TABLE 1.

LIST OF ATTRIBUTES TO CHARACTERIZE EACH HEALTH STATES BASED ON THE CLAMES SYSTEM (MCINTOSH ET AL., 2007)

Attribute	Level	Description
Core Attributes
Pain or discomfort	1	Generally free of pain and discomfort
	2	Mild pain or discomfort
	3	Moderate pain or discomfort
	4	Severe pain or discomfort
Physical functioning	1	Generally no limitations in physical functioning
	2	Mild limitations in physical functioning
	3	Moderate limitations in physical functioning
	4	Severe limitations in physical functioning
Emotional state	1	Happy and interested in life
	2	Somewhat happy
	3	Somewhat unhappy
	4	Very unhappy
	5	So unhappy that life is not worthwhile
Fatigue	1	Generally no feelings of tiredness, no lack of energy
	2	Sometimes feel tired and have little energy
	3	Most of the time feel tired and have little energy
	4	Always feel tired and have no energy
Memory and thinking	1	Able to remember most things, think clearly and solve day-to-day problems
	2	Able to remember most things but have some difficulty when trying to think and solve day-to-day problems
	3	Somewhat forgetful, but able to think clearly and solve day-to-day problems
	4	Very forgetful, and have great difficulty when trying to think or solve day-to-day problems
Social relationships	1	No limitations in the capacity to sustain social relationships
	2	Mild limitations in the capacity to sustain social relationships
	3	Moderate limitations in the capacity to sustain social relationships
	4	Severe limitations in the capacity to sustain social relationships
	5	No capacity or unable to relate to other people socially
Supplementary attributes
Anxiety	1	Generally not anxious
	2	Mild levels of anxiety experienced occasionally
	3	Moderate levels of anxiety experienced regularly
	4	Severe levels of anxiety experienced most of the time
Speech	1	Able to be understood completely when speaking with strangers or friends
	2	Able to be understood partially when speaking with strangers but able to be understood completely when speaking with people who know you well
	3	Able to be understood partially when speaking with strangers and people who know you well
	4	Unable to be understood when speaking to other people
Hearing	1	Able to hear what is said in a group conversation, without a hearing aid, with at least 3 other people
	2	Able to hear what is said in a conversation with 1 other person in a quiet room, with or without a hearing aid, but require a hearing aid to hear what is said in a group conversation with at least 3 other people
	3	Able to hear what is said in a conversation with 1 other person in a quiet room, with or without a hearing aid, but unable to hear what is said in a group conversation with at least 3 other people
	4	Unable to hear what others say, even with a hearing aid
Vision	1	Able to see well enough, with or without glasses or contact lenses, to read ordinary newsprint and recognize a friend on the other side of the street
	2	Unable to see well enough, even with glasses or contact lenses, to recognize a friend on the other side of the street but can see well enough to read ordinary print
	3	Unable to see well enough, even with glasses or contact lenses, to read ordinary newsprint or to recognize a friend on the other side of the street
Use of hands and fingers	1	No limitations in the use of hands and fingers
	2	Limitations in the use of hands and fingers but do not require special tools or the help of another person
	3	Limitations in the use of hands and fingers, independent with special tools and do not require the help of another person
	4	Limitations in the use of hands and fingers, require the help of another person for some tasks
	5	Limitations in the use of hands and fingers, require the help of another person for most tasks

Score 1 - no problem; Scores 4 or 5 - the highest levels of disability