CDE Detailed Report
Disease: Sickle Cell Disease
Sub-Domain: Additional Proposed Instruments
CRF: PhenX Toolkit: Functionality After Stroke

Displaying 1 - 50 of 60
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
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
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
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
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
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
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
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
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
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
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
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
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
C59456 Difficult dress upper body past 2 week scale DifDrsUprBodyPst2WkScl Scale of the difficulty the subject/participant had over the past 2 weeks dressing his or her upper body Scale of the difficulty the subject/participant had over the past 2 weeks dressing his or her upper body In the past 2 weeks, how difficult was it to dress the top part of your body? 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 5b
C59468 Difficult walk without lose balance past 2 week scale DifWalkWoLoseBalPst2WkScl Scale of the difficulty the subject/participant had over the past 2 weeks to walk without losing his or her balance Scale of the difficulty the subject/participant had over the past 2 weeks to walk without losing his or her balance In the past 2 weeks, how difficult was it to walk 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 6c
C59433 Difficult remember day of week past week scale DifRemDayOfWkPstWkScl Scale of the difficulty the subject/participant has had in the past week remembering the day of the week Scale of the difficulty the subject/participant has had in the past week remembering the day of the week In the past week, how difficult was it for you to remember the day of the week? 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 2d
C59479 Difficult use hand most affect stroke pick up dime past 2 week scale DfUsHdMsAfStPcUpDmPs2WkScl 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 pick up a dime 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 pick up a dime In the past 2 weeks, how difficult was it to use your hand that was most affected by your stroke to pick up a dime? 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 7e
C59446 Feel life worth living past week frequency scale FlLfWrthLvngPstWkFrqScl Scale of the frequency over the past week that the subject/participant felt life is worth living Scale of the frequency over the past week that the subject/participant felt life is worth living In the past week, how often did you feel that life is worth living? 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 3h
C59457 Difficult bathe self past 2 week scale DifBathSelfPst2WkScl Scale of the difficulty the subject/participant had over the past 2 weeks bathing him or herself Scale of the difficulty the subject/participant had over the past 2 weeks bathing him or herself In the past 2 weeks, how difficult was it to bathe yourself? 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 5c
C59469 Difficult move from bed to chair past 2 week scale DifMvFrmBdToChrPst2WkScl Scale of the difficulty the subject/participant had over the past 2 weeks to move from a bed to a chair Scale of the difficulty the subject/participant had over the past 2 weeks to move from a bed to a chair In the past 2 weeks, how difficult was it to move from a bed to a chair? 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 6d
C59434 Difficult concentrate past week scale DifConcentratePstWkScl Scale of the difficulty the subject/participant has had concentrating in the past week Scale of the difficulty the subject/participant has had concentrating in the past week In the past week, how difficult was it for you to concentrate? 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 2e
C59480 Limited work past 4 week scale LtdWrkPst4WkScl Scale of the amount of time over the past 4 weeks that the subject/participant has been limited in his or her work Scale of the amount of time over the past 4 weeks that the subject/participant has been limited in his or her work During the past 4 weeks, how much of the time have you been limited in your work (paid, voluntary or other)? 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 8a
C59447 Smile laugh least once day past week frequency scale SmlLghLstOnceDyPstWkFrqScl Scale of the frequency over the past week that the subject/participant smiled and laughed at least once a day Scale of the frequency over the past week that the subject/participant smiled and laughed at least once a day In the past week, how often did you smile and laugh at least once a day? 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 3i
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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