CDE Detailed Report
Subdomain Name: Fatigue
CRF: welcome
Displaying 1 - 24 of 24
| CDE ID | CDE Name | Variable Name | Definition | Short Description | 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 / Guidance) | Subdomain Name | Domain Name | Size | Input Restrictions | Min Value | Max Value | Measurement Type | External Id Loinc | External Id Snomed | External Id caDSR | External Id CDISC |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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) questionnair | 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 |
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| 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) questionnair | 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 |
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| 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) questionnair | 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 |
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| 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) questionnair | 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 |
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| 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) questionnair | 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 |
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| 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) questionnair | 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 |
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| 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) questionnair | 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 |
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| 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) questionnair | 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 |
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| 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) questionnair | 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 |
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| 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) questionnair | 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 |
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| 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) questionnair | 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 |
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| 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) questionnair | 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 |
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| 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) questionnair | 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 |
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| 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) questionnair | 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 |
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| 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) questionnair | 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 |
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| 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) questionnair | 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 |
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| 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) questionnair | 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 |
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| 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) questionnair | 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 |
Free-Form Entry |
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| 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) questionnair | 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 |
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| 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) questionnair | 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 |
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| 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) questionnair | 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 |
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| 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) questionnair | 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 |
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| 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) questionnair | 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 |
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| 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) questionnair | 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 |
