CDEs
Forms
Specify type of notification to the IRB per institutional policy
Expedited reporting date
Was any corrective action taken?
Record corrective action
Date of evaluation
During the past 7 days I feel fatigued
During the past 7 days I have trouble starting things because I am tired
In the past 7 days how run-down did you feel on average?
In the past 7 days how fatigued were you on average?
In the past 7 days how much were you bothered by your fatigue on average?
In the past 7 days to what degree did your fatigue interfere with your physical functioning?
In the past 7 days how often did you have to push yourself to get things done because of your fatigue?
In the past 7 days how often did you have trouble finishing things because of your fatigue?
In the past 7 days how much did pain interfere with your day to day activities?
In the past 7 days how much did pain interfere with work around the home?
In the past 7 days how much did pain interfere with your ability to participate in social activities?
In the past 7 days how much did pain interfere with your household chores?
In the past 7 days how much did pain interfere with the things you usually do for fun?
In the past 7 days how much did pain interfere with your enjoyment of social activities?
In the past 7 days how much did pain interfere with your enjoyment of life?
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