of the arm most affected by the subject/participant's stroke | Strength over the past week of the arm most affected by the subject/participant's stroke | In the past week, how would you rate the strength of your arm that was most affected by your stroke? | 5;4;3;2;1 | A lot of strength;Quite a big of strength;Some strength;A little strength;No strength at all | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 11:53:50.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 1a | ||||||||||||||||||||||||||
| C59460 | Difficult control bladder past 2 week scale | DifCtrlBladrPst2WkScl | Scale of the difficulty the subject/participant had over the past 2 weeks controlling his or her bladder | Scale of the difficulty the subject/participant had over the past 2 weeks controlling his or her bladder | In the past 2 weeks, how difficult was it to control your bladder (not have an accident)? | 2;3;4;5;1 | Very difficult;Somewhat difficult;A little difficult;Not difficult at all;Could not do at all | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 15:25:21.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 5f | ||||||||||||||||||||||||||
| C59437 | Feel sad past week frequency scale | FlSadPstWkFrqScl | Scale of the frequency that the subject/participant felt sad over the past week | Scale of the frequency that the subject/participant felt sad over the past week | In the past week, how often did you feel sad? | 1;2;3;4;5;1;2;3;4;5 | All of the time;Most of the time;Some of the time;A little of the time;None of the time;All of the time;Most of the time;Some of the time;A little of the time;None of the time | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 12:48:29.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 3a | ||||||||||||||||||||||||||
| C59472 | Difficult climb 1 flight stairs past 2 week scale | DifClm1FltStrPst2WkScl | Scale of the difficulty the subject/participant had over the past 2 weeks to climb one flight of stairs | Scale of the difficulty the subject/participant had over the past 2 weeks to climb one flight of stairs | In the past 2 weeks, how difficult was it to climb one flight of stairs? | 2;3;4;5;1 | Very difficult;Somewhat difficult;A little difficult;Not difficult at all;Could not do at all | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 15:25:21.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 6g | ||||||||||||||||||||||||||
| C59450 | Difficult reply question past week scale | DifRplyQuestnPstWkScl | Scale for the difficulty over the past week that the subject/participant has had replying to questions | Scale for the difficulty over the past week that the subject/participant has had replying to questions | In the past week, how difficult was it to reply to questions? | 1;2;3;4;5 | Extremely difficult;Very difficult;Somewhat difficult;A little difficult;Not difficult at all | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 14:50:26.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 4c | ||||||||||||||||||||||||||
| C59483 | Limited active recreation past 4 week scale | LtdActRecrtnPst4WkScl | Scale of the amount of time over the past 4 weeks that the subject/participant has been limited in his or her active recreational activities | Scale of the amount of time over the past 4 weeks that the subject/participant has been limited in his or her active recreational activities | During the past 4 weeks, how much of the time have you been limited in your active reacreation (sports, outings, travel)? | 1;2;3;4;5;1;2;3;4;5 | All of the time;Most of the time;Some of the time;A little of the time;None of the time;All of the time;Most of the time;Some of the time;A little of the time;None of the time | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-05 12:23:41.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 8d | ||||||||||||||||||||||||||
| C59427 | Strength grip hand most affect stroke past week scale | StgthGpHdMostAffctStrkPstWkScl | Strength over the past week of the grip of the hand most affected by the subject/participant's stroke | Strength over the past week of the grip of the hand most affected by the subject/participant's stroke | In the past week, how would you rate the strength of your grip of your hand that was most affected by your stroke? | 5;4;3;2;1 | A lot of strength;Quite a big of strength;Some strength;A little strength;No strength at all | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 11:53:50.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 1b | ||||||||||||||||||||||||||
| C59461 | Difficult control bowels past 2 week scale | DifCtrlBowelsPst2WkScl | Scale of the difficulty the subject/participant had over the past 2 weeks controlling his or her bowels | Scale of the difficulty the subject/participant had over the past 2 weeks controlling his or her bowels | In the past 2 weeks, how difficult was it to control your bowels (not have an accident)? | 2;3;4;5;1 | Very difficult;Somewhat difficult;A little difficult;Not difficult at all;Could not do at all | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 15:25:21.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 5g | ||||||||||||||||||||||||||
| C59438 | Feel nobody close past week frequency scale | FlNobdyClosPstWkFrqScl | Scale of the frequency that the subject/participant felt over the past week that there is nobody he or she is close to | Scale of the frequency that the subject/participant felt over the past week that there is nobody he or she is close to | In the past week, how often did you feel that there is nobody you are close to? | 1;2;3;4;5;1;2;3;4;5 | All of the time;Most of the time;Some of the time;A little of the time;None of the time;All of the time;Most of the time;Some of the time;A little of the time;None of the time | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 12:48:29.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 3b | ||||||||||||||||||||||||||
| C59473 | Difficult climb several flight stairs past 2 week scale | DifClmSvlFltStrPst2WkScl | Scale of the difficulty the subject/participant had over the past 2 weeks to climb several flights of stairs | Scale of the difficulty the subject/participant had over the past 2 weeks to climb several flights of stairs | In the past 2 weeks, how difficult was it to climb several flights of stairs? | 2;3;4;5;1 | Very difficult;Somewhat difficult;A little difficult;Not difficult at all;Could not do at all | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 15:25:21.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 6h | ||||||||||||||||||||||||||
| C59451 | Difficult correctly name object past week scale | DifCrctlyNamObjPstWkScl | Scale for the difficulty over the past week that the subject/participant has had correctly naming objects | Scale for the difficulty over the past week that the subject/participant has had correctly naming objects | In the past week, how difficult was it to correctly name objects? | 1;2;3;4;5 | Extremely difficult;Very difficult;Somewhat difficult;A little difficult;Not difficult at all | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 14:50:26.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 4d | ||||||||||||||||||||||||||
| C59484 | Limited role family member friend past 4 week scale | LtdRolFmlMbrFrdPst4WkScl | Scale of the amount of time over the past 4 weeks that the subject/participant has been limited in his or her role as a family member or friend | Scale of the amount of time over the past 4 weeks that the subject/participant has been limited in his or her role as a family member or friend | During the past 4 weeks, how much of the time have you been limited in your role as a family member and/or friend? | 1;2;3;4;5;1;2;3;4;5 | All of the time;Most of the time;Some of the time;A little of the time;None of the time;All of the time;Most of the time;Some of the time;A little of the time;None of the time | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-05 12:23:41.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 8e | ||||||||||||||||||||||||||
| C59428 | Strength leg most affect stroke past week scale | StgthLegMostAffctStrkPstWkScl | Strength over the past week of the leg most affected by the subject/participant's stroke | Strength over the past week of the leg most affected by the subject/participant's stroke | In the past week, how would you rate the strength of your leg that was most affected by your stroke? | 5;4;3;2;1 | A lot of strength;Quite a big of strength;Some strength;A little strength;No strength at all | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 11:53:50.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 1c | ||||||||||||||||||||||||||
| C59462 | Difficult do light household task chore past 2 week scale | DifDoLtHshldTskChorPst2WkScl | Scale of the difficulty the subject/participant had over the past 2 weeks doing light household tasks or chores, such as dusting, making bed, taking out garbage, doing dishes | Scale of the difficulty the subject/participant had over the past 2 weeks doing light household tasks or chores, such as dusting, making bed, taking out garbage, doing dishes | In the past 2 weeks, how difficult was it to do light household tasks/chores (e.g., dust, make a bed, take out garbage, do the dishes)? | 2;3;4;5;1 | Very difficult;Somewhat difficult;A little difficult;Not difficult at all;Could not do at all | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 15:25:21.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 5h | ||||||||||||||||||||||||||
| C59441 | Feel burden other past week frequency scale | FlBrdnOthrPstWkFrqScl | Scale of the frequency that the subject/participant felt over the past week that he or she is a burden to others | Scale of the frequency that the subject/participant felt over the past week that he or she is a burden to others | In the past week, how often did you feel that you are a burden to others? | 1;2;3;4;5;1;2;3;4;5 | All of the time;Most of the time;Some of the time;A little of the time;None of the time;All of the time;Most of the time;Some of the time;A little of the time;None of the time | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 12:48:29.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 3c | ||||||||||||||||||||||||||
| C59474 | Difficult get in out car past 2 week scale | DifGetInOutCarPst2WkScl | Scale of the difficulty the subject/participant had over the past 2 weeks to get in and out of a car | Scale of the difficulty the subject/participant had over the past 2 weeks to get in and out of a car | In the past 2 weeks, how difficult was it to get in and out of a car? | 2;3;4;5;1 | Very difficult;Somewhat difficult;A little difficult;Not difficult at all;Could not do at all | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 15:25:21.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 6i | ||||||||||||||||||||||||||
| C59452 | Difficult participate group conversation past week scale | DifPtcptGrpConvoPstWkScl | Scale for the difficulty over the past week that the subject/participant has had participating in group conversations | Scale for the difficulty over the past week that the subject/participant has had participating in group conversations | In the past week, how difficult was it to participate in a conversation with a group of people? | 1;2;3;4;5 | Extremely difficult;Very difficult;Somewhat difficult;A little difficult;Not difficult at all | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 14:50:26.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 4e | ||||||||||||||||||||||||||
| C59485 | Limited participate spiritual religious activities past 4 week scale | LtdPtcptSprRelgActPst4WkScl | Scale of the amount of time over the past 4 weeks that the subject/participant has been limited in his or her participation in spiritual or religious activities | Scale of the amount of time over the past 4 weeks that the subject/participant has been limited in his or her participation in spiritual or religious activities | During the past 4 weeks, how much of the time have you been limited in your participation in spiritual or religious activities? | 1;2;3;4;5;1;2;3;4;5 | All of the time;Most of the time;Some of the time;A little of the time;None of the time;All of the time;Most of the time;Some of the time;A little of the time;None of the time | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-05 12:23:41.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 8f | ||||||||||||||||||||||||||
| C59429 | Strength foot ankle most affect stroke past week scale | StgthFtAnMostAffctStrkPstWkScl | Strength over the past week of the foot/ankle most affected by the subject/participant's stroke | Strength over the past week of the foot/ankle most affected by the subject/participant's stroke | In the past week, how would you rate the strength of your foot/ankle that was most affected by your stroke? | 5;4;3;2;1 | A lot of strength;Quite a big of strength;Some strength;A little strength;No strength at all | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 11:53:50.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 1d | ||||||||||||||||||||||||||
| C59463 | Difficult shop past 2 week scale | DifShopPst2WkScl | Scale of the difficulty the subject/participant had shopping over the past 2 weeks | Scale of the difficulty the subject/participant had shopping over the past 2 weeks | In the past 2 weeks, how difficult was it to go shopping? | 2;3;4;5;1 | Very difficult;Somewhat difficult;A little difficult;Not difficult at all;Could not do at all | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 15:25:21.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 5i | ||||||||||||||||||||||||||
| C59442 | Feel nothing look forward to past week frequency scale | FlNothLkFwdToPstWkFrqScl | Scale of the frequency that the subject/participant felt over the past week that he or she has nothing to look forward to | Scale of the frequency that the subject/participant felt over the past week that he or she has nothing to look forward to | In the past week, how often did you feel that you have nothing to look forward to? | 1;2;3;4;5;1;2;3;4;5 | All of the time;Most of the time;Some of the time;A little of the time;None of the time;All of the time;Most of the time;Some of the time;A little of the time;None of the time | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 12:48:29.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 3d | ||||||||||||||||||||||||||
| C59475 | Difficult use hand most affect stroke carry heavy object past 2 week scale | DfUsHdMsAfStCyHvObPs2WkScl | Scale of the difficulty the subject/participant had over the past 2 weeks using his or her hand that was most affected by the stroke to carry heavy objects | Scale of the difficulty the subject/participant had over the past 2 weeks using his or her hand that was most affected by the stroke to carry heavy objects | In the past 2 weeks, how difficult was it to use your hand that was most affected by your stroke to carry heavy objects (e.g., a bag of groceries)? | 2;3;4;5;1 | Very difficult;Somewhat difficult;A little difficult;Not difficult at all;Could not do at all | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 15:25:21.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 7a | ||||||||||||||||||||||||||
| C59453 | Difficult conversation telephone past week scale | DifConvoTlphnPstWkScl | Scale for the difficulty over the past week that the subject/participant has had having a telephone conversation | Scale for the difficulty over the past week that the subject/participant has had having a telephone conversation | In the past week, how difficult was it to have a conversation on the telephone? | 1;2;3;4;5 | Extremely difficult;Very difficult;Somewhat difficult;A little difficult;Not difficult at all | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 14:50:26.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 4f | ||||||||||||||||||||||||||
| C59486 | Limited ability control life as wish past 4 week scale | LtdAblCtrlLfAsWshPst4WkScl | Scale of the amount of time over the past 4 weeks that the subject/participant has been limited in his or her ability to control his or her life as he or she wishes | Scale of the amount of time over the past 4 weeks that the subject/participant has been limited in his or her ability to control his or her life as he or she wishes | During the past 4 weeks, how much of the time have you been limited in your ability to control your life as you wish? | 1;2;3;4;5;1;2;3;4;5 | All of the time;Most of the time;Some of the time;A little of the time;None of the time;All of the time;Most of the time;Some of the time;A little of the time;None of the time | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-05 12:23:41.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 8g | ||||||||||||||||||||||||||
| C59430 | Difficult remember things just told past week scale | DiffRememThgJstTldPstWkScl | Scale of the difficulty the subject/participant has had in the past week remembering things that people just told him or her | Scale of the difficulty the subject/participant has had in the past week remembering things that people just told him or her | In the past week, how difficult was it for you to remember things that people just told you? | 1;2;3;4;5 | Extremely difficult;Very difficult;Somewhat difficult;A little difficult;Not difficult at all | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 12:24:55.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 2a | ||||||||||||||||||||||||||
| C59464 | Difficult do heavy household chore past 2 week scale | DifDoHvyHshldChorPst2WkScl | Scale of the difficulty the subject/participant had over the past 2 weeks doing heavy household chores such as vacuuming, laundry, yard work | Scale of the difficulty the subject/participant had over the past 2 weeks doing heavy household chores such as vacuuming, laundry, yard work | In the past 2 weeks, how difficult was it to do heavy household chores (e.g., vacuum, laundry or yard work)? | 2;3;4;5;1 | Very difficult;Somewhat difficult;A little difficult;Not difficult at all;Could not do at all | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 15:25:21.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 5j | ||||||||||||||||||||||||||
| C59443 | Blame self mistake past week frequency scale | BlamSlfMstkPstWkFrqScl | Scale of the frequency over the past week that the subject/participant blamed him or herself for mistakes that he or she made | Scale of the frequency over the past week that the subject/participant blamed him or herself for mistakes that he or she made | In the past week, how often did you blame yourself for mistakes that you made? | 1;2;3;4;5;1;2;3;4;5 | All of the time;Most of the time;Some of the time;A little of the time;None of the time;All of the time;Most of the time;Some of the time;A little of the time;None of the time | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 12:48:29.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 3e | ||||||||||||||||||||||||||
| C59476 | Difficult use hand most affect stroke turn doorknob past 2 week scale | DfUsHdMsAfStTnDrkbPs2WkScl | Scale of the difficulty the subject/participant had over the past 2 weeks using his or her hand that was most affected by the stroke to turn a doorknob | Scale of the difficulty the subject/participant had over the past 2 weeks using his or her hand that was most affected by the stroke to turn a doorknob | In the past 2 weeks, how difficult was it to use your hand that was most affected by your stroke to turn a doorknob? | 2;3;4;5;1 | Very difficult;Somewhat difficult;A little difficult;Not difficult at all;Could not do at all | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 15:25:21.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 7b | ||||||||||||||||||||||||||
| C59454 | Difficult place telephone call past week scale | DifPlcTlphnCalPstWkScl | Scale for the difficulty over the past week that the subject/participant has had placing a telephone call, including selecting the correct number and dialing | Scale for the difficulty over the past week that the subject/participant has had placing a telephone call, including selecting the correct number and dialing | In the past week, how difficult was it to call another person on the telephone, including selecting the correct phone number and dialing? | 1;2;3;4;5 | Extremely difficult;Very difficult;Somewhat difficult;A little difficult;Not difficult at all | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 14:50:26.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 4g | ||||||||||||||||||||||||||
| C59487 | Limited ability help others past 4 week scale | LtdAblHlpOthPst4WkScl | Scale of the amount of time over the past 4 weeks that the subject/participant has been limited in his or her ability to help others | Scale of the amount of time over the past 4 weeks that the subject/participant has been limited in his or her ability to help others | During the past 4 weeks, how much of the time have you been limited in your ability to help others? | 1;2;3;4;5;1;2;3;4;5 | All of the time;Most of the time;Some of the time;A little of the time;None of the time;All of the time;Most of the time;Some of the time;A little of the time;None of the time | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-05 12:23:41.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 8h | ||||||||||||||||||||||||||
| C59431 | Difficult remember things happen day before past week scale | DifRemThgHpnDayBfrPstWkScl | Scale of the difficulty the subject/participant has had in the past week remembering things that happened the day before | Scale of the difficulty the subject/participant has had in the past week remembering things that happened the day before | In the past week, how difficult was it for you to remember things that happened the day before? | 1;2;3;4;5 | Extremely difficult;Very difficult;Somewhat difficult;A little difficult;Not difficult at all | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 12:24:55.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 2b | ||||||||||||||||||||||||||
| C59466 | Difficult continue sit without lose balance past 2 week scale | DifCnSitWoLoseBalPst2WkScl | Scale of the difficulty the subject/participant had over the past 2 weeks to continue sitting without losing his or her balance | Scale of the difficulty the subject/participant had over the past 2 weeks to continue sitting without losing his or her balance | In the past 2 weeks, how difficult was it to stay sitting without losing your balance? | 2;3;4;5;1 | Very difficult;Somewhat difficult;A little difficult;Not difficult at all;Could not do at all | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 15:25:21.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 6a | ||||||||||||||||||||||||||
| C59444 | Enjoy thing much as ever past week frequency scale | EnjyThngMchAsEvrPstWkFrqScl | Scale of the frequency over the past week that the subject/participant enjoyed things as much as ever | Scale of the frequency over the past week that the subject/participant enjoyed things as much as ever | In the past week, how often did you enjoy things as much as ever? | 1;2;3;4;5;1;2;3;4;5 | All of the time;Most of the time;Some of the time;A little of the time;None of the time;All of the time;Most of the time;Some of the time;A little of the time;None of the time | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 12:48:29.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 3f | ||||||||||||||||||||||||||
| C59477 | Difficult use hand most affect stroke open can jar past 2 week scale | DfUsHdMsAfStOpCnJrPs2WkScl | Scale of the difficulty the subject/participant had over the past 2 weeks using his or her hand that was most affected by the stroke to open a can or jar | Scale of the difficulty the subject/participant had over the past 2 weeks using his or her hand that was most affected by the stroke to open a can or jar | In the past 2 weeks, how difficult was it to use your hand that was most affected by your stroke to open a can or jar? | 2;3;4;5;1 | Very difficult;Somewhat difficult;A little difficult;Not difficult at all;Could not do at all | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 15:25:21.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 7c | ||||||||||||||||||||||||||
| C59455 | Difficult cut food knife fork past 2 week scale | DifCutFdKnfFrkPst2WkScl | Scale of the difficulty the subject/participant had over the past 2 weeks cutting his or her food with a knife and fork | Scale of the difficulty the subject/participant had over the past 2 weeks cutting his or her food with a knife and fork | In the past 2 weeks, how difficult was it to cut your food with a knife and fork? | 2;3;4;5;1 | Very difficult;Somewhat difficult;A little difficult;Not difficult at all;Could not do at all | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 15:25:21.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 5a | ||||||||||||||||||||||||||
| C59488 | Stroke recovery 0 100 scale | StrokRecovry0100Scl | Scale from 0 to 100 of the subject/participant's self-reported recovery from his or her stroke | Scale from 0 to 100 of the subject/participant's self-reported recovery from his or her stroke | On a scale of 0 to 100, with 100 representing full recovery and 0 representing no recovery, how much have you recovered from your stroke? | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-05 13:05:27.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Free-Form Entry |
0 | 100 | PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 9 | ||||||||||||||||||||||||||
| C59432 | Difficult remember do things past week scale | DifRemDoThgPstWkScl | Scale of the difficulty the subject/participant has had in the past week remembering to do things (e.g., keep a scheduled appointment or take medication) | Scale of the difficulty the subject/participant has had in the past week remembering to do things (e.g., keep a scheduled appointment or take medication) |
In the past week, how difficult was it for you to remember to do things (e.g., keep scheduled appointments or take medication)? |
1;2;3;4;5 | Extremely difficult;Very difficult;Somewhat difficult;A little difficult;Not difficult at all | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 12:24:55.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 2c | ||||||||||||||||||||||||||
| C59467 | Difficult continue stand without lose balance past 2 week scale | DifCnStndWoLoseBalPst2WkScl | Scale of the difficulty the subject/participant had over the past 2 weeks to continue standing without losing his or her balance | Scale of the difficulty the subject/participant had over the past 2 weeks to continue standing without losing his or her balance | In the past 2 weeks, how difficult was it to stay standing without losing your balance? | 2;3;4;5;1 | Very difficult;Somewhat difficult;A little difficult;Not difficult at all;Could not do at all | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 15:25:21.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 6b | ||||||||||||||||||||||||||
| C59445 | Feel quite nervous past week frequency scale | FlQuiteNrvousPstWkFrqScl | Scale of the frequency over the past week that the subject/participant felt quite nervous | Scale of the frequency over the past week that the subject/participant felt quite nervous | In the past week, how often did you feel quite nervous? | 1;2;3;4;5;1;2;3;4;5 | All of the time;Most of the time;Some of the time;A little of the time;None of the time;All of the time;Most of the time;Some of the time;A little of the time;None of the time | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 12:48:29.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 3g | ||||||||||||||||||||||||||
| C59478 | Difficult use hand most affect stroke tie shoelace past 2 week scale | DfUsHdMsAfStTiShlcPs2WkScl | Scale of the difficulty the subject/participant had over the past 2 weeks using his or her hand that was most affected by the stroke to tie a shoelace | Scale of the difficulty the subject/participant had over the past 2 weeks using his or her hand that was most affected by the stroke to tie a shoelace | In the past 2 weeks, how difficult was it to use your hand that was most affected by your stroke to tie a shoe lace? | 2;3;4;5;1 | Very difficult;Somewhat difficult;A little difficult;Not difficult at all;Could not do at all | Numeric Values | PhenX Protocol: Stroke Impact Scale (SIS) - Adults (#820701) | Adult | Proposed | 1.00 | 2019-04-04 15:25:21.0 | PhenX Toolkit: Functionality After Stroke | Additional Proposed Instruments | Phen-X |
Single Pre-Defined Value Selected |
PhenX | Neurology, Quality of Life, and Health Services Specialty Collection | Functionality after Stroke | 7d |