ID

5500

Beschreibung

NSABP Protocol B-36 Quality of Life Questionnaire (English Version) Comparison of Two Combination Chemotherapy Regimens in Treating Women With Breast Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=C907A026-1DAB-1D7C-E034-0003BA12F5E7

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=C907A026-1DAB-1D7C-E034-0003BA12F5E7

Stichworte

  1. 07.08.14 07.08.14 - Martin Dugas
  2. 09.01.15 09.01.15 - Martin Dugas
  3. 20.03.15 20.03.15 - Martin Dugas
  4. 10.04.21 10.04.21 - Ahmed Rafee, MD
  5. 20.09.21 20.09.21 -
Hochgeladen am

7. August 2014

DOI

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Lizenz

Creative Commons BY-NC 3.0 Legacy

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Breast Cancer NCT00087178 Quality of Life - NSABP Protocol B-36 Quality of Life Questionnaire (English Version) - 2176065v3.0

No Instruction available.

  1. StudyEvent: NSABP Protocol B-36 Quality of Life Questionnaire (English Version)
    1. No Instruction available.
Unnamed1
Beschreibung

Unnamed1

Patient Initials (Last, First Middle)
Beschreibung

PatientInitialsName

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25536
UMLS 2011AA Property
C1555582
NSABP Patient ID
Beschreibung

PatientNationalSurgicalAdjuvantBreastProjectIdentifierNumber

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus Property
C15818
UMLS 2011AA Property
C1513905
Unnamed2
Beschreibung

Unnamed2

Unnamed3
Beschreibung

Unnamed3

Institution Name
Beschreibung

InstitutionName

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ObjectClass
C21541
UMLS 2011AA ObjectClass
C0018704
NCI Thesaurus ValueDomain
C21541
UMLS 2011AA ValueDomain
C0018704
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Affiliate Name
Beschreibung

AffiliatedInstitutionName

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C21541
UMLS 2011AA ObjectClass
C0018704
NCI Thesaurus ObjectClass
C25413
UMLS 2011AA ObjectClass
C1510826
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ValueDomain
C21541
UMLS 2011AA ValueDomain
C0018704
Staff member administering form (Last Name)
Beschreibung

PersonFormAdministrationLastName

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C19464
UMLS 2011AA Property
C0376315
NCI Thesaurus ValueDomain
C25551
UMLS 2011AA ValueDomain
C1517741
NCI Thesaurus Property
C25409
UMLS 2011AA Property
C1533734
Staff member administering form, first name
Beschreibung

PersonFormAdministrationFirstName

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C19464
UMLS 2011AA Property
C0376315
NCI Thesaurus Property
C25409
UMLS 2011AA Property
C1533734
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ValueDomain
C25509
UMLS 2011AA ValueDomain
C1279901
Staff Member Administering Form, Phone
Beschreibung

PersonFormAdministrationPhoneNumber

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C19464
UMLS 2011AA Property
C0376315
NCI Thesaurus Property
C25409
UMLS 2011AA Property
C1533734
Today's Date (Month Day Year)
Beschreibung

Today'sDate

Datentyp

text

Unnamed4
Beschreibung

Unnamed4

Time point
Beschreibung

AssessmentPeriodType

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus Property
C25616
UMLS 2011AA Property
C1948053
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
C25250
UMLS 2011AA Property
C0205197
Unnamed5
Beschreibung

Unnamed5

NSABP Patient ID
Beschreibung

PatientNationalSurgicalAdjuvantBreastProjectIdentifierNumber

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus Property
C15818
UMLS 2011AA Property
C1513905
Date this questionnaire is completed (For example, if you were completing the questionnaire on September 8, 2003, you would write 09 08 2003 in the boxes.)
Beschreibung

QuestionnaireCompletionDate

Datentyp

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
Unnamed6
Beschreibung

Unnamed6

I have a lack of energy.
Beschreibung

FatigueAssessmentResponseScale

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus Property
C25755
UMLS 2011AA Property
C0871261
NCI Thesaurus ObjectClass
C3036
UMLS 2011AA ObjectClass
C0015672
I have nausea.
Beschreibung

NauseaAssessmentResponseScale

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus Property
C25755
UMLS 2011AA Property
C0871261
NCI Thesaurus ObjectClass
C3258
UMLS 2011AA ObjectClass
C0027497
Because of my physical condition, I have trouble meeting the needs of my family.
Beschreibung

FamilyNeedAssessmentResponse

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
I have pain.
Beschreibung

PainAssessmentResponseScale

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus Property
C25755
UMLS 2011AA Property
C0871261
NCI Thesaurus ObjectClass
C3303
UMLS 2011AA ObjectClass
C0030193
I am bothered by side effects of treatment.
Beschreibung

AdverseEventAssessmentResponse

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus ObjectClass
C41331
UMLS 2011AA ObjectClass
C0877248
NCI Thesaurus Property
C38757
UMLS 2011AA Property
C1513916
I feel ill.
Beschreibung

IllnessAssessmentResponse

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
I am forced to spend time in bed.
Beschreibung

BedrestAssessmentResponse

Datentyp

text

I feel close to my friends.
Beschreibung

FriendsCloseAssessmentResponse

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
I get emotional support from my family.
Beschreibung

FamilyPatientEmotionalSupportAssessmentQualityofLifeScale

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus ObjectClass
C25173
UMLS 2011AA ObjectClass
C0015576
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Metathesaurus Property
C0600015
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
NCI Thesaurus ValueDomain
C17047
UMLS 2011AA ValueDomain
C0518214
I get support from my friends.
Beschreibung

SupportAssessmentExternalResponseType

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus Property
C25755
UMLS 2011AA Property
C0871261
My family has accepted my illness.
Beschreibung

IllnessAcceptanceAssessmentResponse

Datentyp

text

I am satisfied with family communication about my illness.
Beschreibung

CommunicationSatisfiedAssessmentResponse

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
I feel close to my partner. (or the person who is my main support)
Beschreibung

PartnerClosenessAssessmentResponse

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
If you prefer not to answer it, please check this box and go to the next section. (Regardless of your current level of sexual activity, please answer the following question.)
Beschreibung

QuestionNotResponsInd-2

Datentyp

text

I am satisfied with my sex life.
Beschreibung

Iamsatisfiedwithmysexlife

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Unnamed7
Beschreibung

Unnamed7

NSABP Patient ID
Beschreibung

PatientNationalSurgicalAdjuvantBreastProjectIdentifierNumber

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus Property
C15818
UMLS 2011AA Property
C1513905
Unnamed8
Beschreibung

Unnamed8

I feel sad.
Beschreibung

PatientDepressionAssessmentQualityofLifeScale

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property
C2982
UMLS 2011AA Property
C0011570
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
NCI Thesaurus ValueDomain
C17047
UMLS 2011AA ValueDomain
C0518214
I am satisfied with how I am coping with my illness.
Beschreibung

PatientAcceptanceofIllnessAssessmentQualityofLifeScale

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Metathesaurus Property
CL140183
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
NCI Thesaurus ValueDomain
C17047
UMLS 2011AA ValueDomain
C0518214
I am losing hope in the fight against my illness.
Beschreibung

LostHopeAssessmentResponse

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
I feel nervous.
Beschreibung

PatientNervousAssessmentQualityofLifeScale

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property
C25584
UMLS 2011AA Property
C0599851
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
NCI Thesaurus ValueDomain
C17047
UMLS 2011AA ValueDomain
C0518214
I worry about dying.
Beschreibung

WorryPatientDeathAssessmentQualityofLifeScale

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Metathesaurus ObjectClass
C0233481
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property
C28554
UMLS 2011AA Property
C0011065
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
NCI Thesaurus ValueDomain
C17047
UMLS 2011AA ValueDomain
C0518214
I worry that my condition will get worse.
Beschreibung

WorseAssessmentResponse

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
I am able to work. (include work at home)
Beschreibung

WorkAssessmentResponseType

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus Property
C25755
UMLS 2011AA Property
C0871261
My work is fulfilling. (include work at home)
Beschreibung

WorkFullfillingAssessmentResponse

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
I am able to enjoy life.
Beschreibung

LifeAssessmentResponseType

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus Property
C25755
UMLS 2011AA Property
C0871261
I have accepted my illness.
Beschreibung

IllnessAcceptanceSelfAssessmentResponse

Datentyp

text

I am sleeping well.
Beschreibung

PatientSleepAssessmentQualityofLifeScale

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Metathesaurus Property
C0037313
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
NCI Thesaurus ValueDomain
C17047
UMLS 2011AA ValueDomain
C0518214
I am enjoying the things I usually do.
Beschreibung

QualityofLifeHobbySatisfactionAssessment

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus Property
C25367
NCI Thesaurus Property
C62185
UMLS 2011AA Property
C0242428
NCI Thesaurus Property
C73426
UMLS 2011AA Property
C0019826
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
I am content with the quality of my life right now.
Beschreibung

ContentAssessmentResponse

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
I have been short of breath.
Beschreibung

DyspneaAssessmentResponse

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
I am self-conscious about the way I dress.
Beschreibung

DressAssessmentResponse

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
One or both of my arms are swollen or tender.
Beschreibung

ArmSwollenAssessmentResponse

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
I feel sexually attractive.
Beschreibung

SexuallyAttractiveAssessmentResponse

Datentyp

text

I am bothered by hair loss.
Beschreibung

HairLossAssessmentResponse

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Unnamed9
Beschreibung

Unnamed9

NSABP Patient ID
Beschreibung

PatientNationalSurgicalAdjuvantBreastProjectIdentifierNumber

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus Property
C15818
UMLS 2011AA Property
C1513905
Unnamed10
Beschreibung

Unnamed10

I worry that other members of my family might someday get the same illness I have.
Beschreibung

IllnessDevelopFamilyAssessmentResponse

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus Property
C25755
UMLS 2011AA Property
C0871261
I worry about the effect of stress on my illness.
Beschreibung

IllnessStressAssessmentResponse

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
I am bothered by a change in weight.
Beschreibung

WeightAssessmentResponseType

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus Property
C25755
UMLS 2011AA Property
C0871261
I am able to feel like a woman.
Beschreibung

WomanAssessmentResponse

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Unnamed11
Beschreibung

Unnamed11

headaches
Beschreibung

HeadachePresentQOLSeverityStatus

Datentyp

text

Alias
NCI Thesaurus Property
C25626
UMLS 2011AA Property
C0150312
NCI Thesaurus ObjectClass
C34661
UMLS 2011AA ObjectClass
C0018681
NCI Thesaurus ValueDomain
C25688
UMLS 2011AA ValueDomain
C0449438
indigestion
Beschreibung

DyspepsiaAssessmentResponseType

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus Property
C25755
UMLS 2011AA Property
C0871261
nausea
Beschreibung

Nausea

Datentyp

text

heartburn
Beschreibung

HeartburnAssessmentResponseType

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus Property
C25755
UMLS 2011AA Property
C0871261
vomiting
Beschreibung

VomitingAssessmentResponseType

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus Property
C25755
UMLS 2011AA Property
C0871261
passing a lot of gas (flatulence)
Beschreibung

FlatulenceAssessmentResponseType

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus Property
C25755
UMLS 2011AA Property
C0871261
mouth sores
Beschreibung

MouthAssessmentResponseType

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus Property
C25755
UMLS 2011AA Property
C0871261
diarrhea
Beschreibung

DiarrheaAssessmentResponse

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus Property
C25755
UMLS 2011AA Property
C0871261
skin problems (including rash, dry skin, itching, irritation or redness)
Beschreibung

DermalAssessmentResponseType

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus Property
C25755
UMLS 2011AA Property
C0871261
numbness or tingling in hands or feet
Beschreibung

ExtremitiesNumbnessAssessmentResponse

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
fever or shivering (shaking, chills)
Beschreibung

FeverAssessmentResponse

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
difficulty with bladder control
Beschreibung

Difficultywithbladdercontrol

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
Unnamed12
Beschreibung

Unnamed12

NSABP Patient ID
Beschreibung

PatientNationalSurgicalAdjuvantBreastProjectIdentifierNumber

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus Property
C15818
UMLS 2011AA Property
C1513905
Unnamed13
Beschreibung

Unnamed13

constipation
Beschreibung

ConstipationAssessmentResponse

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
hot flashes
Beschreibung

HotFlashes

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
genital itching or irritation
Beschreibung

GenitalItchingAssessmentResponse

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
mood swings
Beschreibung

EmotionsAssessmentResponse

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
vaginal discharge
Beschreibung

VaginalDischargeAssessmentResponse

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
vaginal bleeding or spotting
Beschreibung

Vaginalbleedingorspotting

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
vaginal dryness
Beschreibung

VaginalDrynessAssessmentResponse

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
pain with intercourse
Beschreibung

Painwithintercourse

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
cramps
Beschreibung

CrampsAssessmentResult

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
general aches and pains
Beschreibung

Generalachesandpains

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
joint pains
Beschreibung

Jointpains

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
swelling of hands
Beschreibung

ExtremityAssessmentResponseType

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus Property
C25755
UMLS 2011AA Property
C0871261
muscle stiffness
Beschreibung

Musclestiffness

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
weight gain
Beschreibung

Weight gain

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25180
UMLS
C0043094
weight loss
Beschreibung

WeightLossAssessmentResponseInd-2

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus Property
C25755
UMLS 2011AA Property
C0871261
NCI Thesaurus ObjectClass
C3445
UMLS 2011AA ObjectClass
C0043096
unhappy with appearance of my body
Beschreibung

Unhappywithappearanceofmybody

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
forgetfulness
Beschreibung

Forgetfulness

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
night sweats
Beschreibung

Nightsweats

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
cold sweats
Beschreibung

Coldsweats

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
difficulty concentrating
Beschreibung

Difficultyconcentrating

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
Unnamed14
Beschreibung

Unnamed14

NSABP Patient ID
Beschreibung

PatientNationalSurgicalAdjuvantBreastProjectIdentifierNumber

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus Property
C15818
UMLS 2011AA Property
C1513905
Unnamed15
Beschreibung

Unnamed15

Vigorous activities, such as running, lifting heavy objects, participating in strenuous sports
Beschreibung

VigorousAssessmentResponseType

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus Property
C25755
UMLS 2011AA Property
C0871261
Moderate activities, such as moving a table, pushing a vacuum cleaner, bowling, or playing golf
Beschreibung

Moderateactivities,suchasmovingatable,pushingavacuumcleaner,bowling,orplayinggolf

Datentyp

text

Lifting or carrying groceries
Beschreibung

QualityofLifePhysicalActivityDifficultyAssessmentScale

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus Property
C25367
NCI Thesaurus Property
C17708
UMLS 2011AA Property
C0026606
NCI Thesaurus Property
C62189
UMLS 2011AA Property
C1299586
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
Climbing several flights of stairs
Beschreibung

ClimbingStairsPhysicalActivityAssessmentScale

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Metathesaurus ObjectClass
CL299704
NCI Thesaurus ObjectClass
C17708
UMLS 2011AA ObjectClass
C0026606
Bending, kneeling, or stooping
Beschreibung

BendingPhysicalAssessmentResponse

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Walking more than a mile
Beschreibung

AmbulatePhysicalOneMileAssessmentResult

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Walking several hundred yards
Beschreibung

AmbulatePhysicalSeveralHundredYardsAssessmentResponse

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Walking one hundred yards
Beschreibung

MobileAssessmentShortResponseType

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus Property
C25755
UMLS 2011AA Property
C0871261
Bathing or dressing yourself
Beschreibung

BathingPhysicalAssessmentResponse

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Unnamed16
Beschreibung

Unnamed16

NSABP Patient ID
Beschreibung

PatientNationalSurgicalAdjuvantBreastProjectIdentifierNumber

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus Property
C15818
UMLS 2011AA Property
C1513905
Unnamed17
Beschreibung

Unnamed17

Did you feel full of life?
Beschreibung

Didyoufeelfulloflife?

Datentyp

text

Did you have a lot of energy?
Beschreibung

VitalityAssessmentResponseType

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus Property
C25755
UMLS 2011AA Property
C0871261
Did you feel worn out?
Beschreibung

WornOutVitalityAssessmentResponse

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Did you feel tired?
Beschreibung

TiredVitalityAssessmentResponse

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
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.
Beschreibung

Pleasescoreyouroverallqualityoflifeasoftodayonan11-pointscalewhere0indicatesbeingintheworstpossiblehealthand10indicatesbeinginperfecthealth.

Datentyp

text

Ccrr Module For Nsabp Protocol B-36 Quality Of Life Questionnaire (english Version)
Beschreibung

Ccrr Module For Nsabp Protocol B-36 Quality Of Life Questionnaire (english Version)

Ähnliche Modelle

No Instruction available.

  1. StudyEvent: NSABP Protocol B-36 Quality of Life Questionnaire (English Version)
    1. No Instruction available.
Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
Alias
Item Group
Unnamed1
PatientInitialsName
Item
Patient Initials (Last, First Middle)
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25536 (NCI Thesaurus Property)
C1555582 (UMLS 2011AA Property)
PatientNationalSurgicalAdjuvantBreastProjectIdentifierNumber
Item
NSABP Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C15818 (NCI Thesaurus Property)
C1513905 (UMLS 2011AA Property)
Item Group
Unnamed2
Item Group
Unnamed3
InstitutionName
Item
Institution Name
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C21541 (NCI Thesaurus ObjectClass)
C0018704 (UMLS 2011AA ObjectClass)
C21541 (NCI Thesaurus ValueDomain)
C0018704 (UMLS 2011AA ValueDomain)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
AffiliatedInstitutionName
Item
Affiliate Name
text
C21541 (NCI Thesaurus ObjectClass)
C0018704 (UMLS 2011AA ObjectClass)
C25413 (NCI Thesaurus ObjectClass)
C1510826 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C21541 (NCI Thesaurus ValueDomain)
C0018704 (UMLS 2011AA ValueDomain)
PersonFormAdministrationLastName
Item
Staff member administering form (Last Name)
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C19464 (NCI Thesaurus Property)
C0376315 (UMLS 2011AA Property)
C25551 (NCI Thesaurus ValueDomain)
C1517741 (UMLS 2011AA ValueDomain)
C25409 (NCI Thesaurus Property)
C1533734 (UMLS 2011AA Property)
PersonFormAdministrationFirstName
Item
Staff member administering form, first name
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C19464 (NCI Thesaurus Property)
C0376315 (UMLS 2011AA Property)
C25409 (NCI Thesaurus Property)
C1533734 (UMLS 2011AA Property)
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C25509 (NCI Thesaurus ValueDomain)
C1279901 (UMLS 2011AA ValueDomain)
PersonFormAdministrationPhoneNumber
Item
Staff Member Administering Form, Phone
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C19464 (NCI Thesaurus Property)
C0376315 (UMLS 2011AA Property)
C25409 (NCI Thesaurus Property)
C1533734 (UMLS 2011AA Property)
Today'sDate
Item
Today's Date (Month Day Year)
text
Item Group
Unnamed4
Item
Time point
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25616 (NCI Thesaurus Property)
C1948053 (UMLS 2011AA Property)
Code List
Time point
CL Item
12 Months (12 months)
CL Item
18 Months (18 months)
CL Item
24 Months (24 months)
CL Item
30 Months (30 months)
CL Item
36 Months (36 months)
CL Item
6 Months (6 months)
CL Item
Baseline (baseline)
C25213 (NCI Thesaurus)
C1442488 (UMLS 2011AA)
CL Item
Day 1 Of Cycle 4 (Day 1 of Cycle 4)
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)
C0205197 (UMLS 2011AA Property)
Code List
This form is being filled out
CL Item
0 By Patient In Office (By patient in doctor's office)
CL Item
By patient not in doctor's office (By patient not in doctor's office)
CL Item
1 By Clinical Staff On Phone With Patient (By clinical staff on phone with patient)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
Item Group
Unnamed5
PatientNationalSurgicalAdjuvantBreastProjectIdentifierNumber
Item
NSABP Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C15818 (NCI Thesaurus Property)
C1513905 (UMLS 2011AA Property)
QuestionnaireCompletionDate
Item
Date this questionnaire is completed (For example, if you were completing the questionnaire on September 8, 2003, you would write 09 08 2003 in the boxes.)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
Item Group
Unnamed6
Item
I have a lack of energy.
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
C3036 (NCI Thesaurus ObjectClass)
C0015672 (UMLS 2011AA ObjectClass)
Code List
I have a lack of energy.
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
CL Item
3 (Somewhat)
C91215 (NCI Thesaurus)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)
Item
I have nausea.
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
C3258 (NCI Thesaurus ObjectClass)
C0027497 (UMLS 2011AA ObjectClass)
Code List
I have nausea.
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
CL Item
3 (Somewhat)
C91215 (NCI Thesaurus)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)
Item
Because of my physical condition, I have trouble meeting the needs of my family.
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
Because of my physical condition, I have trouble meeting the needs of my family.
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item
I have pain.
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
C3303 (NCI Thesaurus ObjectClass)
C0030193 (UMLS 2011AA ObjectClass)
Code List
I have pain.
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
CL Item
3 (Somewhat)
C91215 (NCI Thesaurus)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)
Item
I am bothered by side effects of treatment.
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
C38757 (NCI Thesaurus Property)
C1513916 (UMLS 2011AA Property)
Code List
I am bothered by side effects of treatment.
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item
I feel ill.
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
I feel ill.
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item
I am forced to spend time in bed.
text
Code List
I am forced to spend time in bed.
CL Item
1 (Not at all)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
CL Item
5 (Very much)
Item
I feel close to my friends.
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
I feel close to my friends.
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item
I get emotional support from my family.
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25173 (NCI Thesaurus ObjectClass)
C0015576 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0600015 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)
Code List
I get emotional support from my family.
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
C2003901 (UMLS 2011AA)
CL Item
2 (A little bit)
CL Item
3 (Somewhat)
C91215 (NCI Thesaurus)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)
Item
I get support from my friends.
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
Code List
I get support from my friends.
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item
My family has accepted my illness.
text
Code List
My family has accepted my illness.
CL Item
1 (Not at all)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
CL Item
5 (Very much)
Item
I am satisfied with family communication about my illness.
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
I am satisfied with family communication about my illness.
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item
I feel close to my partner. (or the person who is my main support)
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
I feel close to my partner. (or the person who is my main support)
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
QuestionNotResponsInd-2
Item
If you prefer not to answer it, please check this box and go to the next section. (Regardless of your current level of sexual activity, please answer the following question.)
text
Item
I am satisfied with my sex life.
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
I am satisfied with my sex life.
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
CL Item
A Little Bit (A little bit)
CL Item
Somewhat (Somewhat)
C91215 (NCI Thesaurus)
CL Item
Quite A Bit (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
A Great Deal (Very much)
C91217 (NCI Thesaurus)
Item Group
Unnamed7
PatientNationalSurgicalAdjuvantBreastProjectIdentifierNumber
Item
NSABP Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C15818 (NCI Thesaurus Property)
C1513905 (UMLS 2011AA Property)
Item Group
Unnamed8
Item
I feel sad.
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C2982 (NCI Thesaurus Property)
C0011570 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)
Code List
I feel sad.
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
C2003901 (UMLS 2011AA)
CL Item
2 (A little bit)
CL Item
3 (Somewhat)
C91215 (NCI Thesaurus)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)
Item
I am satisfied with how I am coping with my illness.
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
CL140183 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)
Code List
I am satisfied with how I am coping with my illness.
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
C2003901 (UMLS 2011AA)
CL Item
2 (A little bit)
CL Item
3 (Somewhat)
C91215 (NCI Thesaurus)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)
Item
I am losing hope in the fight against my illness.
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
I am losing hope in the fight against my illness.
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item
I feel nervous.
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25584 (NCI Thesaurus Property)
C0599851 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)
Code List
I feel nervous.
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
C2003901 (UMLS 2011AA)
CL Item
2 (A little bit)
CL Item
3 (Somewhat)
C91215 (NCI Thesaurus)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)
Item
I worry about dying.
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C0233481 (NCI Metathesaurus ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C28554 (NCI Thesaurus Property)
C0011065 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)
Code List
I worry about dying.
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
C2003901 (UMLS 2011AA)
CL Item
2 (A little bit)
CL Item
3 (Somewhat)
C91215 (NCI Thesaurus)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)
Item
I worry that my condition will get worse.
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
I worry that my condition will get worse.
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item
I am able to work. (include work at home)
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
Code List
I am able to work. (include work at home)
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item
My work is fulfilling. (include work at home)
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
My work is fulfilling. (include work at home)
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item
I am able to enjoy life.
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
Code List
I am able to enjoy life.
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item
I have accepted my illness.
text
Code List
I have accepted my illness.
CL Item
1 (Not at all)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
CL Item
5 (Very much)
Item
I am sleeping well.
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0037313 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)
Code List
I am sleeping well.
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
C2003901 (UMLS 2011AA)
CL Item
2 (A little bit)
CL Item
3 (Somewhat)
C91215 (NCI Thesaurus)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)
Item
I am enjoying the things I usually do.
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C62185 (NCI Thesaurus Property)
C0242428 (UMLS 2011AA Property)
C73426 (NCI Thesaurus Property)
C0019826 (UMLS 2011AA Property)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
I am enjoying the things I usually do.
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item
I am content with the quality of my life right now.
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
I am content with the quality of my life right now.
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item
I have been short of breath.
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
I have been short of breath.
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item
I am self-conscious about the way I dress.
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
I am self-conscious about the way I dress.
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item
One or both of my arms are swollen or tender.
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
One or both of my arms are swollen or tender.
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item
I feel sexually attractive.
text
Code List
I feel sexually attractive.
CL Item
1 (Not at all)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
CL Item
5 (Very much)
Item
I am bothered by hair loss.
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
I am bothered by hair loss.
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item Group
Unnamed9
PatientNationalSurgicalAdjuvantBreastProjectIdentifierNumber
Item
NSABP Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C15818 (NCI Thesaurus Property)
C1513905 (UMLS 2011AA Property)
Item Group
Unnamed10
Item
I worry that other members of my family might someday get the same illness I have.
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
Code List
I worry that other members of my family might someday get the same illness I have.
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item
I worry about the effect of stress on my illness.
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
I worry about the effect of stress on my illness.
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item
I am bothered by a change in weight.
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
Code List
I am bothered by a change in weight.
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item
I am able to feel like a woman.
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
I am able to feel like a woman.
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item Group
Unnamed11
Item
headaches
text
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C34661 (NCI Thesaurus ObjectClass)
C0018681 (UMLS 2011AA ObjectClass)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
Code List
headaches
CL Item
Not at all (Not at all)
CL Item
A little bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite a bit (Quite a bit)
CL Item
Very much (Very much)
Item
indigestion
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
Code List
indigestion
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item
nausea
text
Code List
nausea
CL Item
Not at all (Not at all)
CL Item
A little bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite a bit (Quite a bit)
CL Item
Very much (Very much)
Item
heartburn
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
Code List
heartburn
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item
vomiting
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
Code List
vomiting
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item
passing a lot of gas (flatulence)
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
Code List
passing a lot of gas (flatulence)
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item
mouth sores
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
Code List
mouth sores
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item
diarrhea
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
Code List
diarrhea
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item
skin problems (including rash, dry skin, itching, irritation or redness)
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
Code List
skin problems (including rash, dry skin, itching, irritation or redness)
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item
numbness or tingling in hands or feet
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
numbness or tingling in hands or feet
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item
fever or shivering (shaking, chills)
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
fever or shivering (shaking, chills)
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item
difficulty with bladder control
text
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
Code List
difficulty with bladder control
CL Item
Not at all (Not at all)
CL Item
A little bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite a bit (Quite a bit)
CL Item
Very much (Very much)
Item Group
Unnamed12
PatientNationalSurgicalAdjuvantBreastProjectIdentifierNumber
Item
NSABP Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C15818 (NCI Thesaurus Property)
C1513905 (UMLS 2011AA Property)
Item Group
Unnamed13
Item
constipation
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
constipation
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item
hot flashes
text
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
Code List
hot flashes
CL Item
Not at all (Not at all)
CL Item
A little bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite a bit (Quite a bit)
CL Item
Very much (Very much)
Item
genital itching or irritation
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
genital itching or irritation
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item
mood swings
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
mood swings
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item
vaginal discharge
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
vaginal discharge
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item
vaginal bleeding or spotting
text
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
Code List
vaginal bleeding or spotting
CL Item
Not at all (Not at all)
CL Item
A little bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite a bit (Quite a bit)
CL Item
Very much (Very much)
Item
vaginal dryness
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
vaginal dryness
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item
pain with intercourse
text
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
Code List
pain with intercourse
CL Item
Not at all (Not at all)
CL Item
A little bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite a bit (Quite a bit)
CL Item
Very much (Very much)
Item
cramps
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
cramps
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item
general aches and pains
text
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
Code List
general aches and pains
CL Item
Not at all (Not at all)
CL Item
A little bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite a bit (Quite a bit)
CL Item
Very much (Very much)
Item
joint pains
text
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
Code List
joint pains
CL Item
Not at all (Not at all)
CL Item
A little bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite a bit (Quite a bit)
CL Item
Very much (Very much)
Item
swelling of hands
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
Code List
swelling of hands
CL Item
1 (Not at all)
C91213 (NCI Thesaurus)
CL Item
2 (A little bit)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Somewhat)
CL Item
4 (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
5 (Very much)
C91217 (NCI Thesaurus)
Item
muscle stiffness
text
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
Code List
muscle stiffness
CL Item
Not at all (Not at all)
CL Item
A little bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite a bit (Quite a bit)
CL Item
Very much (Very much)
Item
weight gain
text
C25180 (NCI Thesaurus ValueDomain)
C0043094 (UMLS)
Code List
weight gain
CL Item
Not at all (Not at all)
CL Item
A little bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite a bit (Quite a bit)
CL Item
Very much (Very much)
Item
weight loss
text
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
C3445 (NCI Thesaurus ObjectClass)
C0043096 (UMLS 2011AA ObjectClass)
Code List
weight loss
CL Item
Not at all (Not at all)
CL Item
A little bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite a bit (Quite a bit)
CL Item
Very much (Very much)
Item
unhappy with appearance of my body
text
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
Code List
unhappy with appearance of my body
CL Item
Not at all (Not at all)
CL Item
A little bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite a bit (Quite a bit)
CL Item
Very much (Very much)
Item
forgetfulness
text
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
Code List
forgetfulness
CL Item
Not at all (Not at all)
CL Item
A little bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite a bit (Quite a bit)
CL Item
Very much (Very much)
Item
night sweats
text
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
Code List
night sweats
CL Item
Not at all (Not at all)
CL Item
A little bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite a bit (Quite a bit)
CL Item
Very much (Very much)
Item
cold sweats
text
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
Code List
cold sweats
CL Item
Not at all (Not at all)
CL Item
A little bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite a bit (Quite a bit)
CL Item
Very much (Very much)
Item
difficulty concentrating
text
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
Code List
difficulty concentrating
CL Item
Not at all (Not at all)
CL Item
A little bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite a bit (Quite a bit)
CL Item
Very much (Very much)
Item Group
Unnamed14
PatientNationalSurgicalAdjuvantBreastProjectIdentifierNumber
Item
NSABP Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C15818 (NCI Thesaurus Property)
C1513905 (UMLS 2011AA Property)
Item Group
Unnamed15
Item
Vigorous activities, such as running, lifting heavy objects, participating in strenuous sports
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
Code List
Vigorous activities, such as running, lifting heavy objects, participating in strenuous sports
CL Item
4 (Yes, limited a lot)
CL Item
2 (Yes, limited a little)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
1 (No, not limited at all)
Item
Moderate activities, such as moving a table, pushing a vacuum cleaner, bowling, or playing golf
text
Code List
Moderate activities, such as moving a table, pushing a vacuum cleaner, bowling, or playing golf
CL Item
Yes, Limited A Lot (Yes, limited a lot)
CL Item
Yes, Limited A Little (Yes, limited a little)
CL Item
No, Not Limited At All (No, not limited at all)
Item
Lifting or carrying groceries
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C17708 (NCI Thesaurus Property)
C0026606 (UMLS 2011AA Property)
C62189 (NCI Thesaurus Property)
C1299586 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
Code List
Lifting or carrying groceries
CL Item
4 (Yes, limited a lot)
CL Item
2 (Yes, limited a little)
CL Item
1 (No, not limited at all)
Item
Climbing several flights of stairs
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
CL299704 (NCI Metathesaurus ObjectClass)
C17708 (NCI Thesaurus ObjectClass)
C0026606 (UMLS 2011AA ObjectClass)
Code List
Climbing several flights of stairs
CL Item
Yes, Limited A Lot (Yes, limited a lot)
CL Item
Yes, Limited A Little (Yes, limited a little)
CL Item
No, Not Limited At All (No, not limited at all)
Item
Bending, kneeling, or stooping
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
Bending, kneeling, or stooping
CL Item
4 (Yes, limited a lot)
CL Item
2 (Yes, limited a little)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
1 (No, not limited at all)
Item
Walking more than a mile
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
Walking more than a mile
CL Item
4 (Yes, limited a lot)
CL Item
2 (Yes, limited a little)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
1 (No, not limited at all)
Item
Walking several hundred yards
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
Walking several hundred yards
CL Item
4 (Yes, limited a lot)
CL Item
2 (Yes, limited a little)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
1 (No, not limited at all)
Item
Walking one hundred yards
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
Code List
Walking one hundred yards
CL Item
4 (Yes, limited a lot)
CL Item
2 (Yes, limited a little)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
1 (No, not limited at all)
Item
Bathing or dressing yourself
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
Bathing or dressing yourself
CL Item
4 (Yes, limited a lot)
CL Item
2 (Yes, limited a little)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
1 (No, not limited at all)
Item Group
Unnamed16
PatientNationalSurgicalAdjuvantBreastProjectIdentifierNumber
Item
NSABP Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C15818 (NCI Thesaurus Property)
C1513905 (UMLS 2011AA Property)
Item Group
Unnamed17
Item
Did you feel full of life?
text
Code List
Did you feel full of life?
CL Item
All Of The Time (All of the time)
CL Item
Most Of The Time (Most of the time)
CL Item
Some Of The Time (Some of the time)
CL Item
A Little Of The Time (A little of the time)
CL Item
None Of The Time (None of the time)
Item
Did you have a lot of energy?
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
Code List
Did you have a lot of energy?
CL Item
5 (All of the time)
CL Item
4 (Most of the time)
CL Item
3 (Some of the time)
CL Item
2 (A little of the time)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
1 (None of the time)
Item
Did you feel worn out?
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
Did you feel worn out?
CL Item
5 (All of the time)
CL Item
4 (Most of the time)
CL Item
3 (Some of the time)
CL Item
2 (A little of the time)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
1 (None of the time)
Item
Did you feel tired?
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
Did you feel tired?
CL Item
5 (All of the time)
CL Item
4 (Most of the time)
CL Item
3 (Some of the time)
CL Item
2 (A little of the time)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
1 (None of the time)
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.
text
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.
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
Ccrr Module For Nsabp Protocol B-36 Quality Of Life Questionnaire (english Version)

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