CDE Detailed Report

Disease: Multiple Sclerosis
Sub-Domain: Performance Measures
CRF: National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25)

Displaying 1 - 42 of 42
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
C14803 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - not driving reason NEIVFQNotDrvngRsn The reason giving up driving based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The reason giving up driving based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). Was that mainly because of your eyesight, mainly for some other reason, or because of both your eyesight and other reasons 1;2;3 mainly eyesight;mainly other reasons;both eyesight and other reasons Numeric values

Choose only one. Only answered if Gave Up is answered for Q15a. For all answers to this question, skip to Q17.

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14814 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - other assist scale NEIVFQIncOtherAssistScale The scale for other assistance based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale for other assistance based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). I need a lot of help from others because of my eyesight 1;2;3;4;5 Definitely true;Mostly true;not sure;Mostly false;Definitely false Numeric values

Choose only one.

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14825 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - assist others scale NEIVFQIncAssistScale The scale for needing help from others based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale for needing help from others based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). Do you have more help from others because of your vision 1;2;3;4;5 All of the time;Most of the time;Some of the time;A little of the time;None of the time Numeric values

Choose only one.

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14793 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - difficulty nearsightedness crowd scale NEIVFQDiffcltyCrwdScale The scale for difficulty nearsightedness for crowded shelf, from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale for difficulty nearsightedness for crowded shelf from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). Because of your eyesight, how much difficulty do you have finding something on a crowded shelf? 1;2;3;4;5;6 no difficulty at all;a little difficulty;moderate difficulty;extreme difficulty;stopped doing this because of your eyesight;stopped doing this for other reasons or not interested in doing this Numeric values

Choose only one

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14804 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - difficulty driving scale NEIVFQDffcltyDrvngScale The scale for difficulty driving based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale for difficulty driving based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). If currently driving: How much difficulty do you have driving during the daytime in familiar places? Would you say you have: 1;2;3;4 no difficulty at all;a little difficulty;moderate difficulty;extreme difficulty Numeric values

Choose only one.

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14815 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - embarrass scale NEIVFQEmbrssmntScale The scale for embarrassment based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale for embarrassment based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). I worry about doing things that will embarrass myself or others, because of my eyesight 1;2;3;4;5 Definitely true;Mostly true;not sure;Mostly false;Definitely false Numeric values

Choose only one.

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14826 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - limit activity scale NEIVFQLimitActvtyScale The scale for limit activities because of vision from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale for limit activities because of vision from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). Are you limited in the kinds of things you can do because of your vision 1;2;3;4;5 All of the time;Most of the time;Some of the time;A little of the time;None of the time Numeric values

Choose only one.

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14794 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - difficulty reading long distance scale NEIVFQDiffcltyScale The scale of for difficulty reading street signs based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale of for difficulty reading street signs based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). How much difficulty do you have reading street signs or the names of stores 1;2;3;4;5;6 no difficulty at all;a little difficulty;moderate difficulty;extreme difficulty;stopped doing this because of your eyesight;stopped doing this for other reasons or not interested in doing this Numeric values

Choose only one

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14805 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - difficulty night driving scale NEIVFQDffcltyNightDrvngScale The scale of difficulty in driving at night based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale of difficulty in driving at night based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). How much difficulty do you have driving at night? Would you say you have: 1;2;3;4;5;6 no difficulty at all;a little difficulty;moderate difficulty;extreme difficulty;have you stopped doing this because of your eyesight;have you stopped doing this for other reasons or not interested in doing this Numeric values

Choose only one.

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14816 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - overall health scale NEIVFQOvrlHlthScale The scale for overall health based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale for overall health based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). How would you rate your overall health, on a scale where zero is as bad as death and 10 is best possible health 0;1;2;3;4;5;6;7;8;9;10 worst;;;;;;;;;;best Numeric values

Choose only one. Use the scale of 0 = worst and 10 = best

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14827 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - irritability scale NEIVFQIrritabilityScale The scale for irritability based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale for irritability based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). I am often irritable because of my eyesight 1;2;3;4;5 Definitely true;Mostly true;not sure;Mostly false;Definitely false Numeric values

Choose only one.

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14795 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - difficulty stair climbing scale NEIVFQStairClimbScale The scale for difficulty stair climbing from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale for difficulty stair climbing from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). Because of your eyesight, how much difficulty do you have going down steps, stairs, or curbs in dim light or at night 1;2;3;4;5;6 no difficulty at all;a little difficulty;moderate difficulty;extreme difficulty;stopped doing this because of your eyesight;stopped doing this for other reasons or not interested in doing this Numeric values

Choose only one

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14806 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - difficulty driving bad weather scale NEIVFQDffcltyDrvngBadScale The scale of difficulty in driving bad weather based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale of difficulty in driving bad weather based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). How much difficulty do you have driving in difficult conditions, such as in bad weather, during rush hour, on the freeway, or in city traffic? Would you say you have: 1;2;3;4;5;6 no difficulty at all;a little difficulty;moderate difficulty;extreme difficulty;have you stopped doing this because of your eyesight;have you stopped doing this for other reasons or not interested in doing this Numeric values

Choose only one.

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14817 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - current eyesight scale NEIVFQCurrentEysghtScale The scale for current eyesight based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale for current eyesight based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). How would you rate your eyesight now (with glasses or contact lens on, if you wear them), on a scale of from 0 to 10, where zero means the worst possible eyesight, as bad or worse than being blind, and 10 means the best possible eyesight 0;1;2;3;4;5;6;7;8;9;10 worst;;;;;;;;;;best Numeric values

Choose only one. Use the scale of 0 = worst and 10 = best

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14828 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - home alone scale NEIVFQHomeAloneScale The scale for remaining home based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale for not leaving home alone based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). I don't go out of my home alone, because of my eyesight 1;2;3;4;5 Definitely true;Mostly true;not sure;Mostly false;Definitely false Numeric values

Choose only one.

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14796 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - difficulty side object scale NEIVFQDffcltySideObjScale The scale for difficulty side object from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale for difficulty side object from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). Because of your eyesight, how much difficulty do you have noticing objects off to the side while you are walking along 1;2;3;4;5;6 no difficulty at all;a little difficulty;moderate difficulty;extreme difficulty;stopped doing this because of your eyesight;stopped doing this for other reasons or not interested in doing this Numeric values

Choose only one

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14807 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - decrease function scale NEIVFQDecFuncScale The scale for accomplishing less because of your vision from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale for accomplishing less because of your vision from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). Do you accomplish less than you would like because of your vision 1;2;3;4;5 All of the time;Most of the time;Some of the time;A little of the time;None of the time Numeric values

Choose only one.

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14818 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - use difficulty reading scale NEIVFQUseDffcltyRdngScale The scale for difficulty reading based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale for difficulty reading based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). Wearing glasses, how much difficulty do you have reading the small print in a telephone book, on a medicine bottle, or on legal forms? Would you say: 1;2;3;4;5;6 no difficulty at all;a little difficulty;moderate difficulty;extreme difficulty;have you stopped doing this because of your eyesight;have you stopped doing this for other reasons or not interested in doing this Numeric values

Choose only one.

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14797 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - difficulty face reaction scale NEIVFQDffcltyFaceRctnScale The scale for difficulty face reaction from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale for difficulty face reaction from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). Because of your eyesight, how much difficulty do you have seeing how people react to things you say 1;2;3;4;5;6 no difficulty at all;a little difficulty;moderate difficulty;extreme difficulty;stopped doing this because of your eyesight;stopped doing this for other reasons or not interested in doing this Numeric values

Choose only one

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14808 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - limit work scale NEIVFQLimitTimeWorkScale The scale for limit in how long can work or do other activities because of vision from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale for limit in how long can work or do other activities because of vision from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). Are you limited in how long you can work or do other activities because of your vision 1;2;3;4;5 All of the time;Most of the time;Some of the time;A little of the time;None of the time Numeric values

Choose only one.

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14819 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - difficulty bill accuracy scale NEIVFQDffcltyBillAccScale The scale for difficulty determining bill accuracy, from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale for difficulty determining bill accuracy, from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). Because of your eyesight, how much difficulty do you have figuring out whether bills you receive are accurate 1;2;3;4;5;6 no difficulty at all;a little difficulty;moderate difficulty;extreme difficulty;have you stopped doing this because of your eyesight;have you stopped doing this for other reasons or not interested in doing this Numeric values

Choose only one.

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14787 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - general health scale NEIVFQGenScale The scale of general health as requested on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale of general health as requested on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). In general, would you say your overall health is 1;2;3;4;5 Excellent;Very good;Good;Fair;Poor Numeric values

Skip this question when the VFQ-25 is administered at the same time as the SF-36 or RAND 36-Item Health Survey 1.0. Choose only one.

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14798 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - difficulty matching clothes scale NEIVFQDffcltyMtchngScale The scale for difficulty finding matching clothing from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale for difficulty finding matching clothing from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). Because of your eyesight, how much difficulty do you have picking out and matching your own clothes 1;2;3;4;5;6 no difficulty at all;a little difficulty;moderate difficulty;extreme difficulty;stopped doing this because of your eyesight;stopped doing this for other reasons or not interested in doing this Numeric values

Choose only one

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14809 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - function scale NEIVslFuncngDffcltyPainFuncScl The scale of for difficulty function based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale of for difficulty function based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). How much does pain or discomfort in or around your eyes, for example, burning, itching, or aching, keep you from doing what you'd like to be doing? Would you say: 1;2;3;4;5 All of the time;Most of the time;Some of the time;A little of the time;None of the time Numeric values

Choose only one.

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14820 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - difficulty personal care scale NEIVFQDffcltyPersnlScale The scale for difficulty personal care from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale for difficulty personal care from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). Because of your eyesight, how much difficulty do you have doing things like shaving, styling your hair, or putting on makeup 1;2;3;4;5;6 no difficulty at all;a little difficulty;moderate difficulty;extreme difficulty;have you stopped doing this because of your eyesight;have you stopped doing this for other reasons or not interested in doing this Numeric values

Choose only one.

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14788 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - overall eye scale NEIVFQOvrlScale The scale for overall assessment of eye from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale for overall assessment of eye from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). At the present time, would you say your eyesight using both eyes (with glasses or contact lenses, if you wear them) is excellent, good, fair, poor, or very poor or are you completely blind 6;2;3;4;5;1 completely blind;Good;Fair;Poor;Very Poor;Excellent Numeric values

Choose only one

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14799 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - difficulty visit people scale NEIVFQDffcltyVisitPplScale The scale for difficulty visiting others from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale for difficulty visiting others from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). Because of your eyesight, how much difficulty do you have visiting with people in their homes, at parties, or in restaurants 1;2;3;4;5;6 no difficulty at all;a little difficulty;moderate difficulty;extreme difficulty;stopped doing this because of your eyesight;stopped doing this for other reasons or not interested in doing this Numeric values

Choose only one

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14810 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - remain home scale NEIVFQRemainHomeScale The scale for remaining home because of eyesight based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale for remaining home because of eyesight based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). I stay home most of the time because of my eyesight 1;2;3;4;5 Definitely true;Mostly true;not sure;Mostly false;Definitely false Numeric values

Choose only one.

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14821 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - difficulty recognize others scale NEIVFQDffcltyOthScale The scale for difficulty recognizing others from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale for difficulty recognizing others from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). Because of your eyesight, how much difficulty do you have recognizing people you know from across a room 1;2;3;4;5;6 no difficulty at all;a little difficulty;moderate difficulty;extreme difficulty;have you stopped doing this because of your eyesight;have you stopped doing this for other reasons or not interested in doing this Numeric values

Choose only one.

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14789 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - worry scale NEIVFQWorryScale The scale for worrying based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale for worrying based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). How much of the time do you worry about your eyesight 1;2;3;4;5 None of the time;A little of the time;Some of the time;Most of the time;All of the time Numeric values

Choose only one

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14800 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - difficulty attend event scale NEIVFQDffcltyEvntsScale The scale for difficulty do going out to see movies, plays, or sports events from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale for difficulty do going out to see movies, plays, or sports events from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). Because of your eyesight, how much difficulty do you have going out to see movies, plays, or sports events 1;2;3;4;5;6 no difficulty at all;a little difficulty;moderate difficulty;extreme difficulty;stopped doing this because of your eyesight;stopped doing this for other reasons or not interested in doing this Numeric values

Choose only one

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14811 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - frustrated scale NEIVFQFrstnScale The scale for frustration based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale for frustration based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). I feel frustrated a lot of the time because of my eyesight 1;2;3;4;5 Definitely true;Mostly true;not sure;Mostly false;Definitely false Numeric values

Choose only one.

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14822 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - difficulty outdoor activity scale NEIVFQDffcltyrActvtyScale The scale for difficulty outdoor activity from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale for difficulty outdoor activity from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). Because of your eyesight, how much difficulty do you have taking part in active sports or other outdoor activities that you enjoy (like golf, bowling, jogging, or walking) 1;2;3;4;5;6 no difficulty at all;a little difficulty;moderate difficulty;extreme difficulty;have you stopped doing this because of your eyesight;have you stopped doing this for other reasons or not interested in doing this Numeric values

Choose only one.

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14790 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - pain scale NEIVFQPainScale The scale for pain based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale for pain based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). How much pain or discomfort have you had in and around your eyes (for example, burning, itching, or aching)? Would you say it is: 1;2;3;4;5 None;mild;Moderate;severe;very severe Numeric values

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Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14801 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - driving indicator NEIVFQDrvngInd The indicator for currently driving from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The indicator for currently driving from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). Are you currently driving, at least once in a while 1;2 Yes;No Numeric values

Choose only one. If Yes is answered, skip to Q15c

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14812 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - decrease control life scale NEIVFQDecCentrlLifeScale The scale for decrease control over life based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale for decrease control over life based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). I have much less control over what I do, because of my eyesight 1;2;3;4;5 Definitely true;Mostly true;not sure;Mostly false;Definitely false Numeric values

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Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14823 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - difficulty indoor activity scale NEIVFQDffcltyIndrActvtyScale The scale for difficulty indoor activity from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale for difficulty indoor activity from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). Because of your eyesight, how much difficulty do you have seeing and enjoying programs on TV 1;2;3;4;5;6 no difficulty at all;a little difficulty;moderate difficulty;extreme difficulty;have you stopped doing this because of your eyesight;have you stopped doing this for other reasons or not interested in doing this Numeric values

Choose only one.

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14791 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - difficulty reading close scale NEIVFQDiffcltyRdngScale The scale of for difficulty reading close based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale of for difficulty reading close based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). How much difficulty do you have reading ordinary print in newspapers? Would you say you have: 1;2;3;4;5;6 no difficulty at all;a little difficulty;moderate difficulty;extreme difficulty;stopped doing this because of your eyesight;stopped doing this for other reasons or not interested in doing this Numeric values

Choose only one

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14802 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - not driving indicator NEIVFQNotDrvngInd The indicator for ever driven car based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The indicator for ever driven car based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). If no, have you never driven a car or have you given up driving? 1;2 never drove;gave up Numeric values

Choose only one. Only answered if No is answered for Q15. If Never drove is answered for this question, skip to Q17

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14813 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - increase dependence others scale NEIVFQIncDepndceOthScale The scale for increased dependence on others from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale for increased dependence on others from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). Because of my eyesight, I have to rely too much on what other people tell me 1;2;3;4;5 Definitely true;Mostly true;not sure;Mostly false;Definitely false Numeric values

Choose only one.

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14824 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - difficulty entertain scale NEIVFQDiffEntScale The scale for difficulty finding something on crowded shelf from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale for difficulty finding something on crowded shelf from the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). Because of your eyesight, how much difficulty do you have entertaining friends and family in your home 1;2;3;4;5;6 no difficulty at all;a little difficulty;moderate difficulty;extreme difficulty;have you stopped doing this because of your eyesight;have you stopped doing this for other reasons or not interested in doing this Numeric values

Choose only one.

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

C14792 National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) - difficulty hobbies scale NEIVFQDiffcltyHobScale The scale of difficult in hobbies based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The scale of difficult in hobbies based on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). How much difficulty do you have doing work or hobbies that require you to see well up close, such as cooking, sewing, fixing things around the house, or using hand tools? Would you say: 1;2;3;4;5;6 no difficulty at all;a little difficulty;moderate difficulty;extreme difficulty;stopped doing this because of your eyesight;stopped doing this for other reasons or not interested in doing this Numeric values

Choose only one

Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058. Adult Supplemental 3.00 2013-06-11 00:00:00.0 National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25) Performance Measures Outcomes and End Points

Single Pre-Defined Value Selected

CSV