CALGBForm
Item
CALGB Form
text
CALGBStudyNo
Item
CALGB Study No
text
CALGBPatientID
Item
CALGB Patient ID
text
DateCompleted
Item
Date Completed (M)
date
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Patient'sName
Item
Patient's Name
text
ResponsibleCRA
Item
Responsible CRA
text
AssessmentNumber
Item
Assessment Number (ADDITIONAL PHYSICAL PROBLEMS DUE TO CANCER TREATMENT [SIDE EFFECTS])
float
ParticipatingGroup
Item
Participating Group
text
C17005 (NCI Thesaurus ObjectClass)
C1257890 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
PatientHospitalNumber
Item
Patient Hospital Number
text
ParticipatingGroupProtocolNo.
Item
Participating Group Protocol No.
text
MainMemberInstitution/Adjunct
Item
Main Member Institution/Adjunct
text
ParticipatingGroupPatientNo.
Item
Participating Group Patient No.
text
Item
Mouth sores
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL Item
Not At All (Not at All)
C91213 (NCI Thesaurus)
CL Item
A Little (A Little)
CL Item
Quite A Bit (Quite a Bit)
C91216 (NCI Thesaurus)
CL Item
Very Much (Very Much)
C91217 (NCI Thesaurus)
Item
Skin changes (such as redness or peeling) on hands or feet
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
Skin changes (such as redness or peeling) on hands or feet
CL Item
Not At All (Not at All)
C91213 (NCI Thesaurus)
CL Item
A Little (A Little)
CL Item
Quite A Bit (Quite a Bit)
C91216 (NCI Thesaurus)
CL Item
Very Much (Very Much)
C91217 (NCI Thesaurus)
Item
Swelling in hands or feet
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
Swelling in hands or feet
CL Item
Not At All (Not at All)
C91213 (NCI Thesaurus)
CL Item
A Little (A Little)
CL Item
Quite A Bit (Quite a Bit)
C91216 (NCI Thesaurus)
CL Item
Very Much (Very Much)
C91217 (NCI Thesaurus)
Item
Pain in hands or feet (OVERALL QUALITY OF LIFE)
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
Pain in hands or feet (OVERALL QUALITY OF LIFE)
CL Item
Not At All (Not at All)
C91213 (NCI Thesaurus)
CL Item
A Little (A Little)
CL Item
Quite A Bit (Quite a Bit)
C91216 (NCI Thesaurus)
CL Item
Very Much (Very Much)
C91217 (NCI Thesaurus)
whatnumberwouldyousaybestdescribesyourcurrentstatofhealthoverjustthepasttwoweeks?
Item
what number would you say best describes your current stat of health over just the past two weeks? (3. Imagine that a friend of yours is expected to live for 15 years with the same quality of live as you have now. Suppose treatment could restore your friend to full health, but would shorten his/her life.)
float
Atmost,howmuchtimewouldyouadviseyourfriendtogiveupoutof15yearsinordertoreturntofullhealth?
Item
At most, how much time would you advise your friend to give up out of 15 years in order to return to full health? (months)
float