of0
Export
 
CDE Detailed Report
This report contains detailed information about the selected CDEs.
Note: If at least one CDE was selected from a copyright- or trademark-protected instrument/scale then all of the CDEs from that instrument/scale are included in this report.
Disease: Friedreich's Ataxia
Sub-Domain: Ataxia and Performance Measures
CRF: Friedreich's Ataxia Impact Scale (FAIS)
Item count: 117 (117 distinct CDEs)
CDE ID
CDE Name
Variable Name
Definition / Description
Question Text
Permissible Value
Description
Data Type
Instructions
References
Population
Classification (e.g., Core)
Version #
Version Date
Aliases for Variable Name
CRF Module / Guideline
© or TM
Sub-Domain
Domain
Previous Title
Size
Input Restrictions
Min Value
Max Value
Measurement Type
LOINC ID
SNOMED
caDSR ID
CDISC ID
C12031
Friedreich's Ataxia Impact Scale (FAIS) - body movement balance loss scale
FAISBodMoveBalanceLossScale
Scale used to determine how much the patient was bothered by general loss of balance as a result of Friedreich's Ataxia in the past two weeks. Part of the Body Movement section of the Friedreich's Ataxia Impact Scale (FAIS)
As a result of your Friedreich’s Ataxia, how much in the past two weeks have you been bothered by loss of balance?
1;2;3;4;5;
1=Not bothered at all;2=A little bothered;3=Moderately bothered;4=Quite a bit bothered;5=Extremely bothered;
Numeric Values
Symptoms (31 Items) Body Movement (19 items) - People like you who have Friedreich’s Ataxia are bothered by different problems. The following questions ask about problems you may have been bothered by during the past 2 weeks. Please draw a line through the number under each scale that best describes your experience.
Cano SJ, Riazi A, Schapira AH, Cooper JM, Hobart JC. Friedreich's ataxia impact scale: a new measure striving to provide the flexibility required by today's studies. Mov Disord. 2009 May 15; 24(7): 984-92.
Adult
Core
3.0
7/11/2013
Aliases for variable name not defined
Friedreich's Ataxia Impact Scale (FAIS)
Ataxia and Performance Measures
Outcomes and End Points
FAIS Q1.1a
 
Single Pre-Defined Value Selected
       
C12032
Friedreich's Ataxia Impact Scale (FAIS) - body movement balance loss standing scale
FAISBodMoveBalLosStandingScale
Scale used to determine how much the patient was bothered by loss of balance when standing as a result of Friedreich's Ataxia in the past two weeks. Part of the Body Movement section of the Friedreich's Ataxia Impact Scale (FAIS)
As a result of your Friedreich’s Ataxia, how much in the past two weeks have you been bothered by loss of balance when standing?
1;2;3;4;5;
1=Not bothered at all;2=A little bothered;3=Moderately bothered;4=Quite a bit bothered;5=Extremely bothered;
Numeric Values
Symptoms (31 Items) Body Movement (19 items) - People like you who have Friedreich’s Ataxia are bothered by different problems. The following questions ask about problems you may have been bothered by during the past 2 weeks. Please draw a line through the number under each scale that best describes your experience.
Cano SJ, Riazi A, Schapira AH, Cooper JM, Hobart JC. Friedreich's ataxia impact scale: a new measure striving to provide the flexibility required by today's studies. Mov Disord. 2009 May 15; 24(7): 984-92.
Adult
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Friedreich's Ataxia Impact Scale (FAIS)
Ataxia and Performance Measures
Outcomes and End Points
FAIS Q1.1b
 
Single Pre-Defined Value Selected
       
C12033
Friedreich's Ataxia Impact Scale (FAIS) - body movement balance loss transferring scale
FAISBodMoveBalLossTransScale
Scale used to determine how much the patient was bothered by loss of balance when transferring as a result of Friedreich's Ataxia in the past two weeks. Part of the Body Movement section of the Friedreich's Ataxia Impact Scale (FAIS)
As a result of your Friedreich’s Ataxia, how much in the past two weeks have you been bothered by loss of balance when transferring?
1;2;3;4;5;
1=Not bothered at all;2=A little bothered;3=Moderately bothered;4=Quite a bit bothered;5=Extremely bothered;
Numeric Values
Symptoms (31 Items) Body Movement (19 items) - People like you who have Friedreich’s Ataxia are bothered by different problems. The following questions ask about problems you may have been bothered by during the past 2 weeks. Please draw a line through the number under each scale that best describes your experience.
Cano SJ, Riazi A, Schapira AH, Cooper JM, Hobart JC. Friedreich's ataxia impact scale: a new measure striving to provide the flexibility required by today's studies. Mov Disord. 2009 May 15; 24(7): 984-92.
Adult
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Friedreich's Ataxia Impact Scale (FAIS)
Ataxia and Performance Measures
Outcomes and End Points
FAIS Q1.1c
 
Single Pre-Defined Value Selected
       
C12034
Friedreich's Ataxia Impact Scale (FAIS) - body movement coordination lack scale
FAISBodMoveCoordLackScale
Scale used to determine how much the patient was bothered by lack of coordination as a result of Friedreich's Ataxia within the past two weeks. Part of the Body Movement section of the Friedreich's Ataxia Impact Scale (FAIS)
As a result of your Friedreich’s Ataxia, how much in the past two weeks have you been bothered by lack of coordination?
1;2;3;4;5;
1=Not bothered at all;2=A little bothered;3=Moderately bothered;4=Quite a bit bothered;5=Extremely bothered;
Numeric Values
Symptoms (31 Items) Body Movement (19 items) - People like you who have Friedreich’s Ataxia are bothered by different problems. The following questions ask about problems you may have been bothered by during the past 2 weeks. Please draw a line through the number under each scale that best describes your experience.
Cano SJ, Riazi A, Schapira AH, Cooper JM, Hobart JC. Friedreich's ataxia impact scale: a new measure striving to provide the flexibility required by today's studies. Mov Disord. 2009 May 15; 24(7): 984-92.
Adult
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Friedreich's Ataxia Impact Scale (FAIS)
Ataxia and Performance Measures
Outcomes and End Points
FAIS Q1.1d
 
Single Pre-Defined Value Selected
       
C12035
Friedreich's Ataxia Impact Scale (FAIS) - body movement clumsy scale
FAISBodMoveClumsyScale
Scale used to determine how much the patient was bothered clumsiness as a result of Friedreich's Ataxia within the past two weeks. Part of the Body Movement section of the Friedreich's Ataxia Impact Scale (FAIS)
As a result of your Friedreich’s Ataxia, how much in the past two weeks have you been bothered by being clumsy?
1;2;3;4;5;
1=Not bothered at all;2=A little bothered;3=Moderately bothered;4=Quite a bit bothered;5=Extremely bothered;
Numeric Values
Symptoms (31 Items) Body Movement (19 items) - People like you who have Friedreich’s Ataxia are bothered by different problems. The following questions ask about problems you may have been bothered by during the past 2 weeks. Please draw a line through the number under each scale that best describes your experience.
Cano SJ, Riazi A, Schapira AH, Cooper JM, Hobart JC. Friedreich's ataxia impact scale: a new measure striving to provide the flexibility required by today's studies. Mov Disord. 2009 May 15; 24(7): 984-92.
Adult
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Friedreich's Ataxia Impact Scale (FAIS)
Ataxia and Performance Measures
Outcomes and End Points
FAIS Q1.1e
 
Single Pre-Defined Value Selected
       
C12036
Friedreich's Ataxia Impact Scale (FAIS) - body movement planning more scale
FAISBodMovePlanMoreScale
Scale used to determine how much the patient was bothered when more planning was needed to do things as a result of Friedreich's Ataxia in the past two weeks. Part of the Body Movement section of the Friedreich's Ataxia Impact Scale (FAIS)
As a result of your Friedreich’s Ataxia, how much in the past two weeks have you been bothered by requiring more planning to do things?
1;2;3;4;5;
1=Not bothered at all;2=A little bothered;3=Moderately bothered;4=Quite a bit bothered;5=Extremely bothered;
Numeric Values
Symptoms (31 Items) Body Movement (19 items) - People like you who have Friedreich’s Ataxia are bothered by different problems. The following questions ask about problems you may have been bothered by during the past 2 weeks. Please draw a line through the number under each scale that best describes your experience.
Cano SJ, Riazi A, Schapira AH, Cooper JM, Hobart JC. Friedreich's ataxia impact scale: a new measure striving to provide the flexibility required by today's studies. Mov Disord. 2009 May 15; 24(7): 984-92.
Adult
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Friedreich's Ataxia Impact Scale (FAIS)
Ataxia and Performance Measures
Outcomes and End Points
FAIS Q1.1f
 
Single Pre-Defined Value Selected
       
C12037
Friedreich's Ataxia Impact Scale (FAIS) - body movement muscle weakness scale
FAISBodMoveMusWeaknessScale
Scale used to determine how much the patient was bothered by muscle weakness as a result of Friedreich's Ataxia within the past two weeks. Part of the Body Movement section of the Friedreich's Ataxia Impact Scale (FAIS)
As a result of your Friedreich’s Ataxia, how much in the past two weeks have you been bothered by weakness in muscles?
1;2;3;4;5;
1=Not bothered at all;2=A little bothered;3=Moderately bothered;4=Quite a bit bothered;5=Extremely bothered;
Numeric Values
Symptoms (31 Items) Body Movement (19 items) - People like you who have Friedreich’s Ataxia are bothered by different problems. The following questions ask about problems you may have been bothered by during the past 2 weeks. Please draw a line through the number under each scale that best describes your experience.
Cano SJ, Riazi A, Schapira AH, Cooper JM, Hobart JC. Friedreich's ataxia impact scale: a new measure striving to provide the flexibility required by today's studies. Mov Disord. 2009 May 15; 24(7): 984-92.
Adult
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Friedreich's Ataxia Impact Scale (FAIS)
Ataxia and Performance Measures
Outcomes and End Points
FAIS Q1.1g
 
Single Pre-Defined Value Selected
       
C12038
Friedreich's Ataxia Impact Scale (FAIS) - body movement body control lack scale
FAISBodMoveBodyConlLackScale
Scale used to determine how much the patient was bothered the by lack of body control as a result of Friedreich's Ataxia in the past two weeks. Part of the Body Movement section of the Friedreich's Ataxia Impact Scale (FAIS)
As a result of your Friedreich’s Ataxia, how much in the past two weeks have you been bothered by lack of control over your body?
1;2;3;4;5;
1=Not bothered at all;2=A little bothered;3=Moderately bothered;4=Quite a bit bothered;5=Extremely bothered;
Numeric Values
Symptoms (31 Items) Body Movement (19 items) - People like you who have Friedreich’s Ataxia are bothered by different problems. The following questions ask about problems you may have been bothered by during the past 2 weeks. Please draw a line through the number under each scale that best describes your experience.
Cano SJ, Riazi A, Schapira AH, Cooper JM, Hobart JC. Friedreich's ataxia impact scale: a new measure striving to provide the flexibility required by today's studies. Mov Disord. 2009 May 15; 24(7): 984-92.
Adult
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Friedreich's Ataxia Impact Scale (FAIS)
Ataxia and Performance Measures
Outcomes and End Points
FAIS Q1.1h
 
Single Pre-Defined Value Selected
       
C12039
Friedreich's Ataxia Impact Scale (FAIS) - body movement concentrate scale
FAISBodMoveConcentrateScale
Scale used to determine how much the patient was bothered by having to concentrate on doing things as a result of Friedreich's Ataxia in the past two weeks. Part of the Body Movement section of Friedreich's Ataxia Impact Scale (FAIS)
As a result of your Friedreich’s Ataxia, how much in the past two weeks have you been bothered by having to concentrate on doing things?
1;2;3;4;5;
1=Not bothered at all;2=A little bothered;3=Moderately bothered;4=Quite a bit bothered;5=Extremely bothered;
Numeric Values
Symptoms (31 Items) Body Movement (19 items) - People like you who have Friedreich’s Ataxia are bothered by different problems. The following questions ask about problems you may have been bothered by during the past 2 weeks. Please draw a line through the number under each scale that best describes your experience.
Cano SJ, Riazi A, Schapira AH, Cooper JM, Hobart JC. Friedreich's ataxia impact scale: a new measure striving to provide the flexibility required by today's studies. Mov Disord. 2009 May 15; 24(7): 984-92.
Adult
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Friedreich's Ataxia Impact Scale (FAIS)
Ataxia and Performance Measures
Outcomes and End Points
FAIS Q1.1i
 
Single Pre-Defined Value Selected
       
C12040
Friedreich's Ataxia Impact Scale (FAIS) - body movement heavy legs scale
FAISBodMoveHeavyLegsScale
Scale used to determine how much the patient was bothered by heavy legs as a result of Friedreich's Ataxia in the past two weeks. Part of Body Movement section of Friedreich's Ataxia Impact Scale (FAIS)
As a result of your Friedreich’s Ataxia, how much in the past two weeks have you been bothered by heavy legs?
1;2;3;4;5;
1=Not bothered at all;2=A little bothered;3=Moderately bothered;4=Quite a bit bothered;5=Extremely bothered;
Numeric Values
Symptoms (31 Items) Body Movement (19 items) - People like you who have Friedreich’s Ataxia are bothered by different problems. The following questions ask about problems you may have been bothered by during the past 2 weeks. Please draw a line through the number under each scale that best describes your experience.
Cano SJ, Riazi A, Schapira AH, Cooper JM, Hobart JC. Friedreich's ataxia impact scale: a new measure striving to provide the flexibility required by today's studies. Mov Disord. 2009 May 15; 24(7): 984-92.
Adult
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Friedreich's Ataxia Impact Scale (FAIS)
Ataxia and Performance Measures
Outcomes and End Points
FAIS Q1.1j
 
Single Pre-Defined Value Selected
       
C12041
Friedreich's Ataxia Impact Scale (FAIS) - body movement hand control use inability
FAISBodMoveHandConUseInaScale
Scale used to determine how much the patient was bothered by the inability to control and use his hands as a result of Friedreich's Ataxia in the past two weeks. Part of Body Movement section of Friedreich's Ataxia Impact Scale (FAIS)
As a result of your Friedreich’s Ataxia, how much in the past two weeks have you been bothered by not able to control and use your hands?
1;2;3;4;5;
1=Not bothered at all;2=A little bothered;3=Moderately bothered;4=Quite a bit bothered;5=Extremely bothered;
Numeric Values
Symptoms (31 Items) Body Movement (19 items) - People like you who have Friedreich’s Ataxia are bothered by different problems. The following questions ask about problems you may have been bothered by during the past 2 weeks. Please draw a line through the number under each scale that best describes your experience.
Cano SJ, Riazi A, Schapira AH, Cooper JM, Hobart JC. Friedreich's ataxia impact scale: a new measure striving to provide the flexibility required by today's studies. Mov Disord. 2009 May 15; 24(7): 984-92.
Adult
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Friedreich's Ataxia Impact Scale (FAIS)
Ataxia and Performance Measures
Outcomes and End Points
FAIS Q1.1k
 
Single Pre-Defined Value Selected
       
C12042
Friedreich's Ataxia Impact Scale (FAIS) - body movement restless legs scale
FAISBodMoveRestlessLegsScale
Scale used to determine how much the patient was bothered by restless legs as a result of Friedreich's Ataxia in the past two weeks. Part of the Body Movement section of the Friedreich's Ataxia Impact Scale (FAIS)
As a result of your Friedreich’s Ataxia, how much in the past two weeks have you been bothered by restless legs?
1;2;3;4;5;
1=Not bothered at all;2=A little bothered;3=Moderately bothered;4=Quite a bit bothered;5=Extremely bothered;
Numeric Values
Symptoms (31 Items) Body Movement (19 items) - People like you who have Friedreich’s Ataxia are bothered by different problems. The following questions ask about problems you may have been bothered by during the past 2 weeks. Please draw a line through the number under each scale that best describes your experience.
Cano SJ, Riazi A, Schapira AH, Cooper JM, Hobart JC. Friedreich's ataxia impact scale: a new measure striving to provide the flexibility required by today's studies. Mov Disord. 2009 May 15; 24(7): 984-92.
Adult
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Friedreich's Ataxia Impact Scale (FAIS)
Ataxia and Performance Measures
Outcomes and End Points
FAIS Q1.1l
 
Single Pre-Defined Value Selected
       
C12043
Friedreich's Ataxia Impact Scale (FAIS) - body movement repetitive movement difficulty scale
FAISBodMoveRepMoveRestlScale
Scale used to determine how much the patient was bothered by repetitive movement difficulty as a result of Friedreich's Ataxia in the past two weeks. Part of the Body Movement section of the Friedreich's Ataxia Impact Scale (FAIS)
As a result of your Friedreich’s Ataxia, how much in the past two weeks have you been bothered by repetitive movement difficulty?
1;2;3;4;5;
1=Not bothered at all;2=A little bothered;3=Moderately bothered;4=Quite a bit bothered;5=Extremely bothered;
Numeric Values
Symptoms (31 Items) Body Movement (19 items) - People like you who have Friedreich’s Ataxia are bothered by different problems. The following questions ask about problems you may have been bothered by during the past 2 weeks. Please draw a line through the number under each scale that best describes your experience.
Cano SJ, Riazi A, Schapira AH, Cooper JM, Hobart JC. Friedreich's ataxia impact scale: a new measure striving to provide the flexibility required by today's studies. Mov Disord. 2009 May 15; 24(7): 984-92.
Adult
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Friedreich's Ataxia Impact Scale (FAIS)
Ataxia and Performance Measures
Outcomes and End Points
FAIS Q1.1m
 
Single Pre-Defined Value Selected
       
C12044
Friedreich's Ataxia Impact Scale (FAIS) - body movement spasms scale
FAISBodMoveSpasmsScale
Scale used to determine how much the patient was bothered by spasms as a result of Friedreich's Ataxia in the past two weeks. Part of Body Movement section of Friedreich's Ataxia Impact Scale (FAIS)
As a result of your Friedreich’s Ataxia, how much in the past two weeks have you been bothered by spasms?
1;2;3;4;5;
1=Not bothered at all;2=A little bothered;3=Moderately bothered;4=Quite a bit bothered;5=Extremely bothered;
Numeric Values
Symptoms (31 Items) Body Movement (19 items) - People like you who have Friedreich’s Ataxia are bothered by different problems. The following questions ask about problems you may have been bothered by during the past 2 weeks. Please draw a line through the number under each scale that best describes your experience.
Cano SJ, Riazi A, Schapira AH, Cooper JM, Hobart JC. Friedreich's ataxia impact scale: a new measure striving to provide the flexibility required by today's studies. Mov Disord. 2009 May 15; 24(7): 984-92.
Adult
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Friedreich's Ataxia Impact Scale (FAIS)
Ataxia and Performance Measures
Outcomes and End Points
FAIS Q1.1n
 
Single Pre-Defined Value Selected
       
C12045
Friedreich's Ataxia Impact Scale (FAIS) - body movement arm strength lack scale
FAISBodMoveArmStrengLackScale
Scale used to determine how much the patient was bothered by the lack of strength in arms as a result of Friedreich's Ataxia in the past two weeks. Part of the Body Movement section of the Friedreich's Ataxia Impact Scale (FAIS)
As a result of your Friedreich’s Ataxia, how much in the past two weeks have you been bothered by lack of strength in arms?
1;2;3;4;5;
1=Not bothered at all;2=A little bothered;3=Moderately bothered;4=Quite a bit bothered;5=Extremely bothered;
Numeric Values
Symptoms (31 Items) Body Movement (19 items) - People like you who have Friedreich’s Ataxia are bothered by different problems. The following questions ask about problems you may have been bothered by during the past 2 weeks. Please draw a line through the number under each scale that best describes your experience.
Cano SJ, Riazi A, Schapira AH, Cooper JM, Hobart JC. Friedreich's ataxia impact scale: a new measure striving to provide the flexibility required by today's studies. Mov Disord. 2009 May 15; 24(7): 984-92.
Adult
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Friedreich's Ataxia Impact Scale (FAIS)
Ataxia and Performance Measures
Outcomes and End Points
FAIS Q1.1o
 
Single Pre-Defined Value Selected
       
C12046
Friedreich's Ataxia Impact Scale (FAIS) - body movement finger movement lack scale
FAISBodMoveFingMoveLackScale
Scale used to determine how much the patient was bothered by the lack of finger movements as a result of Friedreich's Ataxia in the past two weeks. Part of Body Movement section of Friedreich's Ataxia Impact Scale (FAIS)
As a result of your Friedreich’s Ataxia, how much in the past two weeks have you been bothered by lack of movement in your fingers?
1;2;3;4;5;
1=Not bothered at all;2=A little bothered;3=Moderately bothered;4=Quite a bit bothered;5=Extremely bothered;
Numeric Values
Symptoms (31 Items) Body Movement (19 items) - People like you who have Friedreich’s Ataxia are bothered by different problems. The following questions ask about problems you may have been bothered by during the past 2 weeks. Please draw a line through the number under each scale that best describes your experience.
Cano SJ, Riazi A, Schapira AH, Cooper JM, Hobart JC. Friedreich's ataxia impact scale: a new measure striving to provide the flexibility required by today's studies. Mov Disord. 2009 May 15; 24(7): 984-92.
Adult
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Friedreich's Ataxia Impact Scale (FAIS)
Ataxia and Performance Measures
Outcomes and End Points
FAIS Q1.1p
 
Single Pre-Defined Value Selected
       
C12047
Friedreich's Ataxia Impact Scale (FAIS) - body movement shaky hands scale
FAISBodMoveShakyHandsScale
Scale used to determine how much the patient was bothered by shaky hands as a result of Friedreich's Ataxia in the past two weeks. Part of Body Movement section of Friedreich's Ataxia Impact Scale (FAIS)
As a result of your Friedreich’s Ataxia, how much in the past two weeks have you been bothered by shaky hands?
1;2;3;4;5;
1=Not bothered at all;2=A little bothered;3=Moderately bothered;4=Quite a bit bothered;5=Extremely bothered;
Numeric Values
Symptoms (31 Items) Body Movement (19 items) - People like you who have Friedreich’s Ataxia are bothered by different problems. The following questions ask about problems you may have been bothered by during the past 2 weeks. Please draw a line through the number under each scale that best describes your experience.
Cano SJ, Riazi A, Schapira AH, Cooper JM, Hobart JC. Friedreich's ataxia impact scale: a new measure striving to provide the flexibility required by today's studies. Mov Disord. 2009 May 15; 24(7): 984-92.
Adult
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Friedreich's Ataxia Impact Scale (FAIS)
Ataxia and Performance Measures
Outcomes and End Points
FAIS Q1.1q
 
Single Pre-Defined Value Selected
       
C12048
Friedreich's Ataxia Impact Scale (FAIS) - body movement shaky legs scale
FAISBodMoveShakyLegsScale
Scale used to determine how much the patient was bothered by shaky legs as a result of Friedreich's Ataxia in the past two weeks. Part of the Body Movement section of the Friedreich's Ataxia Impact Scale (FAIS)
As a result of your Friedreich’s Ataxia, how much in the past two weeks have you been bothered by shaky legs?
1;2;3;4;5;
1=Not bothered at all;2=A little bothered;3=Moderately bothered;4=Quite a bit bothered;5=Extremely bothered;
Numeric Values
Symptoms (31 Items) Body Movement (19 items) - People like you who have Friedreich’s Ataxia are bothered by different problems. The following questions ask about problems you may have been bothered by during the past 2 weeks. Please draw a line through the number under each scale that best describes your experience.
Cano SJ, Riazi A, Schapira AH, Cooper JM, Hobart JC. Friedreich's ataxia impact scale: a new measure striving to provide the flexibility required by today's studies. Mov Disord. 2009 May 15; 24(7): 984-92.
Adult
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Friedreich's Ataxia Impact Scale (FAIS)
Ataxia and Performance Measures
Outcomes and End Points
FAIS Q1.1r
 
Single Pre-Defined Value Selected
       
C12049
Friedreich's Ataxia Impact Scale (FAIS) - body movement shaky head scale
FAISBodMoveShakyHeadScale
Scale used to determine how much the patient was bothered by a shaky head as a result of Friedreich's Ataxia in the past two weeks. Part of the Body Movement section of the Friedreich's Ataxia Impact Scale (FAIS)
As a result of your Friedreich’s Ataxia, how much in the past two weeks have you been bothered by shaky head?
1;2;3;4;5;
1=Not bothered at all;2=A little bothered;3=Moderately bothered;4=Quite a bit bothered;5=Extremely bothered;
Numeric Values
Symptoms (31 Items) Body Movement (19 items) - People like you who have Friedreich’s Ataxia are bothered by different problems. The following questions ask about problems you may have been bothered by during the past 2 weeks. Please draw a line through the number under each scale that best describes your experience.
Cano SJ, Riazi A, Schapira AH, Cooper JM, Hobart JC. Friedreich's ataxia impact scale: a new measure striving to provide the flexibility required by today's studies. Mov Disord. 2009 May 15; 24(7): 984-92.
Adult
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Friedreich's Ataxia Impact Scale (FAIS)
Ataxia and Performance Measures
Outcomes and End Points
FAIS Q1.1s
 
Single Pre-Defined Value Selected
       
C12050
Friedreich's Ataxia Impact Scale (FAIS) - speech swallowing self-conscious voice scale
FAISSpSwalSelfConVoiceScale
Scale used to determine how much the patient was bothered by being self-conscious about his voice as a result of Friedreich's Ataxia in the past two weeks. Part of the Speech and Swallowing section of the Friedreich's Ataxia Impact Scale (FAIS)
As a result of your Friedreich’s Ataxia, how much in the past two weeks have you been bothered by being self-conscious about your voice?
1;2;3;4;5;
1=Not bothered at all;2=A little bothered;3=Moderately bothered;4=Quite a bit bothered;5=Extremely bothered;
Numeric Values
Symtpoms (31 items) Speech and Swallowing (12 items)- People like you who have Friedreich’s Ataxia are bothered by different problems. The following questions ask about problems you may have been bothered by during the past 2 weeks. Please draw a line through the number under each scale that best describes your experience.
Cano SJ, Riazi A, Schapira AH, Cooper JM, Hobart JC. Friedreich's ataxia impact scale: a new measure striving to provide the flexibility required by today's studies. Mov Disord. 2009 May 15; 24(7): 984-92.
Adult
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Friedreich's Ataxia Impact Scale (FAIS)
Ataxia and Performance Measures
Outcomes and End Points
FAIS Q1.2a
 
Single Pre-Defined Value Selected
       
C12051
Friedreich's Ataxia Impact Scale (FAIS) - speech swallowing talk repeat scale
FAISSpSwalTalkRepeatScale
Scale used to determine how much the patient was bothered by being asked to repeat himself when talking as a result of Friedreich's Ataxia in the past two weeks. Part of the Speech and Swallowing section of the Friedreich's Ataxia Impact Scale (FAIS)
As a result of your Friedreich’s Ataxia, how much in the past two weeks have you been bothered by being asked to repeat yourself when talking?
1;2;3;4;5;
1=Not bothered at all;2=A little bothered;3=Moderately bothered;4=Quite a bit bothered;5=Extremely bothered;
Numeric Values
Symtpoms (31 items) Speech and Swallowing (12 items)- People like you who have Friedreich’s Ataxia are bothered by different problems. The following questions ask about problems you may have been bothered by during the past 2 weeks. Please draw a line through the number under each scale that best describes your experience.
Cano SJ, Riazi A, Schapira AH, Cooper JM, Hobart JC. Friedreich's ataxia impact scale: a new measure striving to provide the flexibility required by today's studies. Mov Disord. 2009 May 15; 24(7): 984-92.
Adult
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Friedreich's Ataxia Impact Scale (FAIS)
Ataxia and Performance Measures
Outcomes and End Points
FAIS Q1.2b
 
Single Pre-Defined Value Selected
       
C12052
Friedreich's Ataxia Impact Scale (FAIS) - speech swallowing slurred speech scale
FAISSpSwalSlurredSpeechScale
Scale used to determine how much the patient was bothered by slurred speech as a result of Friedreich's Ataxia in the past two weeks. Part of the Speech and Swallowing section of the Friedreich's Ataxia Impact Scale (FAIS)
As a result of your Friedreich’s Ataxia, how much in the past two weeks have you been bothered by slurred speech?
1;2;3;4;5;
1=Not bothered at all;2=A little bothered;3=Moderately bothered;4=Quite a bit bothered;5=Extremely bothered;
Numeric Values
Symtpoms (31 items) Speech and Swallowing (12 items)- People like you who have Friedreich’s Ataxia are bothered by different problems. The following questions ask about problems you may have been bothered by during the past 2 weeks. Please draw a line through the number under each scale that best describes your experience.
Cano SJ, Riazi A, Schapira AH, Cooper JM, Hobart JC. Friedreich's ataxia impact scale: a new measure striving to provide the flexibility required by today's studies. Mov Disord. 2009 May 15; 24(7): 984-92.
Adult
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Friedreich's Ataxia Impact Scale (FAIS)
Ataxia and Performance Measures
Outcomes and End Points
FAIS Q1.2c
 
Single Pre-Defined Value Selected
       
C12053
Friedreich's Ataxia Impact Scale (FAIS) - speech swallowing slow speech scale
FAISSpSwalSlowSpeechScale
Scale used to determine how much the patient was bothered by slow speech as a result of Friedreich's Ataxia in the past two weeks. Part of the Speech and Swallowing section of the Friedreich's Ataxia Impact Scale (FAIS)
As a result of your Friedreich’s Ataxia, how much in the past two weeks have you been bothered by slow speech?
1;2;3;4;5;
1=Not bothered at all;2=A little bothered;3=Moderately bothered;4=Quite a bit bothered;5=Extremely bothered;
Numeric Values
Symtpoms (31 items) Speech and Swallowing (12 items)- People like you who have Friedreich’s Ataxia are bothered by different problems. The following questions ask about problems you may have been bothered by during the past 2 weeks. Please draw a line through the number under each scale that best describes your experience.
Cano SJ, Riazi A, Schapira AH, Cooper JM, Hobart JC. Friedreich's ataxia impact scale: a new measure striving to provide the flexibility required by today's studies. Mov Disord. 2009 May 15; 24(7): 984-92.
Adult
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Friedreich's Ataxia Impact Scale (FAIS)
Ataxia and Performance Measures
Outcomes and End Points
FAIS Q1.2d
 
Single Pre-Defined Value Selected
       
C12054
Friedreich's Ataxia Impact Scale (FAIS) - speech swallowing telephone talking scale
FAISSpSwalTeleTalkingScale
Scale used to determine how much the patient was bothered by talking on the telephone as a result of Friedreich's Ataxia in the past two weeks. Part of the Speech and Swallowing section of the Friedreich's Ataxia Impact Scale (FAIS)
As a result of your Friedreich’s Ataxia, how much in the past two weeks have you been bothered by talking on the telephone?
1;2;3;4;5;
1=Not bothered at all;2=A little bothered;3=Moderately bothered;4=Quite a bit bothered;5=Extremely bothered;
Numeric Values
Symtpoms (31 items) Speech and Swallowing (12 items)- People like you who have Friedreich’s Ataxia are bothered by different problems. The following questions ask about problems you may have been bothered by during the past 2 weeks. Please draw a line through the number under each scale that best describes your experience.
Cano SJ, Riazi A, Schapira AH, Cooper JM, Hobart JC. Friedreich's ataxia impact scale: a new measure striving to provide the flexibility required by today's studies. Mov Disord. 2009 May 15; 24(7): 984-92.
Adult
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Friedreich's Ataxia Impact Scale (FAIS)
Ataxia and Performance Measures
Outcomes and End Points
FAIS Q1.2e
 
Single Pre-Defined Value Selected
       
C12055
Friedreich's Ataxia Impact Scale (FAIS) - speech swallowing choking swallowing drinking scale
FAISSpSwalChokSwalDrinkScale
Scale used to determine how much the patient was bothered by choking when swallowing or drinking as a result of Friedreich's Ataxia in the past two weeks. Part of the Speech and Swallowing section of the Friedreich's Ataxia Impact Scale (FAIS)
As a result of your Friedreich’s Ataxia, how much in the past two weeks have you been bothered by choking when swallowing or drinking?
1;2;3;4;5;
1=Not bothered at all;2=A little bothered;3=Moderately bothered;4=Quite a bit bothered;5=Extremely bothered;
Numeric Values
Symtpoms (31 items) Speech and Swallowing (12 items)- People like you who have Friedreich’s Ataxia are bothered by different problems. The following questions ask about problems you may have been bothered by during the past 2 weeks. Please draw a line through the number under each scale that best describes your experience.
Cano SJ, Riazi A, Schapira AH, Cooper JM, Hobart JC. Friedreich's ataxia impact scale: a new measure striving to provide the flexibility required by today's studies. Mov Disord. 2009 May 15; 24(7): 984-92.
Adult
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Friedreich's Ataxia Impact Scale (FAIS)
Ataxia and Performance Measures
Outcomes and End Points
FAIS Q1.2f
 
Single Pre-Defined Value Selected
       
C12056
Friedreich's Ataxia Impact Scale (FAIS) - speech swallowing talking effort scale
FAISSpSwalTalkingEffortScale
Scale used to determine how much the patient was bothered by the effort needed to talk as a result of Friedreich's Ataxia in the past two weeks. Part of the Speech and Swallowing section of the Friedreich's Ataxia Impact Scale (FAIS)
As a result of your Friedreich’s Ataxia, how much in the past two weeks have you been bothered by effort needed to talk?
1;2;3;4;5;
1=Not bothered at all;2=A little bothered;3=Moderately bothered;4=Quite a bit bothered;5=Extremely bothered;
Numeric Values
Symtpoms (31 items) Speech and Swallowing (12 items)- People like you who have Friedreich’s Ataxia are bothered by different problems. The following questions ask about problems you may have been bothered by during the past 2 weeks. Please draw a line through the number under each scale that best describes your experience.
Cano SJ, Riazi A, Schapira AH, Cooper JM, Hobart JC. Friedreich's ataxia impact scale: a new measure striving to provide the flexibility required by today's studies. Mov Disord. 2009 May 15; 24(7): 984-92.
Adult
Supplemental
3.0
7/11/2013
Aliases for variable name not defined
Friedreich's Ataxia Impact Scale (FAIS)
Ataxia and Performance Measures
Outcomes and End Points
FAIS Q1.2g
 
Single Pre-Defined Value Selected
       
07-15-2019
Page 1 of 4