CDE Detailed Report

Disease: Multiple Sclerosis
Sub-Domain: Activities of Daily Living/Performance
CRF: Fatigue Severity Scale (FSS)

Displaying 1 - 10 of 10
CDE ID CDE Name Variable Name Definition Short Description Additional Notes (Question Text) Permissible Values Description Data Type Disease Specific Instructions Disease Specific Reference Population Classification (e.g., Core) Version Number Version Date CRF Name (CRF Module / Guideline) Sub Domain Name Domain Name Size Input Restrictions Min Value Max Value Measurement Type External Id Loinc External Id Snomed External Id caDSR External Id CDISC
C09647 Fatigue Severity Scale (FSS) - interfere work family social scale FSSIntrfreWrkFmlySoclScale Scale used to describe the extent to which fatigue interferes with the patient's work, family, or social life, as part of the Fatigue Severity Scale (FSS) Scale used to describe the extent to which fatigue interferes with the patient's work, family, or social life, as part of the Fatigue Severity Scale (FSS) Fatigue interferes in my work, family, or social life 1;2;3;4;5;6;7 1(Strong Disagreement);2;3;4;5;6;7(Strong Agreement) Numeric Values

Read each statement and circle a number from 1 to 7, based on how accurately it reflects your condition during the past week and the extent to which you agree or disagree that the statement applies to you. • A low value (e.g., 1) indicates strong disagreement with the statement, whereas a high value (e.g., 7) indicates strong agreement. • It is important that you circle a number (1 to 7) for every question.

Lauren B. Krupp; Nicholas G. LaRocca; Joanne Muir-Nash; Alfred D. Steinberg The Fatigue Severity Scale: Application to Patients With Multiple Sclerosis and Systemic Lupus Erythematosus. Arch Neurol. 1989;46(10):1121-1123. Friedman, JH (Friedman, Joseph H.); Alves, G (Alves, Guido); Hagell, P (Hagell, Peter); Marinus, J (Marinus, Johan); Marsh, L (Marsh, Laura); Martinez-Martin, P (Martinez-Martin, Pablo); Goetz, CG (Goetz, Christopher G.); Poewe, W (Poewe, Werner); Rascol, O (Rascol, Olivier); Sampaio, C (Sampaio, Cristina); Stebbins, G (Stebbins, Glenn); Schrag, A (Schrag, Anette) Fatigue Rating Scales Critique and Recommendations by the Movement Disorders Society Task Force on Rating Scales for Parkinson's Disease MOVEMENT DISORDERS, 25 (7): 805-822 MAY 15 2010 Adult Supplemental 3.00 2013-07-22 16:57:17.79 Fatigue Severity Scale (FSS) Activities of Daily Living/Performance Outcomes and End Points

Single Pre-Defined Value Selected

C10477 Fatigue Severity Scale (FSS) - total score FSSTotlScore Score calculated by adding all scale values, as part of the Fatigue Severity Scale (FSS) Score calculated by adding all scale values, as part of the Fatigue Severity Scale (FSS) Total Score Numeric Values

Scoring your results Now that you have completed the questionnaire, it is time to score your results and evaluate your level of fatigue. It's simple: Add all the numbers you circled to get your total score. The Fatigue Severity Scale Key A total score of less than 36 suggests that you may not be suffering from fatigue. A total score of 36 or more suggests that you may need further evaluation by a physician. Your next steps This scale should not be used to make your own diagnosis. If your score is 36 or more, please share this information with your physician. Be sure to describe all your symptoms as clearly as possible to aid in your diagnosis and treatment.

Lauren B. Krupp; Nicholas G. LaRocca; Joanne Muir-Nash; Alfred D. Steinberg The Fatigue Severity Scale: Application to Patients With Multiple Sclerosis and Systemic Lupus Erythematosus. Arch Neurol. 1989;46(10):1121-1123. Friedman, JH (Friedman, Joseph H.); Alves, G (Alves, Guido); Hagell, P (Hagell, Peter); Marinus, J (Marinus, Johan); Marsh, L (Marsh, Laura); Martinez-Martin, P (Martinez-Martin, Pablo); Goetz, CG (Goetz, Christopher G.); Poewe, W (Poewe, Werner); Rascol, O (Rascol, Olivier); Sampaio, C (Sampaio, Cristina); Stebbins, G (Stebbins, Glenn); Schrag, A (Schrag, Anette) Fatigue Rating Scales Critique and Recommendations by the Movement Disorders Society Task Force on Rating Scales for Parkinson's Disease MOVEMENT DISORDERS, 25 (7): 805-822 MAY 15 2010 Adult Supplemental 3.00 2013-07-22 16:57:17.79 Fatigue Severity Scale (FSS) Activities of Daily Living/Performance Outcomes and End Points

Free-Form Entry

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C09639 Fatigue Severity Scale (FSS) - low motivation scale FSSLowMotvtnScale Scale used to describe the extent to which the patient's motivation was lower in the past week, as part of the Fatigue Severity Scale (FSS) Scale used to describe the extent to which the patient's motivation was lower in the past week, as part of the Fatigue Severity Scale (FSS) My motivation is lower when I am fatigued 1;2;3;4;5;6;7 1 - strong disagreement;;;;;;7 - strong agreement Numeric Values

Read each statement and circle a number from 1 to 7, based on how accurately it reflects your condition during the past week and the extent to which you agree or disagree that the statement applies to you. • A low value (e.g., 1) indicates strong disagreement with the statement, whereas a high value (e.g., 7) indicates strong agreement. • It is important that you circle a number (1 to 7) for every question.

Lauren B. Krupp; Nicholas G. LaRocca; Joanne Muir-Nash; Alfred D. Steinberg The Fatigue Severity Scale: Application to Patients With Multiple Sclerosis and Systemic Lupus Erythematosus. Arch Neurol. 1989;46(10):1121-1123. Friedman, JH (Friedman, Joseph H.); Alves, G (Alves, Guido); Hagell, P (Hagell, Peter); Marinus, J (Marinus, Johan); Marsh, L (Marsh, Laura); Martinez-Martin, P (Martinez-Martin, Pablo); Goetz, CG (Goetz, Christopher G.); Poewe, W (Poewe, Werner); Rascol, O (Rascol, Olivier); Sampaio, C (Sampaio, Cristina); Stebbins, G (Stebbins, Glenn); Schrag, A (Schrag, Anette) Fatigue Rating Scales Critique and Recommendations by the Movement Disorders Society Task Force on Rating Scales for Parkinson's Disease MOVEMENT DISORDERS, 25 (7): 805-822 MAY 15 2010 Adult Supplemental 3.00 2013-07-22 16:57:17.79 Fatigue Severity Scale (FSS) Activities of Daily Living/Performance Outcomes and End Points

Single Pre-Defined Value Selected

C09640 Fatigue Severity Scale (FSS) - exercise fatigue scale FSSExrcsFatgScale Scale used to describe the extent to which exercise brought on the patient's fatigue in the past week, as part of the Fatigue Severity Scale (FSS) Scale used to describe the extent to which exercise brought on the patient's fatigue in the past week, as part of the Fatigue Severity Scale (FSS) Exercise brings on my fatigue 1;2;3;4;5;6;7 1 - strong disagreement;;;;;;7 - strong agreement Numeric Values

Read each statement and circle a number from 1 to 7, based on how accurately it reflects your condition during the past week and the extent to which you agree or disagree that the statement applies to you. • A low value (e.g., 1) indicates strong disagreement with the statement, whereas a high value (e.g., 7) indicates strong agreement. • It is important that you circle a number (1 to 7) for every question.

Lauren B. Krupp; Nicholas G. LaRocca; Joanne Muir-Nash; Alfred D. Steinberg The Fatigue Severity Scale: Application to Patients With Multiple Sclerosis and Systemic Lupus Erythematosus. Arch Neurol. 1989;46(10):1121-1123. Friedman, JH (Friedman, Joseph H.); Alves, G (Alves, Guido); Hagell, P (Hagell, Peter); Marinus, J (Marinus, Johan); Marsh, L (Marsh, Laura); Martinez-Martin, P (Martinez-Martin, Pablo); Goetz, CG (Goetz, Christopher G.); Poewe, W (Poewe, Werner); Rascol, O (Rascol, Olivier); Sampaio, C (Sampaio, Cristina); Stebbins, G (Stebbins, Glenn); Schrag, A (Schrag, Anette) Fatigue Rating Scales Critique and Recommendations by the Movement Disorders Society Task Force on Rating Scales for Parkinson's Disease MOVEMENT DISORDERS, 25 (7): 805-822 MAY 15 2010 Adult Supplemental 3.00 2013-07-22 16:57:17.79 Fatigue Severity Scale (FSS) Activities of Daily Living/Performance Outcomes and End Points

Single Pre-Defined Value Selected

C09641 Fatigue Severity Scale (FSS) - easy fatigue scale FSSEasyFatgScale Scale used to describe the extent to which the patient was easily fatigued in the past week, as part of the Fatigue Severity Scale (FSS) Scale used to describe the extent to which the patient was easily fatigued in the past week, as part of the Fatigue Severity Scale (FSS) I am easily fatigued 1;2;3;4;5;6;7 1 - strong disagreement;;;;;;7 - strong agreement Numeric Values

Read each statement and circle a number from 1 to 7, based on how accurately it reflects your condition during the past week and the extent to which you agree or disagree that the statement applies to you. • A low value (e.g., 1) indicates strong disagreement with the statement, whereas a high value (e.g., 7) indicates strong agreement. • It is important that you circle a number (1 to 7) for every question.

Lauren B. Krupp; Nicholas G. LaRocca; Joanne Muir-Nash; Alfred D. Steinberg The Fatigue Severity Scale: Application to Patients With Multiple Sclerosis and Systemic Lupus Erythematosus. Arch Neurol. 1989;46(10):1121-1123. Friedman, JH (Friedman, Joseph H.); Alves, G (Alves, Guido); Hagell, P (Hagell, Peter); Marinus, J (Marinus, Johan); Marsh, L (Marsh, Laura); Martinez-Martin, P (Martinez-Martin, Pablo); Goetz, CG (Goetz, Christopher G.); Poewe, W (Poewe, Werner); Rascol, O (Rascol, Olivier); Sampaio, C (Sampaio, Cristina); Stebbins, G (Stebbins, Glenn); Schrag, A (Schrag, Anette) Fatigue Rating Scales Critique and Recommendations by the Movement Disorders Society Task Force on Rating Scales for Parkinson's Disease MOVEMENT DISORDERS, 25 (7): 805-822 MAY 15 2010 Adult Supplemental 3.00 2013-07-22 16:57:17.79 Fatigue Severity Scale (FSS) Activities of Daily Living/Performance Outcomes and End Points

Single Pre-Defined Value Selected

C09642 Fatigue Severity Scale (FSS) - interfere physical function scale FSSIntrfrePhysclFunctScale Scale used to describe the extent to which fatigue interfered with the patient's physical functioning in the past week, as part of the Fatigue Severity Scale (FSS) Scale used to describe the extent to which fatigue interfered with the patient's physical functioning in the past week, as part of the Fatigue Severity Scale (FSS) Fatigue interferes with my physical functioning 1;2;3;4;5;6;7 1 - strong disagreement;;;;;;7 - strong agreement Numeric Values

Read each statement and circle a number from 1 to 7, based on how accurately it reflects your condition during the past week and the extent to which you agree or disagree that the statement applies to you. • A low value (e.g., 1) indicates strong disagreement with the statement, whereas a high value (e.g., 7) indicates strong agreement. • It is important that you circle a number (1 to 7) for every question.

Lauren B. Krupp; Nicholas G. LaRocca; Joanne Muir-Nash; Alfred D. Steinberg The Fatigue Severity Scale: Application to Patients With Multiple Sclerosis and Systemic Lupus Erythematosus. Arch Neurol. 1989;46(10):1121-1123. Friedman, JH (Friedman, Joseph H.); Alves, G (Alves, Guido); Hagell, P (Hagell, Peter); Marinus, J (Marinus, Johan); Marsh, L (Marsh, Laura); Martinez-Martin, P (Martinez-Martin, Pablo); Goetz, CG (Goetz, Christopher G.); Poewe, W (Poewe, Werner); Rascol, O (Rascol, Olivier); Sampaio, C (Sampaio, Cristina); Stebbins, G (Stebbins, Glenn); Schrag, A (Schrag, Anette) Fatigue Rating Scales Critique and Recommendations by the Movement Disorders Society Task Force on Rating Scales for Parkinson's Disease MOVEMENT DISORDERS, 25 (7): 805-822 MAY 15 2010 Adult Supplemental 3.00 2013-07-22 16:57:17.79 Fatigue Severity Scale (FSS) Activities of Daily Living/Performance Outcomes and End Points

Single Pre-Defined Value Selected

C09643 Fatigue Severity Scale (FSS) - frequent problem scale FSSFreqPrblmScale Scale used to describe the extent to which fatigue caused frequent problems for the patient in the past week, as part of the Fatigue Severity Scale (FSS) Scale used to describe the extent to which fatigue caused frequent problems for the patient in the past week, as part of the Fatigue Severity Scale (FSS) Fatigue causes frequent problems for me 1;2;3;4;5;6;7 1 - strong disagreement;;;;;;7 - strong agreement Numeric Values

Read each statement and circle a number from 1 to 7, based on how accurately it reflects your condition during the past week and the extent to which you agree or disagree that the statement applies to you. • A low value (e.g., 1) indicates strong disagreement with the statement, whereas a high value (e.g., 7) indicates strong agreement. • It is important that you circle a number (1 to 7) for every question.

Lauren B. Krupp; Nicholas G. LaRocca; Joanne Muir-Nash; Alfred D. Steinberg The Fatigue Severity Scale: Application to Patients With Multiple Sclerosis and Systemic Lupus Erythematosus. Arch Neurol. 1989;46(10):1121-1123. Friedman, JH (Friedman, Joseph H.); Alves, G (Alves, Guido); Hagell, P (Hagell, Peter); Marinus, J (Marinus, Johan); Marsh, L (Marsh, Laura); Martinez-Martin, P (Martinez-Martin, Pablo); Goetz, CG (Goetz, Christopher G.); Poewe, W (Poewe, Werner); Rascol, O (Rascol, Olivier); Sampaio, C (Sampaio, Cristina); Stebbins, G (Stebbins, Glenn); Schrag, A (Schrag, Anette) Fatigue Rating Scales Critique and Recommendations by the Movement Disorders Society Task Force on Rating Scales for Parkinson's Disease MOVEMENT DISORDERS, 25 (7): 805-822 MAY 15 2010 Adult Supplemental 3.00 2013-07-22 16:57:17.79 Fatigue Severity Scale (FSS) Activities of Daily Living/Performance Outcomes and End Points

Single Pre-Defined Value Selected

C09644 Fatigue Severity Scale (FSS) - prevent sustain physical function scale FSSPrvntPhysclFunctScale Scale used to describe the extent to which fatigue prevented the patient's sustained physical functioning in the past week, as part of the Fatigue Severity Scale (FSS) Scale used to describe the extent to which fatigue prevented the patient's sustained physical functioning in the past week, as part of the Fatigue Severity Scale (FSS) Fatigue prevents sustained physical functioning 1;2;3;4;5;6;7 1 - strong disagreement;;;;;;7 - strong agreement Numeric Values

Read each statement and circle a number from 1 to 7, based on how accurately it reflects your condition during the past week and the extent to which you agree or disagree that the statement applies to you. • A low value (e.g., 1) indicates strong disagreement with the statement, whereas a high value (e.g., 7) indicates strong agreement. • It is important that you circle a number (1 to 7) for every question.

Lauren B. Krupp; Nicholas G. LaRocca; Joanne Muir-Nash; Alfred D. Steinberg The Fatigue Severity Scale: Application to Patients With Multiple Sclerosis and Systemic Lupus Erythematosus. Arch Neurol. 1989;46(10):1121-1123. Friedman, JH (Friedman, Joseph H.); Alves, G (Alves, Guido); Hagell, P (Hagell, Peter); Marinus, J (Marinus, Johan); Marsh, L (Marsh, Laura); Martinez-Martin, P (Martinez-Martin, Pablo); Goetz, CG (Goetz, Christopher G.); Poewe, W (Poewe, Werner); Rascol, O (Rascol, Olivier); Sampaio, C (Sampaio, Cristina); Stebbins, G (Stebbins, Glenn); Schrag, A (Schrag, Anette) Fatigue Rating Scales Critique and Recommendations by the Movement Disorders Society Task Force on Rating Scales for Parkinson's Disease MOVEMENT DISORDERS, 25 (7): 805-822 MAY 15 2010 Adult Supplemental 3.00 2013-07-22 16:57:17.79 Fatigue Severity Scale (FSS) Activities of Daily Living/Performance Outcomes and End Points

Single Pre-Defined Value Selected

C09645 Fatigue Severity Scale (FSS) - interfere duty responsibility scale FSSIntrfreDutyRespnsbltyScale Scale used to describe the extent to which fatigue interfered with the patient's ability to carry out certain duties and responsibilities, as part of the Fatigue Severity Scale (FSS) Scale used to describe the extent to which fatigue interfered with the patient's ability to carry out certain duties and responsibilities, as part of the Fatigue Severity Scale (FSS) Fatigue interferes with carrying out certain duties and responsibilities 1;2;3;4;5;6;7 1 - strong disagreement;;;;;;7 - strong agreement Numeric Values

Read each statement and circle a number from 1 to 7, based on how accurately it reflects your condition during the past week and the extent to which you agree or disagree that the statement applies to you. • A low value (e.g., 1) indicates strong disagreement with the statement, whereas a high value (e.g., 7) indicates strong agreement. • It is important that you circle a number (1 to 7) for every question.

Lauren B. Krupp; Nicholas G. LaRocca; Joanne Muir-Nash; Alfred D. Steinberg The Fatigue Severity Scale: Application to Patients With Multiple Sclerosis and Systemic Lupus Erythematosus. Arch Neurol. 1989;46(10):1121-1123. Friedman, JH (Friedman, Joseph H.); Alves, G (Alves, Guido); Hagell, P (Hagell, Peter); Marinus, J (Marinus, Johan); Marsh, L (Marsh, Laura); Martinez-Martin, P (Martinez-Martin, Pablo); Goetz, CG (Goetz, Christopher G.); Poewe, W (Poewe, Werner); Rascol, O (Rascol, Olivier); Sampaio, C (Sampaio, Cristina); Stebbins, G (Stebbins, Glenn); Schrag, A (Schrag, Anette) Fatigue Rating Scales Critique and Recommendations by the Movement Disorders Society Task Force on Rating Scales for Parkinson's Disease MOVEMENT DISORDERS, 25 (7): 805-822 MAY 15 2010 Adult Supplemental 3.00 2013-07-22 16:57:17.79 Fatigue Severity Scale (FSS) Activities of Daily Living/Performance Outcomes and End Points

Single Pre-Defined Value Selected

C09646 Fatigue Severity Scale (FSS) - top 3 disable symptom scale FSSTop3DisblSympScale Scale used to describe the extent to which fatigue is among the patient's three most disabling symptoms, as part of the Fatigue Severity Scale (FSS) Scale used to describe the extent to which fatigue is among the patient's three most disabling symptoms, as part of the Fatigue Severity Scale (FSS) Fatigue is among my three most disabling symptoms 1;2;3;4;5;6;7 1 - strong disagreement;;;;;;7 - strong agreement Numeric Values

Read each statement and circle a number from 1 to 7, based on how accurately it reflects your condition during the past week and the extent to which you agree or disagree that the statement applies to you. • A low value (e.g., 1) indicates strong disagreement with the statement, whereas a high value (e.g., 7) indicates strong agreement. • It is important that you circle a number (1 to 7) for every question.

Lauren B. Krupp; Nicholas G. LaRocca; Joanne Muir-Nash; Alfred D. Steinberg The Fatigue Severity Scale: Application to Patients With Multiple Sclerosis and Systemic Lupus Erythematosus. Arch Neurol. 1989;46(10):1121-1123. Friedman, JH (Friedman, Joseph H.); Alves, G (Alves, Guido); Hagell, P (Hagell, Peter); Marinus, J (Marinus, Johan); Marsh, L (Marsh, Laura); Martinez-Martin, P (Martinez-Martin, Pablo); Goetz, CG (Goetz, Christopher G.); Poewe, W (Poewe, Werner); Rascol, O (Rascol, Olivier); Sampaio, C (Sampaio, Cristina); Stebbins, G (Stebbins, Glenn); Schrag, A (Schrag, Anette) Fatigue Rating Scales Critique and Recommendations by the Movement Disorders Society Task Force on Rating Scales for Parkinson's Disease MOVEMENT DISORDERS, 25 (7): 805-822 MAY 15 2010 Adult Supplemental 3.00 2013-07-22 16:57:17.79 Fatigue Severity Scale (FSS) Activities of Daily Living/Performance Outcomes and End Points

Single Pre-Defined Value Selected

CSV