ID

690

Beschreibung

CALGB: ORIENTATION-MEMORY-CONCENTRATION TEST FORM Comparison of Combination Chemotherapy Regimens in Treating Older Women Who Have Undergone Surgery for Breast Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A50D6435-FF10-3254-E034-080020C9C0E0

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A50D6435-FF10-3254-E034-080020C9C0E0

Stichworte

  1. 26.08.12 26.08.12 -
  2. 18.03.15 18.03.15 - Martin Dugas
Hochgeladen am

26. August 2012

DOI

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Lizenz

Creative Commons BY-NC 3.0 Legacy

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Breast Cancer NCT00024102 Quality of Life - CALGB: ORIENTATION-MEMORY-CONCENTRATION TEST FORM - 2042573v3.0

Scoring: Score 1 for each incorrect response; maximum weight score=28.

  1. StudyEvent: CALGB: ORIENTATION-MEMORY-CONCENTRATION TEST FORM
    1. Scoring: Score 1 for each incorrect response; maximum weight score=28.
Unnamed1
Beschreibung

Unnamed1

CALGB Form
Beschreibung

CALGBForm

Datentyp

text

CALGB Study No
Beschreibung

CALGBStudyNo

Datentyp

text

CALGB Patient ID
Beschreibung

CALGBPatientID

Datentyp

text

Date Completed (M)
Beschreibung

DateCompleted

Datentyp

date

Amended data?
Beschreibung

Amendeddata?

Datentyp

text

Unnamed2
Beschreibung

Unnamed2

Patient's Name
Beschreibung

Patient'sName

Datentyp

text

Participating Group
Beschreibung

ParticipatingGroup

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C17005
UMLS 2011AA ObjectClass
C1257890
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Patient Hospital Number
Beschreibung

PatientHospitalNumber

Datentyp

text

Participating Group Protocol No.
Beschreibung

ParticipatingGroupProtocolNo.

Datentyp

text

Main Member Institution/Adjunct
Beschreibung

MainMemberInstitution/Adjunct

Datentyp

text

Participating Group Patient No.
Beschreibung

ParticipatingGroupPatientNo.

Datentyp

text

Unnamed3
Beschreibung

Unnamed3

Completed By (Print or Type Name)
Beschreibung

CompletedBy

Datentyp

text

Assessment Number (1.)
Beschreibung

AssessmentNumber

Datentyp

double

Unnamed4
Beschreibung

Unnamed4

What year is it now? (Patient's Response)
Beschreibung

Whatyearisitnow?

Datentyp

double

Score (Weight)
Beschreibung

PerQuestionScore

Datentyp

double

Score (Weight)
Beschreibung

PerQuestionScore

Datentyp

double

Score (Weight)
Beschreibung

PerQuestionScore

Datentyp

double

Score (Weight)
Beschreibung

PerQuestionScore

Datentyp

double

Score (Weight)
Beschreibung

PerQuestionScore

Datentyp

double

Score (Weight)
Beschreibung

PerQuestionScore

Datentyp

double

Final Score
Beschreibung

WeightedScore

Datentyp

double

Final Score
Beschreibung

WeightedScore

Datentyp

double

Final Score
Beschreibung

WeightedScore

Datentyp

double

Final Score
Beschreibung

WeightedScore

Datentyp

double

Final Score
Beschreibung

WeightedScore

Datentyp

double

Final Score
Beschreibung

WeightedScore

Datentyp

double

What month is it now? (Patient's Response)
Beschreibung

Whatmonthisitnow?

Datentyp

double

About what time is it? ([within 1 hour])
Beschreibung

Aboutwhattimeisit?

Datentyp

text

Unnamed5
Beschreibung

Unnamed5

TOTAL SCORE
Beschreibung

TOTALSCORE

Datentyp

double

Ccrr Module For Calgb: Orientation-memory-concentration Test Form
Beschreibung

Ccrr Module For Calgb: Orientation-memory-concentration Test Form

Ähnliche Modelle

Scoring: Score 1 for each incorrect response; maximum weight score=28.

  1. StudyEvent: CALGB: ORIENTATION-MEMORY-CONCENTRATION TEST FORM
    1. Scoring: Score 1 for each incorrect response; maximum weight score=28.
Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
Alias
Item Group
Unnamed1
CALGBForm
Item
CALGB Form
text
CALGBStudyNo
Item
CALGB Study No
text
CALGBPatientID
Item
CALGB Patient ID
text
DateCompleted
Item
Date Completed (M)
date
Item
Amended data?
text
Code List
Amended data?
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item Group
Unnamed2
Patient'sName
Item
Patient's Name
text
ParticipatingGroup
Item
Participating Group
text
C17005 (NCI Thesaurus ObjectClass)
C1257890 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
PatientHospitalNumber
Item
Patient Hospital Number
text
ParticipatingGroupProtocolNo.
Item
Participating Group Protocol No.
text
MainMemberInstitution/Adjunct
Item
Main Member Institution/Adjunct
text
ParticipatingGroupPatientNo.
Item
Participating Group Patient No.
text
Item Group
Unnamed3
CompletedBy
Item
Completed By (Print or Type Name)
text
AssessmentNumber
Item
Assessment Number (1.)
double
Item Group
Unnamed4
Whatyearisitnow?
Item
What year is it now? (Patient's Response)
double
PerQuestionScore
Item
Score (Weight)
double
PerQuestionScore
Item
Score (Weight)
double
PerQuestionScore
Item
Score (Weight)
double
PerQuestionScore
Item
Score (Weight)
double
PerQuestionScore
Item
Score (Weight)
double
PerQuestionScore
Item
Score (Weight)
double
WeightedScore
Item
Final Score
double
WeightedScore
Item
Final Score
double
WeightedScore
Item
Final Score
double
WeightedScore
Item
Final Score
double
WeightedScore
Item
Final Score
double
WeightedScore
Item
Final Score
double
Whatmonthisitnow?
Item
What month is it now? (Patient's Response)
double
Aboutwhattimeisit?
Item
About what time is it? ([within 1 hour])
text
Item Group
Unnamed5
TOTALSCORE
Item
TOTAL SCORE
double
Item Group
Ccrr Module For Calgb: Orientation-memory-concentration Test Form

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