Version 2.78

86473-6 Please indicate how much you are limited by heart failure (shortness of breath or fatigue) in your ability to do the following activities over the past 2 weeks. Dressing yourself

Observation Required in Panel

Required

Form Context

Heart failure affects different people in different ways. Some feel shortness of breath while others feel fatigue

Source: John Spertus, MD, MPH

Fully-Specified Name

Component
Dressing yourself was limited by heart failure over the past 2W
Property
Find
Time
2W
System
^Patient
Scale
Ord
Method
KCCQ

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.61
Last Updated
Version 2.63
Order vs. Observation
Observation

Survey Question

Text
Please indicate how much you are limited by heart failure (shortness of breath or fatigue) in your ability to do the following activities over the past 2 weeks. Dressing yourself
Source
KCCQ_Q1a

Normative Answer List LL4532-9

Answer Code Score Answer ID
Extremely limited 1 LA27701-4
Quite a bit limited 2 LA27702-2
Moderately limited 3 LA6460-5
Slightly limited 4 LA9605-2
Not at all limited 5 LA27707-1
Limited for other reasons or did not do the activity 6 LA27708-9

Member of these Panels

LOINC Long Common Name
71941-9 Kansas City Cardiomyopathy Questionnaire [KCCQ]

86483-5 Please indicate how much you are limited by heart failure (shortness of breath or fatigue) in your ability to do the following activities over the past 2 weeks. Showering or bathing

Observation Required in Panel

Required

Form Context

Heart failure affects different people in different ways. Some feel shortness of breath while others feel fatigue

Source: John Spertus, MD, MPH

Fully-Specified Name

Component
Showering or bathing was limited by heart failure over the past 2W
Property
Find
Time
2W
System
^Patient
Scale
Ord
Method
KCCQ

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.61
Last Updated
Version 2.63
Order vs. Observation
Observation

Survey Question

Text
Please indicate how much you are limited by heart failure (shortness of breath or fatigue) in your ability to do the following activities over the past 2 weeks. Showering or bathing
Source
KCCQ_Q1b

Normative Answer List LL4532-9

Answer Code Score Answer ID
Extremely limited 1 LA27701-4
Quite a bit limited 2 LA27702-2
Moderately limited 3 LA6460-5
Slightly limited 4 LA9605-2
Not at all limited 5 LA27707-1
Limited for other reasons or did not do the activity 6 LA27708-9

Member of these Panels

LOINC Long Common Name
86923-0 Kansas City Cardiomyopathy Questionnaire - 12 item [KCCQ-12]
71941-9 Kansas City Cardiomyopathy Questionnaire [KCCQ]

86474-4 Please indicate how much you are limited by heart failure (shortness of breath or fatigue) in your ability to do the following activities over the past 2 weeks. Walking 1 block on level ground

Observation Required in Panel

Required

Form Context

Heart failure affects different people in different ways. Some feel shortness of breath while others feel fatigue

Source: John Spertus, MD, MPH

Fully-Specified Name

Component
Walking 1 block on level ground was limited by heart failure over the past 2W
Property
Find
Time
2W
System
^Patient
Scale
Ord
Method
KCCQ

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.61
Last Updated
Version 2.63
Order vs. Observation
Observation

Survey Question

Text
Please indicate how much you are limited by heart failure (shortness of breath or fatigue) in your ability to do the following activities over the past 2 weeks. Walking 1 block on level ground
Source
KCCQ_Q1c

Normative Answer List LL4532-9

Answer Code Score Answer ID
Extremely limited 1 LA27701-4
Quite a bit limited 2 LA27702-2
Moderately limited 3 LA6460-5
Slightly limited 4 LA9605-2
Not at all limited 5 LA27707-1
Limited for other reasons or did not do the activity 6 LA27708-9

Member of these Panels

LOINC Long Common Name
86923-0 Kansas City Cardiomyopathy Questionnaire - 12 item [KCCQ-12]
71941-9 Kansas City Cardiomyopathy Questionnaire [KCCQ]

86475-1 Please indicate how much you are limited by heart failure (shortness of breath or fatigue) in your ability to do the following activities over the past 2 weeks. Doing yardwork, housework or carrying groceries

Observation Required in Panel

Required

Form Context

Heart failure affects different people in different ways. Some feel shortness of breath while others feel fatigue

Source: John Spertus, MD, MPH

Fully-Specified Name

Component
Doing yardwork, housework or carrying groceries was limited by heart failure over the past 2W
Property
Find
Time
2W
System
^Patient
Scale
Ord
Method
KCCQ

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.61
Last Updated
Version 2.63
Order vs. Observation
Observation

Survey Question

Text
Please indicate how much you are limited by heart failure (shortness of breath or fatigue) in your ability to do the following activities over the past 2 weeks. Doing yardwork, housework or carrying groceries
Source
KCCQ_Q1d

Normative Answer List LL4532-9

Answer Code Score Answer ID
Extremely limited 1 LA27701-4
Quite a bit limited 2 LA27702-2
Moderately limited 3 LA6460-5
Slightly limited 4 LA9605-2
Not at all limited 5 LA27707-1
Limited for other reasons or did not do the activity 6 LA27708-9

Member of these Panels

LOINC Long Common Name
71941-9 Kansas City Cardiomyopathy Questionnaire [KCCQ]

86476-9 Please indicate how much you are limited by heart failure (shortness of breath or fatigue) in your ability to do the following activities over the past 2 weeks. Climbing a flight of stairs without stopping

Observation Required in Panel

Required

Form Context

Heart failure affects different people in different ways. Some feel shortness of breath while others feel fatigue

Source: John Spertus, MD, MPH

Fully-Specified Name

Component
Climbing a flight of stairs without stopping was limited by heart failure over the past 2W
Property
Find
Time
2W
System
^Patient
Scale
Ord
Method
KCCQ

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.61
Last Updated
Version 2.63
Order vs. Observation
Observation

Survey Question

Text
Please indicate how much you are limited by heart failure (shortness of breath or fatigue) in your ability to do the following activities over the past 2 weeks. Climbing a flight of stairs without stopping
Source
KCCQ_Q1e

Normative Answer List LL4532-9

Answer Code Score Answer ID
Extremely limited 1 LA27701-4
Quite a bit limited 2 LA27702-2
Moderately limited 3 LA6460-5
Slightly limited 4 LA9605-2
Not at all limited 5 LA27707-1
Limited for other reasons or did not do the activity 6 LA27708-9

Member of these Panels

LOINC Long Common Name
71941-9 Kansas City Cardiomyopathy Questionnaire [KCCQ]

86477-7 Please indicate how much you are limited by heart failure (shortness of breath or fatigue) in your ability to do the following activities over the past 2 weeks. Hurrying or jogging (as if to catch a bus)

Observation Required in Panel

Required

Form Context

Heart failure affects different people in different ways. Some feel shortness of breath while others feel fatigue

Source: John Spertus, MD, MPH

Fully-Specified Name

Component
Hurrying or jogging (as if to catch a bus) was limited by heart failure over the past 2W
Property
Find
Time
2W
System
^Patient
Scale
Ord
Method
KCCQ

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.61
Last Updated
Version 2.63
Order vs. Observation
Observation

Survey Question

Text
Please indicate how much you are limited by heart failure (shortness of breath or fatigue) in your ability to do the following activities over the past 2 weeks. Hurrying or jogging (as if to catch a bus)
Source
KCCQ_Q1f

Normative Answer List LL4532-9

Answer Code Score Answer ID
Extremely limited 1 LA27701-4
Quite a bit limited 2 LA27702-2
Moderately limited 3 LA6460-5
Slightly limited 4 LA9605-2
Not at all limited 5 LA27707-1
Limited for other reasons or did not do the activity 6 LA27708-9

Member of these Panels

LOINC Long Common Name
86923-0 Kansas City Cardiomyopathy Questionnaire - 12 item [KCCQ-12]
71941-9 Kansas City Cardiomyopathy Questionnaire [KCCQ]

86478-5 Compared with 2 weeks ago, have your symptoms of heart failure (shortness of breath, fatigue or ankle swelling) changed? My symptoms of heart failure have become

Observation Required in Panel

Required

Fully-Specified Name

Component
Change in symptoms of heart failure compared with 2W ago
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
KCCQ

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.61
Last Updated
Version 2.61
Order vs. Observation
Observation

Survey Question

Text
Compared with 2 weeks ago, have your symptoms of heart failure (shortness of breath, fatigue or ankle swelling) changed? My symptoms of heart failure have become
Source
KCCQ_2

Normative Answer List LL4533-7

Answer Code Score Answer ID
Much worse 1 LA18865-8
Slightly worse 2 LA27710-5
Not changed 3 LA27711-3
Slightly better 4 LA27712-1
Much better 5 LA18864-1
I've had no symptoms over the last 2 weeks 6 LA27717-0

Member of these Panels

LOINC Long Common Name
71941-9 Kansas City Cardiomyopathy Questionnaire [KCCQ]

86479-3 Over the past 2 weeks, how many times did you have swelling in your feet, ankles or legs when you woke up in the morning?

Observation Required in Panel

Required

Fully-Specified Name

Component
Swelling in your feet, ankles or legs when you woke up over the past 2W
Property
Find
Time
2W
System
^Patient
Scale
Ord
Method
KCCQ

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.61
Last Updated
Version 2.61
Order vs. Observation
Observation

Survey Question

Text
Over the past 2 weeks, how many times did you have swelling in your feet, ankles or legs when you woke up in the morning?
Source
KCCQ_3

Normative Answer List LL4534-5

Answer Code Score Answer ID
Every morning 1 LA27719-6
3 or more times a week, but not every day 2 LA27720-4
1-2 times a week 3 LA14506-2
Less than once a week 4 LA27722-0
Never over the past 2 weeks 5 LA27723-8

Member of these Panels

LOINC Long Common Name
86923-0 Kansas City Cardiomyopathy Questionnaire - 12 item [KCCQ-12]
71941-9 Kansas City Cardiomyopathy Questionnaire [KCCQ]

86480-1 Over the past 2 weeks, how much has swelling in your feet, ankles or legs bothered you? It has been

Observation Required in Panel

Required

Fully-Specified Name

Component
Bothered by swelling in your feet, ankles or legs over the past 2W
Property
Find
Time
2W
System
^Patient
Scale
Ord
Method
KCCQ

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.61
Last Updated
Version 2.61
Order vs. Observation
Observation

Survey Question

Text
Over the past 2 weeks, how much has swelling in your feet, ankles or legs bothered you? It has been
Source
KCCQ_4

Normative Answer List LL4535-2

Answer Code Score Answer ID
Extremely bothersome 1 LA27766-7
Quite a bit bothersome 2 LA27724-6
Moderately bothersome 3 LA27725-3
Slightly bothersome 4 LA27726-1
Not at all bothersome 5 LA24969-0
I've had no swelling 6 LA27718-8

Member of these Panels

LOINC Long Common Name
71941-9 Kansas City Cardiomyopathy Questionnaire [KCCQ]

86481-9 Over the past 2 weeks, on average, how many times has fatigue limited your ability to do what you want?

Observation Required in Panel

Required

Fully-Specified Name

Component
Fatigue limited your ability to do what you wanted over the past 2W
Property
Find
Time
2W
System
^Patient
Scale
Ord
Method
KCCQ

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.61
Last Updated
Version 2.61
Order vs. Observation
Observation

Survey Question

Text
Over the past 2 weeks, on average, how many times has fatigue limited your ability to do what you want?
Source
KCCQ_5

Normative Answer List LL4536-0

Answer Code Score Answer ID
All of the time 1 LA6154-4
Several times per day 2 LA27729-5
At least once a day 3 LA27730-3
3 or more times per week but not every day 4 LA27770-9
1-2 times per week 5 LA13834-9
Less than once a week 6 LA27722-0
Never over the past 2 weeks 7 LA27723-8

Member of these Panels

LOINC Long Common Name
86923-0 Kansas City Cardiomyopathy Questionnaire - 12 item [KCCQ-12]
71941-9 Kansas City Cardiomyopathy Questionnaire [KCCQ]

86482-7 Over the past 2 weeks, how much has your fatigue bothered you? It has been

Observation Required in Panel

Required

Fully-Specified Name

Component
Bothered by fatigue over the past 2W
Property
Find
Time
2W
System
^Patient
Scale
Ord
Method
KCCQ

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.61
Last Updated
Version 2.61
Order vs. Observation
Observation

Survey Question

Text
Over the past 2 weeks, how much has your fatigue bothered you? It has been
Source
KCCQ_6

Normative Answer List LL4537-8

Answer Code Score Answer ID
Extremely bothersome 1 LA27766-7
Quite a bit bothersome 2 LA27724-6
Moderately bothersome 3 LA27725-3
Slightly bothersome 4 LA27726-1
Not at all bothersome 5 LA24969-0
I've had no fatigue 6 LA27733-7

Member of these Panels

LOINC Long Common Name
71941-9 Kansas City Cardiomyopathy Questionnaire [KCCQ]

86472-8 Over the past 2 weeks, on average, how many times has shortness of breath limited your ability to do what you wanted?

Observation Required in Panel

Required

Fully-Specified Name

Component
Shortness of breath limited your ability to do what you wanted over the past 2W
Property
Find
Time
2W
System
^Patient
Scale
Ord
Method
KCCQ

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.61
Last Updated
Version 2.61
Order vs. Observation
Observation

Survey Question

Text
Over the past 2 weeks, on average, how many times has shortness of breath limited your ability to do what you wanted?
Source
KCCQ_7

Normative Answer List LL4536-0

Answer Code Score Answer ID
All of the time 1 LA6154-4
Several times per day 2 LA27729-5
At least once a day 3 LA27730-3
3 or more times per week but not every day 4 LA27770-9
1-2 times per week 5 LA13834-9
Less than once a week 6 LA27722-0
Never over the past 2 weeks 7 LA27723-8

Member of these Panels

LOINC Long Common Name
86923-0 Kansas City Cardiomyopathy Questionnaire - 12 item [KCCQ-12]
71941-9 Kansas City Cardiomyopathy Questionnaire [KCCQ]

86484-3 Over the past 2 weeks, how much has your shortness of breath bothered you? It has been...

Observation Required in Panel

Required

Fully-Specified Name

Component
Bothered by shortness of breath over the past 2W
Property
Find
Time
2W
System
^Patient
Scale
Ord
Method
KCCQ

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.61
Last Updated
Version 2.63
Change Reason
Corrected display of the Component
Order vs. Observation
Observation

Survey Question

Text
Over the past 2 weeks, how much has your shortness of breath bothered you? It has been...
Source
KCCQ_8

Normative Answer List LL4538-6

Answer Code Score Answer ID
Extremely bothersome 1 LA27766-7
Quite a bit bothersome 2 LA27724-6
Moderately bothersome 3 LA27725-3
Slightly bothersome 4 LA27726-1
Not at all bothersome 5 LA24969-0
I've had no shortness of breath 6 LA27734-5

Member of these Panels

LOINC Long Common Name
71941-9 Kansas City Cardiomyopathy Questionnaire [KCCQ]

86485-0 Over the past 2 weeks, on average, how many times have you been forced to sleep sitting up in a chair or with at least 3 pillows to prop you up because of shortness of breath?

Observation Required in Panel

Required

Fully-Specified Name

Component
Sleep sitting up in a chair or with at least 3 pillows to prop you up because of shortness of breath over the past 2W
Property
Find
Time
2W
System
^Patient
Scale
Ord
Method
KCCQ

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.61
Last Updated
Version 2.61
Order vs. Observation
Observation

Survey Question

Text
Over the past 2 weeks, on average, how many times have you been forced to sleep sitting up in a chair or with at least 3 pillows to prop you up because of shortness of breath?
Source
KCCQ_9

Normative Answer List LL4539-4

Answer Code Score Answer ID
Every night 1 LA14806-6
3 or more times a week, but not every day 2 LA27720-4
1-2 times a week 3 LA14506-2
Less than once a week 4 LA27722-0
Never over the past 2 weeks 5 LA27723-8

Member of these Panels

LOINC Long Common Name
86923-0 Kansas City Cardiomyopathy Questionnaire - 12 item [KCCQ-12]
71941-9 Kansas City Cardiomyopathy Questionnaire [KCCQ]

86486-8 How sure are you that you know what to do, or whom to call, if your heart failure gets worse?

Observation Required in Panel

Required

Form Context

Heart failure symptoms can worsen for a number of reasons

Source: John Spertus, MD, MPH

Fully-Specified Name

Component
You know what to do, or whom to call, if your heart failure gets worse
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
KCCQ

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.61
Last Updated
Version 2.63
Order vs. Observation
Observation

Survey Question

Text
How sure are you that you know what to do, or whom to call, if your heart failure gets worse?
Source
KCCQ_10

Normative Answer List LL4540-2

Answer Code Score Answer ID
Not at all sure 1 LA27735-2
Not very sure 2 LA27736-0
Somewhat sure 3 LA27737-8
Mostly sure 4 LA27738-6
Completely sure 5 LA27739-4

Member of these Panels

LOINC Long Common Name
71941-9 Kansas City Cardiomyopathy Questionnaire [KCCQ]

86487-6 How well do you understand what things you are able to do to keep your heart failure symptoms from getting worse? (for example, weighing yourself, eating a low salt diet, etc.)

Observation Required in Panel

Required

Fully-Specified Name

Component
Understand what things you are able to do to keep your heart failure symptoms from getting worse
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
KCCQ

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.61
Last Updated
Version 2.61
Order vs. Observation
Observation

Survey Question

Text
How well do you understand what things you are able to do to keep your heart failure symptoms from getting worse? (for example, weighing yourself, eating a low salt diet, etc.)
Source
KCCQ_11

Normative Answer List LL4541-0

Answer Code Score Answer ID
Do not understand at all 1 LA27740-2
Do not understand very well 2 LA27741-0
Somewhat understand 3 LA27742-8
Mostly understand 4 LA27743-6
Completely understand 5 LA27744-4

Member of these Panels

LOINC Long Common Name
71941-9 Kansas City Cardiomyopathy Questionnaire [KCCQ]

86488-4 Over the past 2 weeks, how much has your heart failure limited your enjoyment of life?

Observation Required in Panel

Required

Fully-Specified Name

Component
Enjoyment of life limited by heart failure over the past 2W
Property
Find
Time
2W
System
^Patient
Scale
Ord
Method
KCCQ

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.61
Last Updated
Version 2.61
Order vs. Observation
Observation

Survey Question

Text
Over the past 2 weeks, how much has your heart failure limited your enjoyment of life?
Source
KCCQ_12

Normative Answer List LL4542-8

Answer Code Score Answer ID
It has extremely limited my enjoyment of life 1 LA27745-1
It has limited my enjoyment of life quite a bit 2 LA27746-9
It has moderately limited my enjoyment of life 3 LA27747-7
It has slightly limited my enjoyment of life 4 LA27748-5
It has not limited my enjoyment of life at all 5 LA27749-3

Member of these Panels

LOINC Long Common Name
86923-0 Kansas City Cardiomyopathy Questionnaire - 12 item [KCCQ-12]
71941-9 Kansas City Cardiomyopathy Questionnaire [KCCQ]

86489-2 If you had to spend the rest of your life with your heart failure the way it is right now, how would you feel about this?

Observation Required in Panel

Required

Fully-Specified Name

Component
How would you feel if you had to spend the rest of your life with your heart failure the way it is right now
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
KCCQ

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.61
Last Updated
Version 2.61
Order vs. Observation
Observation

Survey Question

Text
If you had to spend the rest of your life with your heart failure the way it is right now, how would you feel about this?
Source
KCCQ_13

Normative Answer List LL4543-6

Answer Code Score Answer ID
Not at all satisfied 1 LA27750-1
Mostly dissatisfied 2 LA24976-5
Somewhat satisfied 3 LA27752-7
Mostly satisfied 4 LA24974-0
Completely satisfied 5 LA27754-3

Member of these Panels

LOINC Long Common Name
86923-0 Kansas City Cardiomyopathy Questionnaire - 12 item [KCCQ-12]
71941-9 Kansas City Cardiomyopathy Questionnaire [KCCQ]

86490-0 Over the past 2 weeks, how often have you felt discouraged or down in the dumps because of your heart failure?

Observation Required in Panel

Required

Fully-Specified Name

Component
Felt discouraged or down in the dumps because of heart failure over the past 2W
Property
Find
Time
2W
System
^Patient
Scale
Ord
Method
KCCQ

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.61
Last Updated
Version 2.61
Order vs. Observation
Observation

Survey Question

Text
Over the past 2 weeks, how often have you felt discouraged or down in the dumps because of your heart failure?
Source
KCCQ_14

Normative Answer List LL4544-4

Answer Code Score Answer ID
I felt that way all of the time 1 LA27755-0
I felt that way most of the time 2 LA27756-8
I occasionally felt that way 3 LA27757-6
I rarely felt that way 4 LA27758-4
I never felt that way 5 LA27759-2

Member of these Panels

LOINC Long Common Name
71941-9 Kansas City Cardiomyopathy Questionnaire [KCCQ]

86491-8 Please indicate how your heart failure may have limited your participation in the following activities over the past 2 weeks. Hobbies, recreational activities

Observation Required in Panel

Required

Form Context

How much does your heart failure affect your lifestyle?

Source: John Spertus, MD, MPH

Fully-Specified Name

Component
Participation in hobbies, recreational activities limited by heart failure over the past 2W
Property
Find
Time
2W
System
^Patient
Scale
Ord
Method
KCCQ

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.61
Last Updated
Version 2.63
Order vs. Observation
Observation

Survey Question

Text
Please indicate how your heart failure may have limited your participation in the following activities over the past 2 weeks. Hobbies, recreational activities
Source
KCCQ_15a

Normative Answer List LL4545-1

Answer Code Score Answer ID
Severely limited 1 LA27761-8
Limited quite a bit 2 LA27760-0
Moderately limited 3 LA6460-5
Slightly limited 4 LA9605-2
Did not limit at all 5 LA27764-2
Does not apply or did not do for other reasons 6 LA27765-9

Member of these Panels

LOINC Long Common Name
86923-0 Kansas City Cardiomyopathy Questionnaire - 12 item [KCCQ-12]
71941-9 Kansas City Cardiomyopathy Questionnaire [KCCQ]

86492-6 Please indicate how your heart failure may have limited your participation in the following activities over the past 2 weeks. Working or doing household chores

Observation Required in Panel

Required

Form Context

How much does your heart failure affect your lifestyle?

Source: John Spertus, MD, MPH

Fully-Specified Name

Component
Participation in working or doing household chores limited by heart failure over the past 2W
Property
Find
Time
2W
System
^Patient
Scale
Ord
Method
KCCQ

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.61
Last Updated
Version 2.63
Order vs. Observation
Observation

Survey Question

Text
Please indicate how your heart failure may have limited your participation in the following activities over the past 2 weeks. Working or doing household chores
Source
KCCQ_15b

Normative Answer List LL4545-1

Answer Code Score Answer ID
Severely limited 1 LA27761-8
Limited quite a bit 2 LA27760-0
Moderately limited 3 LA6460-5
Slightly limited 4 LA9605-2
Did not limit at all 5 LA27764-2
Does not apply or did not do for other reasons 6 LA27765-9

Member of these Panels

LOINC Long Common Name
86923-0 Kansas City Cardiomyopathy Questionnaire - 12 item [KCCQ-12]
71941-9 Kansas City Cardiomyopathy Questionnaire [KCCQ]

86493-4 Please indicate how your heart failure may have limited your participation in the following activities over the past 2 weeks. Visiting family or friends out of your home

Observation Required in Panel

Required

Form Context

How much does your heart failure affect your lifestyle?

Source: John Spertus, MD, MPH

Fully-Specified Name

Component
Participation in visiting family or friends out of your home limited by heart failure over the past 2W
Property
Find
Time
2W
System
^Patient
Scale
Ord
Method
KCCQ

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.61
Last Updated
Version 2.63
Order vs. Observation
Observation

Survey Question

Text
Please indicate how your heart failure may have limited your participation in the following activities over the past 2 weeks. Visiting family or friends out of your home
Source
KCCQ_15c

Normative Answer List LL4545-1

Answer Code Score Answer ID
Severely limited 1 LA27761-8
Limited quite a bit 2 LA27760-0
Moderately limited 3 LA6460-5
Slightly limited 4 LA9605-2
Did not limit at all 5 LA27764-2
Does not apply or did not do for other reasons 6 LA27765-9

Member of these Panels

LOINC Long Common Name
86923-0 Kansas City Cardiomyopathy Questionnaire - 12 item [KCCQ-12]
71941-9 Kansas City Cardiomyopathy Questionnaire [KCCQ]

86494-2 Please indicate how your heart failure may have limited your participation in the following activities over the past 2 weeks. Intimate relationships with loved ones

Observation Required in Panel

Required

Form Context

How much does your heart failure affect your lifestyle?

Source: John Spertus, MD, MPH

Fully-Specified Name

Component
Participation in intimate relationships with loved ones limited by heart failure over the past 2W
Property
Find
Time
2W
System
^Patient
Scale
Ord
Method
KCCQ

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.61
Last Updated
Version 2.63
Order vs. Observation
Observation

Survey Question

Text
Please indicate how your heart failure may have limited your participation in the following activities over the past 2 weeks. Intimate relationships with loved ones
Source
KCCQ_15d

Normative Answer List LL4545-1

Answer Code Score Answer ID
Severely limited 1 LA27761-8
Limited quite a bit 2 LA27760-0
Moderately limited 3 LA6460-5
Slightly limited 4 LA9605-2
Did not limit at all 5 LA27764-2
Does not apply or did not do for other reasons 6 LA27765-9

Member of these Panels

LOINC Long Common Name
71941-9 Kansas City Cardiomyopathy Questionnaire [KCCQ]

72195-1 KCCQ physical limitation score

Term Description

KCCQ physical limitation score is calculated from the average of responses to 6 items (1a through 1f).
Source: Regenstrief LOINC

Fully-Specified Name

Component
Physical limitation score
Property
Score
Time
Pt
System
^Patient
Scale
Qn
Method
KCCQ

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.42
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
KCCQ physical limitation score

Member of these Panels

LOINC Long Common Name
71941-9 Kansas City Cardiomyopathy Questionnaire [KCCQ]

Example Units

Unit Source
{score} Example UCUM Units

72196-9 KCCQ social limitation score

Term Description

KCCQ social limitation score is calculated from the average of responses to 4 items (15a through 15d).
Source: Regenstrief LOINC

Fully-Specified Name

Component
Social limitation score
Property
Score
Time
Pt
System
^Patient
Scale
Qn
Method
KCCQ

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.42
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
KCCQ social limitation score

Member of these Panels

LOINC Long Common Name
71941-9 Kansas City Cardiomyopathy Questionnaire [KCCQ]

Example Units

Unit Source
{score} Example UCUM Units

72189-4 KCCQ quality of life score

Term Description

KCCQ quality of life score is calculated from the average of responses to 3 items (12 through 14).
Source: Regenstrief LOINC

Fully-Specified Name

Component
Quality of life score
Property
Score
Time
Pt
System
^Patient
Scale
Qn
Method
KCCQ

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.42
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
KCCQ quality of life score

Member of these Panels

LOINC Long Common Name
71941-9 Kansas City Cardiomyopathy Questionnaire [KCCQ]

Example Units

Unit Source
{score} Example UCUM Units

72190-2 KCCQ self-efficacy score

Term Description

KCCQ self-efficacy score is calculated from the average of responses to 2 items (10 and 11).
Source: Regenstrief LOINC

Fully-Specified Name

Component
Self-efficacy score
Property
Score
Time
Pt
System
^Patient
Scale
Qn
Method
KCCQ

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.42
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
KCCQ self-efficacy score

Member of these Panels

LOINC Long Common Name
71941-9 Kansas City Cardiomyopathy Questionnaire [KCCQ]

Example Units

Unit Source
{score} Example UCUM Units

72192-8 KCCQ symptom burden score

Term Description

KCCQ symptom burden score is calculated from the average of responses to 3 items (4, 6, and 8).
Source: Regenstrief LOINC

Fully-Specified Name

Component
Symptom burden score
Property
Score
Time
Pt
System
^Patient
Scale
Qn
Method
KCCQ

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.42
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
KCCQ symptom burden score

Member of these Panels

LOINC Long Common Name
71941-9 Kansas City Cardiomyopathy Questionnaire [KCCQ]

Example Units

Unit Source
{score} Example UCUM Units

72193-6 KCCQ symptom frequency score

Term Description

KCCQ symptom frequency score is calculated from the average of responses to 4 items (3, 5, 7, and 9).
Source: Regenstrief LOINC

Fully-Specified Name

Component
Symptom frequency score
Property
Score
Time
Pt
System
^Patient
Scale
Qn
Method
KCCQ

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.42
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
KCCQ symptom frequency score

Member of these Panels

LOINC Long Common Name
71941-9 Kansas City Cardiomyopathy Questionnaire [KCCQ]

Example Units

Unit Source
{score} Example UCUM Units

72194-4 KCCQ symptom stability score

Term Description

KCCQ symptom stability score is calculated from the response to 1 item (2).
Source: Regenstrief LOINC

Fully-Specified Name

Component
Symptom stability score
Property
Score
Time
Pt
System
^Patient
Scale
Qn
Method
KCCQ

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.42
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
KCCQ symptom stability score

Member of these Panels

LOINC Long Common Name
71941-9 Kansas City Cardiomyopathy Questionnaire [KCCQ]

Example Units

Unit Source
{score} Example UCUM Units

72191-0 KCCQ total symptom score

Term Description

KCCQ total symptom score is the mean of the following available summary scores: KCCQ symptom frequency score, KCCQ symptom burden score.
Source: Regenstrief LOINC

Fully-Specified Name

Component
Total symptom score
Property
Score
Time
Pt
System
^Patient
Scale
Qn
Method
KCCQ

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.42
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
KCCQ total symptom score

Member of these Panels

LOINC Long Common Name
71941-9 Kansas City Cardiomyopathy Questionnaire [KCCQ]

Example Units

Unit Source
{score} Example UCUM Units

72188-6 KCCQ clinical summary score

Term Description

KCCQ clinical summary score is the mean of the following available summary scores: KCCQ physical limitation score, KCCQ total symptom score.
Source: Regenstrief LOINC

Fully-Specified Name

Component
Clinical summary score
Property
Score
Time
Pt
System
^Patient
Scale
Qn
Method
KCCQ

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.42
Last Updated
Version 2.67
Order vs. Observation
Observation

Survey Question

Text
KCCQ clinical summary score

Member of these Panels

LOINC Long Common Name
71941-9 Kansas City Cardiomyopathy Questionnaire [KCCQ]

Example Units

Unit Source
{score} Example UCUM Units

71940-1 KCCQ overall summary score

Term Description

KCCQ overall summary score is the sum of responses from all 23 items.
Source: Regenstrief LOINC

Reference Information

Type Source Reference
Citation John Spertus, MD, MPHCopyright Copyright © 1996-2005 John Spertus, MD, MPH. Green CP, Porter CB, Bresnahan DR, Spertus JA. Development and evaluation of the Kansas City Cardiomyopathy Questionnaire: a new health status measure for heart failure. J Am Coll Cardiol. 2000 Apr;35(5):1245-55. [PMID: 10758967]

Fully-Specified Name

Component
Overall summary score
Property
Score
Time
Pt
System
^Patient
Scale
Qn
Method
KCCQ

Basic Attributes

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

Survey Question

Text
KCCQ overall summary score

Member of these Panels

LOINC Long Common Name
71941-9 Kansas City Cardiomyopathy Questionnaire [KCCQ]

Example Units

Unit Source
{score} Example UCUM Units