ID

933

Description

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

Lien

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

Mots-clés

  1. 26/08/2012 26/08/2012 -
  2. 08/01/2015 08/01/2015 - Martin Dugas
  3. 08/06/2015 08/06/2015 -
Téléchargé le

26 août 2012

DOI

Pour une demande vous connecter.

Licence

Creative Commons BY-NC 3.0 Legacy

Modèle Commentaires :

Ici, vous pouvez faire des commentaires sur le modèle. À partir des bulles de texte, vous pouvez laisser des commentaires spécifiques sur les groupes Item et les Item.

Groupe Item commentaires pour :

Item commentaires pour :

Vous devez être connecté pour pouvoir télécharger des formulaires. Veuillez vous connecter ou s’inscrire gratuitement.

Breast Cancer NCT00310180 Quality of Life - PACCT-1 TAILORx FACT - Endocrine Symptoms Form - 3072561v1.0

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

Unnamed1
Description

Unnamed1

ECOG Protocol Number
Description

ProtocolECOGIdentifierNumber

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C25320
UMLS 2011AA ObjectClass
C1507394
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus Property
C25491
UMLS 2011AA Property
C1512162
ECOG Patient ID
Description

PatientECOGIdentifierNumber

Type de données

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
C25491
UMLS 2011AA Property
C1512162
DCI Name
Description

CollectedDataFormName

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus Property
C19464
UMLS 2011AA Property
C0376315
NCI Thesaurus ObjectClass
C25474
UMLS 2011AA ObjectClass
C1511726
NCI Thesaurus ObjectClass
C25452
On Treatment
Description

On Treatment

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

TreatmentEvaluationPeriodType

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus Property
C25214
UMLS 2011AA Property
C0220825
NCI Thesaurus Property
C25616
UMLS 2011AA Property
C1948053
NCI Thesaurus ObjectClass
C15368
Unnamed2
Description

Unnamed2

Are data amended
Description

DataAmendedInd-3

Type de données

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C25474
UMLS 2011AA ObjectClass
C1511726
NCI Thesaurus Property
C25416
UMLS 2011AA Property
C1691222
Date data amended (s M D Y)
Description

DataAmendedDate

Type de données

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C25474
UMLS 2011AA ObjectClass
C1511726
NCI Thesaurus Property
C25416
UMLS 2011AA Property
C1691222
NCI Thesaurus ValueDomain
C25367
Date data amended (s M D Y)
Description

DataAmendedDate

Type de données

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C25474
UMLS 2011AA ObjectClass
C1511726
NCI Thesaurus Property
C25416
UMLS 2011AA Property
C1691222
NCI Thesaurus ValueDomain
C25367
Unnamed1
Description

Unnamed1

Assessment date
Description

AssessmentPerformedDate

Type de données

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C25367
NCI Thesaurus ValueDomain
C25367
NCI Thesaurus Property
C38000
UMLS 2011AA Property
C0884358
Additional Concerns
Description

Additional Concerns

I have hot flashes
Description

QualityofLifeHotFlashesEvaluationScale

Type de données

text

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

QualityofLifeColdSweatEvaluationScale

Type de données

text

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

QualityofLifeNightSweatsEvaluationScale

Type de données

text

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

QualityofLifeVaginaFluidDischargeEvaluationScale

Type de données

text

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

PruritusAssessmentGenitaliaResponseType

Type de données

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
Description

QualityofLifeVaginaHemorrhageEvaluationScale

Type de données

text

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

VaginalAssessmentDrynessResponseType

Type de données

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
Description

QualityofLifeSexualIntercoursePainEvaluationScale

Type de données

text

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

QualityofLifeLostInterestSexBehavior7DaysPriorAssessmentScore

Type de données

text

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

Quality-of-LifeAssessmentPatientWeightGainScale

Type de données

text

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

QualityofLifeDizziness7DaysPriorAssessmentScore

Type de données

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus Property
C25367
NCI Thesaurus Property
C37943
UMLS 2011AA Property
C0012833
NCI Thesaurus ValueDomain
C17047
UMLS 2011AA ValueDomain
C0518214
NCI Thesaurus ValueDomain
C25629
UMLS 2011AA ValueDomain
C0332152
NCI Thesaurus ValueDomain
C25301
UMLS 2011AA ValueDomain
C0439228
NCI Thesaurus ValueDomain
C45255
UMLS 2011AA ValueDomain
C1708523
NCI Thesaurus ValueDomain
C25338
UMLS 2011AA ValueDomain
C0449820
NCI Metathesaurus ValueDomain
C0679207
I have been vomiting
Description

VomitingAssessmentResponseType

Type de données

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
Description

QualityofLifeDiarrheaEvaluationScale

Type de données

text

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

BrainQualityofLifeHeadachePatientAssessmentScale

Type de données

text

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

QualityofLifeAbdominalMuscleCrampSwellingAssessmentType

Type de données

text

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

QualityofLifeBreastSensitivityTenderness7DaysPriorAssessmentScore

Type de données

text

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

QualityofLifeMoodSwing7DaysPriorAssessmentScore

Type de données

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus Property
C25367
NCI Thesaurus Property
C62592
UMLS 2011AA Property
C2939186
NCI Thesaurus ValueDomain
C17047
UMLS 2011AA ValueDomain
C0518214
NCI Thesaurus ValueDomain
C25629
UMLS 2011AA ValueDomain
C0332152
NCI Thesaurus ValueDomain
C25301
UMLS 2011AA ValueDomain
C0439228
NCI Thesaurus ValueDomain
C45255
UMLS 2011AA ValueDomain
C1708523
NCI Thesaurus ValueDomain
C25338
UMLS 2011AA ValueDomain
C0449820
NCI Metathesaurus ValueDomain
C0679207
I am irritable
Description

EmotionalAssessmentResponseType

Type de données

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
Description

NeurotoxicityPatientArthralgiaAssessmentQualityofLifeScale

Type de données

text

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

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

Name
Type
Description | Question | Decode (Coded Value)
Type de données
Alias
Item Group
Unnamed1
ProtocolECOGIdentifierNumber
Item
ECOG Protocol Number
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C25320 (NCI Thesaurus ObjectClass)
C1507394 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C25491 (NCI Thesaurus Property)
C1512162 (UMLS 2011AA Property)
PatientECOGIdentifierNumber
Item
ECOG 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)
C25491 (NCI Thesaurus Property)
C1512162 (UMLS 2011AA Property)
CollectedDataFormName
Item
DCI Name
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C19464 (NCI Thesaurus Property)
C0376315 (UMLS 2011AA Property)
C25474 (NCI Thesaurus ObjectClass)
C1511726 (UMLS 2011AA ObjectClass)
C25452 (NCI Thesaurus ObjectClass)
Item Group
On Treatment
Item
Report Period (since start of Step 2 Choose one)
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C25214 (NCI Thesaurus Property)
C0220825 (UMLS 2011AA Property)
C25616 (NCI Thesaurus Property)
C1948053 (UMLS 2011AA Property)
C15368 (NCI Thesaurus ObjectClass)
Code List
Report Period (since start of Step 2 Choose one)
CL Item
Baseline (baseline)
C25213 (NCI Thesaurus)
C1442488 (UMLS 2011AA)
C25213 (NCI Thesaurus)
C1442488 (UMLS 2011AA)
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
Item
Are data amended
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25474 (NCI Thesaurus ObjectClass)
C1511726 (UMLS 2011AA ObjectClass)
C25416 (NCI Thesaurus Property)
C1691222 (UMLS 2011AA Property)
Code List
Are data amended
CL Item
No (no)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
DataAmendedDate
Item
Date data amended (s M D Y)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25474 (NCI Thesaurus ObjectClass)
C1511726 (UMLS 2011AA ObjectClass)
C25416 (NCI Thesaurus Property)
C1691222 (UMLS 2011AA Property)
C25367 (NCI Thesaurus ValueDomain)
DataAmendedDate
Item
Date data amended (s M D Y)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25474 (NCI Thesaurus ObjectClass)
C1511726 (UMLS 2011AA ObjectClass)
C25416 (NCI Thesaurus Property)
C1691222 (UMLS 2011AA Property)
C25367 (NCI Thesaurus ValueDomain)
Item Group
Unnamed1
AssessmentPerformedDate
Item
Assessment date
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ObjectClass)
C25367 (NCI Thesaurus ValueDomain)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA 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)
C0600142 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)
Code List
I have hot flashes
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
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)
CL Item
Very Much (Very much)
C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)
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)
C0009264 (UMLS 2011AA Property)
C13280 (NCI Thesaurus Property)
C0038984 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)
Code List
I have cold sweats
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
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)
CL Item
Very Much (Very much)
C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)
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)
C0028081 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)
Code List
I have night sweats
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
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)
CL Item
Very Much (Very much)
C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)
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)
C0042232 (UMLS 2011AA Property)
C34548 (NCI Thesaurus Property)
C0012621 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)
Code List
I have vaginal discharge
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
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)
CL Item
Very Much (Very much)
C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)
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)
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)
C0019080 (UMLS 2011AA Property)
C12407 (NCI Thesaurus Property)
C0042232 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)
Code List
I have vaginal bleeding or spotting
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
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)
CL Item
Very Much (Very much)
C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)
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)
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)
C0030193 (UMLS 2011AA Property)
C72881 (NCI Thesaurus Property)
C0009253 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)
Code List
I have pain or discomfort with intercourse
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
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)
CL Item
Very Much (Very much)
C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)
Item
I have lost interest in sex.
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C25560 (NCI Thesaurus Property)
C0745777 (UMLS 2011AA Property)
C17127 (NCI Thesaurus Property)
C0036864 (UMLS 2011AA Property)
C60730 (NCI Thesaurus Property)
C0543488 (UMLS 2011AA Property)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)
C25629 (NCI Thesaurus ValueDomain)
C0332152 (UMLS 2011AA ValueDomain)
C25301 (NCI Thesaurus ValueDomain)
C0439228 (UMLS 2011AA ValueDomain)
C45255 (NCI Thesaurus ValueDomain)
C1708523 (UMLS 2011AA ValueDomain)
C25338 (NCI Thesaurus ValueDomain)
C0449820 (UMLS 2011AA ValueDomain)
C0679207 (NCI Metathesaurus ValueDomain)
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)
C0043094 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)
Code List
I have gained weight
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
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)
CL Item
Very Much (Very much)
C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)
Item
I feel lightheaded (dizzy).
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C37943 (NCI Thesaurus Property)
C0012833 (UMLS 2011AA Property)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)
C25629 (NCI Thesaurus ValueDomain)
C0332152 (UMLS 2011AA ValueDomain)
C25301 (NCI Thesaurus ValueDomain)
C0439228 (UMLS 2011AA ValueDomain)
C45255 (NCI Thesaurus ValueDomain)
C1708523 (UMLS 2011AA ValueDomain)
C25338 (NCI Thesaurus ValueDomain)
C0449820 (UMLS 2011AA ValueDomain)
C0679207 (NCI Metathesaurus ValueDomain)
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)
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)
C0011991 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)
Code List
I have diarrhea
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
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)
CL Item
Very Much (Very much)
C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)
Item
I get headaches
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C12439 (NCI Thesaurus ObjectClass)
C0006104 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C34661 (NCI Thesaurus Property)
C0018681 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
Code List
I get headaches
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
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)
C91216 (NCI Thesaurus)
CL Item
Very Much (Very much)
C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)
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)
C0000726 (UMLS 2011AA Property)
C3399 (NCI Thesaurus Property)
C0038999 (UMLS 2011AA Property)
C34827 (NCI Thesaurus Property)
C0026821 (UMLS 2011AA Property)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
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)
C0006141 (UMLS 2011AA Property)
C75540 (NCI Thesaurus Property)
C0234233 (UMLS 2011AA Property)
C68816 (NCI Thesaurus Property)
C2349185 (UMLS 2011AA Property)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)
C25629 (NCI Thesaurus ValueDomain)
C0332152 (UMLS 2011AA ValueDomain)
C25301 (NCI Thesaurus ValueDomain)
C0439228 (UMLS 2011AA ValueDomain)
C45255 (NCI Thesaurus ValueDomain)
C1708523 (UMLS 2011AA ValueDomain)
C25338 (NCI Thesaurus ValueDomain)
C0449820 (UMLS 2011AA ValueDomain)
C0679207 (NCI Metathesaurus ValueDomain)
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)
C2939186 (UMLS 2011AA Property)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)
C25629 (NCI Thesaurus ValueDomain)
C0332152 (UMLS 2011AA ValueDomain)
C25301 (NCI Thesaurus ValueDomain)
C0439228 (UMLS 2011AA ValueDomain)
C45255 (NCI Thesaurus ValueDomain)
C1708523 (UMLS 2011AA ValueDomain)
C25338 (NCI Thesaurus ValueDomain)
C0449820 (UMLS 2011AA ValueDomain)
C0679207 (NCI Metathesaurus ValueDomain)
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)
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)
C0235032 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0003862 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)
Code List
I have pain in my joints
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
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)
CL Item
Very Much (Very much)
C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

Utilisez ce formulaire pour les retours, les questions et les améliorations suggérées.

Les champs marqués d’un * sont obligatoires.

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial