Version 2.78

83129-7 Respondent type

Observation Required in Panel

Optional

Fully-Specified Name

Component
Respondent type
Property
Find
Time
Pt
System
^Patient
Scale
Nom
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.58
Last Updated
Version 2.58
Order vs. Observation
Observation

Example Answer List LL4174-0

Answer Code Score Answer ID
Self LA15312-4
Guardian LA26831-0

Member of these Panels

LOINC Long Common Name
82954-9 Amyotrophic lateral sclerosis functional rating scale - revised [ALSFRS-R]

82940-8 Speech

Observation Required in Panel

Required

Fully-Specified Name

Component
Speech
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
ALSFRS-R

Basic Attributes

Class
SURVEY.ALSFRSR
Type
Surveys
First Released
Version 2.58
Last Updated
Version 2.58
Order vs. Observation
Observation

Survey Question

Text
Speech
Source
1

Normative Answer List LL4091-6

Answer Code Score Answer ID
Normal speech processes 4 LA26567-0
Detectable speech disturbance 3 LA26568-8
Intelligible with repeating 2 LA26569-6
Speech combined with nonvocal communication 1 LA26570-4
Loss of useful speech 0 LA26571-2

Member of these Panels

LOINC Long Common Name
82954-9 Amyotrophic lateral sclerosis functional rating scale - revised [ALSFRS-R]

82941-6 Salivation

Observation Required in Panel

Required

Fully-Specified Name

Component
Salivation
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
ALSFRS-R

Basic Attributes

Class
SURVEY.ALSFRSR
Type
Surveys
First Released
Version 2.58
Last Updated
Version 2.58
Order vs. Observation
Observation

Survey Question

Text
Salivation
Source
2

Normative Answer List LL4170-8

Answer Code Score Answer ID
Normal Copyright http://snomed.info/sct ID:17621005 Normal (qualifier value) 4 LA6626-1
Slight but definite excess of saliva in mouth; may have nighttime drooling 3 LA23498-1
Moderately excessive saliva; may have minimal drooling 2 LA23499-9
Marked excess of saliva with some drooling 1 LA23500-4
Marked drooling, requires constant tissue or handkerchief 0 LA23501-2

Member of these Panels

LOINC Long Common Name
82954-9 Amyotrophic lateral sclerosis functional rating scale - revised [ALSFRS-R]

82942-4 Swallowing

Observation Required in Panel

Required

Fully-Specified Name

Component
Swallowing
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
ALSFRS-R

Basic Attributes

Class
SURVEY.ALSFRSR
Type
Surveys
First Released
Version 2.58
Last Updated
Version 2.58
Order vs. Observation
Observation

Survey Question

Text
Swallowing
Source
3

Normative Answer List LL4092-4

Answer Code Score Answer ID
Normal eating habits 4 LA26573-8
Early eating problems - occasional choking 3 LA26574-6
Dietary consistency changes 2 LA26575-3
Needs supplemental tube feeding 1 LA26576-1
NPO (exclusively parenteral or enteral feeding) 0 LA26577-9

Member of these Panels

LOINC Long Common Name
82954-9 Amyotrophic lateral sclerosis functional rating scale - revised [ALSFRS-R]

82943-2 Handwriting

Observation Required in Panel

Required

Fully-Specified Name

Component
Handwriting
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
ALSFRS-R

Basic Attributes

Class
SURVEY.ALSFRSR
Type
Surveys
First Released
Version 2.58
Last Updated
Version 2.58
Order vs. Observation
Observation

Survey Question

Text
Handwriting
Source
4

Normative Answer List LL4093-2

Answer Code Score Answer ID
Normal Copyright http://snomed.info/sct ID:17621005 Normal (qualifier value) 4 LA6626-1
Slow or sloppy, all words are legible 3 LA26578-7
Not all words are legible 2 LA26579-5
Able to grip pen but unable to write 1 LA26580-3
Unable to grip pen 0 LA26581-1

Member of these Panels

LOINC Long Common Name
82954-9 Amyotrophic lateral sclerosis functional rating scale - revised [ALSFRS-R]

82944-0 Cutting food and handling utensils (patients without gastronomy)

Condition for Inclusion

For patients without gastrostomy

Observation Required in Panel

Conditional

Fully-Specified Name

Component
Cutting food and handling utensils (patients without gastrostomy)
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
ALSFRS-R

Basic Attributes

Class
SURVEY.ALSFRSR
Type
Surveys
First Released
Version 2.58
Last Updated
Version 2.58
Order vs. Observation
Observation

Survey Question

Text
Cutting food and handling utensils (patients without gastronomy)
Source
5a

Normative Answer List LL4171-6

Answer Code Score Answer ID
Normal Copyright http://snomed.info/sct ID:17621005 Normal (qualifier value) 4 LA6626-1
Somewhat slow and clumsy, but no help needed 3 LA23511-1
Can cut most foods, although clumsy and slow; some help needed 2 LA23584-8
Food must be cut by someone, but can still feed slowly 1 LA23513-7
Needs to be fed 0 LA23514-5

Member of these Panels

LOINC Long Common Name
82954-9 Amyotrophic lateral sclerosis functional rating scale - revised [ALSFRS-R]

82945-7 Cutting food and handling utensils (alternate scale for patients with gastrostomy)?

Condition for Inclusion

For patients with gastrostomy

Observation Required in Panel

Conditional

Fully-Specified Name

Component
Cutting food and handling utensils (patients with gastrostomy)
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
ALSFRS-R

Basic Attributes

Class
SURVEY.ALSFRSR
Type
Surveys
First Released
Version 2.58
Last Updated
Version 2.58
Order vs. Observation
Observation

Survey Question

Text
Cutting food and handling utensils (alternate scale for patients with gastrostomy)?
Source
5b

Normative Answer List LL4094-0

Answer Code Score Answer ID
Normal Copyright http://snomed.info/sct ID:17621005 Normal (qualifier value) 4 LA6626-1
Clumsy but able to perform all manipulations independently 3 LA26584-5
Some help needed with closures and fasteners 2 LA26585-2
Provides minimal assistance to caregiver 1 LA26586-0
Unable to perform any aspect of task 0 LA26587-8

Member of these Panels

LOINC Long Common Name
82954-9 Amyotrophic lateral sclerosis functional rating scale - revised [ALSFRS-R]

82946-5 Dressing and hygiene

Observation Required in Panel

Required

Fully-Specified Name

Component
Dressing and hygiene
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
ALSFRS-R

Basic Attributes

Class
SURVEY.ALSFRSR
Type
Surveys
First Released
Version 2.58
Last Updated
Version 2.58
Order vs. Observation
Observation

Survey Question

Text
Dressing and hygiene
Source
6

Normative Answer List LL4095-7

Answer Code Score Answer ID
Normal function 4 LA25393-2
Independent and complete self-care with effort or decreased efficiency 3 LA26588-6
Intermittent assistance or substitute methods 2 LA26589-4
Needs attendant for self-care 1 LA26590-2
Total dependence 0 LA114-1

Member of these Panels

LOINC Long Common Name
82954-9 Amyotrophic lateral sclerosis functional rating scale - revised [ALSFRS-R]

82947-3 Turning in bed and adjusting bed clothes

Observation Required in Panel

Required

Fully-Specified Name

Component
Turning in bed and adjusting bed clothes
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
ALSFRS-R

Basic Attributes

Class
SURVEY.ALSFRSR
Type
Surveys
First Released
Version 2.58
Last Updated
Version 2.58
Order vs. Observation
Observation

Survey Question

Text
Turning in bed and adjusting bed clothes
Source
7

Normative Answer List LL4168-2

Answer Code Score Answer ID
Normal Copyright http://snomed.info/sct ID:17621005 Normal (qualifier value) 4 LA6626-1
Somewhat slow and clumsy, but no help needed 3 LA23511-1
Can turn alone or adjust sheets, but with great difficulty 2 LA23523-6
Can initiate, but not turn or adjust sheets alone 1 LA23524-4
Helpless 0 LA23525-1

Member of these Panels

LOINC Long Common Name
82954-9 Amyotrophic lateral sclerosis functional rating scale - revised [ALSFRS-R]

82948-1 Walking

Observation Required in Panel

Required

Fully-Specified Name

Component
Walking
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
ALSFRS-R

Basic Attributes

Class
SURVEY.ALSFRSR
Type
Surveys
First Released
Version 2.58
Last Updated
Version 2.58
Order vs. Observation
Observation

Survey Question

Text
Walking
Source
8

Normative Answer List LL4097-3

Answer Code Score Answer ID
Normal Copyright http://snomed.info/sct ID:17621005 Normal (qualifier value) 4 LA6626-1
Early ambulation difficulties 3 LA26591-0
Walks with assistance 2 LA26592-8
Nonambulatory functional movement 1 LA26593-6
No purposeful leg movement 0 LA26594-4

Member of these Panels

LOINC Long Common Name
82954-9 Amyotrophic lateral sclerosis functional rating scale - revised [ALSFRS-R]

82949-9 Climbing stairs

Observation Required in Panel

Required

Fully-Specified Name

Component
Climbing stairs
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
ALSFRS-R

Basic Attributes

Class
SURVEY.ALSFRSR
Type
Surveys
First Released
Version 2.58
Last Updated
Version 2.58
Order vs. Observation
Observation

Survey Question

Text
Climbing stairs
Source
9

Normative Answer List LL4099-9

Answer Code Score Answer ID
Normal Copyright http://snomed.info/sct ID:17621005 Normal (qualifier value) 4 LA6626-1
Slow 3 LA24898-1
Mild unsteadiness or fatigue 2 LA26595-1
Needs assistance 1 LA26596-9
Cannot do 0 LA13868-7

Member of these Panels

LOINC Long Common Name
82954-9 Amyotrophic lateral sclerosis functional rating scale - revised [ALSFRS-R]

82950-7 Dyspnea

Observation Required in Panel

Required

Fully-Specified Name

Component
Dyspnea
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
ALSFRS-R

Basic Attributes

Class
SURVEY.ALSFRSR
Type
Surveys
First Released
Version 2.58
Last Updated
Version 2.58
Order vs. Observation
Observation

Survey Question

Text
Dyspnea
Source
10

Normative Answer List LL4100-5

Answer Code Score Answer ID
None Copyright http://snomed.info/sct ID:260413007 None (qualifier value) 4 LA137-2
Occurs when walking 3 LA26597-7
Occurs with one or more of the following: eating, bathing, dressing (ADL) 2 LA26598-5
Occurs at rest, difficulty breathing when either sitting or lying 1 LA26599-3
Significant difficulty, considering using mechanical respiratory support 0 LA26600-9

Member of these Panels

LOINC Long Common Name
82954-9 Amyotrophic lateral sclerosis functional rating scale - revised [ALSFRS-R]

82951-5 Orthopnea

Observation Required in Panel

Required

Fully-Specified Name

Component
Orthopnea
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
ALSFRS-R

Basic Attributes

Class
SURVEY.ALSFRSR
Type
Surveys
First Released
Version 2.58
Last Updated
Version 2.58
Order vs. Observation
Observation

Survey Question

Text
Orthopnea
Source
11

Normative Answer List LL4101-3

Answer Code Score Answer ID
None Copyright http://snomed.info/sct ID:260413007 None (qualifier value) 4 LA137-2
Some difficulty sleeping at night due to shortness of breath, does not routinely use more than two pillows 3 LA26601-7
Needs extra pillows in order to sleep (more than two) 2 LA26602-5
Can only sleep sitting up 1 LA26603-3
Unable to sleep 0 LA15849-5

Member of these Panels

LOINC Long Common Name
82954-9 Amyotrophic lateral sclerosis functional rating scale - revised [ALSFRS-R]

82952-3 Respiratory insufficiency

Observation Required in Panel

Required

Fully-Specified Name

Component
Respiratory insufficiency
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
ALSFRS-R

Basic Attributes

Class
SURVEY.ALSFRSR
Type
Surveys
First Released
Version 2.58
Last Updated
Version 2.58
Order vs. Observation
Observation

Survey Question

Text
Respiratory insufficiency
Source
12

Normative Answer List LL4102-1

Answer Code Score Answer ID
None Copyright http://snomed.info/sct ID:260413007 None (qualifier value) 4 LA137-2
Intermittent use of BiPAP 3 LA26604-1
Continuous use of BiPAP during the night 2 LA26605-8
Continuous use of BiPAP during the night and day 1 LA26606-6
Invasive mechanical ventilation by intubation or tracheostomy 0 LA26607-4

Member of these Panels

LOINC Long Common Name
82954-9 Amyotrophic lateral sclerosis functional rating scale - revised [ALSFRS-R]

82953-1 Total score [ALSFRS-R]

Term Description

The 12 items in the ALSFRS-R are rated on a 5-point scale, 0 to 4, with a maximum score of 48 indicating the highest level of functioning. There is not information on the clinical interpretation of scores (i.e. a score in this range is classified as this level of functioning), but there is some evidence that scores are predictive of 9-month survival (90% for patients with scores over 30; 76% for patients with scores under 30). PMID: 10540002
Source: Regenstrief LOINC

Observation Required in Panel

Required

Fully-Specified Name

Component
Total score
Property
Score
Time
Pt
System
^Patient
Scale
Qn
Method
ALSFRS-R

Basic Attributes

Class
SURVEY.ALSFRSR
Type
Surveys
First Released
Version 2.58
Last Updated
Version 2.58
Order vs. Observation
Observation

Member of these Panels

LOINC Long Common Name
82954-9 Amyotrophic lateral sclerosis functional rating scale - revised [ALSFRS-R]

Example Units

Unit Source
{score} Example UCUM Units