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Innovation Panel Questionnaire Module

scaeq5d3learly_ip11

Self Completion EQ-5D-3L Early Interviewer Question module

Questions 5

scaeq5d3learly_ip11.eq3lactear

EQ-5D-3L Activities Early

Type: choice

Source: EQ-5D

Text: Usual Acticities (e.g. work, study, housework, family or leisure activities)

OptionLabel
1I have no problems with performing my usual activities.
2I have some problems with performing my usual activities.
3I am unable to perform my usual activities.

Universe:
if (GRIDVARIABLES.modetype = 1 & CASIEARLYSTART.SCACEARLY = 1) | GRIDVARIABLES.modetype = 3 (Mode is face to face and has agreed to self-completion OR Mode is web)
and if EXPERIMENTALVARIABLES.EQ5DCOND = 2 (EQ-5D condition is ASK 3L Early module and 5L Late module.)

scaeq5d3learly_ip11.eq3lmobear

EQ-5D-3L Mobility Early

Type: choice

Source: EQ-5D

Text: Please click the ONE box that best describes your health TODAY. Mobility

OptionLabel
1I have no problems in walking about.
2I have some problems in walking about.
3I am confined to bed.

Universe:
if (GRIDVARIABLES.modetype = 1 & CASIEARLYSTART.SCACEARLY = 1) | GRIDVARIABLES.modetype = 3 (Mode is face to face and has agreed to self-completion OR Mode is web)
and if EXPERIMENTALVARIABLES.EQ5DCOND = 2 (EQ-5D condition is ASK 3L Early module and 5L Late module.)

scaeq5d3learly_ip11.eq3lpainear

EQ-5D-3L Pain Early

Type: choice

Source: EQ-5D

Text: Pain/Discomfort

OptionLabel
1I have no pain or discomfort.
2I have moderate pain or discomfort.
3I have extreme pain or discomfort.

Universe:
if (GRIDVARIABLES.modetype = 1 & CASIEARLYSTART.SCACEARLY = 1) | GRIDVARIABLES.modetype = 3 (Mode is face to face and has agreed to self-completion OR Mode is web)
and if EXPERIMENTALVARIABLES.EQ5DCOND = 2 (EQ-5D condition is ASK 3L Early module and 5L Late module.)

scaeq5d3learly_ip11.eq3lanxear

EQ-5D-3L Anxiety Early

Type: choice

Source: EQ-5D

Text: Anxiety/Depression

OptionLabel
1I am not anxious or depressed.
2I am moderately anxious or depressed.
3I am extremely anxious or depressed.

Universe:
if (GRIDVARIABLES.modetype = 1 & CASIEARLYSTART.SCACEARLY = 1) | GRIDVARIABLES.modetype = 3 (Mode is face to face and has agreed to self-completion OR Mode is web)
and if EXPERIMENTALVARIABLES.EQ5DCOND = 2 (EQ-5D condition is ASK 3L Early module and 5L Late module.)

scaeq5d3learly_ip11.eq3lcareear

EQ-5D-3L Self-Care Early

Type: choice

Source: EQ-5D

Text: Self-Care

OptionLabel
1I have no problems with self-care.
2I have some problems washing or dressing myself.
3I am unable to wash or dress myself.

Universe:
if (GRIDVARIABLES.modetype = 1 & CASIEARLYSTART.SCACEARLY = 1) | GRIDVARIABLES.modetype = 3 (Mode is face to face and has agreed to self-completion OR Mode is web)
and if EXPERIMENTALVARIABLES.EQ5DCOND = 2 (EQ-5D condition is ASK 3L Early module and 5L Late module.)

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