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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: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
Sub-Domain: Fatigue
CRF: Checklist for Individual Strength - Fatigue (CIS)
Item count: 24 (24 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
C11631
Checklist Individual Strength (CIS20R) - tired feeling scale
CIS20RTiredFeelScale
Scale assessing the extent to which the following statement has been true for the participant during the last two weeks: I feel tired. Part of the Checklist Individual Strength (CIS20R) questionnaire.
I feel tired.
7;6;5;4;3;2;1;
Yes, that is true;;;;;;No, that is not true;
Numeric Values
On the next page you find 20 statements. With these statements we wish to get an impression of how you have felt during the last two weeks .If you feel that this statement is entirely true, tick the left box. If you feel that this statement is not true at all, tick the right box. If you feel that this statement is neither "yes, that is true", nor "no, that is not true", tick the box that is most in accordance with how you have felt. Do not skip any statement and tick each statement only once.
Vercoulen JHMM et al. The measurement of fatigue in patients with multiple sclerosis: a multidimensional comparison with chronic fatigue syndrome and healthy subjects. Arch Neurol. 1996;53:642-9. Vercoulen JHMM, Alberts M, Bleijenberg G: De Checklist Individual Strength (CIS). Gedragstherapie 1999, 32:131-136. Beurskens AJ, Bultmann U, Kant I, Vercoulen J, Bleijenberg G, and Swaen G: Fatigue among working people: validity of a questionnaire measure. Occup Environ Med. 2000 May; 57(5): 353-357.
Adult
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Checklist for Individual Strength - Fatigue (CIS)
Fatigue
Outcomes and End Points
CIS20R Q1
 
Single Pre-Defined Value Selected
       
C11632
Checklist Individual Strength (CIS20R) - active feeling scale
CIS20RActvFeelScale
Scale assessing the extent to which the following statement has been true for the participant during the last two weeks: I feel very active. Part of the Checklist Individual Strength (CIS20R) questionnaire.
I feel very active.
1;2;3;4;5;6;7;
Yes, that is true;;;;;;No, that is not true;
Numeric Values
On the next page you find 20 statements. With these statements we wish to get an impression of how you have felt during the last two weeks .If you feel that this statement is entirely true, tick the left box. If you feel that this statement is not true at all, tick the right box. If you feel that this statement is neither "yes, that is true", nor "no, that is not true", tick the box that is most in accordance with how you have felt. Do not skip any statement and tick each statement only once.
Vercoulen JHMM et al. The measurement of fatigue in patients with multiple sclerosis: a multidimensional comparison with chronic fatigue syndrome and healthy subjects. Arch Neurol. 1996;53:642-9. Vercoulen JHMM, Alberts M, Bleijenberg G: De Checklist Individual Strength (CIS). Gedragstherapie 1999, 32:131-136. Beurskens AJ, Bultmann U, Kant I, Vercoulen J, Bleijenberg G, and Swaen G: Fatigue among working people: validity of a questionnaire measure. Occup Environ Med. 2000 May; 57(5): 353-357.
Adult
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Checklist for Individual Strength - Fatigue (CIS)
Fatigue
Outcomes and End Points
CIS20R Q2
 
Single Pre-Defined Value Selected
       
C11633
Checklist Individual Strength (CIS20R) - thought effort scale
CIS20RThoughtEffortScale
Scale assessing the extent to which the following statement has been true for the participant during the last two weeks: Thinking requires effort. Part of the Checklist Individual Strength (CIS20R) questionnaire.
Thinking requires effort.
7;6;5;4;3;2;1;
Yes, that is true;;;;;;No, that is not true;
Numeric Values
On the next page you find 20 statements. With these statements we wish to get an impression of how you have felt during the last two weeks. If you feel that this statement is entirely true, tick the left box. If you feel that this statement is not true at all, tick the right box. If you feel that this statement is neither "yes, that is true", nor "no, that is not true", tick the box that is most in accordance with how you have felt. Do not skip any statement and tick each statement only once.
Vercoulen JHMM et al. The measurement of fatigue in patients with multiple sclerosis: a multidimensional comparison with chronic fatigue syndrome and healthy subjects. Arch Neurol. 1996;53:642-9. Vercoulen JHMM, Alberts M, Bleijenberg G: De Checklist Individual Strength (CIS). Gedragstherapie 1999, 32:131-136. Beurskens AJ, Bultmann U, Kant I, Vercoulen J, Bleijenberg G, and Swaen G: Fatigue among working people: validity of a questionnaire measure. Occup Environ Med. 2000 May; 57(5): 353-357.
Adult
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Checklist for Individual Strength - Fatigue (CIS)
Fatigue
Outcomes and End Points
CIS20R Q3
 
Single Pre-Defined Value Selected
       
C11634
Checklist Individual Strength (CIS20R) - physically exhausted feeling scale
CIS20RPhysExhstFeelScale
Scale assessing the extent to which the following statement has been true for the participant during the last two weeks: Physically I feel exhausted. Part of the Checklist Individual Strength (CIS20R) questionnaire.
Physically I feel exhausted.
7;6;5;4;3;2;1;
Yes, that is true;;;;;;No, that is not true;
Numeric Values
On the next page you find 20 statements. With these statements we wish to get an impression of how you have felt during the last two weeks. If you feel that this statement is entirely true, tick the left box. If you feel that this statement is not true at all, tick the right box. If you feel that this statement is neither "yes, that is true", nor "no, that is not true", tick the box that is most in accordance with how you have felt. Do not skip any statement and tick each statement only once.
Vercoulen JHMM et al. The measurement of fatigue in patients with multiple sclerosis: a multidimensional comparison with chronic fatigue syndrome and healthy subjects. Arch Neurol. 1996;53:642-9. Vercoulen JHMM, Alberts M, Bleijenberg G: De Checklist Individual Strength (CIS). Gedragstherapie 1999, 32:131-136. Beurskens AJ, Bultmann U, Kant I, Vercoulen J, Bleijenberg G, and Swaen G: Fatigue among working people: validity of a questionnaire measure. Occup Environ Med. 2000 May; 57(5): 353-357.
Adult
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Checklist for Individual Strength - Fatigue (CIS)
Fatigue
Outcomes and End Points
CIS20R Q4
 
Single Pre-Defined Value Selected
       
C11635
Checklist Individual Strength (CIS20R) - do nice thing feeling scale
CIS20RDoNiceThingFeelScale
Scale assessing the extent to which the following statement has been true for the participant during the last two weeks: I feel like doing lots of nice things. Part of the Checklist Individual Strength (CIS20R) questionnaire.
I feel like doing lots of nice things.
1;2;3;4;5;6;7;
Yes, that is true;;;;;;No, that is not true;
Numeric Values
On the next page you find 20 statements. With these statements we wish to get an impression of how you have felt during the last two weeks. If you feel that this statement is entirely true, tick the left box. If you feel that this statement is not true at all, tick the right box. If you feel that this statement is neither "yes, that is true", nor "no, that is not true", tick the box that is most in accordance with how you have felt. Do not skip any statement and tick each statement only once.
Vercoulen JHMM et al. The measurement of fatigue in patients with multiple sclerosis: a multidimensional comparison with chronic fatigue syndrome and healthy subjects. Arch Neurol. 1996;53:642-9. Vercoulen JHMM, Alberts M, Bleijenberg G: De Checklist Individual Strength (CIS). Gedragstherapie 1999, 32:131-136. Beurskens AJ, Bultmann U, Kant I, Vercoulen J, Bleijenberg G, and Swaen G: Fatigue among working people: validity of a questionnaire measure. Occup Environ Med. 2000 May; 57(5): 353-357.
Adult
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Checklist for Individual Strength - Fatigue (CIS)
Fatigue
Outcomes and End Points
CIS20R Q5
 
Single Pre-Defined Value Selected
       
C11636
Checklist Individual Strength (CIS20R) - fit feeling scale
CIS20RFitFeelScale
Scale assessing the extent to which the following statement has been true for the participant during the last two weeks: I feel fit. Part of the Checklist Individual Strength (CIS20R) questionnaire.
I feel fit.
1;2;3;4;5;6;7;
Yes, that is true;;;;;;No, that is not true;
Numeric Values
On the next page you find 20 statements. With these statements we wish to get an impression of how you have felt during the last two weeks. If you feel that this statement is entirely true, tick the left box. If you feel that this statement is not true at all, tick the right box. If you feel that this statement is neither "yes, that is true", nor "no, that is not true", tick the box that is most in accordance with how you have felt. Do not skip any statement and tick each statement only once.
Vercoulen JHMM et al. The measurement of fatigue in patients with multiple sclerosis: a multidimensional comparison with chronic fatigue syndrome and healthy subjects. Arch Neurol. 1996;53:642-9. Vercoulen JHMM, Alberts M, Bleijenberg G: De Checklist Individual Strength (CIS). Gedragstherapie 1999, 32:131-136. Beurskens AJ, Bultmann U, Kant I, Vercoulen J, Bleijenberg G, and Swaen G: Fatigue among working people: validity of a questionnaire measure. Occup Environ Med. 2000 May; 57(5): 353-357.
Adult
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Checklist for Individual Strength - Fatigue (CIS)
Fatigue
Outcomes and End Points
CIS20R Q6
 
Single Pre-Defined Value Selected
       
C11637
Checklist Individual Strength (CIS20R) - daily activity perception scale
CIS20RDailyActPerceptScale
Scale assessing the extent to which the following statement has been true for the participant during the last two weeks: I think I do a lot in a day. Part of the Checklist Individual Strength (CIS20R) questionnaire.
I think I do a lot in a day.
1;2;3;4;5;6;7;
Yes, that is true;;;;;;No, that is not true;
Numeric Values
On the next page you find 20 statements. With these statements we wish to get an impression of how you have felt during the last two weeks. If you feel that this statement is entirely true, tick the left box. If you feel that this statement is not true at all, tick the right box. If you feel that this statement is neither "yes, that is true", nor "no, that is not true", tick the box that is most in accordance with how you have felt. Do not skip any statement and tick each statement only once.
Vercoulen JHMM et al. The measurement of fatigue in patients with multiple sclerosis: a multidimensional comparison with chronic fatigue syndrome and healthy subjects. Arch Neurol. 1996;53:642-9. Vercoulen JHMM, Alberts M, Bleijenberg G: De Checklist Individual Strength (CIS). Gedragstherapie 1999, 32:131-136. Beurskens AJ, Bultmann U, Kant I, Vercoulen J, Bleijenberg G, and Swaen G: Fatigue among working people: validity of a questionnaire measure. Occup Environ Med. 2000 May; 57(5): 353-357.
Adult
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Checklist for Individual Strength - Fatigue (CIS)
Fatigue
Outcomes and End Points
CIS20R Q7
 
Single Pre-Defined Value Selected
       
C11638
Checklist Individual Strength (CIS20R) - task focus ability scale
CIS20RTaskFocusAbilityScale
Scale assessing the extent to which the following statement has been true for the participant during the last two weeks: When I am doing something, I can keep my thoughts on it. Part of the Checklist Individual Strength (CIS20R) questionnaire.
When I am doing something, I can keep my thoughts on it.
1;2;3;4;5;6;7;
Yes, that is true;;;;;;No, that is not true;
Numeric Values
On the next page you find 20 statements. With these statements we wish to get an impression of how you have felt during the last two weeks. If you feel that this statement is entirely true, tick the left box. If you feel that this statement is not true at all, tick the right box. If you feel that this statement is neither "yes, that is true", nor "no, that is not true", tick the box that is most in accordance with how you have felt. Do not skip any statement and tick each statement only once.
Vercoulen JHMM et al. The measurement of fatigue in patients with multiple sclerosis: a multidimensional comparison with chronic fatigue syndrome and healthy subjects. Arch Neurol. 1996;53:642-9. Vercoulen JHMM, Alberts M, Bleijenberg G: De Checklist Individual Strength (CIS). Gedragstherapie 1999, 32:131-136. Beurskens AJ, Bultmann U, Kant I, Vercoulen J, Bleijenberg G, and Swaen G: Fatigue among working people: validity of a questionnaire measure. Occup Environ Med. 2000 May; 57(5): 353-357.
Adult
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Checklist for Individual Strength - Fatigue (CIS)
Fatigue
Outcomes and End Points
CIS20R Q8
 
Single Pre-Defined Value Selected
       
C11639
Checklist Individual Strength (CIS20R) - powerless feeling scale
CIS20RPowrlessFeelScale
Scale assessing the extent to which the following statement has been true for the participant during the last two weeks: I feel powerless. Part of the Checklist Individual Strength (CIS20R) questionnaire.
I feel powerless.
7;6;5;4;3;2;1;
Yes, that is true;;;;;;No, that is not true;
Numeric Values
On the next page you find 20 statements. With these statements we wish to get an impression of how you have felt during the last two weeks. If you feel that this statement is entirely true, tick the left box. If you feel that this statement is not true at all, tick the right box. If you feel that this statement is neither "yes, that is true", nor "no, that is not true", tick the box that is most in accordance with how you have felt. Do not skip any statement and tick each statement only once.
Vercoulen JHMM et al. The measurement of fatigue in patients with multiple sclerosis: a multidimensional comparison with chronic fatigue syndrome and healthy subjects. Arch Neurol. 1996;53:642-9. Vercoulen JHMM, Alberts M, Bleijenberg G: De Checklist Individual Strength (CIS). Gedragstherapie 1999, 32:131-136. Beurskens AJ, Bultmann U, Kant I, Vercoulen J, Bleijenberg G, and Swaen G: Fatigue among working people: validity of a questionnaire measure. Occup Environ Med. 2000 May; 57(5): 353-357.
Adult
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Checklist for Individual Strength - Fatigue (CIS)
Fatigue
Outcomes and End Points
CIS20R Q9
 
Single Pre-Defined Value Selected
       
C11640
Checklist Individual Strength (CIS20R) - low activity daily scale
CIS20RLowActDlyScale
Scale assessing the extent to which the following statement has been true for the participant during the last two weeks: I think I do very little in a day. Part of the Checklist Individual Strength (CIS20R) questionnaire.
I think I do very little in a day.
7;6;5;4;3;2;1;
Yes, that is true;;;;;;No, that is not true;
Numeric Values
On the next page you find 20 statements. With these statements we wish to get an impression of how you have felt during the last two weeks. If you feel that this statement is entirely true, tick the left box. If you feel that this statement is not true at all, tick the right box. If you feel that this statement is neither "yes, that is true", nor "no, that is not true", tick the box that is most in accordance with how you have felt. Do not skip any statement and tick each statement only once.
Vercoulen JHMM et al. The measurement of fatigue in patients with multiple sclerosis: a multidimensional comparison with chronic fatigue syndrome and healthy subjects. Arch Neurol. 1996;53:642-9. Vercoulen JHMM, Alberts M, Bleijenberg G: De Checklist Individual Strength (CIS). Gedragstherapie 1999, 32:131-136. Beurskens AJ, Bultmann U, Kant I, Vercoulen J, Bleijenberg G, and Swaen G: Fatigue among working people: validity of a questionnaire measure. Occup Environ Med. 2000 May; 57(5): 353-357.
Adult
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Checklist for Individual Strength - Fatigue (CIS)
Fatigue
Outcomes and End Points
CIS20R Q10
 
Single Pre-Defined Value Selected
       
C11641
Checklist Individual Strength (CIS20R) - focus mind easily scale
CIS20RFocusMindEasyScale
Scale assessing the extent to which the following statement has been true for the participant during the last two weeks: I find it easy to focus my mind. Part of the Checklist Individual Strength (CIS20R) questionnaire.
I find it easy to focus my mind.
1;2;3;4;5;6;7;
Yes, that is true;;;;;;No, that is not true;
Numeric Values
On the next page you find 20 statements. With these statements we wish to get an impression of how you have felt during the last two weeks. If you feel that this statement is entirely true, tick the left box. If you feel that this statement is not true at all, tick the right box. If you feel that this statement is neither "yes, that is true", nor "no, that is not true", tick the box that is most in accordance with how you have felt. Do not skip any statement and tick each statement only once.
Vercoulen JHMM et al. The measurement of fatigue in patients with multiple sclerosis: a multidimensional comparison with chronic fatigue syndrome and healthy subjects. Arch Neurol. 1996;53:642-9. Vercoulen JHMM, Alberts M, Bleijenberg G: De Checklist Individual Strength (CIS). Gedragstherapie 1999, 32:131-136. Beurskens AJ, Bultmann U, Kant I, Vercoulen J, Bleijenberg G, and Swaen G: Fatigue among working people: validity of a questionnaire measure. Occup Environ Med. 2000 May; 57(5): 353-357.
Adult
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Checklist for Individual Strength - Fatigue (CIS)
Fatigue
Outcomes and End Points
CIS20R Q11
 
Single Pre-Defined Value Selected
       
C11642
Checklist Individual Strength (CIS20R) - rest scale
CIS20RRestScale
Scale assessing the extent to which the following statement has been true for the participant during the last two weeks: I am rested. Part of the Checklist Individual Strength (CIS20R) questionnaire.
I am rested.
1;2;3;4;5;6;7;
Yes, that is true;;;;;;No, that is not true;
Numeric Values
On the next page you find 20 statements. With these statements we wish to get an impression of how you have felt during the last two weeks. If you feel that this statement is entirely true, tick the left box. If you feel that this statement is not true at all, tick the right box. If you feel that this statement is neither "yes, that is true", nor "no, that is not true", tick the box that is most in accordance with how you have felt. Do not skip any statement and tick each statement only once.
Vercoulen JHMM et al. The measurement of fatigue in patients with multiple sclerosis: a multidimensional comparison with chronic fatigue syndrome and healthy subjects. Arch Neurol. 1996;53:642-9. Vercoulen JHMM, Alberts M, Bleijenberg G: De Checklist Individual Strength (CIS). Gedragstherapie 1999, 32:131-136. Beurskens AJ, Bultmann U, Kant I, Vercoulen J, Bleijenberg G, and Swaen G: Fatigue among working people: validity of a questionnaire measure. Occup Environ Med. 2000 May; 57(5): 353-357.
Adult
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Checklist for Individual Strength - Fatigue (CIS)
Fatigue
Outcomes and End Points
CIS20R Q12
 
Single Pre-Defined Value Selected
       
C11643
Checklist Individual Strength (CIS20R) - concentration effort scale
CIS20RConcEffortScale
Scale assessing the extent to which the following statement has been true for the participant during the last two weeks: It takes a lot of effort to concentrate on things. Part of the Checklist Individual Strength (CIS20R) questionnaire.
It takes a lot of effort to concentrate on things.
7;6;5;4;3;2;1;
Yes, that is true;;;;;;No, that is not true;
Numeric Values
On the next page you find 20 statements. With these statements we wish to get an impression of how you have felt during the last two weeks. If you feel that this statement is entirely true, tick the left box. If you feel that this statement is not true at all, tick the right box. If you feel that this statement is neither "yes, that is true", nor "no, that is not true", tick the box that is most in accordance with how you have felt. Do not skip any statement and tick each statement only once.
Vercoulen JHMM et al. The measurement of fatigue in patients with multiple sclerosis: a multidimensional comparison with chronic fatigue syndrome and healthy subjects. Arch Neurol. 1996;53:642-9. Vercoulen JHMM, Alberts M, Bleijenberg G: De Checklist Individual Strength (CIS). Gedragstherapie 1999, 32:131-136. Beurskens AJ, Bultmann U, Kant I, Vercoulen J, Bleijenberg G, and Swaen G: Fatigue among working people: validity of a questionnaire measure. Occup Environ Med. 2000 May; 57(5): 353-357.
Adult
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Checklist for Individual Strength - Fatigue (CIS)
Fatigue
Outcomes and End Points
CIS20R Q13
 
Single Pre-Defined Value Selected
       
C11644
Checklist Individual Strength (CIS20R) - bad form feeling scale
CIS20RBadFrmFeelScal
Scale assessing the extent to which the following statement has been true for the participant during the last two weeks: Physically I fell I am in bad form. Part of the Checklist Individual Strength (CIS20R) questionnaire.
Physically I fell I am in bad form.
7;6;5;4;3;2;1;
Yes, that is true;;;;;;No, that is not true;
Numeric Values
On the next page you find 20 statements. With these statements we wish to get an impression of how you have felt during the last two weeks. If you feel that this statement is entirely true, tick the left box. If you feel that this statement is not true at all, tick the right box. If you feel that this statement is neither "yes, that is true", nor "no, that is not true", tick the box that is most in accordance with how you have felt. Do not skip any statement and tick each statement only once.
Vercoulen JHMM et al. The measurement of fatigue in patients with multiple sclerosis: a multidimensional comparison with chronic fatigue syndrome and healthy subjects. Arch Neurol. 1996;53:642-9. Vercoulen JHMM, Alberts M, Bleijenberg G: De Checklist Individual Strength (CIS). Gedragstherapie 1999, 32:131-136. Beurskens AJ, Bultmann U, Kant I, Vercoulen J, Bleijenberg G, and Swaen G: Fatigue among working people: validity of a questionnaire measure. Occup Environ Med. 2000 May; 57(5): 353-357.
Adult
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Checklist for Individual Strength - Fatigue (CIS)
Fatigue
Outcomes and End Points
CIS20R Q14
 
Single Pre-Defined Value Selected
       
C11645
Checklist Individual Strength (CIS20R) - plan level scale
CIS20RPlanLvlScale
Scale assessing the extent to which the following statement has been true for the participant during the last two weeks: I have a lot of plans. Part of the Checklist Individual Strength (CIS20R) questionnaire.
I have a lot of plans.
1;2;3;4;5;6;7;
Yes, that is true;;;;;;No, that is not true;
Numeric Values
On the next page you find 20 statements. With these statements we wish to get an impression of how you have felt during the last two weeks. If you feel that this statement is entirely true, tick the left box. If you feel that this statement is not true at all, tick the right box. If you feel that this statement is neither "yes, that is true", nor "no, that is not true", tick the box that is most in accordance with how you have felt. Do not skip any statement and tick each statement only once.
Vercoulen JHMM et al. The measurement of fatigue in patients with multiple sclerosis: a multidimensional comparison with chronic fatigue syndrome and healthy subjects. Arch Neurol. 1996;53:642-9. Vercoulen JHMM, Alberts M, Bleijenberg G: De Checklist Individual Strength (CIS). Gedragstherapie 1999, 32:131-136. Beurskens AJ, Bultmann U, Kant I, Vercoulen J, Bleijenberg G, and Swaen G: Fatigue among working people: validity of a questionnaire measure. Occup Environ Med. 2000 May; 57(5): 353-357.
Adult
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Checklist for Individual Strength - Fatigue (CIS)
Fatigue
Outcomes and End Points
CIS20R Q15
 
Single Pre-Defined Value Selected
       
C11646
Checklist Individual Strength (CIS20R) - tire easily scale
CIS20RTireEaseScale
Scale assessing the extent to which the following statement has been true for the participant during the last two weeks: I tire easily. Part of the Checklist Individual Strength (CIS20R) questionnaire.
I tire easily.
7;6;5;4;3;2;1;
Yes, that is true;;;;;;No, that is not true;
Numeric Values
On the next page you find 20 statements. With these statements we wish to get an impression of how you have felt during the last two weeks. If you feel that this statement is entirely true, tick the left box. If you feel that this statement is not true at all, tick the right box. If you feel that this statement is neither "yes, that is true", nor "no, that is not true", tick the box that is most in accordance with how you have felt. Do not skip any statement and tick each statement only once.
Vercoulen JHMM et al. The measurement of fatigue in patients with multiple sclerosis: a multidimensional comparison with chronic fatigue syndrome and healthy subjects. Arch Neurol. 1996;53:642-9. Vercoulen JHMM, Alberts M, Bleijenberg G: De Checklist Individual Strength (CIS). Gedragstherapie 1999, 32:131-136. Beurskens AJ, Bultmann U, Kant I, Vercoulen J, Bleijenberg G, and Swaen G: Fatigue among working people: validity of a questionnaire measure. Occup Environ Med. 2000 May; 57(5): 353-357.
Adult
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Checklist for Individual Strength - Fatigue (CIS)
Fatigue
Outcomes and End Points
CIS20R Q16
 
Single Pre-Defined Value Selected
       
C11647
Checklist Individual Strength (CIS20R) - done little activity scale
CIS20RDoneLittleActScale
Scale assessing the extent to which the following statement has been true for the participant during the last two weeks: I get little done. Part of the Checklist Individual Strength (CIS20R) questionnaire.
I get little done.
7;6;5;4;3;2;1;
Yes, that is true;;;;;;No, that is not true;
Numeric Values
On the next page you find 20 statements. With these statements we wish to get an impression of how you have felt during the last two weeks. If you feel that this statement is entirely true, tick the left box. If you feel that this statement is not true at all, tick the right box. If you feel that this statement is neither "yes, that is true", nor "no, that is not true", tick the box that is most in accordance with how you have felt. Do not skip any statement and tick each statement only once.
Vercoulen JHMM et al. The measurement of fatigue in patients with multiple sclerosis: a multidimensional comparison with chronic fatigue syndrome and healthy subjects. Arch Neurol. 1996;53:642-9. Vercoulen JHMM, Alberts M, Bleijenberg G: De Checklist Individual Strength (CIS). Gedragstherapie 1999, 32:131-136. Beurskens AJ, Bultmann U, Kant I, Vercoulen J, Bleijenberg G, and Swaen G: Fatigue among working people: validity of a questionnaire measure. Occup Environ Med. 2000 May; 57(5): 353-357.
Adult
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Checklist for Individual Strength - Fatigue (CIS)
Fatigue
Outcomes and End Points
CIS20R Q17
 
Single Pre-Defined Value Selected
       
C11648
Checklist Individual Strength (CIS20R) - activity interest low scale
CIS20RActivityIntLowScale
Scale assessing the extent to which the following statement has been true for the participant during the last two weeks: I don't feel like doing anything. Part of the Checklist Individual Strength (CIS20R) questionnaire.
I don't feel like doing anything.
7;6;5;4;3;2;1;
Yes, that is true;;;;;;No, that is not true;
Numeric Values
On the next page you find 20 statements. With these statements we wish to get an impression of how you have felt during the last two weeks. If you feel that this statement is entirely true, tick the left box. If you feel that this statement is not true at all, tick the right box. If you feel that this statement is neither "yes, that is true", nor "no, that is not true", tick the box that is most in accordance with how you have felt. Do not skip any statement and tick each statement only once.
Vercoulen JHMM et al. The measurement of fatigue in patients with multiple sclerosis: a multidimensional comparison with chronic fatigue syndrome and healthy subjects. Arch Neurol. 1996;53:642-9. Vercoulen JHMM, Alberts M, Bleijenberg G: De Checklist Individual Strength (CIS). Gedragstherapie 1999, 32:131-136. Beurskens AJ, Bultmann U, Kant I, Vercoulen J, Bleijenberg G, and Swaen G: Fatigue among working people: validity of a questionnaire measure. Occup Environ Med. 2000 May; 57(5): 353-357.
Adult
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Checklist for Individual Strength - Fatigue (CIS)
Fatigue
Outcomes and End Points
CIS20R Q18
 
Single Pre-Defined Value Selected
       
C11649
Checklist Individual Strength (CIS20R) - thought wander easily scale
CIS20RThtWandEsyScale
Scale assessing the extent to which the following statement has been true for the participant during the last two weeks: My thoughts easily wander. Part of the Checklist Individual Strength (CIS20R) questionnaire.
My thouhgts easily wander.
7;6;5;4;3;2;1;
Yes, that is true;;;;;;No, that is not true;
Numeric Values
On the next page you find 20 statements. With these statements we wish to get an impression of how you have felt during the last two weeks. If you feel that this statement is entirely true, tick the left box. If you feel that this statement is not true at all, tick the right box. If you feel that this statement is neither "yes, that is true", nor "no, that is not true", tick the box that is most in accordance with how you have felt. Do not skip any statement and tick each statement only once.
Vercoulen JHMM et al. The measurement of fatigue in patients with multiple sclerosis: a multidimensional comparison with chronic fatigue syndrome and healthy subjects. Arch Neurol. 1996;53:642-9. Vercoulen JHMM, Alberts M, Bleijenberg G: De Checklist Individual Strength (CIS). Gedragstherapie 1999, 32:131-136. Beurskens AJ, Bultmann U, Kant I, Vercoulen J, Bleijenberg G, and Swaen G: Fatigue among working people: validity of a questionnaire measure. Occup Environ Med. 2000 May; 57(5): 353-357.
Adult
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Checklist for Individual Strength - Fatigue (CIS)
Fatigue
Outcomes and End Points
CIS20R Q19
 
Single Pre-Defined Value Selected
       
C11650
Checklist Individual Strength (CIS20R) - physical condition excellent feeling scale
CIS20RPhysCondExcelFeelScale
Scale assessing the extent to which the following statement has been true for the participant during the last two weeks: Physically I feel I am in excellent condition. Part of the Checklist Individual Strength (CIS20R) questionnaire.
Physically I feel I am in excellent condition.
1;2;3;4;5;6;7;
Yes, that is true;;;;;;No, that is not true;
Numeric Values
On the next page you find 20 statements. With these statements we wish to get an impression of how you have felt during the last two weeks. If you feel that this statement is entirely true, tick the left box. If you feel that this statement is not true at all, tick the right box. If you feel that this statement is neither "yes, that is true", nor "no, that is not true", tick the box that is most in accordance with how you have felt. Do not skip any statement and tick each statement only once.
Vercoulen JHMM et al. The measurement of fatigue in patients with multiple sclerosis: a multidimensional comparison with chronic fatigue syndrome and healthy subjects. Arch Neurol. 1996;53:642-9. Vercoulen JHMM, Alberts M, Bleijenberg G: De Checklist Individual Strength (CIS). Gedragstherapie 1999, 32:131-136. Beurskens AJ, Bultmann U, Kant I, Vercoulen J, Bleijenberg G, and Swaen G: Fatigue among working people: validity of a questionnaire measure. Occup Environ Med. 2000 May; 57(5): 353-357.
Adult
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Checklist for Individual Strength - Fatigue (CIS)
Fatigue
Outcomes and End Points
CIS20R Q20
 
Single Pre-Defined Value Selected
       
C11651
Checklist Individual Strength (CIS20R) - subjective fatigue total score
CIS20RSubFatigeTotScore
Sum of items 1, 4, 6, 9, 12, 14,16, and 20 (range 8-56). Part of the Checklist Individual Strength (CIS20R) questionnaire.
subscale 1: CIS-Subjective Fatigue
  
Numeric Values
The subscales are calculatede by summing the scores of the items: 1, 4, 6, 9, 12, 14,16, and 20 (range 8-56)
Vercoulen JHMM et al. The measurement of fatigue in patients with multiple sclerosis: a multidimensional comparison with chronic fatigue syndrome and healthy subjects. Arch Neurol. 1996;53:642-9. Vercoulen JHMM, Alberts M, Bleijenberg G: De Checklist Individual Strength (CIS). Gedragstherapie 1999, 32:131-136. Beurskens AJ, Bultmann U, Kant I, Vercoulen J, Bleijenberg G, and Swaen G: Fatigue among working people: validity of a questionnaire measure. Occup Environ Med. 2000 May; 57(5): 353-357.
Adult
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Checklist for Individual Strength - Fatigue (CIS)
Fatigue
Outcomes and End Points
CIS20R Subjective Fatigue Total
 
Free-Form Entry
       
C11652
Checklist Individual Strength (CIS20R) - concentration total score
CIS20RConcenTotScore
Sum of items 3, 8, 11, 13, 19 (range 5-35). Part of the Checklist Individual Strength (CIS20R) questionnaire.
subscale 2: CIS-Concentration
  
Numeric Values
The subscales are calculated by summing the scores of the items: 3, 8, 11, 13, 19 (range 5-35)
Vercoulen JHMM et al. The measurement of fatigue in patients with multiple sclerosis: a multidimensional comparison with chronic fatigue syndrome and healthy subjects. Arch Neurol. 1996;53:642-9. Vercoulen JHMM, Alberts M, Bleijenberg G: De Checklist Individual Strength (CIS). Gedragstherapie 1999, 32:131-136. Beurskens AJ, Bultmann U, Kant I, Vercoulen J, Bleijenberg G, and Swaen G: Fatigue among working people: validity of a questionnaire measure. Occup Environ Med. 2000 May; 57(5): 353-357.
Adult
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Checklist for Individual Strength - Fatigue (CIS)
Fatigue
Outcomes and End Points
CIS20R Concentration Total
 
Free-Form Entry
       
C11653
Checklist Individual Strength (CIS20R) - motivation total score
CIS20RMotivnTotScore
Sum of items 2, 5, 15, 18 (range 4-28). Part of the Checklist Individual Strength (CIS20R) questionnaire.
subscale 3: CIS-Motivation
  
Numeric Values
The subscales are calculated by summing the scores of the items: 2, 5, 15, 18 (range 4-28)
Vercoulen JHMM et al. The measurement of fatigue in patients with multiple sclerosis: a multidimensional comparison with chronic fatigue syndrome and healthy subjects. Arch Neurol. 1996;53:642-9. Vercoulen JHMM, Alberts M, Bleijenberg G: De Checklist Individual Strength (CIS). Gedragstherapie 1999, 32:131-136. Beurskens AJ, Bultmann U, Kant I, Vercoulen J, Bleijenberg G, and Swaen G: Fatigue among working people: validity of a questionnaire measure. Occup Environ Med. 2000 May; 57(5): 353-357.
Adult
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Checklist for Individual Strength - Fatigue (CIS)
Fatigue
Outcomes and End Points
CIS20R Motivation Total
 
Free-Form Entry
       
C11654
Checklist Individual Strength (CIS20R) - activity total score
CIS20RActvTotScore
Sum of items 7, 10, 17 (range 3-21). Part of the Checklist Individual Strength (CIS20R) questionnaire.
subscale 4: CIS-Activity
  
Numeric Values
The subscales are calculated by summing the scores of the items: 7, 10, 17 (range 3-21)
Vercoulen JHMM et al. The measurement of fatigue in patients with multiple sclerosis: a multidimensional comparison with chronic fatigue syndrome and healthy subjects. Arch Neurol. 1996;53:642-9. Vercoulen JHMM, Alberts M, Bleijenberg G: De Checklist Individual Strength (CIS). Gedragstherapie 1999, 32:131-136. Beurskens AJ, Bultmann U, Kant I, Vercoulen J, Bleijenberg G, and Swaen G: Fatigue among working people: validity of a questionnaire measure. Occup Environ Med. 2000 May; 57(5): 353-357.
Adult
Supplemental
3.0
7/22/2013
Aliases for variable name not defined
Checklist for Individual Strength - Fatigue (CIS)
Fatigue
Outcomes and End Points
CIS20R Activity Total
 
Free-Form Entry
       
12-14-2018
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