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Providence, RI
Best answers
This is one of those very subjective gray areas... I doubt you will find any confirmation in writing on this one, but if you're asking my opinion, I agree with Pam. I would count it as a quality as written. If it was slightly altered (Regarding his chronic back pain, he says he is feeling much better, no pain) you could count it as Severity (since it does indicate decreased severity of their symptoms.)

Many experienced auditors don't typically mark something as Severity or Quality or Timing right away.... instead we just sort of highlight or underline things until we are done scanning the HPI, then we decide how we want to count the items. A lot of phrases can be counted more than one way.