ID

7059

Beschrijving

PACCT-1 TAILORx FACT - Endocrine Symptoms Form Hormone Therapy With or Without Combination Chemotherapy in Treating Women Who Have Undergone Surgery for Node-Negative Breast Cancer (The TAILORx Trial) Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=84B85E26-3D9D-5248-E040-BB89AD43122A

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=84B85E26-3D9D-5248-E040-BB89AD43122A

Trefwoorden

Versies (3)
  1. 26-08-12 26-08-12 -
  2. 08-01-15 08-01-15 - Martin Dugas
  3. 08-06-15 08-06-15 -
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8 januari 2015

DOI

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Licentie

Creative Commons BY-NC 3.0 Legacy
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Breast Cancer NCT00310180 Quality of Life - PACCT-1 TAILORx FACT - Endocrine Symptoms Form - 3072561v1.0

Engels

INSTRUCTIONS: Please complete this form according to the forms submission schedule. Submit original to the ECOG Coordinating Center. Keep a copy for your files. Please submit form to the address below: ECOG Coordinating Center Attn: Data, 900 Commonwealth Ave, 2nd Floor, Boston, MA, 02215

1 Formulieren  
Header
Beschrijving

Header

ECOG Protocol Number
Beschrijving

Protocol Number ECOG

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C3274381
NCI Thesaurus ObjectClass
C25320
UMLS CUI-2
C1512162
NCI Thesaurus Property
C25364
NCI Thesaurus Property-2
C25491
ECOG Patient ID
Beschrijving

Patient ID ECOG

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C2348585
NCI Thesaurus ObjectClass
C16960
UMLS CUI-2
C1512162
NCI Thesaurus Property
C25364
NCI Thesaurus Property-2
C25491
DCI Name
Beschrijving

Generic drug form

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C3242750
NCI Thesaurus Property
C19464
NCI Thesaurus ObjectClass
C25474
NCI Thesaurus ObjectClass-2
C25452
On Treatment
Beschrijving

On Treatment

Report Period (since start of Step 2 Choose one)
Beschrijving

Cycle number

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS CUI-1
C2045829
NCI Thesaurus Property
C25214
NCI Thesaurus Property-2
C25616
NCI Thesaurus ObjectClass
C15368
Unnamed2
Beschrijving

Unnamed2

Are data amended
Beschrijving

Data amended

Datatype

boolean

Alias
NCI Thesaurus ValueDomain
C38148
UMLS CUI-1
C0680532
NCI Thesaurus ObjectClass
C25474
NCI Thesaurus Property
C25416
Date data amended (s M D Y)
Beschrijving

Data amended date

Datatype

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS CUI-1
C0680532
NCI Thesaurus ObjectClass
C25474
UMLS CUI-2
C0011008
NCI Thesaurus Property
C25416
NCI Thesaurus ValueDomain-2
C25367
Date data amended (s M D Y)
Beschrijving

Data amended date

Datatype

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS CUI-1
C0680532
NCI Thesaurus ObjectClass
C25474
UMLS CUI-2
C0011008
NCI Thesaurus Property
C25416
NCI Thesaurus ValueDomain-2
C25367
Header
Beschrijving

Header

Assessment date
Beschrijving

Assessment Date

Datatype

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS CUI-1
C2985720
NCI Thesaurus ObjectClass
C25367
NCI Thesaurus ValueDomain-2
C25367
NCI Thesaurus Property
C38000
Additional Concerns
Beschrijving

Additional Concerns

I have hot flashes
Beschrijving

QualityofLifeHotFlashesEvaluationScale

Datatype

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus Property
C25214
UMLS 2011AA Property
C0220825
NCI Thesaurus Property-2
C3109
UMLS 2011AA Property-2
C0600142
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
NCI Thesaurus ValueDomain-2
C17047
UMLS 2011AA ValueDomain-2
C0518214
I have cold sweats
Beschrijving

QualityofLifeColdSweatEvaluationScale

Datatype

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus Property
C25214
UMLS 2011AA Property
C0220825
NCI Thesaurus Property-2
C62180
UMLS 2011AA Property-2
C0009264
NCI Thesaurus Property-3
C13280
UMLS 2011AA Property-3
C0038984
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
NCI Thesaurus ValueDomain-2
C17047
UMLS 2011AA ValueDomain-2
C0518214
I have night sweats
Beschrijving

QualityofLifeNightSweatsEvaluationScale

Datatype

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus Property
C25214
UMLS 2011AA Property
C0220825
NCI Thesaurus Property-2
C3279
UMLS 2011AA Property-2
C0028081
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
NCI Thesaurus ValueDomain-2
C17047
UMLS 2011AA ValueDomain-2
C0518214
I have vaginal discharge
Beschrijving

QualityofLifeVaginaFluidDischargeEvaluationScale

Datatype

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus Property
C25214
UMLS 2011AA Property
C0220825
NCI Thesaurus Property-2
C12407
UMLS 2011AA Property-2
C0042232
NCI Thesaurus Property-3
C34548
UMLS 2011AA Property-3
C0012621
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
NCI Thesaurus ValueDomain-2
C17047
UMLS 2011AA ValueDomain-2
C0518214
I have vaginal itching/irritation
Beschrijving

PruritusAssessmentGenitaliaResponseType

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 vaginal bleeding or spotting
Beschrijving

QualityofLifeVaginaHemorrhageEvaluationScale

Datatype

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus Property
C25214
UMLS 2011AA Property
C0220825
NCI Thesaurus Property-2
C26791
UMLS 2011AA Property-2
C0019080
NCI Thesaurus Property-3
C12407
UMLS 2011AA Property-3
C0042232
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
NCI Thesaurus ValueDomain-2
C17047
UMLS 2011AA ValueDomain-2
C0518214
I have vaginal dryness
Beschrijving

VaginalAssessmentDrynessResponseType

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 pain or discomfort with intercourse
Beschrijving

QualityofLifeSexualIntercoursePainEvaluationScale

Datatype

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus Property
C25214
UMLS 2011AA Property
C0220825
NCI Thesaurus Property-2
C3303
UMLS 2011AA Property-2
C0030193
NCI Thesaurus Property-3
C72881
UMLS 2011AA Property-3
C0009253
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
NCI Thesaurus ValueDomain-2
C17047
UMLS 2011AA ValueDomain-2
C0518214
I have lost interest in sex.
Beschrijving

QualityofLifeLostInterestSexBehavior7DaysPriorAssessmentScore

Datatype

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus Property
C25367
NCI Thesaurus Property-2
C25560
UMLS 2011AA Property
C0745777
NCI Thesaurus Property-3
C17127
UMLS 2011AA Property-2
C0036864
NCI Thesaurus Property-4
C60730
UMLS 2011AA Property-3
C0543488
NCI Thesaurus ValueDomain
C17047
UMLS 2011AA ValueDomain
C0518214
NCI Thesaurus ValueDomain-2
C25629
UMLS 2011AA ValueDomain-2
C0332152
NCI Thesaurus ValueDomain-3
C25301
UMLS 2011AA ValueDomain-3
C0439228
NCI Thesaurus ValueDomain-4
C45255
UMLS 2011AA ValueDomain-4
C1708523
NCI Thesaurus ValueDomain-5
C25338
UMLS 2011AA ValueDomain-5
C0449820
NCI Metathesaurus ValueDomain
C0679207
I have gained weight
Beschrijving

Quality-of-LifeAssessmentPatientWeightGainScale

Datatype

text

Alias
NCI Thesaurus ObjectClass
C15584
UMLS 2011AA ObjectClass
C0281588
NCI Thesaurus Property
C16960
UMLS 2011AA Property
C0030705
NCI Thesaurus Property-2
C62754
UMLS 2011AA Property-2
C0043094
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
NCI Thesaurus ValueDomain-2
C17047
UMLS 2011AA ValueDomain-2
C0518214
I feel lightheaded (dizzy).
Beschrijving

QualityofLifeDizziness7DaysPriorAssessmentScore

Datatype

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus Property
C25367
NCI Thesaurus Property-2
C37943
UMLS 2011AA Property
C0012833
NCI Thesaurus ValueDomain
C17047
UMLS 2011AA ValueDomain
C0518214
NCI Thesaurus ValueDomain-2
C25629
UMLS 2011AA ValueDomain-2
C0332152
NCI Thesaurus ValueDomain-3
C25301
UMLS 2011AA ValueDomain-3
C0439228
NCI Thesaurus ValueDomain-4
C45255
UMLS 2011AA ValueDomain-4
C1708523
NCI Thesaurus ValueDomain-5
C25338
UMLS 2011AA ValueDomain-5
C0449820
NCI Metathesaurus ValueDomain
C0679207
I have been 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
I have diarrhea
Beschrijving

QualityofLifeDiarrheaEvaluationScale

Datatype

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus Property
C25214
UMLS 2011AA Property
C0220825
NCI Thesaurus Property-2
C2987
UMLS 2011AA Property-2
C0011991
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
NCI Thesaurus ValueDomain-2
C17047
UMLS 2011AA ValueDomain-2
C0518214
I get headaches
Beschrijving

BrainQualityofLifeHeadachePatientAssessmentScale

Datatype

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus ObjectClass-2
C12439
UMLS 2011AA ObjectClass-2
C0006104
NCI Thesaurus Property
C25367
NCI Thesaurus Property-2
C34661
UMLS 2011AA Property
C0018681
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
I feel bloated
Beschrijving

QualityofLifeAbdominalMuscleCrampSwellingAssessmentType

Datatype

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus Property
C25217
UMLS 2011AA Property
C1516048
NCI Thesaurus Property-2
C25342
UMLS 2011AA Property-2
C0000726
NCI Thesaurus Property-3
C3399
UMLS 2011AA Property-3
C0038999
NCI Thesaurus Property-4
C34827
UMLS 2011AA Property-4
C0026821
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
I have breast sensitivity/tenderness
Beschrijving

QualityofLifeBreastSensitivityTenderness7DaysPriorAssessmentScore

Datatype

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus Property
C25367
NCI Thesaurus Property-2
C12971
UMLS 2011AA Property
C0006141
NCI Thesaurus Property-3
C75540
UMLS 2011AA Property-2
C0234233
NCI Thesaurus Property-4
C68816
UMLS 2011AA Property-3
C2349185
NCI Thesaurus ValueDomain
C17047
UMLS 2011AA ValueDomain
C0518214
NCI Thesaurus ValueDomain-2
C25629
UMLS 2011AA ValueDomain-2
C0332152
NCI Thesaurus ValueDomain-3
C25301
UMLS 2011AA ValueDomain-3
C0439228
NCI Thesaurus ValueDomain-4
C45255
UMLS 2011AA ValueDomain-4
C1708523
NCI Thesaurus ValueDomain-5
C25338
UMLS 2011AA ValueDomain-5
C0449820
NCI Metathesaurus ValueDomain
C0679207
I have mood swings
Beschrijving

QualityofLifeMoodSwing7DaysPriorAssessmentScore

Datatype

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus Property
C25367
NCI Thesaurus Property-2
C62592
UMLS 2011AA Property
C2939186
NCI Thesaurus ValueDomain
C17047
UMLS 2011AA ValueDomain
C0518214
NCI Thesaurus ValueDomain-2
C25629
UMLS 2011AA ValueDomain-2
C0332152
NCI Thesaurus ValueDomain-3
C25301
UMLS 2011AA ValueDomain-3
C0439228
NCI Thesaurus ValueDomain-4
C45255
UMLS 2011AA ValueDomain-4
C1708523
NCI Thesaurus ValueDomain-5
C25338
UMLS 2011AA ValueDomain-5
C0449820
NCI Metathesaurus ValueDomain
C0679207
I am irritable
Beschrijving

EmotionalAssessmentResponseType

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 pain in my joints
Beschrijving

NeurotoxicityPatientArthralgiaAssessmentQualityofLifeScale

Datatype

text

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus ObjectClass-2
C27961
UMLS 2011AA ObjectClass-2
C0235032
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Metathesaurus Property
C0003862
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
NCI Thesaurus ValueDomain-2
C17047
UMLS 2011AA ValueDomain-2
C0518214
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Similar models

INSTRUCTIONS: Please complete this form according to the forms submission schedule. Submit original to the ECOG Coordinating Center. Keep a copy for your files. Please submit form to the address below: ECOG Coordinating Center Attn: Data, 900 Commonwealth Ave, 2nd Floor, Boston, MA, 02215

1 Formulieren
Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
Header
Protocol Number ECOG
Item
ECOG Protocol Number
text
C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1512162 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25491 (NCI Thesaurus Property-2)
Patient ID ECOG
Item
ECOG Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1512162 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25491 (NCI Thesaurus Property-2)
Generic drug form
Item
DCI Name
text
C25191 (NCI Thesaurus ValueDomain)
C3242750 (UMLS CUI-1)
C19464 (NCI Thesaurus Property)
C25474 (NCI Thesaurus ObjectClass)
C25452 (NCI Thesaurus ObjectClass-2)
Item Group
On Treatment
Item
Report Period (since start of Step 2 Choose one)
text
C25284 (NCI Thesaurus ValueDomain)
C2045829 (UMLS CUI-1)
C25214 (NCI Thesaurus Property)
C25616 (NCI Thesaurus Property-2)
C15368 (NCI Thesaurus ObjectClass)
CL.1
Code List
Report Period (since start of Step 2 Choose one)
CL Item
Baseline (baseline)
C25213 (NCI Thesaurus)
C1442488 (UMLS 2011AA)
C25213 (NCI Thesaurus-3)
C1442488 (UMLS 2011AA-4)
CL Item
3 Months (3 months)
CL Item
6 Months (6 months)
CL Item
12 Months (12 months)
CL Item
24 Months (24 months)
CL Item
36 Months (36 months)
Item Group
Unnamed2
Data amended
Item
Are data amended
boolean
C38148 (NCI Thesaurus ValueDomain)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
Data amended date
Item
Date data amended (s M D Y)
date
C25164 (NCI Thesaurus ValueDomain)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C0011008 (UMLS CUI-2)
C25416 (NCI Thesaurus Property)
C25367 (NCI Thesaurus ValueDomain-2)
Data amended date
Item
Date data amended (s M D Y)
date
C25164 (NCI Thesaurus ValueDomain)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C0011008 (UMLS CUI-2)
C25416 (NCI Thesaurus Property)
C25367 (NCI Thesaurus ValueDomain-2)
Item Group
Header
Assessment Date
Item
Assessment date
date
C25164 (NCI Thesaurus ValueDomain)
C2985720 (UMLS CUI-1)
C25367 (NCI Thesaurus ObjectClass)
C25367 (NCI Thesaurus ValueDomain-2)
C38000 (NCI Thesaurus Property)
Item Group
Additional Concerns
Item
I have hot flashes
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25214 (NCI Thesaurus Property)
C0220825 (UMLS 2011AA Property)
C3109 (NCI Thesaurus Property-2)
C0600142 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)
CL.3
Code List
I have hot flashes
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
C70543 (NCI Thesaurus-3)
C2003901 (UMLS 2011AA)
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)
C91216 (NCI Thesaurus-2)
CL Item
Very Much (Very much)
C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus-2)
Item
I have cold sweats
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25214 (NCI Thesaurus Property)
C0220825 (UMLS 2011AA Property)
C62180 (NCI Thesaurus Property-2)
C0009264 (UMLS 2011AA Property-2)
C13280 (NCI Thesaurus Property-3)
C0038984 (UMLS 2011AA Property-3)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)
CL.4
Code List
I have cold sweats
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
C70543 (NCI Thesaurus-3)
C2003901 (UMLS 2011AA)
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)
C91216 (NCI Thesaurus-2)
CL Item
Very Much (Very much)
C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus-2)
Item
I have night sweats
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25214 (NCI Thesaurus Property)
C0220825 (UMLS 2011AA Property)
C3279 (NCI Thesaurus Property-2)
C0028081 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)
CL.5
Code List
I have night sweats
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
C70543 (NCI Thesaurus-3)
C2003901 (UMLS 2011AA)
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)
C91216 (NCI Thesaurus-2)
CL Item
Very Much (Very much)
C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus-2)
Item
I have vaginal discharge
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25214 (NCI Thesaurus Property)
C0220825 (UMLS 2011AA Property)
C12407 (NCI Thesaurus Property-2)
C0042232 (UMLS 2011AA Property-2)
C34548 (NCI Thesaurus Property-3)
C0012621 (UMLS 2011AA Property-3)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)
CL.6
Code List
I have vaginal discharge
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
C70543 (NCI Thesaurus-3)
C2003901 (UMLS 2011AA)
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)
C91216 (NCI Thesaurus-2)
CL Item
Very Much (Very much)
C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus-2)
Item
I have vaginal itching/irritation
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)
CL.7
Code List
I have vaginal itching/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
I have vaginal bleeding or spotting
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25214 (NCI Thesaurus Property)
C0220825 (UMLS 2011AA Property)
C26791 (NCI Thesaurus Property-2)
C0019080 (UMLS 2011AA Property-2)
C12407 (NCI Thesaurus Property-3)
C0042232 (UMLS 2011AA Property-3)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)
CL.8
Code List
I have vaginal bleeding or spotting
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
C70543 (NCI Thesaurus-3)
C2003901 (UMLS 2011AA)
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)
C91216 (NCI Thesaurus-2)
CL Item
Very Much (Very much)
C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus-2)
Item
I have vaginal dryness
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)
CL.9
Code List
I have 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
I have pain or discomfort with intercourse
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25214 (NCI Thesaurus Property)
C0220825 (UMLS 2011AA Property)
C3303 (NCI Thesaurus Property-2)
C0030193 (UMLS 2011AA Property-2)
C72881 (NCI Thesaurus Property-3)
C0009253 (UMLS 2011AA Property-3)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)
CL.10
Code List
I have pain or discomfort with intercourse
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
C70543 (NCI Thesaurus-3)
C2003901 (UMLS 2011AA)
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)
C91216 (NCI Thesaurus-2)
CL Item
Very Much (Very much)
C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus-2)
Item
I have lost interest in sex.
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C25560 (NCI Thesaurus Property-2)
C0745777 (UMLS 2011AA Property)
C17127 (NCI Thesaurus Property-3)
C0036864 (UMLS 2011AA Property-2)
C60730 (NCI Thesaurus Property-4)
C0543488 (UMLS 2011AA Property-3)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)
C25629 (NCI Thesaurus ValueDomain-2)
C0332152 (UMLS 2011AA ValueDomain-2)
C25301 (NCI Thesaurus ValueDomain-3)
C0439228 (UMLS 2011AA ValueDomain-3)
C45255 (NCI Thesaurus ValueDomain-4)
C1708523 (UMLS 2011AA ValueDomain-4)
C25338 (NCI Thesaurus ValueDomain-5)
C0449820 (UMLS 2011AA ValueDomain-5)
C0679207 (NCI Metathesaurus ValueDomain)
CL.11
Code List
I have lost interest in sex.
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
CL Item
A Little Bit (A little bit)
C91214 (NCI Thesaurus)
CL Item
Somewhat (Somewhat)
C91215 (NCI Thesaurus)
CL Item
Quite A Bit (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
Very Much (Very much)
C91217 (NCI Thesaurus)
Item
I have gained weight
text
C15584 (NCI Thesaurus ObjectClass)
C0281588 (UMLS 2011AA ObjectClass)
C16960 (NCI Thesaurus Property)
C0030705 (UMLS 2011AA Property)
C62754 (NCI Thesaurus Property-2)
C0043094 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)
CL.12
Code List
I have gained weight
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
C70543 (NCI Thesaurus-3)
C2003901 (UMLS 2011AA)
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)
C91216 (NCI Thesaurus-2)
CL Item
Very Much (Very much)
C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus-2)
Item
I feel lightheaded (dizzy).
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C37943 (NCI Thesaurus Property-2)
C0012833 (UMLS 2011AA Property)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)
C25629 (NCI Thesaurus ValueDomain-2)
C0332152 (UMLS 2011AA ValueDomain-2)
C25301 (NCI Thesaurus ValueDomain-3)
C0439228 (UMLS 2011AA ValueDomain-3)
C45255 (NCI Thesaurus ValueDomain-4)
C1708523 (UMLS 2011AA ValueDomain-4)
C25338 (NCI Thesaurus ValueDomain-5)
C0449820 (UMLS 2011AA ValueDomain-5)
C0679207 (NCI Metathesaurus ValueDomain)
CL.13
Code List
I feel lightheaded (dizzy).
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
CL Item
A Little Bit (A little bit)
C91214 (NCI Thesaurus)
CL Item
Somewhat (Somewhat)
C91215 (NCI Thesaurus)
CL Item
Quite A Bit (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
Very Much (Very much)
C91217 (NCI Thesaurus)
Item
I have been 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)
CL.14
Code List
I have been 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
I have diarrhea
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25214 (NCI Thesaurus Property)
C0220825 (UMLS 2011AA Property)
C2987 (NCI Thesaurus Property-2)
C0011991 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)
CL.15
Code List
I have diarrhea
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
C70543 (NCI Thesaurus-3)
C2003901 (UMLS 2011AA)
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)
C91216 (NCI Thesaurus-2)
CL Item
Very Much (Very much)
C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus-2)
Item
I get headaches
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C12439 (NCI Thesaurus ObjectClass-2)
C0006104 (UMLS 2011AA ObjectClass-2)
C25367 (NCI Thesaurus Property)
C34661 (NCI Thesaurus Property-2)
C0018681 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.16
Code List
I get headaches
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
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)
C91216 (NCI Thesaurus-2)
CL Item
Very Much (Very much)
C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus-2)
Item
I feel bloated
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25217 (NCI Thesaurus Property)
C1516048 (UMLS 2011AA Property)
C25342 (NCI Thesaurus Property-2)
C0000726 (UMLS 2011AA Property-2)
C3399 (NCI Thesaurus Property-3)
C0038999 (UMLS 2011AA Property-3)
C34827 (NCI Thesaurus Property-4)
C0026821 (UMLS 2011AA Property-4)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.17
Code List
I feel bloated
CL Item
A Little Bit (A little bit)
CL Item
Quite A Bit (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
Somewhat (Somewhat)
C91215 (NCI Thesaurus)
Item
I have breast sensitivity/tenderness
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C12971 (NCI Thesaurus Property-2)
C0006141 (UMLS 2011AA Property)
C75540 (NCI Thesaurus Property-3)
C0234233 (UMLS 2011AA Property-2)
C68816 (NCI Thesaurus Property-4)
C2349185 (UMLS 2011AA Property-3)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)
C25629 (NCI Thesaurus ValueDomain-2)
C0332152 (UMLS 2011AA ValueDomain-2)
C25301 (NCI Thesaurus ValueDomain-3)
C0439228 (UMLS 2011AA ValueDomain-3)
C45255 (NCI Thesaurus ValueDomain-4)
C1708523 (UMLS 2011AA ValueDomain-4)
C25338 (NCI Thesaurus ValueDomain-5)
C0449820 (UMLS 2011AA ValueDomain-5)
C0679207 (NCI Metathesaurus ValueDomain)
CL.18
Code List
I have breast sensitivity/tenderness
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
CL Item
A Little Bit (A little bit)
C91214 (NCI Thesaurus)
CL Item
Somewhat (Somewhat)
C91215 (NCI Thesaurus)
CL Item
Quite A Bit (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
Very Much (Very much)
C91217 (NCI Thesaurus)
Item
I have mood swings
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C62592 (NCI Thesaurus Property-2)
C2939186 (UMLS 2011AA Property)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)
C25629 (NCI Thesaurus ValueDomain-2)
C0332152 (UMLS 2011AA ValueDomain-2)
C25301 (NCI Thesaurus ValueDomain-3)
C0439228 (UMLS 2011AA ValueDomain-3)
C45255 (NCI Thesaurus ValueDomain-4)
C1708523 (UMLS 2011AA ValueDomain-4)
C25338 (NCI Thesaurus ValueDomain-5)
C0449820 (UMLS 2011AA ValueDomain-5)
C0679207 (NCI Metathesaurus ValueDomain)
CL.19
Code List
I have mood swings
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
CL Item
A Little Bit (A little bit)
C91214 (NCI Thesaurus)
CL Item
Somewhat (Somewhat)
C91215 (NCI Thesaurus)
CL Item
Quite A Bit (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
Very Much (Very much)
C91217 (NCI Thesaurus)
Item
I am irritable
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)
CL.20
Code List
I am irritable
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 in my joints
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C27961 (NCI Thesaurus ObjectClass-2)
C0235032 (UMLS 2011AA ObjectClass-2)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0003862 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)
CL.21
Code List
I have pain in my joints
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
C70543 (NCI Thesaurus-3)
C2003901 (UMLS 2011AA)
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)
C91216 (NCI Thesaurus-2)
CL Item
Very Much (Very much)
C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus-2)
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