ID

5500

Beschrijving

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

Trefwoorden

  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 -
Geüploaded op

7 augustus 2014

DOI

Voor een aanvraag inloggen.

Licentie

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
Beschrijving

Unnamed1

Patient Initials (Last, First Middle)
Beschrijving

PatientInitialsName

Datatype

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
Beschrijving

PatientNationalSurgicalAdjuvantBreastProjectIdentifierNumber

Datatype

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
Beschrijving

Unnamed2

Unnamed3
Beschrijving

Unnamed3

Institution Name
Beschrijving

InstitutionName

Datatype

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
Beschrijving

AffiliatedInstitutionName

Datatype

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)
Beschrijving

PersonFormAdministrationLastName

Datatype

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
Beschrijving

PersonFormAdministrationFirstName

Datatype

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
Beschrijving

PersonFormAdministrationPhoneNumber

Datatype

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)
Beschrijving

Today'sDate

Datatype

text

Unnamed4
Beschrijving

Unnamed4

Time point
Beschrijving

AssessmentPeriodType

Datatype

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
Beschrijving

CaseReportFormPersonCompleteType

Datatype

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
Beschrijving

Unnamed5

NSABP Patient ID
Beschrijving

PatientNationalSurgicalAdjuvantBreastProjectIdentifierNumber

Datatype

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.)
Beschrijving

QuestionnaireCompletionDate

Datatype

date

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

Unnamed6

I have a lack of energy.
Beschrijving

FatigueAssessmentResponseScale

Datatype

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.
Beschrijving

NauseaAssessmentResponseScale

Datatype

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.
Beschrijving

FamilyNeedAssessmentResponse

Datatype

text

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

PainAssessmentResponseScale

Datatype

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.
Beschrijving

AdverseEventAssessmentResponse

Datatype

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.
Beschrijving

IllnessAssessmentResponse

Datatype

text

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

BedrestAssessmentResponse

Datatype

text

I feel close to my friends.
Beschrijving

FriendsCloseAssessmentResponse

Datatype

text

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

FamilyPatientEmotionalSupportAssessmentQualityofLifeScale

Datatype

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.
Beschrijving

SupportAssessmentExternalResponseType

Datatype

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.
Beschrijving

IllnessAcceptanceAssessmentResponse

Datatype

text

I am satisfied with family communication about my illness.
Beschrijving

CommunicationSatisfiedAssessmentResponse

Datatype

text

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

PartnerClosenessAssessmentResponse

Datatype

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.)
Beschrijving

QuestionNotResponsInd-2

Datatype

text

I am satisfied with my sex life.
Beschrijving

Iamsatisfiedwithmysexlife

Datatype

text

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

Unnamed7

NSABP Patient ID
Beschrijving

PatientNationalSurgicalAdjuvantBreastProjectIdentifierNumber

Datatype

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
Beschrijving

Unnamed8

I feel sad.
Beschrijving

PatientDepressionAssessmentQualityofLifeScale

Datatype

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.
Beschrijving

PatientAcceptanceofIllnessAssessmentQualityofLifeScale

Datatype

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.
Beschrijving

LostHopeAssessmentResponse

Datatype

text

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

PatientNervousAssessmentQualityofLifeScale

Datatype

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.
Beschrijving

WorryPatientDeathAssessmentQualityofLifeScale

Datatype

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.
Beschrijving

WorseAssessmentResponse

Datatype

text

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

WorkAssessmentResponseType

Datatype

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)
Beschrijving

WorkFullfillingAssessmentResponse

Datatype

text

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

LifeAssessmentResponseType

Datatype

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.
Beschrijving

IllnessAcceptanceSelfAssessmentResponse

Datatype

text

I am sleeping well.
Beschrijving

PatientSleepAssessmentQualityofLifeScale

Datatype

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.
Beschrijving

QualityofLifeHobbySatisfactionAssessment

Datatype

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.
Beschrijving

ContentAssessmentResponse

Datatype

text

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

DyspneaAssessmentResponse

Datatype

text

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

DressAssessmentResponse

Datatype

text

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

ArmSwollenAssessmentResponse

Datatype

text

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

SexuallyAttractiveAssessmentResponse

Datatype

text

I am bothered by hair loss.
Beschrijving

HairLossAssessmentResponse

Datatype

text

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

Unnamed9

NSABP Patient ID
Beschrijving

PatientNationalSurgicalAdjuvantBreastProjectIdentifierNumber

Datatype

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
Beschrijving

Unnamed10

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

IllnessDevelopFamilyAssessmentResponse

Datatype

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.
Beschrijving

IllnessStressAssessmentResponse

Datatype

text

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

WeightAssessmentResponseType

Datatype

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.
Beschrijving

WomanAssessmentResponse

Datatype

text

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

Unnamed11

headaches
Beschrijving

HeadachePresentQOLSeverityStatus

Datatype

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
Beschrijving

DyspepsiaAssessmentResponseType

Datatype

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
Beschrijving

Nausea

Datatype

text

heartburn
Beschrijving

HeartburnAssessmentResponseType

Datatype

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
Beschrijving

VomitingAssessmentResponseType

Datatype

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)
Beschrijving

FlatulenceAssessmentResponseType

Datatype

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
Beschrijving

MouthAssessmentResponseType

Datatype

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
Beschrijving

DiarrheaAssessmentResponse

Datatype

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)
Beschrijving

DermalAssessmentResponseType

Datatype

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
Beschrijving

ExtremitiesNumbnessAssessmentResponse

Datatype

text

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

FeverAssessmentResponse

Datatype

text

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

Difficultywithbladdercontrol

Datatype

text

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

Unnamed12

NSABP Patient ID
Beschrijving

PatientNationalSurgicalAdjuvantBreastProjectIdentifierNumber

Datatype

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
Beschrijving

Unnamed13

constipation
Beschrijving

ConstipationAssessmentResponse

Datatype

text

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

HotFlashes

Datatype

text

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

GenitalItchingAssessmentResponse

Datatype

text

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

EmotionsAssessmentResponse

Datatype

text

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

VaginalDischargeAssessmentResponse

Datatype

text

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

Vaginalbleedingorspotting

Datatype

text

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

VaginalDrynessAssessmentResponse

Datatype

text

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

Painwithintercourse

Datatype

text

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

CrampsAssessmentResult

Datatype

text

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

Generalachesandpains

Datatype

text

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

Jointpains

Datatype

text

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

ExtremityAssessmentResponseType

Datatype

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
Beschrijving

Musclestiffness

Datatype

text

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

Weight gain

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25180
UMLS
C0043094
weight loss
Beschrijving

WeightLossAssessmentResponseInd-2

Datatype

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
Beschrijving

Unhappywithappearanceofmybody

Datatype

text

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

Forgetfulness

Datatype

text

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

Nightsweats

Datatype

text

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

Coldsweats

Datatype

text

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

Difficultyconcentrating

Datatype

text

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

Unnamed14

NSABP Patient ID
Beschrijving

PatientNationalSurgicalAdjuvantBreastProjectIdentifierNumber

Datatype

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
Beschrijving

Unnamed15

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

VigorousAssessmentResponseType

Datatype

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
Beschrijving

Moderateactivities,suchasmovingatable,pushingavacuumcleaner,bowling,orplayinggolf

Datatype

text

Lifting or carrying groceries
Beschrijving

QualityofLifePhysicalActivityDifficultyAssessmentScale

Datatype

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
Beschrijving

ClimbingStairsPhysicalActivityAssessmentScale

Datatype

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
Beschrijving

BendingPhysicalAssessmentResponse

Datatype

text

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

AmbulatePhysicalOneMileAssessmentResult

Datatype

text

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

AmbulatePhysicalSeveralHundredYardsAssessmentResponse

Datatype

text

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

MobileAssessmentShortResponseType

Datatype

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
Beschrijving

BathingPhysicalAssessmentResponse

Datatype

text

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

Unnamed16

NSABP Patient ID
Beschrijving

PatientNationalSurgicalAdjuvantBreastProjectIdentifierNumber

Datatype

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
Beschrijving

Unnamed17

Did you feel full of life?
Beschrijving

Didyoufeelfulloflife?

Datatype

text

Did you have a lot of energy?
Beschrijving

VitalityAssessmentResponseType

Datatype

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?
Beschrijving

WornOutVitalityAssessmentResponse

Datatype

text

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

TiredVitalityAssessmentResponse

Datatype

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.
Beschrijving

Pleasescoreyouroverallqualityoflifeasoftodayonan11-pointscalewhere0indicatesbeingintheworstpossiblehealthand10indicatesbeinginperfecthealth.

Datatype

text

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

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

Similar models

No Instruction available.

  1. StudyEvent: NSABP Protocol B-36 Quality of Life Questionnaire (English Version)
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Datatype
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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