Evaluation of TRANSFoRm Mobile eHealth Solution for Remote Patient Monitoring during Clinical Trials

Table 2

The content of questions used in the study.

Section	ID	Question content
S1	Header	PROM Demographics
	Q1	How many persons (excluding yourself) currently live in your household? Number of persons:
	Q2	How would you describe your current occupation or employment status?
	Q3	What is the highest level of education that you achieved?
S2	Header	Smoking
	Q4	Do you currently smoke?
	Q5	If yes, number of cigarettes/day?
S3	Header	Self-Rated Health
	Q6	How would you rate your general health status
S4	Header	Thinking about your symptoms over the past 7 days, how often did you have the following?
	Q7	A burning feeling behind your breastbone
	Q8	Pain behind your breastbone
	Q9	A burning feeling in the centre of the upper stomach
	Q10	A pain in the centre of the upper stomach
	Q11	An acid taste in your mouth
	Q12	Unpleasant movement of material upwards from the stomach
S5	Header	Are you suffering from?
	Q13	Unintentional weight loss
	Q14	Difficulties swallowing
	Q15	Anemia