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Información:
Error:
ID
690
Descripción
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
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Versiones (2)
- 26/8/12 26/8/12 -
- 18/3/15 18/3/15 - Martin Dugas
Subido en
26 de agosto de 2012
DOI
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Licencia
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.
- StudyEvent: CALGB: ORIENTATION-MEMORY-CONCENTRATION TEST FORM
Similar models
Scoring: Score 1 for each incorrect response; maximum weight score=28.
- StudyEvent: CALGB: ORIENTATION-MEMORY-CONCENTRATION TEST FORM
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
CALGBForm
Item
CALGB Form
text
CALGBStudyNo
Item
CALGB Study No
text
CALGBPatientID
Item
CALGB Patient ID
text
DateCompleted
Item
Date Completed (M)
date
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
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)
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
CompletedBy
Item
Completed By (Print or Type Name)
text
AssessmentNumber
Item
Assessment Number (1.)
double
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
TOTALSCORE
Item
TOTAL SCORE
double