Description:

RTOG 0834/EORTC 26053_22054/NCIC CTG CEC.1: Medical Outcome Scale: Cognitive Radiation Therapy With or Without Temozolomide in Treating Patients With Anaplastic Glioma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=5AF816A5-3103-0942-E044-0003BA3F9857

Lien:
https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=5AF816A5-3103-0942-E044-0003BA3F9857
Mots-clés:
  1. 26/08/2012 26/08/2012 -
  2. 09/01/2015 09/01/2015 - Martin Dugas
  3. 09/01/2015 09/01/2015 - Martin Dugas
  4. 08/07/2015 08/07/2015 -
Téléchargé le:

9 janvier 2015

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.

Brain and Central Nervous System Tumors NCT00626990 On-Study - RTOG 0834: Medical Outcome Scale: Cognitive - 2797747v1.0

No Instruction available.

  1. StudyEvent: RTOG 0834: Medical Outcome Scale: Cognitive
    1. No Instruction available.
Unnamed Module 1
Amended Data
Unamed Module 2
Time point
Was patient questionnaire completed
Reason Questionnaire was not Completed
Specify method of completion
Did the patient require any assistance in completing the questionnaire?
Specify the person who assisted the patient
Extent of assistance given
Unnamed2
How much of the time did you have difficulty reasoning and solving problems (During the past month - e.g., difficulty making plans, making decisions, learning new things)
How much of the time did you forget (During the past month - e.g., things that happen recently, where you put things, appointments)
How much of the time did you have trouble keeping your attention on any activity for long (During the past month)
How much of the time did you have difficulty doing activities involving concentration and thinking (During the past month)
How much of the time did you become confused and start several actions at a time (During the past month)
How much of the time did you react slowly to things that were said and done (During the past month)

Similar models

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