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EDRD-1159
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ANLKMRK committed Dec 13, 2024
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<?xml version="1.0" encoding="UTF-8"?>
<AssessmentQuestionSet xmlns="http://soap.sforce.com/2006/04/metadata">
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q01</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q02</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q03</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q04</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q05</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q06</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q05_R1</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q06_R1</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q07</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q07_R1</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q08</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q08_R1</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q09</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q09_R1</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q10</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q10_R1</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q11</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q12</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q13</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q14</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q15</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q15_R1</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q15_R2</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q15_R3</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q16</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q16_R1</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q16_R2</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q16_R3</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q17</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q17_R1</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q17_R2</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q17_R3</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q18</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q18_R1</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q18_R2</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q18_R3</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q19</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q19_R1</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q19_R2</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q19_R3</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q20</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q20_R1</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q20_R2</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q20_R3</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q21</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q21_R1</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q21_R2</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q21_R3</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q22</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q22_R1</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q22_R2</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q22_R3</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q23</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q23_R1</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q23_R2</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Initial_Q23_R3</assessmentQuestionDeveloperNames>
<developerName>miglustat_NPC_Initial_QS</developerName>
<name>miglustat-NPC_Initial_QS</name>
</AssessmentQuestionSet>
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<?xml version="1.0" encoding="UTF-8"?>
<AssessmentQuestionSet xmlns="http://soap.sforce.com/2006/04/metadata">
<assessmentQuestionDeveloperNames>miglustat_NPC_Renwal_Q01</assessmentQuestionDeveloperNames>
<assessmentQuestionDeveloperNames>miglustat_NPC_Renwal_Q02</assessmentQuestionDeveloperNames>
<developerName>miglustat_NPC_Renewal_QS</developerName>
<name>miglustat-NPC_Renewal_QS</name>
</AssessmentQuestionSet>
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<?xml version="1.0" encoding="UTF-8"?>
<AssessmentQuestion xmlns="http://soap.sforce.com/2006/04/metadata">
<assessmentQuestionVersion>
<isActive>true</isActive>
<name>miglustat-NPC_Initial_Q01</name>
<optionSourceResponseValue>false</optionSourceResponseValue>
<questionText>Please describe biochemical and molecular confirmation of disease or attach any relevant documents at the end of this form.</questionText>
<status>Active</status>
<versionNumber>1</versionNumber>
</assessmentQuestionVersion>
<dataType>TextArea</dataType>
<developerName>miglustat_NPC_Initial_Q01</developerName>
<name>miglustat-NPC_Initial_Q01</name>
<questionCategory>Demographic</questionCategory>
</AssessmentQuestion>
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<?xml version="1.0" encoding="UTF-8"?>
<AssessmentQuestion xmlns="http://soap.sforce.com/2006/04/metadata">
<assessmentQuestionVersion>
<isActive>true</isActive>
<name>miglustat-NPC_Initial_Q02</name>
<optionSourceResponseValue>false</optionSourceResponseValue>
<questionText>Describe all relevant clinical information regarding the patient or attach a consult note at the end of this form:</questionText>
<status>Active</status>
<versionNumber>1</versionNumber>
</assessmentQuestionVersion>
<dataType>TextArea</dataType>
<developerName>miglustat_NPC_Initial_Q02</developerName>
<name>miglustat-NPC_Initial_Q02</name>
<questionCategory>Demographic</questionCategory>
</AssessmentQuestion>
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<?xml version="1.0" encoding="UTF-8"?>
<AssessmentQuestion xmlns="http://soap.sforce.com/2006/04/metadata">
<assessmentQuestionVersion>
<isActive>true</isActive>
<name>miglustat-NPC_Initial_Q03</name>
<optionSourceResponseValue>false</optionSourceResponseValue>
<questionText>Please describe the patient’s current quality of life. Feel free to use any relevant age-appropriate quality of life tools.</questionText>
<status>Active</status>
<versionNumber>1</versionNumber>
</assessmentQuestionVersion>
<dataType>TextArea</dataType>
<developerName>miglustat_NPC_Initial_Q03</developerName>
<name>miglustat-NPC_Initial_Q03</name>
<questionCategory>Demographic</questionCategory>
</AssessmentQuestion>
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<?xml version="1.0" encoding="UTF-8"?>
<AssessmentQuestion xmlns="http://soap.sforce.com/2006/04/metadata">
<assessmentQuestionVersion>
<isActive>true</isActive>
<name>miglustat-NPC_Initial_Q04</name>
<optionSourceResponseValue>false</optionSourceResponseValue>
<questionText>I. Functional disability scale</questionText>
<status>Active</status>
<versionNumber>1</versionNumber>
</assessmentQuestionVersion>
<dataType>TextBlock</dataType>
<developerName>miglustat_NPC_Initial_Q04</developerName>
<name>miglustat-NPC_Initial_Q04</name>
<questionCategory>Demographic</questionCategory>
</AssessmentQuestion>
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<?xml version="1.0" encoding="UTF-8"?>
<AssessmentQuestion xmlns="http://soap.sforce.com/2006/04/metadata">
<assessmentQuestionVersion>
<isActive>true</isActive>
<name>miglustat-NPC_Initial_Q05</name>
<optionSourceResponseValue>false</optionSourceResponseValue>
<questionText>Ambulation</questionText>
<responseValues>Normal
Clumsiness
Autonomous ataxic gait
Outdoor assisted ambulation
Indoor assisted ambulation
Wheelchair-bound</responseValues>
<status>Active</status>
<versionNumber>2</versionNumber>
</assessmentQuestionVersion>
<dataType>Select</dataType>
<developerName>miglustat_NPC_Initial_Q05</developerName>
<name>miglustat-NPC_Initial_Q05</name>
<questionCategory>Demographic</questionCategory>
</AssessmentQuestion>
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<?xml version="1.0" encoding="UTF-8"?>
<AssessmentQuestion xmlns="http://soap.sforce.com/2006/04/metadata">
<assessmentQuestionVersion>
<isActive>true</isActive>
<name>miglustat_NPC_Initial_Q05_R1</name>
<optionSourceResponseValue>false</optionSourceResponseValue>
<questionText>Ambulation Score</questionText>
<status>Active</status>
<versionNumber>2</versionNumber>
</assessmentQuestionVersion>
<dataType>Formula</dataType>
<developerName>miglustat_NPC_Initial_Q05_R1</developerName>
<formulaResponseDataType>Integer</formulaResponseDataType>
<name>miglustat_NPC_Initial_Q05_R1</name>
<questionCategory>Demographic</questionCategory>
</AssessmentQuestion>
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<?xml version="1.0" encoding="UTF-8"?>
<AssessmentQuestion xmlns="http://soap.sforce.com/2006/04/metadata">
<assessmentQuestionVersion>
<isActive>true</isActive>
<name>miglustat-NPC_Initial_Q06</name>
<optionSourceResponseValue>false</optionSourceResponseValue>
<questionText>Manipulation</questionText>
<responseValues>Normal
Tremor
Slight dysmetria/dystonia (allows autonomous manipulation)
Mild dysmetria/dystonia (requires help for several tasks but is able to feed themselves)
Severe dysmetria/dystonia (requires assistance in all activities)</responseValues>
<status>Active</status>
<versionNumber>1</versionNumber>
</assessmentQuestionVersion>
<dataType>Select</dataType>
<developerName>miglustat_NPC_Initial_Q06</developerName>
<name>miglustat-NPC_Initial_Q06</name>
<questionCategory>Demographic</questionCategory>
</AssessmentQuestion>
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<?xml version="1.0" encoding="UTF-8"?>
<AssessmentQuestion xmlns="http://soap.sforce.com/2006/04/metadata">
<assessmentQuestionVersion>
<isActive>true</isActive>
<name>miglustat-NPC_Initial_Q06_R1</name>
<optionSourceResponseValue>false</optionSourceResponseValue>
<questionText>Manipulation Score</questionText>
<status>Active</status>
<versionNumber>1</versionNumber>
</assessmentQuestionVersion>
<dataType>Formula</dataType>
<developerName>miglustat_NPC_Initial_Q06_R1</developerName>
<formulaResponseDataType>Integer</formulaResponseDataType>
<name>miglustat-NPC_Initial_Q06_R1</name>
<questionCategory>Demographic</questionCategory>
</AssessmentQuestion>
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<?xml version="1.0" encoding="UTF-8"?>
<AssessmentQuestion xmlns="http://soap.sforce.com/2006/04/metadata">
<assessmentQuestionVersion>
<isActive>true</isActive>
<name>miglustat-NPC_Initial_Q07</name>
<optionSourceResponseValue>false</optionSourceResponseValue>
<questionText>Language</questionText>
<responseValues>Normal
Delayed acquisition
Mild dysarthria (understandable)
Severe dysarthria (only comprehensible to some family members)
Non-verbal communication
Absence of communication</responseValues>
<status>Active</status>
<versionNumber>1</versionNumber>
</assessmentQuestionVersion>
<dataType>Select</dataType>
<developerName>miglustat_NPC_Initial_Q07</developerName>
<name>miglustat-NPC_Initial_Q07</name>
<questionCategory>Demographic</questionCategory>
</AssessmentQuestion>
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<?xml version="1.0" encoding="UTF-8"?>
<AssessmentQuestion xmlns="http://soap.sforce.com/2006/04/metadata">
<assessmentQuestionVersion>
<isActive>true</isActive>
<name>miglustat-NPC_Initial_Q07_R1</name>
<optionSourceResponseValue>false</optionSourceResponseValue>
<questionText>Language Score</questionText>
<status>Active</status>
<versionNumber>1</versionNumber>
</assessmentQuestionVersion>
<dataType>Formula</dataType>
<developerName>miglustat_NPC_Initial_Q07_R1</developerName>
<formulaResponseDataType>Integer</formulaResponseDataType>
<name>miglustat-NPC_Initial_Q07_R1</name>
<questionCategory>Demographic</questionCategory>
</AssessmentQuestion>
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<?xml version="1.0" encoding="UTF-8"?>
<AssessmentQuestion xmlns="http://soap.sforce.com/2006/04/metadata">
<assessmentQuestionVersion>
<isActive>true</isActive>
<name>miglustat-NPC_Initial_Q08</name>
<optionSourceResponseValue>false</optionSourceResponseValue>
<questionText>Swallowing</questionText>
<responseValues>Normal
Occasional dysphagia
Daily dysphagia
Nasogastric tube or gastric button feeding</responseValues>
<status>Active</status>
<versionNumber>1</versionNumber>
</assessmentQuestionVersion>
<dataType>Select</dataType>
<developerName>miglustat_NPC_Initial_Q08</developerName>
<name>miglustat-NPC_Initial_Q08</name>
<questionCategory>Demographic</questionCategory>
</AssessmentQuestion>
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<?xml version="1.0" encoding="UTF-8"?>
<AssessmentQuestion xmlns="http://soap.sforce.com/2006/04/metadata">
<assessmentQuestionVersion>
<isActive>true</isActive>
<name>miglustat-NPC_Initial_Q08_R1</name>
<optionSourceResponseValue>false</optionSourceResponseValue>
<questionText>Swallowing Score</questionText>
<status>Active</status>
<versionNumber>1</versionNumber>
</assessmentQuestionVersion>
<dataType>Formula</dataType>
<developerName>miglustat_NPC_Initial_Q08_R1</developerName>
<formulaResponseDataType>Integer</formulaResponseDataType>
<name>miglustat-NPC_Initial_Q08_R1</name>
<questionCategory>Demographic</questionCategory>
</AssessmentQuestion>
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<?xml version="1.0" encoding="UTF-8"?>
<AssessmentQuestion xmlns="http://soap.sforce.com/2006/04/metadata">
<assessmentQuestionVersion>
<isActive>true</isActive>
<name>miglustat-NPC_Initial_Q09</name>
<optionSourceResponseValue>false</optionSourceResponseValue>
<questionText>Eye movements</questionText>
<responseValues>Normal
Slow ocular pursuit
Vertical ophthalmoplegia
Complete ophthalmoplegia</responseValues>
<status>Active</status>
<versionNumber>1</versionNumber>
</assessmentQuestionVersion>
<dataType>Select</dataType>
<developerName>miglustat_NPC_Initial_Q09</developerName>
<name>miglustat-NPC_Initial_Q09</name>
<questionCategory>Demographic</questionCategory>
</AssessmentQuestion>
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<?xml version="1.0" encoding="UTF-8"?>
<AssessmentQuestion xmlns="http://soap.sforce.com/2006/04/metadata">
<assessmentQuestionVersion>
<isActive>true</isActive>
<name>miglustat-NPC_Initial_Q09_R1</name>
<optionSourceResponseValue>false</optionSourceResponseValue>
<questionText>Eye movements Score</questionText>
<status>Active</status>
<versionNumber>1</versionNumber>
</assessmentQuestionVersion>
<dataType>Formula</dataType>
<developerName>miglustat_NPC_Initial_Q09_R1</developerName>
<formulaResponseDataType>Integer</formulaResponseDataType>
<name>miglustat-NPC_Initial_Q09_R1</name>
<questionCategory>Demographic</questionCategory>
</AssessmentQuestion>
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<?xml version="1.0" encoding="UTF-8"?>
<AssessmentQuestion xmlns="http://soap.sforce.com/2006/04/metadata">
<assessmentQuestionVersion>
<isActive>true</isActive>
<name>miglustat-NPC_Initial_Q10</name>
<optionSourceResponseValue>false</optionSourceResponseValue>
<questionText>Seizure</questionText>
<responseValues>No
Yes, controlled by antiepileptic drugs
Yes, uncontrolled on two or more antiepileptic drugs of maximally tolerable dose</responseValues>
<status>Active</status>
<versionNumber>1</versionNumber>
</assessmentQuestionVersion>
<dataType>Select</dataType>
<developerName>miglustat_NPC_Initial_Q10</developerName>
<name>miglustat-NPC_Initial_Q10</name>
<questionCategory>Demographic</questionCategory>
</AssessmentQuestion>
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<?xml version="1.0" encoding="UTF-8"?>
<AssessmentQuestion xmlns="http://soap.sforce.com/2006/04/metadata">
<assessmentQuestionVersion>
<isActive>true</isActive>
<name>miglustat-NPC_Initial_Q10_R1</name>
<optionSourceResponseValue>false</optionSourceResponseValue>
<questionText>Seizure Score</questionText>
<status>Active</status>
<versionNumber>1</versionNumber>
</assessmentQuestionVersion>
<dataType>Formula</dataType>
<developerName>miglustat_NPC_Initial_Q10_R1</developerName>
<formulaResponseDataType>Integer</formulaResponseDataType>
<name>miglustat-NPC_Initial_Q10_R1</name>
<questionCategory>Demographic</questionCategory>
</AssessmentQuestion>
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<?xml version="1.0" encoding="UTF-8"?>
<AssessmentQuestion xmlns="http://soap.sforce.com/2006/04/metadata">
<assessmentQuestionVersion>
<isActive>true</isActive>
<name>miglustat-NPC_Initial_Q11</name>
<optionSourceResponseValue>false</optionSourceResponseValue>
<questionText>II. Neurocognitive Assessment</questionText>
<status>Active</status>
<versionNumber>1</versionNumber>
</assessmentQuestionVersion>
<dataType>TextBlock</dataType>
<developerName>miglustat_NPC_Initial_Q11</developerName>
<name>miglustat-NPC_Initial_Q11</name>
<questionCategory>Demographic</questionCategory>
</AssessmentQuestion>
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