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/^((0?[1-9])|([1-8][0-9])|(9[0-8]))[0-9]{3}$/

/^((29([-\/])02\3(\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00)))|((((0[1-9]|1\d|2[0-8])([-\/])(0[1-9]|1[012]))|((29|30)([-\/])(0[13-9]|1[012]))|(31([-\/])(0[13578]|1[02])))(\11|\15|\18)\d{4}))$/

/^((02([-\/])29\3(\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00)))|((((0[1-9]|1[012])([-\/])(0[1-9]|1\d|2[0-8]))|((0[13-9]|1[012])([-\/])(29|30))|((0[13578]|1[02])([-\/])31))(\11|\15|\19)\d{4}))$/

/^(((\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00))([-\/])02(\6)29)|(\d{4}([-\/])((0[1-9]|1[012])(\9)(0[1-9]|1\d|2[0-8])|((0[13-9]|1[012])(\9)(29|30))|((0[13578]|1[02])(\9)31))))$/

/^((29([-\/])02\3(\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00)))|((((0[1-9]|1\d|2[0-8])([-\/])(0[1-9]|1[012]))|((29|30)([-\/])(0[13-9]|1[012]))|(31([-\/])(0[13578]|1[02])))(\11|\15|\18)\d{4})) (\d|[0-1]\d|[2][0-3]):[0-5]\d$/

/^((02([-\/])29\3(\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00)))|((((0[1-9]|1[012])([-\/])(0[1-9]|1\d|2[0-8]))|((0[13-9]|1[012])([-\/])(29|30))|((0[13578]|1[02])([-\/])31))(\11|\15|\19)\d{4})) (\d|[0-1]\d|[2][0-3]):[0-5]\d$/

/^(((\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00))([-\/])02(\6)29)|(\d{4}([-\/])((0[1-9]|1[012])(\9)(0[1-9]|1\d|2[0-8])|((0[13-9]|1[012])(\9)(29|30))|((0[13578]|1[02])(\9)31)))) (\d|[0-1]\d|[2][0-3]):[0-5]\d$/

/^((29([-\/])02\3(\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00)))|((((0[1-9]|1\d|2[0-8])([-\/])(0[1-9]|1[012]))|((29|30)([-\/])(0[13-9]|1[012]))|(31([-\/])(0[13578]|1[02])))(\11|\15|\18)\d{4})) (\d|[0-1]\d|[2][0-3])(:[0-5]\d){2}$/

/^((02([-\/])29\3(\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00)))|((((0[1-9]|1[012])([-\/])(0[1-9]|1\d|2[0-8]))|((0[13-9]|1[012])([-\/])(29|30))|((0[13578]|1[02])([-\/])31))(\11|\15|\19)\d{4})) (\d|[0-1]\d|[2][0-3])(:[0-5]\d){2}$/

/^(((\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00))([-\/])02(\6)29)|(\d{4}([-\/])((0[1-9]|1[012])(\9)(0[1-9]|1\d|2[0-8])|((0[13-9]|1[012])(\9)(29|30))|((0[13578]|1[02])(\9)31)))) (\d|[0-1]\d|[2][0-3])(:[0-5]\d){2}$/

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/^[-+]?\b\d+\b$/

/^KL-\d{7}$/

/^S-\d{4}-\d{6}$/

/^[a-z]+$/i

/^\d{10}$/

/^[a-z0-9-_]+$/i

/^[-+]?[0-9]*\.?[0-9]+([eE][-+]?[0-9]+)?$/

/^-?\d+,\d$/

/^-?\d+\.\d$/

/^-?\d+,\d{2}$/

/^-?\d+\.\d{2}$/

/^-?\d+,\d{3}$/

/^-?\d+\.\d{3}$/

/^-?\d+,\d{4}$/

/^-?\d+\.\d{4}$/

/^[-+]?[0-9]*,?[0-9]+([eE][-+]?[0-9]+)?$/

/^(\(0[2-8]\)|0[2-8])\s*\d{4}\s*\d{4}$/

/^(?:\(?([2-9]0[1-9]|[2-9]1[02-9]|[2-9][2-9][0-9]|800|811)\)?)\s*(?:[.-]\s*)?([2-9]1[02-9]|[2-9][02-9]1|[2-9][02-9]{2})\s*(?:[.-]\s*)?([0-9]{4})(?:\s*(?:#|x\.?|ext\.?|extension)\s*(\d+))?$/

/^\d{4}$/

/^[ABCEGHJKLMNPRSTVXY]{1}\d{1}[A-Z]{1}\s*\d{1}[A-Z]{1}\d{1}$/i

/^(0[1-9]|[1-9]\d)\d{3}$/

/^\d{3}-\d\d-\d{4}$/

/^(\d|[01]\d|(2[0-3]))(:[0-5]\d){2}$/

/^([0-9]|[0-1][0-9]|[2][0-3]):([0-5][0-9])$/

/^[0-5]\d:[0-5]\d$/

/^[0-9]{4,9}$/

/^\d{5}(-\d{4})?$/

Patient-Reported Outcomes in PD (PRO-PD)

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Please rate the severity of your symptoms over the past 7 days, on average. The more severe and debilitating the symptom, slide right. If you're not having that symptom, slide to the left.

Slowness

* must provide value

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Constipation (incomplete bowel emptying)

* must provide value

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Walking

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Freezing

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Falling

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Rising from Seated Position

* must provide value

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Dressing, Eating, & Grooming

* must provide value

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Motivation/ Initiative

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Handwriting or Typing

* must provide value

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Depression (feeling sad, blues)

* must provide value

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Loss of Interest

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Anxiety

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Fatigue

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Daytime Sleepiness

* must provide value

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Dyskinesia
(rocking, writhing, twisting, squirming movements associated with medication.)

* must provide value

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Tremor

* must provide value

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Balance

* must provide value

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Control of Body Temperature
(symptoms may include cold hands and feet or sweating)

* must provide value

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Dizzy on standing

* must provide value

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Visual Disturbance

* must provide value

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Insomnia
(Inability to sleep)

* must provide value

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REM Sleep Behavior Disorder
(acting out dreams)

* must provide value

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Restless Leg Syndrome
(urge to move legs in order to stop unpleasant sensations.)

* must provide value

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Muscle cramping, pain, or aching
(most common in the morning or as medications wear off)

* must provide value

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Speech

* must provide value

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Drooling

* must provide value

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Stooped posture

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Memory/ Forgetfulness

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Comprehension

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Sense of smell

* must provide value

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Medication Side Effects

* must provide value

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Sexual Dysfunction
(loss of libido, erectile dysfunction, difficulty with orgasm)

* must provide value

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Urinary symtpoms
(dribbling, urgency, incontinence)

* must provide value

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Hallucinations or Delusions
(seeing things that aren't there)

* must provide value

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Nausea

* must provide value

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Age

Years since PD diagnosis

Do you have a diagnosis of Parkinson's disease?

* must provide value

No. I'm a healthy control.

PD suspected, not diagnosed.

I have something related to PD, but it's not PD.

I have a diagnosis of PD

Gender

Do we have your permission to use your data for research?

* must provide value

Yes

No

Cumulative Score= Sum of all variables
(Each variable scored 0-100)

View equation

We are trying to eradicate PD and improve the lives of those currently affected.

Do we have your permission to contact you (via email) if there is an internet-based study for which you may be eligible?

Yes

No

Name

Email address:

How do you score?

Please contact lmischley@bastyr.edu for questions about using this scale.

Copyright Laurie K Mischley 2013

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To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.