Version 2.78

70532-7 Functional Assessment of Cancer Therapy - Prostate Symptom Index Questionnaire - 8 items (FAPSI-8) [FACIT]

Term Description

For patients with Prostate cancer; A FACT-Prostate Symptom Index (a subset of FACT-P containing 8 items)
Source: Regenstrief LOINC

Form Coding Instructions

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

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of cancer therapy - prostate symptom index questionnaire - 8 items
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a lack of energy
Source
GP1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have pain
Source
GP4

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I worry that my condition will get worse
Source
GE6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70346-2 I am losing weight

Observation ID in Form

C2

Fully-Specified Name

Component
I am losing weight in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am losing weight
Source
C2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

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

Observation ID in Form

P2

Fully-Specified Name

Component
I have certain parts of my body where I experience pain in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

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

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70558-2 My pain keeps me from doing things I want to do

Observation ID in Form

P3

Fully-Specified Name

Component
My pain keeps me from doing things I want to do in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
My pain keeps me from doing things I want to do
Source
P3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70566-5 I have difficulty urinating

Observation ID in Form

P7

Fully-Specified Name

Component
I have difficulty urinating in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have difficulty urinating
Source
P7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70559-0 My problems with urinating limit my activities

Observation ID in Form

P8

Fully-Specified Name

Component
My problems with urinating limit my activities in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
My problems with urinating limit my activities
Source
P8

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70533-5 Functional Assessment of Cancer Therapy - Bladder Symptom Index Questionnaire - 7 items (FBlSI) [FACIT]

Term Description

For patients with Bladder cancer; a FACT-Bladder Symptom Index (a subset of FACT-Bl containing 7 items)
Source: Regenstrief LOINC

Form Coding Instructions

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

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of cancer therapy - bladder symptom index questionnaire - 7 items
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have pain
Source
GP4

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a lack of energy
Source
GP1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70346-2 I am losing weight

Observation ID in Form

C2

Fully-Specified Name

Component
I am losing weight in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am losing weight
Source
C2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have nausea
Source
GP2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70410-6 I feel ill

Observation ID in Form

GP6

Fully-Specified Name

Component
I feel ill in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I feel ill
Source
GP6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I worry that my condition will get worse
Source
GE6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70314-0 I have trouble controlling my urine

Observation ID in Form

BL1

Fully-Specified Name

Component
I have trouble controlling my urine in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have trouble controlling my urine
Source
BL1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70534-3 National Comprehensive Cancer Network - Bladder Symptom Index Questionnaire - 18 items (NCCN-FBlSI-18) [FACIT]

Term Description

For patients with Bladder cancer; A FACT/National Comprehensive Cancer Network-Bladder Symptom Index - 18 items
Source: Regenstrief LOINC

Form Coding Instructions

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

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
National comprehensive cancer network - bladder symptom index questionnaire - 18 items
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have pain
Source
GP4

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70346-2 I am losing weight

Observation ID in Form

C2

Fully-Specified Name

Component
I am losing weight in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am losing weight
Source
C2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70314-0 I have trouble controlling my urine

Observation ID in Form

BL1

Fully-Specified Name

Component
I have trouble controlling my urine in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have trouble controlling my urine
Source
BL1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70425-4 I feel weak all over

Observation ID in Form

HI12

Fully-Specified Name

Component
I feel weak all over in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Change Reason
Release 2.67: SURVEY_QUEST_TEXT: Corrected the omission of "over" from Survey Question Text; Previous Releases: Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I feel weak all over
Source
HI12

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70560-8 I feel light-headed (dizzy)

Observation ID in Form

An9

Fully-Specified Name

Component
I feel light-headed, dizzy in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I feel light-headed (dizzy)
Source
An9

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

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

70407-2 Because of my physical condition, I have trouble meeting the needs of my family

Observation ID in Form

GP3

Fully-Specified Name

Component
Because of my physical condition, I have trouble meeting the needs of my family in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
Because of my physical condition, I have trouble meeting the needs of my family
Source
GP3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70350-4 I have a good appetite

Observation ID in Form

C6

Fully-Specified Name

Component
I have a good appetite in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a good appetite
Source
C6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70318-1 (For men only) I am able to have and maintain an erection

Observation ID in Form

BL5

Fully-Specified Name

Component
For men only - I am able to have and maintain an erection in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
(For men only) I am able to have and maintain an erection
Source
BL5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70402-3 I am sleeping well

Observation ID in Form

GF5

Fully-Specified Name

Component
I am sleeping well in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am sleeping well
Source
GF5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I worry that my condition will get worse
Source
GE6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70392-6 I feel sad

Observation ID in Form

GE1

Fully-Specified Name

Component
I feel sad in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I feel sad
Source
GE1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have nausea
Source
GP2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a lack of energy
Source
GP1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70410-6 I feel ill

Observation ID in Form

GP6

Fully-Specified Name

Component
I feel ill in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I feel ill
Source
GP6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70347-0 I have control of my bowels

Observation ID in Form

C3

Fully-Specified Name

Component
I have control of my bowels in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have control of my bowels
Source
C3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70409-8 I am bothered by side effects of treatment

Observation ID in Form

GP5

Fully-Specified Name

Component
I am bothered by side effects of treatment in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am bothered by side effects of treatment
Source
GP5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy life in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am able to enjoy life
Source
GF3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am content with the quality of my life right now
Source
GF7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70535-0 Functional Assessment of Cancer Therapy - Brain Symptom Index Questionnaire - 15 items [FACIT]

Term Description

For patients with Brain cancer; a FACT-Brain Symptom Index (a subset of FACT-Br containing 15 items)
Source: Regenstrief LOINC

Form Coding Instructions

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

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of cancer therapy - brain symptom index questionnaire - 15 items
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70302-5 I get headaches

Observation ID in Form

An10

Fully-Specified Name

Component
I get headaches in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I get headaches
Source
An10

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70334-8 I have had seizures (convulsions)

Observation ID in Form

Br2

Fully-Specified Name

Component
I have had seizures - convulsions - in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have had seizures (convulsions)
Source
Br2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70335-5 I have weakness in my arms or legs

Observation ID in Form

Br20

Fully-Specified Name

Component
I have weakness in my arms or legs in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have weakness in my arms or legs
Source
Br20

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70328-0 I need help caring for myself - bathing, dressing, eating, etc.

Observation ID in Form

Br14

Fully-Specified Name

Component
I need help caring for myself - bathing, dressing, eating, etc in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I need help caring for myself - bathing, dressing, eating, etc.
Source
Br14

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a lack of energy
Source
GP1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70343-9 I have difficulty expressing my thoughts

Observation ID in Form

Br9

Fully-Specified Name

Component
I have difficulty expressing my thoughts in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have difficulty expressing my thoughts
Source
Br9

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70336-3 I have trouble with coordination

Observation ID in Form

Br21

Fully-Specified Name

Component
I have trouble with coordination in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have trouble with coordination
Source
Br21

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70338-9 I get frustrated that I cannot do the things I used to

Observation ID in Form

Br4

Fully-Specified Name

Component
I get frustrated that I cannot do the things I used to in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I get frustrated that I cannot do the things I used to
Source
Br4

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have nausea
Source
GP2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70342-1 I am able to find the right words to say what I mean

Observation ID in Form

Br8

Fully-Specified Name

Component
I am able to find the right words to say what I mean in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am able to find the right words to say what I mean
Source
Br8

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70394-2 I am losing hope in the fight against my illness

Observation ID in Form

GE3

Fully-Specified Name

Component
I am losing hope in the fight against my illness in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am losing hope in the fight against my illness
Source
GE3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70407-2 Because of my physical condition, I have trouble meeting the needs of my family

Observation ID in Form

GP3

Fully-Specified Name

Component
Because of my physical condition, I have trouble meeting the needs of my family in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
Because of my physical condition, I have trouble meeting the needs of my family
Source
GP3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I worry that my condition will get worse
Source
GE6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70339-7 I am afraid of having a seizure (convulsion)

Observation ID in Form

Br5

Fully-Specified Name

Component
I am afraid of having a seizure - convulsion - in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am afraid of having a seizure (convulsion)
Source
Br5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy life in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am able to enjoy life
Source
GF3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70536-8 National comprehensive cancer network - Brain Symptom Index Questionnaire - 24 items (NCCN-FACT - FBrSI-24) [FACIT]

Term Description

For patients with Brain cancer; A FACT/NCCN-Brain Symptom Index( a subset of FACT-Br containing 24 items)
Source: Regenstrief LOINC

Form Coding Instructions

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

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
National comprehensive cancer network - brain symptom index questionnaire - 24 items
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70302-5 I get headaches

Observation ID in Form

An10

Fully-Specified Name

Component
I get headaches in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I get headaches
Source
An10

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70336-3 I have trouble with coordination

Observation ID in Form

Br21

Fully-Specified Name

Component
I have trouble with coordination in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have trouble with coordination
Source
Br21

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70334-8 I have had seizures (convulsions)

Observation ID in Form

Br2

Fully-Specified Name

Component
I have had seizures - convulsions - in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have had seizures (convulsions)
Source
Br2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70328-0 I need help caring for myself - bathing, dressing, eating, etc.

Observation ID in Form

Br14

Fully-Specified Name

Component
I need help caring for myself - bathing, dressing, eating, etc in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I need help caring for myself - bathing, dressing, eating, etc.
Source
Br14

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70335-5 I have weakness in my arms or legs

Observation ID in Form

Br20

Fully-Specified Name

Component
I have weakness in my arms or legs in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have weakness in my arms or legs
Source
Br20

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70346-2 I am losing weight

Observation ID in Form

C2

Fully-Specified Name

Component
I am losing weight in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am losing weight
Source
C2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70407-2 Because of my physical condition, I have trouble meeting the needs of my family

Observation ID in Form

GP3

Fully-Specified Name

Component
Because of my physical condition, I have trouble meeting the needs of my family in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
Because of my physical condition, I have trouble meeting the needs of my family
Source
GP3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70343-9 I have difficulty expressing my thoughts

Observation ID in Form

Br9

Fully-Specified Name

Component
I have difficulty expressing my thoughts in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have difficulty expressing my thoughts
Source
Br9

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70402-3 I am sleeping well

Observation ID in Form

GF5

Fully-Specified Name

Component
I am sleeping well in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am sleeping well
Source
GF5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70323-1 I am able to concentrate

Observation ID in Form

Br1

Fully-Specified Name

Component
I am able to concentrate in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am able to concentrate
Source
Br1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70337-1 I can remember new things

Observation ID in Form

Br3

Fully-Specified Name

Component
I can remember new things in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I can remember new things
Source
Br3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70342-1 I am able to find the right words to say what I mean

Observation ID in Form

Br8

Fully-Specified Name

Component
I am able to find the right words to say what I mean in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am able to find the right words to say what I mean
Source
Br8

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70324-9 I am bothered by the change in my personality

Observation ID in Form

Br10

Fully-Specified Name

Component
I am bothered by the change in my personality in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am bothered by the change in my personality
Source
Br10

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I worry that my condition will get worse
Source
GE6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70339-7 I am afraid of having a seizure (convulsion)

Observation ID in Form

Br5

Fully-Specified Name

Component
I am afraid of having a seizure - convulsion - in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am afraid of having a seizure (convulsion)
Source
Br5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70338-9 I get frustrated that I cannot do the things I used to

Observation ID in Form

Br4

Fully-Specified Name

Component
I get frustrated that I cannot do the things I used to in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I get frustrated that I cannot do the things I used to
Source
Br4

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70394-2 I am losing hope in the fight against my illness

Observation ID in Form

GE3

Fully-Specified Name

Component
I am losing hope in the fight against my illness in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am losing hope in the fight against my illness
Source
GE3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a lack of energy
Source
GP1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have nausea
Source
GP2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70409-8 I am bothered by side effects of treatment

Observation ID in Form

GP5

Fully-Specified Name

Component
I am bothered by side effects of treatment in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am bothered by side effects of treatment
Source
GP5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70426-2 I feel fatigued

Observation ID in Form

HI7

Fully-Specified Name

Component
I feel fatigued in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I feel fatigued
Source
HI7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70350-4 I have a good appetite

Observation ID in Form

C6

Fully-Specified Name

Component
I have a good appetite in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a good appetite
Source
C6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy life in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am able to enjoy life
Source
GF3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am content with the quality of my life right now
Source
GF7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70537-6 Functional Assessment of Cancer Therapy - Breast Symptom Index Questionnaire - 8 items (FBSI-8) [FACIT]

Term Description

For patients with Breast cancer; A FACT-Breast Symptom Index (a subset of FACT-B containing 8 items)
Source: Regenstrief LOINC

Form Coding Instructions

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

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of cancer therapy - breast symptom index questionnaire - 8 items
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a lack of energy
Source
GP1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have pain
Source
GP4

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have nausea
Source
GP2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

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

Observation ID in Form

P2

Fully-Specified Name

Component
I have certain parts of my body where I experience pain in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

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

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70305-8 I have been short of breath

Observation ID in Form

B1

Fully-Specified Name

Component
I have been short of breath in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.72
Change Reason
Release 2.72: SURVEY_QUEST_TEXT: Moved to Form Data table.; METHOD_TYP: Removed Method to increase usability.; Previous Releases: Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
99357-6 COVID-19 health questions panel
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel
98520-0 PROMIS item bank - dyspnea characteristics - version 1.0

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I worry that my condition will get worse
Source
GE6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am content with the quality of my life right now
Source
GF7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70407-2 Because of my physical condition, I have trouble meeting the needs of my family

Observation ID in Form

GP3

Fully-Specified Name

Component
Because of my physical condition, I have trouble meeting the needs of my family in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
Because of my physical condition, I have trouble meeting the needs of my family
Source
GP3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70538-4 National Comprehensive Cancer Network - Breast Symptom Index Questionnaire - 16 items (NCCN-FBSI-16) [FACIT]

Term Description

For patients with Breast cancer; a FACT/NCCN-Breast Symptom Index
Source: Regenstrief LOINC

Form Coding Instructions

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

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
National comprehensive cancer network - breast symptom index questionnaire - 16 items
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a lack of energy
Source
GP1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have pain
Source
GP4

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70410-6 I feel ill

Observation ID in Form

GP6

Fully-Specified Name

Component
I feel ill in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I feel ill
Source
GP6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70305-8 I have been short of breath

Observation ID in Form

B1

Fully-Specified Name

Component
I have been short of breath in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.72
Change Reason
Release 2.72: SURVEY_QUEST_TEXT: Moved to Form Data table.; METHOD_TYP: Removed Method to increase usability.; Previous Releases: Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
99357-6 COVID-19 health questions panel
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel
98520-0 PROMIS item bank - dyspnea characteristics - version 1.0

70407-2 Because of my physical condition, I have trouble meeting the needs of my family

Observation ID in Form

GP3

Fully-Specified Name

Component
Because of my physical condition, I have trouble meeting the needs of my family in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
Because of my physical condition, I have trouble meeting the needs of my family
Source
GP3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70426-2 I feel fatigued

Observation ID in Form

HI7

Fully-Specified Name

Component
I feel fatigued in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I feel fatigued
Source
HI7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70322-3 I have bone pain

Observation ID in Form

BP1

Fully-Specified Name

Component
I have bone pain in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have bone pain
Source
BP1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70402-3 I am sleeping well

Observation ID in Form

GF5

Fully-Specified Name

Component
I am sleeping well in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am sleeping well
Source
GF5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I worry that my condition will get worse
Source
GE6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have nausea
Source
GP2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70561-6 I have mouth sores

Observation ID in Form

N6

Fully-Specified Name

Component
I have mouth sores in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have mouth sores
Source
N6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

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

70409-8 I am bothered by side effects of treatment

Observation ID in Form

GP5

Fully-Specified Name

Component
I am bothered by side effects of treatment in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am bothered by side effects of treatment
Source
GP5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70309-0 I am bothered by hair loss

Observation ID in Form

B5

Fully-Specified Name

Component
I am bothered by hair loss in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am bothered by hair loss
Source
B5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70398-3 I am able to work (include work at home)

Observation ID in Form

GF1

Fully-Specified Name

Component
I am able to work - include work at home - in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am able to work (include work at home)
Source
GF1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy life in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am able to enjoy life
Source
GF3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am content with the quality of my life right now
Source
GF7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70539-2 Functional Assessment of Cancer Therapy - Colorectal Symptom Index Questionnaire - 9 items (FCSI-9) [FACIT]

Term Description

For patients with Colorectal cancer; A FACT-Colorectal Symptom Index (a subset of FACT-C containing 9 items)
Source: Regenstrief LOINC

Form Coding Instructions

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

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of cancer therapy - colorectal symptom index questionnaire - 9 items
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a lack of energy
Source
GP1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have pain
Source
GP4

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70346-2 I am losing weight

Observation ID in Form

C2

Fully-Specified Name

Component
I am losing weight in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am losing weight
Source
C2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70349-6 I have diarrhea

Observation ID in Form

C5

Fully-Specified Name

Component
I have diarrhea in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have diarrhea
Source
C5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have nausea
Source
GP2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70345-4 I have swelling or cramps in my stomach

Observation ID in Form

C1

Fully-Specified Name

Component
I have swelling or cramps in my stomach area in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have swelling or cramps in my stomach
Source
C1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70350-4 I have a good appetite

Observation ID in Form

C6

Fully-Specified Name

Component
I have a good appetite in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a good appetite
Source
C6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy life in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am able to enjoy life
Source
GF3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am content with the quality of my life right now
Source
GF7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70540-0 National Comprehensive Cancer Network - Colorectal Symptom Index Questionnaire - 19 items (NCCN - FCSI-19) [FACIT]

Term Description

For patients with Colorectal cancer; a FACT/NCCN-Colorectal Symptom Index-19 items
Source: Regenstrief LOINC

Form Coding Instructions

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

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
National comprehensive cancer network - colorectal symptom index questionnaire - 19 items
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a lack of energy
Source
GP1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have pain
Source
GP4

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70346-2 I am losing weight

Observation ID in Form

C2

Fully-Specified Name

Component
I am losing weight in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am losing weight
Source
C2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70345-4 I have swelling or cramps in my stomach

Observation ID in Form

C1

Fully-Specified Name

Component
I have swelling or cramps in my stomach area in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have swelling or cramps in my stomach
Source
C1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70426-2 I feel fatigued

Observation ID in Form

HI7

Fully-Specified Name

Component
I feel fatigued in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I feel fatigued
Source
HI7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70407-2 Because of my physical condition, I have trouble meeting the needs of my family

Observation ID in Form

GP3

Fully-Specified Name

Component
Because of my physical condition, I have trouble meeting the needs of my family in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
Because of my physical condition, I have trouble meeting the needs of my family
Source
GP3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70350-4 I have a good appetite

Observation ID in Form

C6

Fully-Specified Name

Component
I have a good appetite in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a good appetite
Source
C6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70402-3 I am sleeping well

Observation ID in Form

GF5

Fully-Specified Name

Component
I am sleeping well in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am sleeping well
Source
GF5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I worry that my condition will get worse
Source
GE6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have nausea
Source
GP2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70309-0 I am bothered by hair loss

Observation ID in Form

B5

Fully-Specified Name

Component
I am bothered by hair loss in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am bothered by hair loss
Source
B5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70347-0 I have control of my bowels

Observation ID in Form

C3

Fully-Specified Name

Component
I have control of my bowels in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have control of my bowels
Source
C3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70349-6 I have diarrhea

Observation ID in Form

C5

Fully-Specified Name

Component
I have diarrhea in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have diarrhea
Source
C5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70365-2 I am bothered by constipation

Observation ID in Form

Cx6

Fully-Specified Name

Component
I am bothered by constipation in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am bothered by constipation
Source
Cx6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70562-4 I have numbness or tingling in my hands

Observation ID in Form

NTX1

Fully-Specified Name

Component
I have numbness or tingling in my hands in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have numbness or tingling in my hands
Source
NTX1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70563-2 I have pain in my hands or feet when I am exposed to cold temperatures

Observation ID in Form

NTX10

Fully-Specified Name

Component
I have pain in my hands or feet when I am exposed to cold temperatures in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have pain in my hands or feet when I am exposed to cold temperatures
Source
NTX10

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70409-8 I am bothered by side effects of treatment

Observation ID in Form

GP5

Fully-Specified Name

Component
I am bothered by side effects of treatment in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am bothered by side effects of treatment
Source
GP5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy life in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am able to enjoy life
Source
GF3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am content with the quality of my life right now
Source
GF7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70541-8 Functional Assessment of Cancer Therapy - Head and Neck Symptom Index Questionnaire - 10 items (FACIT - FHNSI) [FACIT]

Term Description

For patients with Head & Neck cancer; a FACT-Head & Neck Symptom Index (a subset of the FACT-H&N containing 10 items)
Source: Regenstrief LOINC

Form Coding Instructions

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

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of cancer therapy - head and neck symptom index questionnaire - 10 items
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have pain
Source
GP4

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a lack of energy
Source
GP1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70436-1 I can swallow naturally and easily

Observation ID in Form

HN7

Fully-Specified Name

Component
I can swallow naturally and easily in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I can swallow naturally and easily
Source
HN7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70430-4 I have pain in my mouth, throat or neck

Observation ID in Form

HN12

Fully-Specified Name

Component
I have pain in my mouth, throat or neck in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have pain in my mouth, throat or neck
Source
HN12

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70432-0 I have trouble breathing

Observation ID in Form

HN3

Fully-Specified Name

Component
I have trouble breathing in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have trouble breathing
Source
HN3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70428-8 I am able to communicate with others

Observation ID in Form

HN10

Fully-Specified Name

Component
I am able to communicate with others in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am able to communicate with others
Source
HN10

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have nausea
Source
GP2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70429-6 I can eat solid food

Observation ID in Form

HN11

Fully-Specified Name

Component
I can eat solid foods in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I can eat solid food
Source
HN11

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I worry that my condition will get worse
Source
GE6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am content with the quality of my life right now
Source
GF7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70542-6 National Comprehensive Cancer Network - Head and Neck Symptom Index Questionnaire - 22 items (NCCN-FACT - FHNSI-22) [FACIT]

Term Description

For patients with Head & Neck cancer; a FACT/NCCN-Head & Neck Symptom Index
Source: Regenstrief LOINC

Form Coding Instructions

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

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
National comprehensive cancer network - head and neck symptom index questionnaire - 22 items
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have pain
Source
GP4

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70346-2 I am losing weight

Observation ID in Form

C2

Fully-Specified Name

Component
I am losing weight in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am losing weight
Source
C2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70432-0 I have trouble breathing

Observation ID in Form

HN3

Fully-Specified Name

Component
I have trouble breathing in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have trouble breathing
Source
HN3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70410-6 I feel ill

Observation ID in Form

GP6

Fully-Specified Name

Component
I feel ill in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I feel ill
Source
GP6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70430-4 I have pain in my mouth, throat or neck

Observation ID in Form

HN12

Fully-Specified Name

Component
I have pain in my mouth, throat or neck in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have pain in my mouth, throat or neck
Source
HN12

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70407-2 Because of my physical condition, I have trouble meeting the needs of my family

Observation ID in Form

GP3

Fully-Specified Name

Component
Because of my physical condition, I have trouble meeting the needs of my family in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
Because of my physical condition, I have trouble meeting the needs of my family
Source
GP3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70436-1 I can swallow naturally and easily

Observation ID in Form

HN7

Fully-Specified Name

Component
I can swallow naturally and easily in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I can swallow naturally and easily
Source
HN7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70427-0 I am able to eat the foods that I like

Observation ID in Form

HN1

Fully-Specified Name

Component
I am able to eat the foods that I like in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am able to eat the foods that I like
Source
HN1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70428-8 I am able to communicate with others

Observation ID in Form

HN10

Fully-Specified Name

Component
I am able to communicate with others in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am able to communicate with others
Source
HN10

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70429-6 I can eat solid food

Observation ID in Form

HN11

Fully-Specified Name

Component
I can eat solid foods in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I can eat solid food
Source
HN11

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70402-3 I am sleeping well

Observation ID in Form

GF5

Fully-Specified Name

Component
I am sleeping well in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am sleeping well
Source
GF5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I worry that my condition will get worse
Source
GE6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a lack of energy
Source
GP1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have nausea
Source
GP2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70422-1 I have had a change in the way food tastes

Observation ID in Form

Hep5

Fully-Specified Name

Component
I have had a change in the way food tastes in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have had a change in the way food tastes
Source
Hep5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70561-6 I have mouth sores

Observation ID in Form

N6

Fully-Specified Name

Component
I have mouth sores in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have mouth sores
Source
N6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

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

70309-0 I am bothered by hair loss

Observation ID in Form

B5

Fully-Specified Name

Component
I am bothered by hair loss in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am bothered by hair loss
Source
B5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70409-8 I am bothered by side effects of treatment

Observation ID in Form

GP5

Fully-Specified Name

Component
I am bothered by side effects of treatment in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am bothered by side effects of treatment
Source
GP5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70350-4 I have a good appetite

Observation ID in Form

C6

Fully-Specified Name

Component
I have a good appetite in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a good appetite
Source
C6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70398-3 I am able to work (include work at home)

Observation ID in Form

GF1

Fully-Specified Name

Component
I am able to work - include work at home - in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am able to work (include work at home)
Source
GF1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy life in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am able to enjoy life
Source
GF3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am content with the quality of my life right now
Source
GF7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70543-4 Functional Assessment of Cancer Therapy - Hepatibiliary Symptom Index Questionnaire - 8 items (FACIT - FHSI-8) [FACIT]

Term Description

For patients with Hepatobiliary cancer (liver, bile duct and pancreas); A FACT-Hepatobiliary Symptom Index (a subset of FACT-Hep containing 8 items)
Source: Regenstrief LOINC

Form Coding Instructions

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

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of cancer therapy - hepatibiliary symptom index questionnaire - 8 items
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a lack of energy
Source
GP1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have nausea
Source
GP2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have pain
Source
GP4

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70346-2 I am losing weight

Observation ID in Form

C2

Fully-Specified Name

Component
I am losing weight in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am losing weight
Source
C2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70359-5 I have a pain in my back

Observation ID in Form

CNS7

Fully-Specified Name

Component
I have pain in my back in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a pain in my back
Source
CNS7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70426-2 I feel fatigued

Observation ID in Form

HI7

Fully-Specified Name

Component
I feel fatigued in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I feel fatigued
Source
HI7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70420-5 I am bothered by jaundice or yellow color to my skin

Observation ID in Form

Hep2

Fully-Specified Name

Component
I am bothered by jaundice or yellow color to my skin in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am bothered by jaundice or yellow color to my skin
Source
Hep2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70424-7 I have discomfort or pain in my stomach area

Observation ID in Form

Hep8

Fully-Specified Name

Component
I have discomfort or pain in my stomach area in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have discomfort or pain in my stomach area
Source
Hep8

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70544-2 National Comprehensive Cancer Network - Hepatibiliary Symptom Index Questionnaire - 18 items (NCCN-FACT - FHSI-18) [FACIT]

Term Description

For patients with Hepatobiliary cancer (liver, bile duct and pancreas); a FACT/NCCN-Hepatobiliary Symptom Index
Source: Regenstrief LOINC

Form Coding Instructions

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

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
National comprehensive cancer network - hepatibiliary symptom index questionnaire - 18 items
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a lack of energy
Source
GP1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have pain
Source
GP4

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70346-2 I am losing weight

Observation ID in Form

C2

Fully-Specified Name

Component
I am losing weight in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am losing weight
Source
C2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70426-2 I feel fatigued

Observation ID in Form

HI7

Fully-Specified Name

Component
I feel fatigued in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I feel fatigued
Source
HI7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70359-5 I have a pain in my back

Observation ID in Form

CNS7

Fully-Specified Name

Component
I have pain in my back in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a pain in my back
Source
CNS7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70420-5 I am bothered by jaundice or yellow color to my skin

Observation ID in Form

Hep2

Fully-Specified Name

Component
I am bothered by jaundice or yellow color to my skin in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am bothered by jaundice or yellow color to my skin
Source
Hep2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70410-6 I feel ill

Observation ID in Form

GP6

Fully-Specified Name

Component
I feel ill in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I feel ill
Source
GP6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70424-7 I have discomfort or pain in my stomach area

Observation ID in Form

Hep8

Fully-Specified Name

Component
I have discomfort or pain in my stomach area in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have discomfort or pain in my stomach area
Source
Hep8

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have nausea
Source
GP2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70407-2 Because of my physical condition, I have trouble meeting the needs of my family

Observation ID in Form

GP3

Fully-Specified Name

Component
Because of my physical condition, I have trouble meeting the needs of my family in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
Because of my physical condition, I have trouble meeting the needs of my family
Source
GP3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70350-4 I have a good appetite

Observation ID in Form

C6

Fully-Specified Name

Component
I have a good appetite in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a good appetite
Source
C6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70402-3 I am sleeping well

Observation ID in Form

GF5

Fully-Specified Name

Component
I am sleeping well in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am sleeping well
Source
GF5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I worry that my condition will get worse
Source
GE6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70392-6 I feel sad

Observation ID in Form

GE1

Fully-Specified Name

Component
I feel sad in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I feel sad
Source
GE1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70409-8 I am bothered by side effects of treatment

Observation ID in Form

GP5

Fully-Specified Name

Component
I am bothered by side effects of treatment in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am bothered by side effects of treatment
Source
GP5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

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

Observation ID in Form

An7

Fully-Specified Name

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

Basic Attributes

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

Survey Question

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

Normative Answer List LL1017-4

Answer Code Score Answer ID
Not at all 1 LA6568-5
A little bit 2 LA13863-8
Somewhat 3 LA13909-9
Quite a bit 4 LA13902-4
Very much 5 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
61795-1 PROMIS item bank - fatigue - version 1.0

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy life in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am able to enjoy life
Source
GF3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am content with the quality of my life right now
Source
GF7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70545-9 Functional Assessment of Chronic Illness Therapy for patients with kidney cancer questionnaire -15 items (FACIT - FKSI-15)

Term Description

For patients with Kidney Cancer, a 15 item scale
Source: Regenstrief LOINC

Form Coding Instructions

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

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of chronic illness therapy for patients with kidney cancer questionnaire - 15 items
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a lack of energy
Source
GP1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70409-8 I am bothered by side effects of treatment

Observation ID in Form

GP5

Fully-Specified Name

Component
I am bothered by side effects of treatment in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am bothered by side effects of treatment
Source
GP5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have pain
Source
GP4

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70346-2 I am losing weight

Observation ID in Form

C2

Fully-Specified Name

Component
I am losing weight in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am losing weight
Source
C2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70322-3 I have bone pain

Observation ID in Form

BP1

Fully-Specified Name

Component
I have bone pain in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have bone pain
Source
BP1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70426-2 I feel fatigued

Observation ID in Form

HI7

Fully-Specified Name

Component
I feel fatigued in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I feel fatigued
Source
HI7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy life in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am able to enjoy life
Source
GF3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70305-8 I have been short of breath

Observation ID in Form

B1

Fully-Specified Name

Component
I have been short of breath in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.72
Change Reason
Release 2.72: SURVEY_QUEST_TEXT: Moved to Form Data table.; METHOD_TYP: Removed Method to increase usability.; Previous Releases: Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
99357-6 COVID-19 health questions panel
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel
98520-0 PROMIS item bank - dyspnea characteristics - version 1.0

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I worry that my condition will get worse
Source
GE6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70350-4 I have a good appetite

Observation ID in Form

C6

Fully-Specified Name

Component
I have a good appetite in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a good appetite
Source
C6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70442-9 I have been coughing

Observation ID in Form

L2

Fully-Specified Name

Component
I have been coughing in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have been coughing
Source
L2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

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

Observation ID in Form

BRM3

Fully-Specified Name

Component
I am bothered by fevers - episodes of high body temperature - in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

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

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70398-3 I am able to work (include work at home)

Observation ID in Form

GF1

Fully-Specified Name

Component
I am able to work - include work at home - in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am able to work (include work at home)
Source
GF1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70564-0 I have had blood in my urine

Observation ID in Form

RCC2

Fully-Specified Name

Component
I have had blood in my urine in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have had blood in my urine
Source
RCC2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70402-3 I am sleeping well

Observation ID in Form

GF5

Fully-Specified Name

Component
I am sleeping well in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am sleeping well
Source
GF5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70546-7 Functional Assessment of Chronic Illness Therapy for patients with kidney cancer questionnaire -10 items (FACIT - FKSI-10)

Term Description

For patients with Kidney Cancer, a 10 item scale
Source: Regenstrief LOINC

Form Coding Instructions

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

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of chronic illness therapy for patients with kidney cancer questionnaire - 10 items
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a lack of energy
Source
GP1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70409-8 I am bothered by side effects of treatment

Observation ID in Form

GP5

Fully-Specified Name

Component
I am bothered by side effects of treatment in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am bothered by side effects of treatment
Source
GP5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have pain
Source
GP4

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70346-2 I am losing weight

Observation ID in Form

C2

Fully-Specified Name

Component
I am losing weight in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am losing weight
Source
C2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70322-3 I have bone pain

Observation ID in Form

BP1

Fully-Specified Name

Component
I have bone pain in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have bone pain
Source
BP1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70426-2 I feel fatigued

Observation ID in Form

HI7

Fully-Specified Name

Component
I feel fatigued in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I feel fatigued
Source
HI7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy life in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am able to enjoy life
Source
GF3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70305-8 I have been short of breath

Observation ID in Form

B1

Fully-Specified Name

Component
I have been short of breath in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.72
Change Reason
Release 2.72: SURVEY_QUEST_TEXT: Moved to Form Data table.; METHOD_TYP: Removed Method to increase usability.; Previous Releases: Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
99357-6 COVID-19 health questions panel
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel
98520-0 PROMIS item bank - dyspnea characteristics - version 1.0

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I worry that my condition will get worse
Source
GE6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70350-4 I have a good appetite

Observation ID in Form

C6

Fully-Specified Name

Component
I have a good appetite in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a good appetite
Source
C6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70547-5 Functional Assessment of Chronic Illness Therapy for patients with kidney cancer - Disease Related Symptoms Questionnaire - 9 items (FACIT - FKSI-DRS 9)

Term Description

For patients with Kidney cancer; a 9 item scale of Disease Related Symptoms
Source: Regenstrief LOINC

Form Coding Instructions

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

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of chronic illness therapy for patients with kidney cancer - disease related symptoms questionnaire - 9 items
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a lack of energy
Source
GP1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have pain
Source
GP4

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70346-2 I am losing weight

Observation ID in Form

C2

Fully-Specified Name

Component
I am losing weight in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am losing weight
Source
C2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70322-3 I have bone pain

Observation ID in Form

BP1

Fully-Specified Name

Component
I have bone pain in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have bone pain
Source
BP1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70426-2 I feel fatigued

Observation ID in Form

HI7

Fully-Specified Name

Component
I feel fatigued in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I feel fatigued
Source
HI7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70305-8 I have been short of breath

Observation ID in Form

B1

Fully-Specified Name

Component
I have been short of breath in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.72
Change Reason
Release 2.72: SURVEY_QUEST_TEXT: Moved to Form Data table.; METHOD_TYP: Removed Method to increase usability.; Previous Releases: Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
99357-6 COVID-19 health questions panel
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel
98520-0 PROMIS item bank - dyspnea characteristics - version 1.0

70442-9 I have been coughing

Observation ID in Form

L2

Fully-Specified Name

Component
I have been coughing in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have been coughing
Source
L2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

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

Observation ID in Form

BRM3

Fully-Specified Name

Component
I am bothered by fevers - episodes of high body temperature - in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

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

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70564-0 I have had blood in my urine

Observation ID in Form

RCC2

Fully-Specified Name

Component
I have had blood in my urine in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have had blood in my urine
Source
RCC2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70548-3 National Comprehensive Cancer Network - Kidney Symptom Index Questionnaire - 19 items (NCCN-FACT - FKSI-19) [FACIT]

Term Description

For patients with Kidney cancer; a FACT/NCCN Symptom Index-19 items
Source: Regenstrief LOINC

Form Coding Instructions

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

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
National comprehensive cancer network - kidney symptom index questionnaire - 19 items
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a lack of energy
Source
GP1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have pain
Source
GP4

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70346-2 I am losing weight

Observation ID in Form

C2

Fully-Specified Name

Component
I am losing weight in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am losing weight
Source
C2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70426-2 I feel fatigued

Observation ID in Form

HI7

Fully-Specified Name

Component
I feel fatigued in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I feel fatigued
Source
HI7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70305-8 I have been short of breath

Observation ID in Form

B1

Fully-Specified Name

Component
I have been short of breath in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.72
Change Reason
Release 2.72: SURVEY_QUEST_TEXT: Moved to Form Data table.; METHOD_TYP: Removed Method to increase usability.; Previous Releases: Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
99357-6 COVID-19 health questions panel
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel
98520-0 PROMIS item bank - dyspnea characteristics - version 1.0

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

Observation ID in Form

BRM3

Fully-Specified Name

Component
I am bothered by fevers - episodes of high body temperature - in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

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

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70322-3 I have bone pain

Observation ID in Form

BP1

Fully-Specified Name

Component
I have bone pain in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have bone pain
Source
BP1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70442-9 I have been coughing

Observation ID in Form

L2

Fully-Specified Name

Component
I have been coughing in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have been coughing
Source
L2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70425-4 I feel weak all over

Observation ID in Form

HI12

Fully-Specified Name

Component
I feel weak all over in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.67
Change Reason
Release 2.67: SURVEY_QUEST_TEXT: Corrected the omission of "over" from Survey Question Text; Previous Releases: Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I feel weak all over
Source
HI12

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70564-0 I have had blood in my urine

Observation ID in Form

RCC2

Fully-Specified Name

Component
I have had blood in my urine in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have had blood in my urine
Source
RCC2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70350-4 I have a good appetite

Observation ID in Form

C6

Fully-Specified Name

Component
I have a good appetite in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a good appetite
Source
C6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70402-3 I am sleeping well

Observation ID in Form

GF5

Fully-Specified Name

Component
I am sleeping well in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am sleeping well
Source
GF5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I worry that my condition will get worse
Source
GE6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have nausea
Source
GP2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70349-6 I have diarrhea

Observation ID in Form

C5

Fully-Specified Name

Component
I have diarrhea in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have diarrhea
Source
C5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70409-8 I am bothered by side effects of treatment

Observation ID in Form

GP5

Fully-Specified Name

Component
I am bothered by side effects of treatment in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am bothered by side effects of treatment
Source
GP5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70398-3 I am able to work (include work at home)

Observation ID in Form

GF1

Fully-Specified Name

Component
I am able to work - include work at home - in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am able to work (include work at home)
Source
GF1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy life in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am able to enjoy life
Source
GF3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am content with the quality of my life right now
Source
GF7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70549-1 Functional Assessment of Cancer Therapy - Lung Symptom Index Questionnaire - 6 items - version 4 (FACT - FLSI 6) [FACIT]

Term Description

For patients with Lung cancer; A FACT-Lung Symptom Index (a subset of FACT-L containing 6 items)
Source: Regenstrief LOINC

Form Coding Instructions

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

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of cancer therapy - lung symptom index questionnaire - 6 items - version 4
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70305-8 I have been short of breath

Observation ID in Form

B1

Fully-Specified Name

Component
I have been short of breath in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.72
Change Reason
Release 2.72: SURVEY_QUEST_TEXT: Moved to Form Data table.; METHOD_TYP: Removed Method to increase usability.; Previous Releases: Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
99357-6 COVID-19 health questions panel
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel
98520-0 PROMIS item bank - dyspnea characteristics - version 1.0

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a lack of energy
Source
GP1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have pain
Source
GP4

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70346-2 I am losing weight

Observation ID in Form

C2

Fully-Specified Name

Component
I am losing weight in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am losing weight
Source
C2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70442-9 I have been coughing

Observation ID in Form

L2

Fully-Specified Name

Component
I have been coughing in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have been coughing
Source
L2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

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

Observation ID in Form

P2

Fully-Specified Name

Component
I have certain parts of my body where I experience pain in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

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

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70550-9 Functional Assessment of Cancer Therapy - Lung Symptom Index Questionnaire - 12 items - version 4 (FACIT - FLSI-12) [FACIT]

Term Description

For patients with Lung cancer; a FACT-Lung Symptom Index (a subset of FACT-L containing 12 items)
Source: Regenstrief LOINC

Form Coding Instructions

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

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of cancer therapy - lung symptom index questionnaire - 12 items - version 4
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70305-8 I have been short of breath

Observation ID in Form

B1

Fully-Specified Name

Component
I have been short of breath in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.72
Change Reason
Release 2.72: SURVEY_QUEST_TEXT: Moved to Form Data table.; METHOD_TYP: Removed Method to increase usability.; Previous Releases: Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
99357-6 COVID-19 health questions panel
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel
98520-0 PROMIS item bank - dyspnea characteristics - version 1.0

70346-2 I am losing weight

Observation ID in Form

C2

Fully-Specified Name

Component
I am losing weight in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am losing weight
Source
C2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70441-1 My thinking is clear

Observation ID in Form

L1

Fully-Specified Name

Component
My thinking is clear in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
My thinking is clear
Source
L1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70442-9 I have been coughing

Observation ID in Form

L2

Fully-Specified Name

Component
I have been coughing in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have been coughing
Source
L2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70350-4 I have a good appetite

Observation ID in Form

C6

Fully-Specified Name

Component
I have a good appetite in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a good appetite
Source
C6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70443-7 I feel tightness in my chest

Observation ID in Form

L3

Fully-Specified Name

Component
I feel tightness in my chest in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I feel tightness in my chest
Source
L3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70444-5 Breathing is easy for me

Observation ID in Form

L4

Fully-Specified Name

Component
Breathing is easy for me in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
Breathing is easy for me
Source
L4

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a lack of energy
Source
GP1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have pain
Source
GP4

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have nausea
Source
GP2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70409-8 I am bothered by side effects of treatment

Observation ID in Form

GP5

Fully-Specified Name

Component
I am bothered by side effects of treatment in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am bothered by side effects of treatment
Source
GP5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am content with the quality of my life right now
Source
GF7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70551-7 Functional Assessment of Cancer Therapy - Lung Symptom Index Questionnaire - 7 items - version 4 (FACIT - FACT-LCS) [FACIT]

Term Description

For patients with Lung cancer; a FACT-Lung Symptom Index (a subset of FACT-L containing 7 items)
Source: Regenstrief LOINC

Form Coding Instructions

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

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of cancer therapy - lung symptom index questionnaire - 7 items - version 4
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70305-8 I have been short of breath

Observation ID in Form

B1

Fully-Specified Name

Component
I have been short of breath in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.72
Change Reason
Release 2.72: SURVEY_QUEST_TEXT: Moved to Form Data table.; METHOD_TYP: Removed Method to increase usability.; Previous Releases: Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
99357-6 COVID-19 health questions panel
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel
98520-0 PROMIS item bank - dyspnea characteristics - version 1.0

70346-2 I am losing weight

Observation ID in Form

C2

Fully-Specified Name

Component
I am losing weight in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am losing weight
Source
C2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70441-1 My thinking is clear

Observation ID in Form

L1

Fully-Specified Name

Component
My thinking is clear in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
My thinking is clear
Source
L1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70442-9 I have been coughing

Observation ID in Form

L2

Fully-Specified Name

Component
I have been coughing in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have been coughing
Source
L2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70350-4 I have a good appetite

Observation ID in Form

C6

Fully-Specified Name

Component
I have a good appetite in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a good appetite
Source
C6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70443-7 I feel tightness in my chest

Observation ID in Form

L3

Fully-Specified Name

Component
I feel tightness in my chest in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I feel tightness in my chest
Source
L3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70444-5 Breathing is easy for me

Observation ID in Form

L4

Fully-Specified Name

Component
Breathing is easy for me in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
Breathing is easy for me
Source
L4

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70552-5 National Comprehensive Cancer Network - Lung Symptom Index Questionnaire - 17 items (NCCN-FACT - FLSI-17) [FACIT]

Term Description

For patients with Lung cancer; a FACT/NCCN-Lung Symptom Index-17 items
Source: Regenstrief LOINC

Form Coding Instructions

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

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
National comprehensive cancer network - lung symptom index questionnaire - 17 items
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a lack of energy
Source
GP1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have pain
Source
GP4

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70346-2 I am losing weight

Observation ID in Form

C2

Fully-Specified Name

Component
I am losing weight in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am losing weight
Source
C2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70305-8 I have been short of breath

Observation ID in Form

B1

Fully-Specified Name

Component
I have been short of breath in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.72
Change Reason
Release 2.72: SURVEY_QUEST_TEXT: Moved to Form Data table.; METHOD_TYP: Removed Method to increase usability.; Previous Releases: Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
99357-6 COVID-19 health questions panel
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel
98520-0 PROMIS item bank - dyspnea characteristics - version 1.0

70426-2 I feel fatigued

Observation ID in Form

HI7

Fully-Specified Name

Component
I feel fatigued in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I feel fatigued
Source
HI7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70442-9 I have been coughing

Observation ID in Form

L2

Fully-Specified Name

Component
I have been coughing in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have been coughing
Source
L2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70322-3 I have bone pain

Observation ID in Form

BP1

Fully-Specified Name

Component
I have bone pain in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have bone pain
Source
BP1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70444-5 Breathing is easy for me

Observation ID in Form

L4

Fully-Specified Name

Component
Breathing is easy for me in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
Breathing is easy for me
Source
L4

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70350-4 I have a good appetite

Observation ID in Form

C6

Fully-Specified Name

Component
I have a good appetite in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a good appetite
Source
C6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70402-3 I am sleeping well

Observation ID in Form

GF5

Fully-Specified Name

Component
I am sleeping well in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am sleeping well
Source
GF5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I worry that my condition will get worse
Source
GE6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have nausea
Source
GP2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70309-0 I am bothered by hair loss

Observation ID in Form

B5

Fully-Specified Name

Component
I am bothered by hair loss in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am bothered by hair loss
Source
B5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70409-8 I am bothered by side effects of treatment

Observation ID in Form

GP5

Fully-Specified Name

Component
I am bothered by side effects of treatment in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am bothered by side effects of treatment
Source
GP5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70441-1 My thinking is clear

Observation ID in Form

L1

Fully-Specified Name

Component
My thinking is clear in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
My thinking is clear
Source
L1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy life in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am able to enjoy life
Source
GF3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am content with the quality of my life right now
Source
GF7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70553-3 National Comprehensive Cancer Network - Lymphoma Symptom Index Questionnaire - 18 items (NCCN-FACT - FLymSI-18) [FACIT]

Term Description

For patients with Lymphoma (NHL); a FACT/NCCN-Lymphoma Symptom Index
Source: Regenstrief LOINC

Form Coding Instructions

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

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
National comprehensive cancer network - lymphoma symptom index questionnaire - 18 items
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a lack of energy
Source
GP1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have pain
Source
GP4

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70346-2 I am losing weight

Observation ID in Form

C2

Fully-Specified Name

Component
I am losing weight in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am losing weight
Source
C2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70446-0 I am bothered by lumps or swelling in certain part of my body (e.g. neck, armpits, or groin)

Observation ID in Form

Leu1

Fully-Specified Name

Component
I am bothered by lumps or swelling in certain part of my body - neck, armpits, or groin - in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am bothered by lumps or swelling in certain part of my body (e.g. neck, armpits, or groin)
Source
Leu1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70528-5 I get tired easily

Observation ID in Form

GE6

Fully-Specified Name

Component
I get tired easily in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I get tired easily
Source
BMT6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70322-3 I have bone pain

Observation ID in Form

BP1

Fully-Specified Name

Component
I have bone pain in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have bone pain
Source
BP1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70530-1 I have trouble concentrating

Observation ID in Form

HI8

Fully-Specified Name

Component
I have trouble concentrating in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have trouble concentrating
Source
HI8

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70402-3 I am sleeping well

Observation ID in Form

GF5

Fully-Specified Name

Component
I am sleeping well in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am sleeping well
Source
GF5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70350-4 I have a good appetite

Observation ID in Form

C6

Fully-Specified Name

Component
I have a good appetite in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a good appetite
Source
C6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I worry that my condition will get worse
Source
GE6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70319-9 I have emotional ups and downs

Observation ID in Form

BRM9

Fully-Specified Name

Component
I have emotional ups and downs in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have emotional ups and downs
Source
BRM9

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70407-2 Because of my physical condition, I have trouble meeting the needs of my family

Observation ID in Form

GP3

Fully-Specified Name

Component
Because of my physical condition, I have trouble meeting the needs of my family in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
Because of my physical condition, I have trouble meeting the needs of my family
Source
GP3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70448-6 I feel uncertain about my future health

Observation ID in Form

Leu5

Fully-Specified Name

Component
I feel uncertain about my future health in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I feel uncertain about my future health
Source
Leu5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have nausea
Source
GP2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70470-0 I worry about getting infections

Observation ID in Form

N3

Fully-Specified Name

Component
I worry about getting infections in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I worry about getting infections
Source
N3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70409-8 I am bothered by side effects of treatment

Observation ID in Form

GP5

Fully-Specified Name

Component
I am bothered by side effects of treatment in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am bothered by side effects of treatment
Source
GP5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy life in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am able to enjoy life
Source
GF3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am content with the quality of my life right now
Source
GF7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70554-1 Functional Assessment of Cancer Therapy - Ovarian Symptom Index Questionnaire - 8 items (FACIT-FOSI 8) [FACIT]

Term Description

For patients with Ovarian cancer; A FACT-Ovarian Symptom Index (a subset of FACT-O containing 8 items)
Source: Regenstrief LOINC

Form Coding Instructions

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

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of cancer therapy - ovarian symptom index questionnaire - 8 items
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a lack of energy
Source
GP1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70479-1 I have been vomiting

Observation ID in Form

O2

Fully-Specified Name

Component
I have been vomiting in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have been vomiting
Source
O2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have pain
Source
GP4

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have nausea
Source
GP2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70478-3 I have swelling in my stomach area

Observation ID in Form

O1

Fully-Specified Name

Component
I have swelling in my stomach area in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have swelling in my stomach area
Source
O1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I worry that my condition will get worse
Source
GE6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am content with the quality of my life right now
Source
GF7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70480-9 I have cramps in my stomach area

Observation ID in Form

O3

Fully-Specified Name

Component
I have cramps in my stomach area in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have cramps in my stomach area
Source
O3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70555-8 National Comprehensive Cancer Network - Ovarian Symptom Index Questionnaire - 18 items (NCCN_FACT - FOSI 18) [FACIT]

Term Description

For patients with Ovarian cancer; a FACT/NCCN-Ovarian Symptom Index- 18 items
Source: Regenstrief LOINC

Form Coding Instructions

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

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
National comprehensive cancer network - ovarian symptom index questionnaire - 18 items
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a lack of energy
Source
GP1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have pain
Source
GP4

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70410-6 I feel ill

Observation ID in Form

GP6

Fully-Specified Name

Component
I feel ill in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I feel ill
Source
GP6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70480-9 I have cramps in my stomach area

Observation ID in Form

O3

Fully-Specified Name

Component
I have cramps in my stomach area in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have cramps in my stomach area
Source
O3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70426-2 I feel fatigued

Observation ID in Form

HI7

Fully-Specified Name

Component
I feel fatigued in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I feel fatigued
Source
HI7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70365-2 I am bothered by constipation

Observation ID in Form

Cx6

Fully-Specified Name

Component
I am bothered by constipation in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am bothered by constipation
Source
Cx6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70478-3 I have swelling in my stomach area

Observation ID in Form

O1

Fully-Specified Name

Component
I have swelling in my stomach area in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have swelling in my stomach area
Source
O1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70347-0 I have control of my bowels

Observation ID in Form

C3

Fully-Specified Name

Component
I have control of my bowels in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have control of my bowels
Source
C3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70402-3 I am sleeping well

Observation ID in Form

GF5

Fully-Specified Name

Component
I am sleeping well in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am sleeping well
Source
GF5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I worry that my condition will get worse
Source
GE6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have nausea
Source
GP2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70309-0 I am bothered by hair loss

Observation ID in Form

B5

Fully-Specified Name

Component
I am bothered by hair loss in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am bothered by hair loss
Source
B5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70409-8 I am bothered by side effects of treatment

Observation ID in Form

GP5

Fully-Specified Name

Component
I am bothered by side effects of treatment in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am bothered by side effects of treatment
Source
GP5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70479-1 I have been vomiting

Observation ID in Form

O2

Fully-Specified Name

Component
I have been vomiting in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have been vomiting
Source
O2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70565-7 I am bothered by skin problems

Observation ID in Form

BMT15

Fully-Specified Name

Component
I am bothered by skin problems in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am bothered by skin problems
Source
BMT15

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70320-7 I am able to get around by myself

Observation ID in Form

BMT5

Fully-Specified Name

Component
I am able to get around by myself in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am able to get around by myself
Source
BMT5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy life in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am able to enjoy life
Source
GF3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am content with the quality of my life right now
Source
GF7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70557-4 National Comprehensive Cancer Network - Prostate Symptom Index Questionnaire - 17 items (NCCN-FACT-FPSI 17) [FACIT]

Term Description

For patients with Prostate cancer; a FACT/NCCN-Prostate Symptom Index- 17 items
Source: Regenstrief LOINC

Form Coding Instructions

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

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
National comprehensive cancer network - prostate symptom index questionnaire - 17 items
Property
-
Time
Pt
System
^Patient
Scale
-
Method
FACIT

Basic Attributes

Class
PANEL.SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a lack of energy
Source
GP1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have pain
Source
GP4

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70566-5 I have difficulty urinating

Observation ID in Form

P7

Fully-Specified Name

Component
I have difficulty urinating in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have difficulty urinating
Source
P7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70346-2 I am losing weight

Observation ID in Form

C2

Fully-Specified Name

Component
I am losing weight in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am losing weight
Source
C2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70322-3 I have bone pain

Observation ID in Form

BP1

Fully-Specified Name

Component
I have bone pain in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have bone pain
Source
BP1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70426-2 I feel fatigued

Observation ID in Form

HI7

Fully-Specified Name

Component
I feel fatigued in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I feel fatigued
Source
HI7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70570-7 I have weakness in my legs

Observation ID in Form

NCCN3

Fully-Specified Name

Component
I have weakness in my legs in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have weakness in my legs
Source
NCCN3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70558-2 My pain keeps me from doing things I want to do

Observation ID in Form

P3

Fully-Specified Name

Component
My pain keeps me from doing things I want to do in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
My pain keeps me from doing things I want to do
Source
P3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70350-4 I have a good appetite

Observation ID in Form

C6

Fully-Specified Name

Component
I have a good appetite in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have a good appetite
Source
C6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70402-3 I am sleeping well

Observation ID in Form

GF5

Fully-Specified Name

Component
I am sleeping well in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am sleeping well
Source
GF5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I worry that my condition will get worse
Source
GE6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have nausea
Source
GP2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70567-3 I have trouble moving my bowels

Observation ID in Form

P6

Fully-Specified Name

Component
I have trouble moving my bowels in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I have trouble moving my bowels
Source
P6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel

70418-9 I am satisfied with my sex life

Observation ID in Form

GS7

Fully-Specified Name

Component
I am satisfied with my sex life in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am satisfied with my sex life
Source
GS7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70409-8 I am bothered by side effects of treatment

Observation ID in Form

GP5

Fully-Specified Name

Component
I am bothered by side effects of treatment in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am bothered by side effects of treatment
Source
GP5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy life in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am able to enjoy life
Source
GF3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am content with the quality of my life right now
Source
GF7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel