Innovation Panel Questionnaire Module
scaeq5d3llate_ip14
Self Completion EQ-5D-3L Late module
Questions 5
scaeq5d3llate_ip14.eq3lmoblat
EQ-5D-3L Mobility Late
Type: choice
Source: EQ-5D
Text: Please click the ONE box that best describes your health TODAY.
| Option | Label |
|---|---|
| 1 | I have no problems in walking about. |
| 2 | I have some problems in walking about. |
| 3 | I am confined to bed. |
Universe:
if ((GRIDVARIABLES.modetype = 1 & CASISTART_SCAC = 1 thru 3) | GRIDVARIABLES.modetype = 2 | 3)) (Mode is face to face and has agreed to self-completion OR mode is telephone or web)
and if EXPERIMENTALVARIABLES.REQ10COND = 2 (ReQoL condition is ASK ReQoL and EQ5D late and GHQ early.)
scaeq5d3llate_ip14.eq3lcarelat
EQ-5D-3L Self-Care Late
Type: choice
Source: EQ-5D
Text: (Please click the ONE box that best describes your health TODAY.)
| Option | Label |
|---|---|
| 1 | I have no problems with self-care. |
| 2 | I have some problems washing or dressing myself. |
| 3 | I am unable to wash or dress myself. |
Universe:
if ((GRIDVARIABLES.modetype = 1 & CASISTART_SCAC = 1 thru 3) | GRIDVARIABLES.modetype = 2 | 3)) (Mode is face to face and has agreed to self-completion OR mode is telephone or web)
and if EXPERIMENTALVARIABLES.REQ10COND = 2 (ReQoL condition is ASK ReQoL and EQ5D late and GHQ early.)
scaeq5d3llate_ip14.eq3lactlat
EQ-5D-3L Activities Late
Type: choice
Source: EQ-5D
Text: (Please click the ONE box that best describes your health TODAY.)
| Option | Label |
|---|---|
| 1 | I have no problems with performing my usual activities. |
| 2 | I have some problems with performing my usual activities. |
| 3 | I am unable to perform my usual activities. |
Universe:
if ((GRIDVARIABLES.modetype = 1 & CASISTART_SCAC = 1 thru 3) | GRIDVARIABLES.modetype = 2 | 3)) (Mode is face to face and has agreed to self-completion OR mode is telephone or web)
and if EXPERIMENTALVARIABLES.REQ10COND = 2 (ReQoL condition is ASK ReQoL and EQ5D late and GHQ early.)
scaeq5d3llate_ip14.eq3lpainlat
EQ-5D-3L Pain Late
Type: choice
Source: EQ-5D
Text: (Please click the ONE box that best describes your health TODAY.)
| Option | Label |
|---|---|
| 1 | I have no pain or discomfort. |
| 2 | I have moderate pain or discomfort. |
| 3 | I have extreme pain or discomfort. |
Universe:
if ((GRIDVARIABLES.modetype = 1 & CASISTART_SCAC = 1 thru 3) | GRIDVARIABLES.modetype = 2 | 3)) (Mode is face to face and has agreed to self-completion OR mode is telephone or web)
and if EXPERIMENTALVARIABLES.REQ10COND = 2 (ReQoL condition is ASK ReQoL and EQ5D late and GHQ early.)
scaeq5d3llate_ip14.eq3lanxlat
EQ-5D-3L Anxiety Late
Type: choice
Source: EQ-5D
Text: (Please click the ONE box that best describes your health TODAY.)
| Option | Label |
|---|---|
| 1 | I am not anxious or depressed. |
| 2 | I am moderately anxious or depressed. |
| 3 | I am extremely anxious or depressed. |
Universe:
if ((GRIDVARIABLES.modetype = 1 & CASISTART_SCAC = 1 thru 3) | GRIDVARIABLES.modetype = 2 | 3)) (Mode is face to face and has agreed to self-completion OR mode is telephone or web)
and if EXPERIMENTALVARIABLES.REQ10COND = 2 (ReQoL condition is ASK ReQoL and EQ5D late and GHQ early.)
