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Protocol - Scoliosis - Quality of Life

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Description:

The Pediatric Outcomes Data Collection Instrument (PODCI) was developed by the American Academy of Orthopaedic Surgeons®, Pediatric Orthopaedic Society of North America, American Academy of Pediatrics, and Shriners Hospitals. The protocol here is based on Version 2.0 of the PODCI which was revised, renumbered, and reformatted in August 2005.

The PODCI consists of 86 items and is designed to collect data regarding an individual’s general health and problems related to bone and muscle conditions. This instrument is completed by parents (or caregivers) of children aged 2-10 years old.

Note: this protocol applies to the three major types of scoliosis; however, only congenital and syndromic scoliosis apply to rare genetic conditions.

Protocol:

Some kind of problems can make it hard to do many activities, such as eating, bathing, school work, and playing with friends. We would like to find out how your child is doing. (Circle one response on each line.)

During the last week was it easy or hard for your child to:

1.

Lift heavy books?

Easy

1

A little hard

2

Very hard

3

Can’t do at all

4

Too young for this activity

5

2.

Pour a half gallon of milk?

1

2

3

4

5

3.

Open a jar that has been opened before?

1

2

3

4

5

4.

Use a fork and spoon?

1

2

3

4

5

5.

Comb his/her hair?

1

2

3

4

5

6.

Button buttons?

1

2

3

4

5

7.

Put on his/her coat?

1

2

3

4

5

8.

Write with a pencil?

1

2

3

4

5

9. On average, over the last 12 months, how often did your child miss school (preschool, day care, camp, etc.) because of his/her health?

[ ] 1. Rarely

[ ] 2. Once a month

[ ] 3. Two or three times a month

[ ] 4. Once a week

[ ] 5. More than once a week

[ ] 6. Does not attend school, etc.

During the last week how happy has your child been with: (Circle one response on each line.)

Very happy

Somewhat happy

Not sure

Somewhat unhappy

Very unhappy

Child is too young

10.

How he/she looks?

1

2

3

4

5

6

11.

His/her body?

1

2

3

4

5

6

12.

What clothes or shoes he/she can wear?

1

2

3

4

5

6

13.

His/her ability to do the same things his/her friends do?

1

2

3

4

5

6

14.

His/her health in general?

1

2

3

4

5

6

During the last week, how much of the time:

(Circle one response on each line.)

Most of the time

Some of the time

A little of the time

None of the time

15.

Did your child feel sick and tired?

1

2

3

4

16.

Were your child full of pep and energy?

1

2

3

4

17.

Did pain or discomfort interfere with your child’s activities?

1

2

3

4

During the last week, has it been easy or hard for your child to:

(Circle one response on each line.)

Easy

A little hard

Very hard

Can’t do at all

Too young for this activity

18.

Run short distances?

1

2

3

4

5

19.

Bicycle or tricycle?

1

2

3

4

5

20.

Climb three flights of stairs?

1

2

3

4

5

21.

Climb one flight of stairs?

1

2

3

4

5

22.

Walk more than a mile?

1

2

3

4

5

23.

Walk three blocks?

1

2

3

4

5

24.

Walk one block?

1

2

3

4

5

25.

Get on and off a bus?

1

2

3

4

5

26. How often does your child need help from another person for walking and climbing? (Circle one response.)

[ ] 1 Never

[ ] 2 Sometimes

[ ] 3 About half the time

[ ] 4 Often

[ ] 5 All the time

27. How often does your child use assistive devices (such as braces, crutches, or wheelchair) for walking and climbing? (Circle one response.)

[ ] 1 Never

[ ] 2 Sometimes

[ ] 3 About half the time

[ ] 4 Often

[ ] 5 All the time

During the last week, has it been easy or hard for your child to:

(Circle one response on each line.)

Easy

A little hard

Very hard

Can’t do at all

Too young for this activity

28.

Stand while washing his/her hands and face at a sink?

1

2

3

4

5

29.

Sit in a regular chair without holding on?

1

2

3

4

5

30.

Get on and off a toilet or chair?

1

2

3

4

5

31.

Get in and out of bed?

1

2

3

4

5

32.

Turn door knobs?

1

2

3

4

5

33.

Bend over from a standing position and pick up something off the floor?

1

2

3

4

5

34. How often does your child need help from another person for sitting and standing? (Circle one response.)

[ ] 1 Never

[ ] 2 Sometimes

[ ] 3 About half the time

[ ] 4 Often

[ ] 5 All the time

35. How often does your child use assistive devices (such as braces, crutches, or wheelchair) for sitting and standing? (Circle one response.)

[ ] 1 Never

[ ] 2 Sometimes

[ ] 3 About half the time

[ ] 4 Often

[ ] 5 All the time

36. Can your child participate in recreational outdoor activities with other children the same age? (For example: bicycling, tricycling, skating, hiking, jogging) (Circle one response.)

[ ] 1 Yes, easily

[ ] 2 Yes, but a little hard

[ ] 3 Yes, but very hard

[ ] 4 No

If you answered "no" to Question 36 above, was your child’s activity limited by: (Circle yes to all that apply)

Yes

37.

Pain?

1

38.

General Health?

1

39.

Doctor or parent instructions?

1

40.

Fear the other kids won’t like him/her?

1

41.

Dislike of recreational outdoor activities?

1

42.

Too young?

1

43.

Activity not in season?

1

44. Can your child participate in pickup games or sports with other children the same age? (For example: tag, dodge ball, basketball, soccer, catch, jump rope, touch football, hop scotch)

(Circle one response.)

[ ] 1 Yes, easily

[ ] 2 Yes, but a little hard

[ ] 3 Yes, but very hard

[ ] 4 No

If you answered "no" to Question 44 above, was your child’s activity limited by: (Circle yes to all that apply)

Yes

45.

Pain?

1

46.

General Health?

1

47.

Doctor or parent instructions?

1

48.

Fear the other kids won’t like him/her?

1

49.

Dislike of pickup games or sports?

1

50.

Too young?

1

51.

Activity not in season?

1

52. Can your child participate in competitive level sports with other children the same age? (For example: hockey, basketball, soccer, football, baseball, swimming, running [track or cross country], gymnastics, or dance) (Circle one response.)

[ ] 1 Yes, easily

[ ] 2 Yes, but a little hard

[ ] 3 Yes, but very hard

[ ] 4 No

If you answered "no" to Question 52 above, was your child’s activity limited by: (Circle yes to all that apply)

Yes

53.

Pain?

1

54.

General Health?

1

55.

Doctor or parent instructions?

1

56.

Fear the other kids won’t like him/her?

1

57.

Dislike of pickup games or sports?

1

58.

Too young?

1

59.

Activity not in season?

1

60. How often in the last week did your child get together and do things with friends? (Circle one response.)

[ ] 1 Often

[ ] 2 Sometimes

[ ] 3 Never or rarely

If you answered "sometimes" or "never or rarely" to Question 60 above, was your child’s activity limited by: (Circle yes to all that apply)

Yes

61.

Pain?

1

62.

General Health?

1

63.

Doctor or parent instructions?

1

64.

Fear the other kids won’t like him/her?

1

65.

Friends not around?

1

66. How often in the last week did your child participate in gym/recess? (Circle one response.)

[ ] 1 Often

[ ] 2 Sometimes

[ ] 3 Never or rarely

[ ] 4 No gym or recess

If you answered "sometimes" or "never or rarely" to Question 63 above, was your child’s activity limited by: (Circle yes to all that apply)

Yes

67.

Pain?

1

68.

General Health?

1

69.

Doctor or parent instructions?

1

70.

Fear the other kids won’t like him/her?

1

71.

Dislike of gym/recess?

1

72.

School not in session?

1

73.

Does not attend school?

1

74. Is it easy or hard for your child to make friends with children his/her own age? (Circle one response.)

[ ] 1 Usually easy

[ ] 2 Sometimes easy

[ ] 3 Sometimes hard

[ ] 4 Usually hard

75. How much pain has your child had during the last week? (Circle one response.)

[ ] 1 None

[ ] 2 Very mild

[ ] 3 Mild

[ ] 4 Moderate

[ ] 5 Severe

[ ] 6 Very severe

76. During the last week, how much did pain interfere with your child’s normal activities (including at home, outside of the home, and at school)? (Circle one response.)

[ ] 1 Not at all

[ ] 2 A little bit

[ ] 3 Moderately

[ ] 4 Quite a bit

[ ] 5 Extremely

What expectations do you have for your child’s treatment?
As a result of my child’s treatment, I expect my child:

(Circle one response on each line.)

Definitely yes

Probably yes

Not sure

Probably not

Definitely not

77.

To have pain relief.

1

2

3

4

5

78.

To look better.

1

2

3

4

5

79.

To feel better about himself/herself.

1

2

3

4

5

80.

To sleep more comfortably.

1

2

3

4

5

81.

To be able to do activities at home.

1

2

3

4

5

82.

To be able to do more at school.

1

2

3

4

5

83.

To be able to do more play or recreational activities (biking, walking, doing things with friends).

1

2

3

4

5

84.

To be able to do more sports.

1

2

3

4

5

85.

To be free from pain or disability as an adult.

1

2

3

4

5

86. If your child had to spend the rest of his/her life with his/her bone and muscle condition as it is right now, how would you feel about it? (Circle one response.)

[ ] 1 Very satisfied

[ ] 2 Somewhat satisfied

[ ] 3 Neutral

[ ] 4 Somewhat dissatisfied

[ ] 5 Very dissatisfied

Protocol Name from Source:

This section will be completed when reviewed by an Expert Review Panel.

Availability:

Publicly available

Personnel and Training Required

None

Equipment Needs

None

Requirements
Requirement CategoryRequired
Major equipment No
Specialized training No
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual Yes
Mode of Administration

Proxy-administered questionnaire

Life Stage:

Toddler, Child

Participants:

Parent or guardian for children 2-10 years old

Specific Instructions:

The physician should complete this form with diagnoses and procedures prior to administering the quality-of-life (QOL) questionnaire.

FOR OFFICE USE ONLY

Clinic ID ___________________ First six letter of patient’s last name _____________

Physician ID ________________ Office Chart # ______________________________

Diagnosis & ICD-9 Code*

Procedure & CPT Code

CPT Date

Side of body procedure was performed on:

Primary DX

DX

Tx

□ Right

□ Left

ICD-9

ICD-9

□ Both

□ N/A

Secondary DX

DX

Tx

□ Right

□ Left

ICD-9

ICD-9

□ Both

□ N/A

Secondary DX

DX

Tx

□ Right

□ Left

ICD-9

ICD-9

□ Both

□ N/A

Secondary DX

DX

Tx

□ Right

□ Left

ICD-9

ICD-9

□ Both

□ N/A

Secondary DX

DX

Tx

□ Right

□ Left

ICD-9

ICD-9

□ Both

□ N/A

The following instructions appear at the beginning of the questionnaire.

Today’s Date / /

Thank you for completing this questionnaire!

This questionnaire will help us to better understand your general health and any problems related to bone and muscle conditions.

Your completion of this questionnaire is completely voluntary and your responses will be held in the strictest confidence.

Please answer every question. Some questions may look like others, but each one is different.

There are no right or wrong answers. If you are not sure how to answer a question, just give the best answer you can. You can make comments in the margin. We do read all your comments, so feel free to make as many as you wish.

Your Child’s Birth Date / /

Your Child’s Social Security Number* ___________________

Your Social Security Number* ______________________

*Personal identifying information that may not need to be collected.

Selection Rationale

The Rare Genetic Conditions Working Group selected the Pediatric Outcomes Data Collection Instrument (PODCI) because of its relevance to scoliosis and validity for many orthopaedic conditions.

Language

English

Standards
StandardNameIDSource
Common Data Elements (CDE) Scoliosis Quality of Life Questionnaire Assessment Text 4798281 CDE Browser
Derived Variables

None

Process and Review

This section will be completed when reviewed by an Expert Review Panel.

Source

American Academy of Orthopaedic Surgeons®, Pediatric Orthopaedic Society of North America, American Academy of Pediatrics, Shriners Hospitals. (2005). Version 2.0 Pediatrics-Parent/Child Outcomes Instrument. American Academy of Orthopaedic Surgeons (AAOS) website: http://www.aaos.org/research/outcomes/outcomes_peds.asp

General References

Allen, D. D., Gorton, G. E., Oeffinger, D. J., Tylkowski, C., Tucker, C. A., & Haley, S. M. (2008). Analysis of the Pediatric Outcomes Data Collection Instrument (PODCI) in ambulatory children with cerebral palsy using confirmatory factor analysis and item response theory methods. Journal of Pediatric Orthopedics, 28(2), 192-198.

Kunkel, S., Eismann, E., & Cornwall, R. (2011). Utility of the pediatric outcomes data collection instrument for assessing acute hand and wrist injuries in children. Journal of Pediatric Orthopaedics, 31(7), 767-772.

Protocol ID:

221501

Variables:
Export Variables
Variable NameVariable IDVariable DescriptionVersiondbGaP Mapping
PX221501_Scoliosis_QOL_Activity_Limited_ByCompetiviteSports PX221501770200 If you answered "no" to Question 52 above, was your child's activity limited by: (Circle yes to all that apply) 4 N/A
PX221501_Scoliosis_QOL_Activity_Limited_ByOutdoor PX221501750200 If you answered "no" to Question 36 above, was your child's activity limited by: (Circle yes to all that apply) 4 N/A
PX221501_Scoliosis_QOL_Activity_Limited_BySports PX221501760200 If you answered "no" to Question 44 above, was your child's activity limited by: (Circle yes to all that apply) 4 N/A
PX221501_Scoliosis_QOL_Child's_DOB PX221501370000 Your Child's Birth Date 4 Variable Mapping
PX221501_Scoliosis_QOL_Child's_SSN PX221501380000 Your Child's Social Security Number 4 N/A
PX221501_Scoliosis_QOL_Child_Need_Help PX221501650000 How often does your child need help from another person for walking and climbing? (Circle one response.) 4 N/A
PX221501_Scoliosis_QOL_Child_Use_AssistiveDevices PX221501660000 How often does your child use assistive devices (such as braces, crutches, or wheelchair) for walking and climbing? (Circle one response.) 4 N/A
PX221501_Scoliosis_QOL_Clinic_ID PX221501020000 Clinic ID of Patient 4 N/A
PX221501_Scoliosis_QOL_CompetitiveLevel_Sports PX221501770100 Can your child participate in competitive level sports with other children the same age? (For example: hockey, basketball, soccer, football, baseball, swimming, running [track or cross country], gymnastics, or dance) (Circle one response.) 4 N/A
PX221501_Scoliosis_QOL_Easy_MakeFriends PX221501800000 Is it easy or hard for your child to make friends with children his/her own age? (Circle one response.) 4 N/A
PX221501_Scoliosis_QOL_FirstSix_Last_Name PX221501040000 First sitx letters of patient's last name 4 N/A
PX221501_Scoliosis_QOL_Frequency_GetTogether_LimitedBy PX221501780200 If you answered "sometimes" or "never or rarely" to Question 60 above, was your child's activity limited by: (Circle yes to all that apply) 4 N/A
PX221501_Scoliosis_QOL_GetTogether_Friends PX221501780100 How often in the last week did your child get together and do things with friends? (Circle one response.) 4 N/A
PX221501_Scoliosis_QOL_Help_SittingStanding PX221501730000 How often does your child need help from another person for sitting and standing? 4 N/A
PX221501_Scoliosis_QOL_Last12Mo_MissSchool PX221501480000 On average, over the last 12 months, how often did your child miss school (preschool, day care, camp, etc.) because of his/her health? 4 N/A
PX221501_Scoliosis_QOL_LastWeek_FullEnergy PX221501550000 During the last week, how much of the time were your child full of pep and energy? 4 N/A
PX221501_Scoliosis_QOL_LastWeek_GymRecess PX221501790100 How often in the last week did your child participate in gym/recess? (Circle one response.) 4 N/A
PX221501_Scoliosis_QOL_LastWeek_Pain PX221501810000 How much pain has your child had during the last week? (Circle one response.) 4 N/A
PX221501_Scoliosis_QOL_LastWeek_PainInterfere PX221501820000 During the last week, how much did pain interfere with your child's normal activities (including at home, outside of the home, and at school)? (Circle one response.) 4 N/A
PX221501_Scoliosis_QOL_Last_Week_1FlightStairs PX221501600000 During the last week, has it been easy or hard for your child to climb one flight of stairs? 4 N/A
PX221501_Scoliosis_QOL_Last_Week_3FlightsStairs PX221501590000 During the last week, has it been easy or hard for your child to climb three flights of stairs? 4 N/A
PX221501_Scoliosis_QOL_Last_Week_BendOver PX221501720000 During the last week, has it been easy or hard for your child to bend over from a standing position and pick up something off the floor? 4 N/A
PX221501_Scoliosis_QOL_Last_Week_BicycleTricycle PX221501580000 During the last week, has it been easy or hard for your child to bicycle or tricycle? 4 N/A
PX221501_Scoliosis_QOL_Last_Week_Buttons PX221501450000 During the last week was it easy or hard for your child to button buttons? 4 N/A
PX221501_Scoliosis_QOL_Last_Week_CombHair PX221501440000 During the last week was it easy or hard for your child to comb his/her hair? 4 N/A
PX221501_Scoliosis_QOL_Last_Week_ForkSpoon PX221501430000 During the last week was it easy or hard for your child to use a fork and spoon? 4 N/A
PX221501_Scoliosis_QOL_Last_Week_GetOnOffBus PX221501640000 During the last week, has it been easy or hard for your child to get on and off a bus? 4 N/A
PX221501_Scoliosis_QOL_Last_Week_HappyAbility PX221501520000 During the last week how happy has your child been with his/her ability to do the same things his/her friends do? 4 N/A
PX221501_Scoliosis_QOL_Last_Week_HappyBody PX221501500000 During the last week how happy has your child been with his/her body? 4 N/A
PX221501_Scoliosis_QOL_Last_Week_HappyClothes PX221501510000 During the last week how happy has your child been with what clothes or shoes he/she can wear? 4 N/A
PX221501_Scoliosis_QOL_Last_Week_HappyHealth PX221501530000 During the last week how happy has your child been with his/her health in general? 4 N/A
PX221501_Scoliosis_QOL_Last_Week_HappYLooks PX221501490000 During the last week how happy has your child been with how he/she looks? 4 N/A
PX221501_Scoliosis_QOL_Last_Week_InOutBed PX221501700000 During the last week, has it been easy or hard for your child to get in and out of bed? 4 N/A
PX221501_Scoliosis_QOL_Last_Week_LiftBooks PX221501400000 During the last week was it easy or hard for your child to lift heavy books? 4 N/A
PX221501_Scoliosis_QOL_Last_Week_OnOffToilet PX221501690000 During the last week, has it been easy or hard for your child to get on and off a toilet or chair? 4 N/A
PX221501_Scoliosis_QOL_Last_Week_OpenJar PX221501420000 During the last week was it easy or hard for your child to Open a jar that has been opened before? 4 N/A
PX221501_Scoliosis_QOL_Last_Week_PainInterfere PX221501560000 During the last week, how much of the time did pain or discomfort interfere with your child's activities? 4 N/A
PX221501_Scoliosis_QOL_Last_Week_PourMilk PX221501410000 During the last week was it easy or hard for your child to Pour a half gallon of milk? 4 N/A
PX221501_Scoliosis_QOL_Last_Week_PutOn_Coat PX221501460000 During the last week was it easy or hard for your child to put on his/her coat? 4 N/A
PX221501_Scoliosis_QOL_Last_Week_Run PX221501570000 During the last week, has it been easy or hard for your child to run short distances? 4 N/A
PX221501_Scoliosis_QOL_Last_Week_SickTIred PX221501540000 During the last week, how much of the time did your child feel sick and tired? 4 N/A
PX221501_Scoliosis_QOL_Last_Week_SitChair PX221501680000 During the last week, has it been easy or hard for your child to sit in a regular chair without holding on? 4 N/A
PX221501_Scoliosis_QOL_Last_Week_StandSink PX221501670000 During the last week, has it been easy or hard for your child to stand while washing his/her hands and face at a sink? 4 N/A
PX221501_Scoliosis_QOL_Last_Week_TurnDoorKnobs PX221501710000 During the last week, has it been easy or hard for your child to turn door knobs? 4 N/A
PX221501_Scoliosis_QOL_Last_Week_WalkMile PX221501610000 During the last week, has it been easy or hard for your child to walk more than a mile? 4 N/A
PX221501_Scoliosis_QOL_Last_Week_WalkOneBlock PX221501630000 During the last week, has it been easy or hard for your child to walk one block? 4 N/A
PX221501_Scoliosis_QOL_Last_Week_WalkThreeBlocks PX221501620000 During the last week, has it been easy or hard for your child to walk three blocks? 4 N/A
PX221501_Scoliosis_QOL_Last_Week_WritePencil PX221501470000 During the last week was it easy or hard for your child to write with a pencil? 4 N/A
PX221501_Scoliosis_QOL_LimitedBY_GymRecess PX221501790200 If you answered "sometimes" or "never or rarely" to Question 63 above, was your child's activity limited by: (Circle yes to all that apply) 4 N/A
PX221501_Scoliosis_QOL_NoChangeDX_HowYouFeel PX221501920000 If your child had to spend the rest of his/her life with his/her bone and muscle condition as it is right now, how would you feel about it? 4 N/A
PX221501_Scoliosis_QOL_Office_Chart# PX221501050000 Office Chart # 4 N/A
PX221501_Scoliosis_QOL_Parent_SSN PX221501390000 Your Social Security Number 4 N/A
PX221501_Scoliosis_QOL_Physician_ID PX221501030000 Physician ID 4 N/A
PX221501_Scoliosis_QOL_PIckupGames_Sports PX221501760100 Can your child participate in pickup games or sports with other children the same age? (For example: tag, dodge ball, basketball, soccer, catch, jump rope, touch football, hop scotch) (Circle one response.) 4 N/A
PX221501_Scoliosis_QOL_PrimaryDX_CPT_Date PX221501100000 Primary DX - CPT Date 4 N/A
PX221501_Scoliosis_QOL_PrimaryDX_DXCode PX221501060000 Primary DX - DX Code 4 N/A
PX221501_Scoliosis_QOL_PrimaryDX_ICD9 PX221501070000 Primary DX - ICD-9 Code 4 N/A
PX221501_Scoliosis_QOL_PrimaryDX_Procedure_BodySite PX221501110000 Primary DX - Side of body procedure was performed on: Right, Left, Both, N/A 4 N/A
PX221501_Scoliosis_QOL_PrimaryDX_TXProcedureCPT_Code PX221501080000 Primary DX - TX Procedure Code 4 N/A
PX221501_Scoliosis_QOL_PrimaryDX_TXProcedureICD9_Code PX221501090000 Primary DX - CPT Code 4 N/A
PX221501_Scoliosis_QOL_Recreational_OutdoorActivities PX221501750100 Can your child participate in recreational outdoor activities with other children the same age? (For example: bicycling, tricycling, skating, hiking, jogging) (Circle one response.) 4 N/A
PX221501_Scoliosis_QOL_SecondarDX1_DXCode PX221501120000 Secondary DX 1 - DX Code 4 N/A
PX221501_Scoliosis_QOL_SecondarDX1_ICD9 PX221501130000 Secondary DX 1- ICD-9 Code 4 N/A
PX221501_Scoliosis_QOL_SecondarDX1_Procedure_BodySite PX221501170000 Secondary DX1 - Side of body procedure was performed on: Right, Left, Both, N/A 4 N/A
PX221501_Scoliosis_QOL_SecondarDX2_DXCode PX221501180000 Secondary DX 2 - DX Code 4 N/A
PX221501_Scoliosis_QOL_SecondarDX2_ICD9 PX221501190000 Secondary DX 2- ICD-9 Code 4 N/A
PX221501_Scoliosis_QOL_SecondarDX2_Procedure_BodySite PX221501230000 Secondary DX2 - Side of body procedure was performed on: Right, Left, Both, N/A 4 N/A
PX221501_Scoliosis_QOL_SecondarDX3_DXCode PX221501240000 Secondary DX 3 - DX Code 4 N/A
PX221501_Scoliosis_QOL_SecondarDX3_ICD9 PX221501250000 Secondary DX 3- ICD-9 Code 4 N/A
PX221501_Scoliosis_QOL_SecondarDX3_Procedure_BodySite PX221501290000 Secondary DX 3 - Side of body procedure was performed on: Right, Left, Both, N/A 4 N/A
PX221501_Scoliosis_QOL_SecondarDX4_DXCode PX221501300000 Secondary DX 4- DX Code 4 N/A
PX221501_Scoliosis_QOL_SecondarDX4_ICD9 PX221501310000 Secondary DX 4- ICD-9 Code 4 N/A
PX221501_Scoliosis_QOL_SecondarDX4_Procedure_BodySite PX221501350000 Secondary DX 4 - Side of body procedure was performed on: Right, Left, Both, N/A 4 N/A
PX221501_Scoliosis_QOL_SecondaryDX1_CPT_Date PX221501160000 Secondary DX 1 - CPT Date 4 N/A
PX221501_Scoliosis_QOL_SecondaryDX1_TXProcedureCPT_Code PX221501140000 Secondary DX 1- TX Procedure Code 4 N/A
PX221501_Scoliosis_QOL_SecondaryDX1_TXProcedureICD9_Code PX221501150000 Secondary DX 1 - CPT Code 4 N/A
PX221501_Scoliosis_QOL_SecondaryDX2_CPT_Date PX221501220000 Secondary DX 2- CPT Date 4 N/A
PX221501_Scoliosis_QOL_SecondaryDX2_TXProcedureCPT_Code PX221501200000 Secondary DX 2- TX Procedure Code 4 N/A
PX221501_Scoliosis_QOL_SecondaryDX2_TXProcedureICD9_Code PX221501210000 Secondary DX 2 - CPT Code 4 N/A
PX221501_Scoliosis_QOL_SecondaryDX3_CPT_Date PX221501280000 Secondary DX 3 - CPT Date 4 N/A
PX221501_Scoliosis_QOL_SecondaryDX3_TXProcedureCPT_Code PX221501260000 Secondary DX 3- TX Procedure Code 4 N/A
PX221501_Scoliosis_QOL_SecondaryDX3_TXProcedureICD9_Code PX221501270000 Secondary DX 3 - CPT Code 4 N/A
PX221501_Scoliosis_QOL_SecondaryDX4_CPT_Date PX221501340000 Secondary DX 4 - CPT Date 4 N/A
PX221501_Scoliosis_QOL_SecondaryDX4_TXProcedureCPT_Code PX221501320000 Secondary DX 4- TX Procedure Code 4 N/A
PX221501_Scoliosis_QOL_SecondaryDX4_TXProcedureICD9_Code PX221501330000 Secondary DX 4- CPT Code 4 N/A
PX221501_Scoliosis_QOL_Today's_Date PX221501360000 Today's Date 4 N/A
PX221501_Scoliosis_QOL_TXExpectations_ActivitiesHome PX221501870000 What expectations do you have for your child's treatment? As a result of my child's treatment, I expect my child to be able to do activities at home. 4 N/A
PX221501_Scoliosis_QOL_TXExpectations_DoMore_Play PX221501890000 What expectations do you have for your child's treatment? As a result of my child's treatment, I expect my child To be able to do more play or recreational activities (biking, walking, doing things with friends). 4 N/A
PX221501_Scoliosis_QOL_TXExpectations_DoMore_School PX221501880000 What expectations do you have for your child's treatment? As a result of my child's treatment, I expect my child to be able to do more at school. 4 N/A
PX221501_Scoliosis_QOL_TXExpectations_DoMore_Sports PX221501900000 What expectations do you have for your child's treatment? As a result of my child's treatment, I expect my child to be able to do more sports. 4 N/A
PX221501_Scoliosis_QOL_TXExpectations_FeelBetterSelf PX221501850000 What expectations do you have for your child's treatment? As a result of my child's treatment, I expect my child to feel better about himself/herself. 4 N/A
PX221501_Scoliosis_QOL_TXExpectations_FreeofPain_NoDisabilityAdult PX221501910000 What expectations do you have for your child's treatment? As a result of my child's treatment, I expect my child to be free from pain or disability as an adult. 4 N/A
PX221501_Scoliosis_QOL_TXExpectations_LookBetter PX221501840000 What expectations do you have for your child's treatment? As a result of my child's treatment, I expect my child to look better. 4 N/A
PX221501_Scoliosis_QOL_TXExpectations_PainRelief PX221501830000 What expectations do you have for your child's treatment? As a result of my child's treatment, I expect my child to have pain relief. 4 N/A
PX221501_Scoliosis_QOL_TXExpectations_Sleep PX221501860000 What expectations do you have for your child's treatment? As a result of my child's treatment, I expect my child to sleep more comfrotably. 4 N/A
PX221501_Scoliosis_QOL_Use_AssistiveDevices_SitStand PX221501740000 . How often does your child use assistive devices (such as braces, crutches, or wheelchair) for sitting and standing? 4 N/A
Research Domain Information
Measure Name:

Scoliosis - Quality of Life

Release Date:

April 30, 2015

Definition

Scoliosis is a spine deformity that can be categorized into three major types: congenital, syndromic, and idiopathic. Individuals can have various medical and/or quality-of-life (QoL) implications, depending on the type and severity of their scoliosis.

Purpose

This measure can be used to evaluate the impact of scoliosis on an individual’s quality of life (QOL). This self-reported information is beneficial to evaluate the severity of scoliosis and how it influences a person’s QOL over time.

Keywords

Scoliosis, growth, height, developmental delay, adolescent, pain, pediatric, short stature, Pediatric Outcomes Data Collection Instrument, PODCI, quality of life, QOL