Table 1.

Parameters and levels

Parameter	Parameter levels with definitions
	Level 1 (least severe)	Level 2 (moderately severe)	Level 3 (most severe)
IGF-I levels	IGF-I levels are within normal limits	Slightly elevated above the normal range	Significantly elevated above the normal range
Tumor size	No change: not visible or has not changed since the previous MRI	Slight increase in size	Significant increase in size or has spread
Signs and symptomsa	None or mild	Moderate acromegaly symptoms	Severe acromegaly symptoms
Comorbid conditionsa	None or mild: does not have diabetes or sleep apnea OR Has cardiac disease, but currently is well controlled	Moderate: has currently controlled diabetes and no cardiac disease or sleep apnea OR Has moderate sleep apnea OR Has cardiac disease that is not well controlled	Severe: poorly controlled diabetes OR Well controlled diabetes, but cardiovascular disease in poorly controlled and signs of moderate to severe sleep apnea
Quality of life	No or minimal impairment in QoL	Moderate impairment in QoL	Significant impairment in QoL

IGF-I insulin-like growth factor I, MRI magnetic resonance imaging, QoL quality of life

^aThe survey used patient-friendly language including describing “comorbid conditions” as “related conditions” and “signs and symptoms” simply as “symptoms”