ID

44125

Beschreibung

Quality of Life Questionnaire Anastrozole or Tamoxifen in Treating Postmenopausal Women With Ductal Carcinoma in Situ Who Are Undergoing Lumpectomy and Radiation Therapy NCT00053898 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A0E240A0-FD2A-46A0-E034-080020C9C0E0

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A0E240A0-FD2A-46A0-E034-080020C9C0E0

Stichworte

Versionen (5)
  1. 26.08.12 26.08.12 -
  2. 07.08.14 07.08.14 - Martin Dugas
  3. 21.03.15 21.03.15 - Martin Dugas
  4. 10.04.21 10.04.21 - Ahmed Rafee, MD
  5. 20.09.21 20.09.21 -
Rechteinhaber

folgt

Hochgeladen am

20. September 2021

DOI

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Lizenz

Creative Commons BY 4.0
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Breast Cancer (NCT00053898)

Englisch

NSABP Protocol B-35 [At bottom ] Record the first three letters of patient's last name and study ID on each of the remaining pages before giving the questionnaire to the patient.

1 Formulare  
Header
Beschreibung

Header

First Three Letters of Patient?s Last Name
Beschreibung

FirstThreeLettersofPatient?sLastName

Datentyp

text

Patient Study ID
Beschreibung

PatientStudyID

Datentyp

text

Institution Name
Beschreibung

InstitutionName

Datentyp

text

Affiliate Name
Beschreibung

AffiliateName

Datentyp

text

Staff member administering form
Beschreibung

PersonFormAdministrationLastName

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C25190
NCI Thesaurus Property
C19464
NCI Thesaurus Property-2
C25409
NCI Thesaurus ValueDomain
C25191
NCI Thesaurus ValueDomain-2
C25551
UMLS CUI-1
C1550483
Phone
Beschreibung

Phone

Datentyp

text

Are data amended? (If yes, circle amended items in red.)
Beschreibung

AmendedDataInd

Datentyp

boolean

Alias
NCI Thesaurus ObjectClass
C25474
UMLS 2011AA ObjectClass
C1511726
NCI Thesaurus Property
C25416
UMLS 2011AA Property
C1691222
Time Point for this Questionnaire (Check One)
Beschreibung

TimePointforthisQuestionnaire

Datentyp

text

This form is being filled out
Beschreibung

CaseReportFormPersonCompleteType

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus Property
C25190
UMLS 2011AA Property
C0027361
NCI Thesaurus ObjectClass
C40988
UMLS 2011AA ObjectClass
C1516308
NCI Thesaurus Property-2
C25250
UMLS 2011AA Property-2
C0205197
Symptom frequency
Beschreibung

Symptom frequency

Alias
UMLS CUI-1
C0436350
I was bothered by things that don't usually bother me.
Beschreibung

QualityofLifeDiscomfortNormalEventAssessmentDayFrequency

Datentyp

text

Alias
UMLS CUI [1]
C3174325
NCI Thesaurus ObjectClass
C17047
NCI Thesaurus Property
C25499
NCI Thesaurus Property-2
C50535
NCI Thesaurus Property-3
C14165
NCI Thesaurus Property-4
C25217
NCI Thesaurus ValueDomain
C25301
NCI Thesaurus ValueDomain-2
C25515
I had trouble keeping my mind on what I was doing.
Beschreibung

IhadtroublekeepingmymindonwhatIwasdoing.

Datentyp

text

Alias
UMLS CUI-1
C0235198
I felt depressed
Beschreibung

Ifeltdepressed

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C17047
NCI Thesaurus Property
C25217
NCI Thesaurus Property-2
C2982
UMLS CUI-1
C0011581
I felt that everything I did was an effort.
Beschreibung

IfeltthateverythingIdidwasaneffort.IfeltthateverythingIdidwasaneffort.Text

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS CUI-1
C3174029
I felt hopeful about the future.
Beschreibung

Ifelthopefulaboutthefuture.Ifelthopefulaboutthefuture

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS CUI-1
C3274937
I felt fearful.
Beschreibung

I felt fearful.

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS CUI-1
C1288289
My sleep was restless.
Beschreibung

My sleep was restless.

Datentyp

text

Alias
UMLS CUI-1
C0235160
I was happy.
Beschreibung

I was happy.

Datentyp

text

Alias
UMLS CUI-1
C0018592
I felt lonely.
Beschreibung

I felt lonely.

Datentyp

text

Alias
UMLS CUI-1
C3175808
I could not get ´going´
Beschreibung

I could not get ´going´

Datentyp

text

Everyday Problems During The Past Four Weeks
Beschreibung

Everyday Problems During The Past Four Weeks

Alias
UMLS CUI-1
C0033213
UMLS CUI-2
C3828653
Hot Flashes
Beschreibung

Hot Flashes

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0600142
Headaches
Beschreibung

Headaches

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
NCI Thesaurus Property
C25626
NCI Thesaurus ObjectClass
C34661
UMLS CUI-1
C0018681
Difficulty with bladder control (at other times)
Beschreibung

Difficultywithbladdercontrol

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
Vaginal discharge
Beschreibung

Vaginal discharge

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0227791
Vaginal bleeding or spotting
Beschreibung

Vaginal bleeding or spotting

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C3475970
Genital itching/irritation
Beschreibung

Genital itching/irritation

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0033777
Vaginal dryness
Beschreibung

Vaginal dryness

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0241633
Pain with intercourse
Beschreibung

Painwithintercourse

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0423742
Breast pain
Beschreibung

Breast pain

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0024902
Difficulty with breast skin
Beschreibung

Difficultywithbreastskin

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
Breast sensitivity/tenderness
Beschreibung

Breastsensitivity/tenderness

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0262397
General aches and pains
Beschreibung

Generalachesandpains

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0150930
Joint pains
Beschreibung

Joint pains

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0003862
Muscle stiffness
Beschreibung

Muscle stiffness

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0427008
Weight gain
Beschreibung

Weightgain

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS
C0043094
Weight loss
Beschreibung

Weight loss

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C38147
NCI Thesaurus ObjectClass
C20989
NCI Thesaurus Property
C25755
NCI Thesaurus ObjectClass-2
C3445
UMLS CUI-1
C1262477
Unhappy with appearance of my body
Beschreibung

Unhappywithappearanceofmybody

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C3274925
Decreased appetite
Beschreibung

Decreasedappetite

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0232462
Forgetfulness
Beschreibung

Forgetfulness

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0542476
Excitability
Beschreibung

Excitability

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0235169
Short temper
Beschreibung

Short temper

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0424331
Tendency to take naps; stay in bed
Beschreibung

Tendencytotakenaps;stayinbed

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0013144
Night sweats
Beschreibung

Night sweats

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0028081
Cold sweats
Beschreibung

Cold sweats

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0232431
Difficulty concentrating
Beschreibung

Difficulty concentrating

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0947509
Easily distracted
Beschreibung

Easily distracted

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0424102
Trouble sleeping
Beschreibung

Trouble sleeping

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C3641752
Early awakening
Beschreibung

Early awakening

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0541798
Any other problems
Beschreibung

Anyotherproblems (Specify below)

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C1273828
Severity
Beschreibung

Severity

Datentyp

text

Alias
UMLS CUI-1
C0439793
Specify other problems
Beschreibung

Specifyotherproblems

Datentyp

text

Alias
UMLS CUI-1
C1273828
Overall health
Beschreibung

Overall health

In general, would you say your health is
Beschreibung

In general, would you say your health is

Datentyp

text

Alias
NCI Thesaurus Property
C20989
NCI Thesaurus ObjectClass
C25178
NCI Thesaurus ValueDomain
C25688
UMLS CUI-1
C0018759
Moderate activities, such as moving a table, pushing a vacuum cleaner, bowling, or playing golf (2)
Beschreibung

Moderateactivities,suchasmovingatable,pushingavacuumcleaner,bowling,orplayinggolf

Datentyp

text

Alias
UMLS CUI-1
C0449295
UMLS CUI-2
C3833417
Climbing several flights of stairs (3)
Beschreibung

ClimbingStairsPhysicalActivityAssessmentScale

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25664
NCI Thesaurus Property
C20989
NCI Metathesaurus ObjectClass
CL299704
NCI Thesaurus ObjectClass
C17708
UMLS CUI-1
C0449295
UMLS CUI-2
C3831080
Accomplished less than you would like. (6)
Beschreibung

ReducedProductivityHealthAssessmentInd-2

Datentyp

boolean

Alias
NCI Thesaurus ObjectClass
C25640
NCI Metathesaurus ObjectClass
C0033269
NCI Thesaurus Property
C20989
NCI Thesaurus Property-2
C25178
NCI Thesaurus ValueDomain
C38147
UMLS CUI-1
C3828382
Were limited in the kind of work or other activities. (5)
Beschreibung

LimitedWorkHealthAssessmentInd-2

Datentyp

boolean

Alias
NCI Metathesaurus ObjectClass
CL110648
NCI Metathesaurus ObjectClass-2
C0043227
NCI Thesaurus Property
C20989
NCI Thesaurus Property-2
C25178
NCI Thesaurus ValueDomain
C38147
UMLS CUI-1
C3641747
Didn't do work or other activities as carefully as usual. (7)
Beschreibung

Didn'tdoworkorotheractivitiesascarefullyasusual.

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C3828404
During the past 4 weeks, how much did pain interfere with your normal work? (8. including both work outside the home and housework)
Beschreibung

PainPatientWorkAssessmentStatus

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus ObjectClass-2
C3303
NCI Thesaurus Property
C20989
NCI Metathesaurus Property
C0043227
NCI Thesaurus ValueDomain
C25688
UMLS CUI-1
C3828383
Mood
Beschreibung

Mood

Alias
UMLS CUI-1
C0026516
Have you felt calm and peaceful? (9)
Beschreibung

PatientRelaxationAssessmentScale

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25664
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C20989
NCI Metathesaurus Property
C0035028
UMLS CUI-1
C3261651
Did you feel full of pep? (10)
Beschreibung

PatientVitalityAssessmentScale

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25664
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C20989
NCI Metathesaurus Property
C0291944
UMLS CUI-1
C3828401
Did you have a lot of energy? (11)
Beschreibung

PatientEnergyAssessmentScale

Datentyp

text

Alias
UMLS CUI [1]
C3828394
NCI Thesaurus ValueDomain
C25664
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C20989
NCI Thesaurus Property-2
C48058
Did you feel worn out? (12)
Beschreibung

PatientFatigueAssessmentScale

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25664
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C20989
NCI Thesaurus Property-2
C3036
UMLS CUI-1
C3828399
Did you feel tired? (13)
Beschreibung

PatientLethargyAssessmentScale

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25664
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C20989
NCI Metathesaurus Property
C0023380
UMLS CUI-1
C3539029
Have you felt downhearted and blue? (14)
Beschreibung

Have you felt downhearted and blue? (14)

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25664
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C20989
NCI Metathesaurus Property
C0026516
UMLS CUI-1
C3828397
During the past 4 weeks, how much of the time has your physical health or emotional problems interfered with your social activities? (15. like visiting with friends, relatives, etc.)
Beschreibung

SocialBehaviorAssessmentDuration

Datentyp

text

Alias
NCI Thesaurus Property
C20989
NCI Metathesaurus ObjectClass
C0037397
NCI Thesaurus ValueDomain
C25330
UMLS CUI-1
C3484327
Please score your overall quality of life as of today on an 11-point scale where 0 indicates being in the worst possible health and 10 indicates being in perfect health. (16)
Beschreibung

Pleasescoreyouroverallqualityoflifeasoftodayonan11-pointscalewhere0indicatesbeingintheworstpossiblehealthand10indicatesbeinginperfecthealth.

Datentyp

text

Alias
UMLS CUI-1
C0451401
Sexual activity
Beschreibung

Sexual activity

Alias
UMLS CUI-1
C0036864
Have you been sexually active during the past SIX MONTHS? (17)
Beschreibung

HaveyoubeensexuallyactiveduringthepastSIXMONTHS?

Datentyp

boolean

Alias
UMLS CUI [1,1]
C0241028
UMLS CUI [1,2]
C3828652
NCI Thesaurus ValueDomain
C25180
Lack of sexual interest
Beschreibung

Lackofsexualinterest

Datentyp

text

Alias
UMLS CUI-1
C3828902
Difficulty in becoming sexually aroused
Beschreibung

Difficultyinbecomingsexuallyaroused

Datentyp

text

Alias
UMLS CUI-1
C1314759
Unable to relax and enjoy sex
Beschreibung

Unabletorelaxandenjoysex

Datentyp

text

Alias
UMLS CUI-1
C3174543
Difficulty in having orgasm
Beschreibung

Difficultyinhavingorgasm

Datentyp

text

Alias
UMLS CUI-1
C0029261
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Ähnliche Modelle

NSABP Protocol B-35 [At bottom ] Record the first three letters of patient's last name and study ID on each of the remaining pages before giving the questionnaire to the patient.

1 Formulare
Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
Alias
Item Group
Header
First 3 Letters Last Name
Item
First Three Letters of Patient?s Last Name
text
PatientStudyID
Item
Patient Study ID
text
InstitutionName
Item
Institution Name
text
AffiliateName
Item
Affiliate Name
text
Person Form Administration Name
Item
Staff member administering form
text
C25190 (NCI Thesaurus ObjectClass)
C19464 (NCI Thesaurus Property)
C25409 (NCI Thesaurus Property-2)
C25191 (NCI Thesaurus ValueDomain)
C25551 (NCI Thesaurus ValueDomain-2)
C1550483 (UMLS CUI-1)
Phone
Item
Phone
text
AmendedDataInd
Item
Are data amended? (If yes, circle amended items in red.)
boolean
C25474 (NCI Thesaurus ObjectClass)
C1511726 (UMLS 2011AA ObjectClass)
C25416 (NCI Thesaurus Property)
C1691222 (UMLS 2011AA Property)
Item
Time Point for this Questionnaire (Check One)
text
CL.2
Code List
Time Point for this Questionnaire (Check One)
CL Item
Baseline (Baseline)
C25213 (NCI Thesaurus)
C1442488 (UMLS 2011AA)
CL Item
6 Month Follow-up (6 month follow-up)
CL Item
12 Month Follow-up (12 month follow-up)
CL Item
18 Month Follow-up (18 month follow-up)
CL Item
2 Year Follow-up (2 year follow-up)
CL Item
30 Month Follow-up (30 month follow-up)
CL Item
3 Year Follow-up (3 year follow-up)
CL Item
42 Month Follow-up (42 month follow-up)
CL Item
4 Year Follow-up (4 year follow-up)
CL Item
54 Month Follow-up (54 month follow-up)
CL Item
5 Year Follow-up (5 year follow-up)
CL Item
66 Month Follow-up (66 month follow-up)
CL Item
6 Year Follow-up (6 year follow-up)
Item
This form is being filled out
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C25190 (NCI Thesaurus Property)
C0027361 (UMLS 2011AA Property)
C40988 (NCI Thesaurus ObjectClass)
C1516308 (UMLS 2011AA ObjectClass)
C25250 (NCI Thesaurus Property-2)
C0205197 (UMLS 2011AA Property-2)
CL.3
Code List
This form is being filled out
CL Item
0 By Patient In Office (0 By patient in office)
CL Item
1 By Clinical Staff On Phone With Patient (1 By clinical staff on phone with patient)
CL Item
2 By Patient, Mailed To Office (2 By patient, mailed to office)
Item Group
Symptom frequency
C0436350 (UMLS CUI-1)
Item
I was bothered by things that don't usually bother me.
text
C3174325 (UMLS CUI [1])
C17047 (NCI Thesaurus ObjectClass)
C25499 (NCI Thesaurus Property)
C50535 (NCI Thesaurus Property-2)
C14165 (NCI Thesaurus Property-3)
C25217 (NCI Thesaurus Property-4)
C25301 (NCI Thesaurus ValueDomain)
C25515 (NCI Thesaurus ValueDomain-2)
CL.4
Code List
I was bothered by things that don't usually bother me.
CL Item
Rarely Or None Of The Time (less Than 1 Day) (1)
C0522498 (UMLS CUI-1)
CL Item
Some Of The Time (1-2 Days) (2)
C1998882 (UMLS CUI-1)
CL Item
Occasion (3-4 Days) (3)
C0521114 (UMLS CUI-1)
CL Item
Most Of The Time (5-7 Days) (4)
C3828954 (UMLS CUI-1)
Item
I had trouble keeping my mind on what I was doing.
text
C0235198 (UMLS CUI-1)
CL.4
Code List
I had trouble keeping my mind on what I was doing.
CL Item
Rarely Or None Of The Time (less Than 1 Day) (1)
C0522498 (UMLS CUI-1)
CL Item
Some Of The Time (1-2 Days) (2)
C1998882 (UMLS CUI-1)
CL Item
Occasion (3-4 Days) (3)
C0521114 (UMLS CUI-1)
CL Item
Most Of The Time (5-7 Days) (4)
C3828954 (UMLS CUI-1)
Item
I felt depressed
text
C17047 (NCI Thesaurus ObjectClass)
C25217 (NCI Thesaurus Property)
C2982 (NCI Thesaurus Property-2)
C0011581 (UMLS CUI-1)
CL.4
Code List
I felt depressed
CL Item
Rarely Or None Of The Time (less Than 1 Day) (1)
C0522498 (UMLS CUI-1)
CL Item
Some Of The Time (1-2 Days) (2)
C1998882 (UMLS CUI-1)
CL Item
Occasion (3-4 Days) (3)
C0521114 (UMLS CUI-1)
CL Item
Most Of The Time (5-7 Days) (4)
C3828954 (UMLS CUI-1)
Item
I felt that everything I did was an effort.
text
C25704 (NCI Thesaurus ValueDomain)
C3174029 (UMLS CUI-1)
CL.4
Code List
I felt that everything I did was an effort.
CL Item
Rarely Or None Of The Time (less Than 1 Day) (1)
C0522498 (UMLS CUI-1)
CL Item
Some Of The Time (1-2 Days) (2)
C1998882 (UMLS CUI-1)
CL Item
Occasion (3-4 Days) (3)
C0521114 (UMLS CUI-1)
CL Item
Most Of The Time (5-7 Days) (4)
C3828954 (UMLS CUI-1)
Item
I felt hopeful about the future.
text
C25704 (NCI Thesaurus ValueDomain)
C3274937 (UMLS CUI-1)
CL.4
Code List
I felt hopeful about the future.
CL Item
Rarely Or None Of The Time (less Than 1 Day) (1)
C0522498 (UMLS CUI-1)
CL Item
Some Of The Time (1-2 Days) (2)
C1998882 (UMLS CUI-1)
CL Item
Occasion (3-4 Days) (3)
C0521114 (UMLS CUI-1)
CL Item
Most Of The Time (5-7 Days) (4)
C3828954 (UMLS CUI-1)
Item
I felt fearful.
text
C25704 (NCI Thesaurus ValueDomain)
C1288289 (UMLS CUI-1)
CL.4
Code List
I felt fearful.
CL Item
Rarely Or None Of The Time (less Than 1 Day) (1)
C0522498 (UMLS CUI-1)
CL Item
Some Of The Time (1-2 Days) (2)
C1998882 (UMLS CUI-1)
CL Item
Occasion (3-4 Days) (3)
C0521114 (UMLS CUI-1)
CL Item
Most Of The Time (5-7 Days) (4)
C3828954 (UMLS CUI-1)
Item
My sleep was restless.
text
C0235160 (UMLS CUI-1)
CL.4
Code List
My sleep was restless.
CL Item
Rarely Or None Of The Time (less Than 1 Day) (1)
C0522498 (UMLS CUI-1)
CL Item
Some Of The Time (1-2 Days) (2)
C1998882 (UMLS CUI-1)
CL Item
Occasion (3-4 Days) (3)
C0521114 (UMLS CUI-1)
CL Item
Most Of The Time (5-7 Days) (4)
C3828954 (UMLS CUI-1)
Item
I was happy.
text
C0018592 (UMLS CUI-1)
CL.4
Code List
I was happy.
CL Item
Rarely Or None Of The Time (less Than 1 Day) (1)
C0522498 (UMLS CUI-1)
CL Item
Some Of The Time (1-2 Days) (2)
C1998882 (UMLS CUI-1)
CL Item
Occasion (3-4 Days) (3)
C0521114 (UMLS CUI-1)
CL Item
Most Of The Time (5-7 Days) (4)
C3828954 (UMLS CUI-1)
Item
I felt lonely.
text
C3175808 (UMLS CUI-1)
CL.4
Code List
I felt lonely.
CL Item
Rarely Or None Of The Time (less Than 1 Day) (1)
C0522498 (UMLS CUI-1)
CL Item
Some Of The Time (1-2 Days) (2)
C1998882 (UMLS CUI-1)
CL Item
Occasion (3-4 Days) (3)
C0521114 (UMLS CUI-1)
CL Item
Most Of The Time (5-7 Days) (4)
C3828954 (UMLS CUI-1)
Item
I could not get ´going´
text
CL.4
Code List
I could not get ´going´
CL Item
Rarely Or None Of The Time (less Than 1 Day) (1)
C0522498 (UMLS CUI-1)
CL Item
Some Of The Time (1-2 Days) (2)
C1998882 (UMLS CUI-1)
CL Item
Occasion (3-4 Days) (3)
C0521114 (UMLS CUI-1)
CL Item
Most Of The Time (5-7 Days) (4)
C3828954 (UMLS CUI-1)
Item Group
Everyday Problems During The Past Four Weeks
C0033213 (UMLS CUI-1)
C3828653 (UMLS CUI-2)
HotFlashes
Item
Hot Flashes
boolean
C25180 (NCI Thesaurus ValueDomain)
C0600142 (UMLS CUI-1)
Headaches
Item
Headaches
boolean
C25180 (NCI Thesaurus ValueDomain)
C25626 (NCI Thesaurus Property)
C34661 (NCI Thesaurus ObjectClass)
C0018681 (UMLS CUI-1)
Difficuly bladder control
Item
Difficulty with bladder control (at other times)
boolean
C25180 (NCI Thesaurus ValueDomain)
Vaginaldischarge
Item
Vaginal discharge
boolean
C25180 (NCI Thesaurus ValueDomain)
C0227791 (UMLS CUI-1)
vaginal bleeding or spotting
Item
Vaginal bleeding or spotting
boolean
C25180 (NCI Thesaurus ValueDomain)
C3475970 (UMLS CUI-1)
Genital itching/irritation
Item
Genital itching/irritation
boolean
C25180 (NCI Thesaurus ValueDomain)
C0033777 (UMLS CUI-1)
Vaginaldryness
Item
Vaginal dryness
boolean
C25180 (NCI Thesaurus ValueDomain)
C0241633 (UMLS CUI-1)
Painwithintercourse
Item
Pain with intercourse
boolean
C25180 (NCI Thesaurus ValueDomain)
C0423742 (UMLS CUI-1)
Breastpain
Item
Breast pain
boolean
C25180 (NCI Thesaurus ValueDomain)
C0024902 (UMLS CUI-1)
Difficultywithbreastskin
Item
Difficulty with breast skin
boolean
C25180 (NCI Thesaurus ValueDomain)
Breast tenderness
Item
Breast sensitivity/tenderness
boolean
C25180 (NCI Thesaurus ValueDomain)
C0262397 (UMLS CUI-1)
Generalachesandpains
Item
General aches and pains
boolean
C25180 (NCI Thesaurus ValueDomain)
C0150930 (UMLS CUI-1)
Jointpains
Item
Joint pains
boolean
C25180 (NCI Thesaurus ValueDomain)
C0003862 (UMLS CUI-1)
Muscle stiffness
Item
Muscle stiffness
boolean
C25180 (NCI Thesaurus ValueDomain)
C0427008 (UMLS CUI-1)
Weightgain
Item
Weight gain
boolean
C25180 (NCI Thesaurus ValueDomain)
C0043094 (UMLS)
WeightLoss
Item
Weight loss
boolean
C38147 (NCI Thesaurus ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C25755 (NCI Thesaurus Property)
C3445 (NCI Thesaurus ObjectClass-2)
C1262477 (UMLS CUI-1)
Unhappywithappearanceofmybody
Item
Unhappy with appearance of my body
boolean
C25180 (NCI Thesaurus ValueDomain)
C3274925 (UMLS CUI-1)
Decrease in appetite
Item
Decreased appetite
boolean
C25180 (NCI Thesaurus ValueDomain)
C0232462 (UMLS CUI-1)
Forgetfulness
Item
Forgetfulness
boolean
C25180 (NCI Thesaurus ValueDomain)
C0542476 (UMLS CUI-1)
Excitability
Item
Excitability
boolean
C25180 (NCI Thesaurus ValueDomain)
C0235169 (UMLS CUI-1)
Temper problem
Item
Short temper
boolean
C25180 (NCI Thesaurus ValueDomain)
C0424331 (UMLS CUI-1)
Drowsiness
Item
Tendency to take naps; stay in bed
boolean
C25180 (NCI Thesaurus ValueDomain)
C0013144 (UMLS CUI-1)
Night sweats
Item
Night sweats
boolean
C25180 (NCI Thesaurus ValueDomain)
C0028081 (UMLS CUI-1)
Cold sweats
Item
Cold sweats
boolean
C25180 (NCI Thesaurus ValueDomain)
C0232431 (UMLS CUI-1)
Difficulty concentrating
Item
Difficulty concentrating
boolean
C25180 (NCI Thesaurus ValueDomain)
C0947509 (UMLS CUI-1)
Easily distracted
Item
Easily distracted
boolean
C25180 (NCI Thesaurus ValueDomain)
C0424102 (UMLS CUI-1)
Trouble sleeping
Item
Trouble sleeping
boolean
C25180 (NCI Thesaurus ValueDomain)
C3641752 (UMLS CUI-1)
Early awakening
Item
Early awakening
boolean
C25180 (NCI Thesaurus ValueDomain)
C0541798 (UMLS CUI-1)
Unspecified problem
Item
Any other problems
boolean
C25180 (NCI Thesaurus ValueDomain)
C1273828 (UMLS CUI-1)
Item
Severity
text
C0439793 (UMLS CUI-1)
CL.44
Code List
Severity
CL Item
Not At All (Not at all)
C2984077 (UMLS CUI-1)
CL Item
Slightly (Slightly)
C0750482 (UMLS CUI-1)
CL Item
Moderately (Moderately)
C1881878 (UMLS CUI-1)
CL Item
Quite A Bit (Quite a bit)
C2984080 (UMLS CUI-1)
CL Item
Extremely (Extremely)
C0205403 (UMLS CUI-1)
other problems
Item
Specify other problems
text
C1273828 (UMLS CUI-1)
Item Group
Overall health
Item
In general, would you say your health is
text
C20989 (NCI Thesaurus Property)
C25178 (NCI Thesaurus ObjectClass)
C25688 (NCI Thesaurus ValueDomain)
C0018759 (UMLS CUI-1)
CL.45
Code List
In general, would you say your health is
CL Item
Excellent (Excellent)
C1961136 (UMLS CUI-1)
CL Item
Very Good (Very good)
C3641222 (UMLS CUI-1)
CL Item
Good (Good)
C0205170 (NCI Metathesaurus)
C0205170 (UMLS CUI-1)
CL Item
Fair (Fair)
C2911689 (UMLS CUI-1)
CL Item
Poor (Poor)
C2700379 (UMLS CUI-1)
Item
Moderate activities, such as moving a table, pushing a vacuum cleaner, bowling, or playing golf (2)
text
C0449295 (UMLS CUI-1)
C3833417 (UMLS CUI-2)
CL.46
Code List
Moderate activities, such as moving a table, pushing a vacuum cleaner, bowling, or playing golf (2)
CL Item
Yes, Limited A Lot (2)
C3829282 (UMLS CUI-1)
CL Item
Yes, Limited A Little (1)
C3829283 (UMLS CUI-1)
CL Item
No, Not Limited At All (0)
C3845941 (UMLS CUI-1)
Item
Climbing several flights of stairs (3)
text
C25664 (NCI Thesaurus ValueDomain)
C20989 (NCI Thesaurus Property)
CL299704 (NCI Metathesaurus ObjectClass)
C17708 (NCI Thesaurus ObjectClass)
C0449295 (UMLS CUI-1)
C3831080 (UMLS CUI-2)
CL.46
Code List
Climbing several flights of stairs (3)
CL Item
Yes, Limited A Lot (2)
C3829282 (UMLS CUI-1)
CL Item
Yes, Limited A Little (1)
C3829283 (UMLS CUI-1)
CL Item
No, Not Limited At All (0)
C3845941 (UMLS CUI-1)
Accomplish less than you would like
Item
Accomplished less than you would like. (6)
boolean
C25640 (NCI Thesaurus ObjectClass)
C0033269 (NCI Metathesaurus ObjectClass)
C20989 (NCI Thesaurus Property)
C25178 (NCI Thesaurus Property-2)
C38147 (NCI Thesaurus ValueDomain)
C3828382 (UMLS CUI-1)
Limitation regarding work
Item
Were limited in the kind of work or other activities. (5)
boolean
CL110648 (NCI Metathesaurus ObjectClass)
C0043227 (NCI Metathesaurus ObjectClass-2)
C20989 (NCI Thesaurus Property)
C25178 (NCI Thesaurus Property-2)
C38147 (NCI Thesaurus ValueDomain)
C3641747 (UMLS CUI-1)
Did Not Do Work as Carefully
Item
Didn't do work or other activities as carefully as usual. (7)
boolean
C25180 (NCI Thesaurus ValueDomain)
C3828404 (UMLS CUI-1)
Item
During the past 4 weeks, how much did pain interfere with your normal work? (8. including both work outside the home and housework)
text
C16960 (NCI Thesaurus ObjectClass)
C3303 (NCI Thesaurus ObjectClass-2)
C20989 (NCI Thesaurus Property)
C0043227 (NCI Metathesaurus Property)
C25688 (NCI Thesaurus ValueDomain)
C3828383 (UMLS CUI-1)
CL.52
Code List
During the past 4 weeks, how much did pain interfere with your normal work? (8. including both work outside the home and housework)
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
C2984077 (UMLS CUI-1)
CL Item
A Little Bit (A little bit)
C2984078 (UMLS CUI-1)
CL Item
Moderately (Moderately)
C1881878 (UMLS CUI-1)
CL Item
Quite A Bit (Quite a bit)
C91216 (NCI Thesaurus)
C2984080 (UMLS CUI-1)
CL Item
Extremely (Extremely)
C0205403 (UMLS CUI-1)
Item Group
Mood
C0026516 (UMLS CUI-1)
Item
Have you felt calm and peaceful? (9)
text
C25664 (NCI Thesaurus ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C20989 (NCI Thesaurus Property)
C0035028 (NCI Metathesaurus Property)
C3261651 (UMLS CUI-1)
CL.53
Code List
Have you felt calm and peaceful? (9)
CL Item
All Of The Time (5)
C3812891 (UMLS CUI-1)
CL Item
Most Of The Time (4)
C3828954 (UMLS CUI-1)
CL Item
A Good Bit Of The Time (3)
C3831592 (UMLS CUI-1)
CL Item
Some Of The Time (2)
C3827992 (UMLS CUI-1)
CL Item
A Little Of The Time (1)
C3831570 (UMLS CUI-1)
CL Item
None Of The Time (0)
C3812882 (UMLS CUI-1)
Item
Did you feel full of pep? (10)
text
C25664 (NCI Thesaurus ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C20989 (NCI Thesaurus Property)
C0291944 (NCI Metathesaurus Property)
C3828401 (UMLS CUI-1)
CL.53
Code List
Did you feel full of pep? (10)
CL Item
All Of The Time (5)
C3812891 (UMLS CUI-1)
CL Item
Most Of The Time (4)
C3828954 (UMLS CUI-1)
CL Item
A Good Bit Of The Time (3)
C3831592 (UMLS CUI-1)
CL Item
Some Of The Time (2)
C3827992 (UMLS CUI-1)
CL Item
A Little Of The Time (1)
C3831570 (UMLS CUI-1)
CL Item
None Of The Time (0)
C3812882 (UMLS CUI-1)
Item
Did you have a lot of energy? (11)
text
C3828394 (UMLS CUI [1])
C25664 (NCI Thesaurus ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C20989 (NCI Thesaurus Property)
C48058 (NCI Thesaurus Property-2)
CL.53
Code List
Did you have a lot of energy? (11)
CL Item
All Of The Time (5)
C3812891 (UMLS CUI-1)
CL Item
Most Of The Time (4)
C3828954 (UMLS CUI-1)
CL Item
A Good Bit Of The Time (3)
C3831592 (UMLS CUI-1)
CL Item
Some Of The Time (2)
C3827992 (UMLS CUI-1)
CL Item
A Little Of The Time (1)
C3831570 (UMLS CUI-1)
CL Item
None Of The Time (0)
C3812882 (UMLS CUI-1)
Item
Did you feel worn out? (12)
text
C25664 (NCI Thesaurus ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C20989 (NCI Thesaurus Property)
C3036 (NCI Thesaurus Property-2)
C3828399 (UMLS CUI-1)
CL.53
Code List
Did you feel worn out? (12)
CL Item
All Of The Time (5)
C3812891 (UMLS CUI-1)
CL Item
Most Of The Time (4)
C3828954 (UMLS CUI-1)
CL Item
A Good Bit Of The Time (3)
C3831592 (UMLS CUI-1)
CL Item
Some Of The Time (2)
C3827992 (UMLS CUI-1)
CL Item
A Little Of The Time (1)
C3831570 (UMLS CUI-1)
CL Item
None Of The Time (0)
C3812882 (UMLS CUI-1)
Item
Did you feel tired? (13)
text
C25664 (NCI Thesaurus ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C20989 (NCI Thesaurus Property)
C0023380 (NCI Metathesaurus Property)
C3539029 (UMLS CUI-1)
CL.53
Code List
Did you feel tired? (13)
CL Item
All Of The Time (5)
C3812891 (UMLS CUI-1)
CL Item
Most Of The Time (4)
C3828954 (UMLS CUI-1)
CL Item
A Good Bit Of The Time (3)
C3831592 (UMLS CUI-1)
CL Item
Some Of The Time (2)
C3827992 (UMLS CUI-1)
CL Item
A Little Of The Time (1)
C3831570 (UMLS CUI-1)
CL Item
None Of The Time (0)
C3812882 (UMLS CUI-1)
Item
Have you felt downhearted and blue? (14)
text
C25664 (NCI Thesaurus ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C20989 (NCI Thesaurus Property)
C0026516 (NCI Metathesaurus Property)
C3828397 (UMLS CUI-1)
CL.53
Code List
Have you felt downhearted and blue? (14)
CL Item
All Of The Time (5)
C3812891 (UMLS CUI-1)
CL Item
Most Of The Time (4)
C3828954 (UMLS CUI-1)
CL Item
A Good Bit Of The Time (3)
C3831592 (UMLS CUI-1)
CL Item
Some Of The Time (2)
C3827992 (UMLS CUI-1)
CL Item
A Little Of The Time (1)
C3831570 (UMLS CUI-1)
CL Item
None Of The Time (0)
C3812882 (UMLS CUI-1)
Item
During the past 4 weeks, how much of the time has your physical health or emotional problems interfered with your social activities? (15. like visiting with friends, relatives, etc.)
text
C20989 (NCI Thesaurus Property)
C0037397 (NCI Metathesaurus ObjectClass)
C25330 (NCI Thesaurus ValueDomain)
C3484327 (UMLS CUI-1)
CL.53
Code List
During the past 4 weeks, how much of the time has your physical health or emotional problems interfered with your social activities? (15. like visiting with friends, relatives, etc.)
CL Item
All Of The Time (5)
C3812891 (UMLS CUI-1)
CL Item
Most Of The Time (4)
C3828954 (UMLS CUI-1)
CL Item
A Good Bit Of The Time (3)
C3831592 (UMLS CUI-1)
CL Item
Some Of The Time (2)
C3827992 (UMLS CUI-1)
CL Item
A Little Of The Time (1)
C3831570 (UMLS CUI-1)
CL Item
None Of The Time (0)
C3812882 (UMLS CUI-1)
Item
Please score your overall quality of life as of today on an 11-point scale where 0 indicates being in the worst possible health and 10 indicates being in perfect health. (16)
text
C0451401 (UMLS CUI-1)
CL.60
Code List
Please score your overall quality of life as of today on an 11-point scale where 0 indicates being in the worst possible health and 10 indicates being in perfect health. (16)
CL Item
0 (0)
C0919414 (NCI Metathesaurus)
CL Item
1 (1)
CL Item
2 (2)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (3)
CL Item
4 (4)
CL Item
5 (5)
CL Item
6 (6)
CL Item
7 (7)
CL Item
8 (8)
CL Item
9 (9)
CL Item
10 (10)
Item Group
Sexual activity
C0036864 (UMLS CUI-1)
Sexually active past 6 months
Item
Have you been sexually active during the past SIX MONTHS? (17)
boolean
C0241028 (UMLS CUI [1,1])
C3828652 (UMLS CUI [1,2])
C25180 (NCI Thesaurus ValueDomain)
Item
Lack of sexual interest
text
C3828902 (UMLS CUI-1)
CL.62
Code List
Lack of sexual interest
CL Item
Not A Problem (0)
C0549184 (UMLS CUI-1)
CL Item
A Little Problem (1)
C2984078 (UMLS CUI-1)
CL Item
A Definite Problem (2)
C0439544 (UMLS CUI-1)
CL Item
A Serious Problem (3)
C0205404 (UMLS CUI-1)
Item
Difficulty in becoming sexually aroused
text
C1314759 (UMLS CUI-1)
CL.62
Code List
Difficulty in becoming sexually aroused
CL Item
Not A Problem (0)
C0549184 (UMLS CUI-1)
CL Item
A Little Problem (1)
C2984078 (UMLS CUI-1)
CL Item
A Definite Problem (2)
C0439544 (UMLS CUI-1)
CL Item
A Serious Problem (3)
C0205404 (UMLS CUI-1)
Item
Unable to relax and enjoy sex
text
C3174543 (UMLS CUI-1)
CL.62
Code List
Unable to relax and enjoy sex
CL Item
Not A Problem (0)
C0549184 (UMLS CUI-1)
CL Item
A Little Problem (1)
C2984078 (UMLS CUI-1)
CL Item
A Definite Problem (2)
C0439544 (UMLS CUI-1)
CL Item
A Serious Problem (3)
C0205404 (UMLS CUI-1)
Item
Difficulty in having orgasm
text
C0029261 (UMLS CUI-1)
CL.62
Code List
Difficulty in having orgasm
CL Item
Not A Problem (0)
C0549184 (UMLS CUI-1)
CL Item
A Little Problem (1)
C2984078 (UMLS CUI-1)
CL Item
A Definite Problem (2)
C0439544 (UMLS CUI-1)
CL Item
A Serious Problem (3)
C0205404 (UMLS CUI-1)
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