AnyQuest for Windows Questionnaire Definition File Version 2.32:D: X':T: /bJ\:GVBO"Arial West"Arial West"Arial West"Arialc Trk"Arialc Trk"Arial West"Arial West"Arial West"Arial WestArialG,.EORTC QLQ-LC13LC13:I::>::}8:)uX* Dear patient,:>|::U dpatients sometimes report that they have the following symptoms. Please indicate the extent to which you have experienced these symptoms during the past week.1,00:>)::U d2,00::8:LL::}:)uX*How much did you cough?During the past week::+2n::j d Not at all1,00:+!n ::Z dA little2,004G+n@GDGI d Quite a bit3,00LG+n`GXG9 d Very much4,00GGGLL GG}G )uX*Did you cough blood?During the past week:XG+2nlGdGj d Not at all1,00G+!nGGZ dA little2,00G+nGGI d Quite a bit3,00 G+nG,G9 d Very much4,000GGGLLG G}$G )uX**Were you short of breath when you rested?During the past week:G+2nG(Gj d Not at all1,00G+!nGGZ dA little2,00DG+nXGPGI d Quite a bit3,00G+nGG9 d Very much4,00,GpGXGLLtGxG}|G)uX**Were you short of breath when you walked?During the past week:G+2nGGj d Not at all1,00G+!n(G GZ dA little2,00lG+nGxGI d Quite a bit3,00G+nGG9 d Very much4,00GPGTGLLlGpG}tG)uX*2Were you short of breath when you climbed stairs?During the past week:xG+2nGGj d Not at all1,00G+!nGGZ dA little2,00G+nGGI d Quite a bit3,00 G+n4 GG9 d Very much4,00 G G GLL G G} G)uX*%Have you had a sore mouth or tongue?During the past week: G+2n$ G Gj d Not at all1,00h G+!n| Gt GZ dA little2,00 G+n G GI d Quite a bit3,00 G+n, G$ G9 d Very much4,00 G0 G GLL G G} G)uX*!Have you had trouble swallowing?During the past week:4 G+2npG@ Gj d Not at all1,00 G+!n G GZ dA little2,00 G+n G GI d Quite a bit3,008 G+nL GD G9 d Very much4,00G G GLL G G} G #)uX*%Have you had tingling hands or feet?During the past week: G+2nhG Gj d Not at all1,00G+!nlGGZ dA little2,00G+nDGGI d Quite a bit3,00\G+npGhG9 d Very much4,00GGGLL G$G}(G$')uX*Have you had hair loss?During the past week:lG+2nGxGj d Not at all1,00G+!nGGZ dA little2,00G+n0G(GI d Quite a bit3,004G+n@GG9 d Very much4,008GGGLL G$G}(G(+)uX*!Have you had pain in your chest?During the past week:,G+2nGGj d Not at all1,00G+!nGGZ dA little2,00<G+nPGHGI d Quite a bit3,00G+nGG9 d Very much4,00\G G$GLL<G@G}DG,/)uX*+Have you had pain in your arm or shoulder?During the past week:HG+2nGTGj d Not at all1,00G+!nLGGZ dA little2,00dG+nxGpGI d Quite a bit3,00G+nGG9 d Very much4,00GHGLGLLdGhG}lG03)uX*/Have you had pain in other parts of your body?During the past week:pG+2nG|Gj d Not at all1,00<G+!nGPGZ dA little2,00G+nHGGI d Quite a bit3,00G+n(GG9 d Very much4,00tGGGLLGG}G44)uX*/In which parts of your body did you have pain?During the past week: G2 GG) d*Please tick here, then enter information!1,00v13 1 =eGGGLLGG}G56)uX*$Did you take any medicine for pain?During the past week:4G)@8G<G\ dNo1,00LG@XGPGS dYes2,00G5GGLLGG-_,G7:)uX*How much did it help?During the past week:"( The medicine you took for pain )|G+2npGtGj d Not at all1,00G+!nGGZ dA little2,00 G+nlG,GI d Quite a bit3,00G+nGG9 d Very much4,00v15 1 =ll,XGd------Dyspnea (combined)Dyspnea (combined)Dyspnea (combined)@nM~@ Undefinedv4 v5 v6 3 avg 1 - 100 * 3 /Gd------Dyspnea (resting)Dyspnea (resting)Dyspnea (resting)@nM~@ Undefinedv4 1 - 100 * 3 /Gd------Dyspnea (walking)Dyspnea (walking)Dyspnea (walking)@nM~@ Undefinedv5 1 - 100 * 3 /@Gd------Dyspnea (climbing stairs)Dyspnea (climbing stairs)Dyspnea (climbing stairs)@nM~@ Undefinedv6 1 - 100 * 3 /hGd------CoughingCoughingCoughing@nM~@ Undefinedv2 1 - 100 * 3 /Gd------ Haemoptysis Haemoptysis Haemoptysis@nM~@ Undefinedv3 1 - 100 * 3 /Gd------ Sore mouth Sore mouth Sore mouth@nM~@ Undefinedv7 1 - 100 * 3 /Gd------ Dysphagia Dysphagia Dysphagia@nM~@ Undefinedv8 1 - 100 * 3 /Gd------Peripheral neuropathyPeripheral neuropathyPeripheral neuropathy@nM~@ Undefinedv9 1 - 100 * 3 /0Gd------AlopeciaAlopeciaAlopecia@nM~@ Undefinedv10 1 - 100 * 3 /XGd------ Pain in chest Pain in chest Pain in chest@nM~@ Undefinedv11 1 - 100 * 3 /Gd------Pain in arm or shoulderPain in arm or shoulderPain in arm or shoulder@nM~@ Undefinedv12 1 - 100 * 3 /Gd------Pain in other partsPain in other partsPain in other parts@nM~@ Undefinedv13 1 - 100 * 3 /Gd------Pain medication helpedPain medication helpedPain medication helped@nM~@ Undefinedv16 1 - 100 * 3 /EORTC QLQ-LC13 Quality of Life Lung Cancer Module 1992 by the EORTC Study Group on Quality of Life Questionnaire definition file for AnyQuest for Windows (French Version) 03.10.1997 by Jrg M. Sigle