CDE Detailed Report

Disease: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
Sub-Domain: Fatigue
CRF: Checklist for Individual Strength - Fatigue (CIS)

Displaying 1 - 24 of 24
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
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. 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 3.00 2013-07-22 16:57:17.79 Checklist for Individual Strength - Fatigue (CIS) Fatigue Outcomes and End Points

Single Pre-Defined Value Selected

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. 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 3.00 2013-07-22 16:57:17.79 Checklist for Individual Strength - Fatigue (CIS) Fatigue Outcomes and End Points

Free-Form Entry

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. 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 3.00 2013-07-22 16:57:17.79 Checklist for Individual Strength - Fatigue (CIS) Fatigue Outcomes and End Points

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. 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 3.00 2013-07-22 16:57:17.79 Checklist for Individual Strength - Fatigue (CIS) Fatigue Outcomes and End Points

Single Pre-Defined Value Selected

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. 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 3.00 2013-07-22 16:57:17.79 Checklist for Individual Strength - Fatigue (CIS) Fatigue Outcomes and End Points

Free-Form Entry

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. 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 3.00 2013-07-22 16:57:17.79 Checklist for Individual Strength - Fatigue (CIS) Fatigue Outcomes and End Points

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. 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 3.00 2013-07-22 16:57:17.79 Checklist for Individual Strength - Fatigue (CIS) Fatigue Outcomes and End Points

Single Pre-Defined Value Selected

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. 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 3.00 2013-07-22 16:57:17.79 Checklist for Individual Strength - Fatigue (CIS) Fatigue Outcomes and End Points

Free-Form Entry

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. 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 3.00 2013-07-22 16:57:17.79 Checklist for Individual Strength - Fatigue (CIS) Fatigue Outcomes and End Points

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. 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 3.00 2013-07-22 16:57:17.79 Checklist for Individual Strength - Fatigue (CIS) Fatigue Outcomes and End Points

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. 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 3.00 2013-07-22 16:57:17.79 Checklist for Individual Strength - Fatigue (CIS) Fatigue Outcomes and End Points

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. 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 3.00 2013-07-22 16:57:17.79 Checklist for Individual Strength - Fatigue (CIS) Fatigue Outcomes and End Points

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. 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 3.00 2013-07-22 16:57:17.79 Checklist for Individual Strength - Fatigue (CIS) Fatigue Outcomes and End Points

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. 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 3.00 2013-07-22 16:57:17.79 Checklist for Individual Strength - Fatigue (CIS) Fatigue Outcomes and End Points

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. 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 3.00 2013-07-22 16:57:17.79 Checklist for Individual Strength - Fatigue (CIS) Fatigue Outcomes and End Points

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. 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 3.00 2013-07-22 16:57:17.79 Checklist for Individual Strength - Fatigue (CIS) Fatigue Outcomes and End Points

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. 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 3.00 2013-07-22 16:57:17.79 Checklist for Individual Strength - Fatigue (CIS) Fatigue Outcomes and End Points

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. 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 3.00 2013-07-22 16:57:17.79 Checklist for Individual Strength - Fatigue (CIS) Fatigue Outcomes and End Points

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. 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 3.00 2013-07-22 16:57:17.79 Checklist for Individual Strength - Fatigue (CIS) Fatigue Outcomes and End Points

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. 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 3.00 2013-07-22 16:57:17.79 Checklist for Individual Strength - Fatigue (CIS) Fatigue Outcomes and End Points

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. 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 3.00 2013-07-22 16:57:17.79 Checklist for Individual Strength - Fatigue (CIS) Fatigue Outcomes and End Points

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. 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 3.00 2013-07-22 16:57:17.79 Checklist for Individual Strength - Fatigue (CIS) Fatigue Outcomes and End Points

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. 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 3.00 2013-07-22 16:57:17.79 Checklist for Individual Strength - Fatigue (CIS) Fatigue Outcomes and End Points

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. 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 3.00 2013-07-22 16:57:17.79 Checklist for Individual Strength - Fatigue (CIS) Fatigue Outcomes and End Points

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