ID

7679

Descrição

E3201 Patient Bowel Function/Uniscale Questionnaire Comparison of Adjuvant Chemotherapy Regimens in Treating Patients With Stage II or Stage III Rectal Cancer Who Are Receiving Radiation Therapy and Fluorouracil Before or After Surgery Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=B552120F-3E84-6D21-E034-0003BA12F5E7

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=B552120F-3E84-6D21-E034-0003BA12F5E7

Palavras-chave

Versões (3)
  1. 27/08/2012 27/08/2012 -
  2. 09/01/2015 09/01/2015 - Martin Dugas
  3. 16/06/2015 16/06/2015 -
Transferido a

9 de janeiro de 2015

DOI

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Licença

Creative Commons BY-NC 3.0 Legacy
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Colorectal Cancer NCT00068692 Quality of Life - E3201 Patient Bowel Function/Uniscale Questionnaire - 2079114v3.0

Inglês

No Instruction available.

1 Formulários  
  1. StudyEvent: E3201 Patient Bowel Function/Uniscale Questionnaire
    1. No Instruction available.
Header
Descrição

Header

DCI Name
Descrição

Generic drug form

Tipo de dados

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C3242750
NCI Thesaurus Property
C19464
NCI Thesaurus ObjectClass
C25474
NCI Thesaurus ObjectClass-2
C25452
Registration Step
Descrição

Registration Number

Tipo de dados

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C1514821
NCI Thesaurus ObjectClass
C25646
UMLS CUI-2
C0237753
NCI Thesaurus Property
C16154
NCI Thesaurus ValueDomain-2
C16154
Time Period (Group 1)
Descrição

TimePeriod(Group1)

Tipo de dados

text

Time Period (Group 2)
Descrição

TimePeriod(Group2)

Tipo de dados

text

Patient Initials
Descrição

Patient Initials

Tipo de dados

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C2986440
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25536
ECOG Protocol Number
Descrição

Protocol Number ECOG

Tipo de dados

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 Protocol Number
Descrição

Protocol Number ECOG

Tipo de dados

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
Descrição

Patient ID ECOG

Tipo de dados

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
ECOG Patient ID
Descrição

Patient ID ECOG

Tipo de dados

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
Participating Group Protocol No.
Descrição

Study Number Participating Group

Tipo de dados

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C3274381
NCI Thesaurus ObjectClass
C25320
UMLS CUI-2
C2347449
NCI Thesaurus Property
C25608
NCI Thesaurus Property-2
C25364
Participating Group Patient ID
Descrição

Trial subject ID Participating Group

Tipo de dados

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C2348585
NCI Thesaurus ObjectClass
C16960
UMLS CUI-2
C2347449
NCI Thesaurus Property
C25608
NCI Thesaurus Property-2
C25364
Institution/Affiliate
Descrição

Institution Name

Tipo de dados

text

Alias
NCI Thesaurus ObjectClass
C25454
UMLS CUI-1
C1301943
NCI Thesaurus ObjectClass-2
C21541
NCI Thesaurus Property
C25364
NCI Thesaurus ValueDomain
C25191
NCI Thesaurus ValueDomain-2
C21541
Unnamed2
Descrição

Unnamed2

Are data amended?
Descrição

Data amended

Tipo de dados

boolean

Alias
NCI Thesaurus ValueDomain
C38148
UMLS CUI-1
C0680532
NCI Thesaurus ObjectClass
C25474
NCI Thesaurus Property
C25416
Overall, would you say that you had problems with your bowel function in the last week?
Descrição

BowelPatientProblemAssessmentInd-2

Tipo de dados

boolean

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus ObjectClass-2
C12736
UMLS 2011AA ObjectClass-2
C0021853
NCI Thesaurus Property-2
C28020
UMLS 2011AA Property-2
C0033213
In the past week, what is the greatest number of bowel movements you have had in a day?
Descrição

BowelPatientFrequencyAssessmentCount

Tipo de dados

float

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus ObjectClass-2
C12736
UMLS 2011AA ObjectClass-2
C0021853
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property-2
C25515
UMLS 2011AA Property-2
C0439603
NCI Thesaurus ValueDomain
C25463
UMLS 2011AA ValueDomain
C0750480
In the past week, have you had a problem causing you to get up at night to have a bowel movement?
Descrição

BowelPatientInsomniaAssessmentInd-2

Tipo de dados

boolean

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus ObjectClass-2
C12736
UMLS 2011AA ObjectClass-2
C0021853
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property-2
C28286
UMLS 2011AA Property-2
C0917801
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
In the past week, have you had a problem causing you to lose control of your bowel movements?
Descrição

BowelPatientIncontinenceAssessmentInd-2

Tipo de dados

boolean

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus ObjectClass-2
C12736
UMLS 2011AA ObjectClass-2
C0021853
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Metathesaurus Property
C0021167
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
In the past week, have you had a problem causing you to have a bowel movement within 30 minutes of a prior bowel movement?
Descrição

BowelPatientFrequencyAssessmentInd-2

Tipo de dados

boolean

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus ObjectClass-2
C12736
UMLS 2011AA ObjectClass-2
C0021853
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property-2
C25515
UMLS 2011AA Property-2
C0439603
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
In the past week, have you had to wear protective clothing or a pad in case you lost control of a bowel movement?
Descrição

BowelPatientUndergarmentAssessmentInd-2

Tipo de dados

boolean

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus ObjectClass-2
C12736
UMLS 2011AA ObjectClass-2
C0021853
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Metathesaurus Property
C0453880
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
In the past week, have you had a problem causing you to be unable to tell the difference between a stool and gas?
Descrição

BowelPatientFlatulenceAssessmentInd-2

Tipo de dados

boolean

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus ObjectClass-2
C12736
UMLS 2011AA ObjectClass-2
C0021853
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property-2
C37954
UMLS 2011AA Property-2
C0016204
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
In the past week, have you had a problem causing you to have stools that are liquid?
Descrição

BowelPatientDiarrheaSeverityAssessmentInd-2

Tipo de dados

boolean

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus ObjectClass-2
C12736
UMLS 2011AA ObjectClass-2
C0021853
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property-2
C25676
UMLS 2011AA Property-2
C0439793
NCI Metathesaurus Property
C0011991
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
In the past week, have you found that once you feel the urge to have a bowel movement, you must do so within 15 minutes to avoid an accident?
Descrição

BowelPatientDefecationUrgencyAssessmentInd-2

Tipo de dados

boolean

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus ObjectClass-2
C12736
UMLS 2011AA ObjectClass-2
C0021853
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Metathesaurus Property
C0426636
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
In the past week, have you had cramping with a bowel movement?
Descrição

BowelPatientAbdominalCrampAssessmentInd-2

Tipo de dados

boolean

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus ObjectClass-2
C12736
UMLS 2011AA ObjectClass-2
C0021853
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property-2
C34331
UMLS 2011AA Property-2
C0000729
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
Is your cramping
Descrição

BowelPatientAbdominalCrampAssessmentGrade

Tipo de dados

text

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus ObjectClass-2
C12736
UMLS 2011AA ObjectClass-2
C0021853
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property-2
C34331
UMLS 2011AA Property-2
C0000729
NCI Thesaurus ValueDomain
C18000
UMLS 2011AA ValueDomain
C0919553
In the past week, have you had blood in your bowel movement?
Descrição

BowelPatientBloodFecesAssessmentInd-2

Tipo de dados

boolean

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus ObjectClass-2
C12736
UMLS 2011AA ObjectClass-2
C0021853
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property-2
C12434
UMLS 2011AA Property-2
C0229664
NCI Thesaurus Property-3
C13234
UMLS 2011AA Property-3
C0015733
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
Check the description that best describes the amount of blood in your bowel movement
Descrição

BowelPatientBloodFecesAssessmentType

Tipo de dados

text

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus ObjectClass-2
C12736
UMLS 2011AA ObjectClass-2
C0021853
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property-2
C12434
UMLS 2011AA Property-2
C0229664
NCI Thesaurus Property-3
C13234
UMLS 2011AA Property-3
C0015733
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
In the past week, how much have problems with bowel movements affected your normal activities?
Descrição

BowelPatientRoutineActivityAssessmentGrade

Tipo de dados

text

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus ObjectClass-2
C12736
UMLS 2011AA ObjectClass-2
C0021853
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property-2
C43431
UMLS 2011AA Property-2
C0441655
NCI Thesaurus Property-3
C47893
UMLS 2011AA Property-3
C0205547
NCI Thesaurus ValueDomain
C18000
UMLS 2011AA ValueDomain
C0919553
Please circle a number below to indicate how you would rate your quality of life during the past week
Descrição

BowelPatientSelfAssessmentQualityofLifeScale

Tipo de dados

float

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus ObjectClass-2
C12736
UMLS 2011AA ObjectClass-2
C0021853
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property-2
C25200
UMLS 2011AA Property-2
C0036588
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
Ccrr Module For E3201 Patient Bowel Function/uniscale Questionnaire
Descrição

Ccrr Module For E3201 Patient Bowel Function/uniscale Questionnaire

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1 Formulários
  1. StudyEvent: E3201 Patient Bowel Function/Uniscale Questionnaire
    1. No Instruction available.
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de dados
Alias
Item Group
Header
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)
Registration Number
Item
Registration Step
text
C25337 (NCI Thesaurus ValueDomain)
C1514821 (UMLS CUI-1)
C25646 (NCI Thesaurus ObjectClass)
C0237753 (UMLS CUI-2)
C16154 (NCI Thesaurus Property)
C16154 (NCI Thesaurus ValueDomain-2)
Item
Time Period (Group 1)
text
CL.1
Code List
Time Period (Group 1)
CL Item
Study Entry (Study Entry)
CL Item
Last Week Of Rt (Last week of RT)
CL Item
Prior To Surgery (Prior to surgery)
CL Item
18+/- 2 Months Post Rt (18+/- 2 months Post RT)
Item
Time Period (Group 2)
text
CL.2
Code List
Time Period (Group 2)
CL Item
Prior To Surgery (Prior to surgery)
CL Item
Study Entry (Study Entry)
CL Item
Prior To Rt (Prior to RT)
CL Item
Last Week Of Rt (Last week of RT)
CL Item
18 +/- 2 Months Post Rt (18 +/- 2 months post RT)
Patient Initials
Item
Patient Initials
text
C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
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)
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)
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)
Study Number Participating Group
Item
Participating Group Protocol No.
text
C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
Trial subject ID Participating Group
Item
Participating Group Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
Institution Name
Item
Institution/Affiliate
text
C25454 (NCI Thesaurus ObjectClass)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C25191 (NCI Thesaurus ValueDomain)
C21541 (NCI Thesaurus ValueDomain-2)
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)
BowelPatientProblemAssessmentInd-2
Item
Overall, would you say that you had problems with your bowel function in the last week?
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C12736 (NCI Thesaurus ObjectClass-2)
C0021853 (UMLS 2011AA ObjectClass-2)
C28020 (NCI Thesaurus Property-2)
C0033213 (UMLS 2011AA Property-2)
BowelPatientFrequencyAssessmentCount
Item
In the past week, what is the greatest number of bowel movements you have had in a day?
float
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C12736 (NCI Thesaurus ObjectClass-2)
C0021853 (UMLS 2011AA ObjectClass-2)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25515 (NCI Thesaurus Property-2)
C0439603 (UMLS 2011AA Property-2)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
BowelPatientInsomniaAssessmentInd-2
Item
In the past week, have you had a problem causing you to get up at night to have a bowel movement?
boolean
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C12736 (NCI Thesaurus ObjectClass-2)
C0021853 (UMLS 2011AA ObjectClass-2)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C28286 (NCI Thesaurus Property-2)
C0917801 (UMLS 2011AA Property-2)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
BowelPatientIncontinenceAssessmentInd-2
Item
In the past week, have you had a problem causing you to lose control of your bowel movements?
boolean
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C12736 (NCI Thesaurus ObjectClass-2)
C0021853 (UMLS 2011AA ObjectClass-2)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0021167 (NCI Metathesaurus Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
BowelPatientFrequencyAssessmentInd-2
Item
In the past week, have you had a problem causing you to have a bowel movement within 30 minutes of a prior bowel movement?
boolean
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C12736 (NCI Thesaurus ObjectClass-2)
C0021853 (UMLS 2011AA ObjectClass-2)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25515 (NCI Thesaurus Property-2)
C0439603 (UMLS 2011AA Property-2)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
BowelPatientUndergarmentAssessmentInd-2
Item
In the past week, have you had to wear protective clothing or a pad in case you lost control of a bowel movement?
boolean
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C12736 (NCI Thesaurus ObjectClass-2)
C0021853 (UMLS 2011AA ObjectClass-2)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0453880 (NCI Metathesaurus Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
BowelPatientFlatulenceAssessmentInd-2
Item
In the past week, have you had a problem causing you to be unable to tell the difference between a stool and gas?
boolean
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C12736 (NCI Thesaurus ObjectClass-2)
C0021853 (UMLS 2011AA ObjectClass-2)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C37954 (NCI Thesaurus Property-2)
C0016204 (UMLS 2011AA Property-2)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
BowelPatientDiarrheaSeverityAssessmentInd-2
Item
In the past week, have you had a problem causing you to have stools that are liquid?
boolean
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C12736 (NCI Thesaurus ObjectClass-2)
C0021853 (UMLS 2011AA ObjectClass-2)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25676 (NCI Thesaurus Property-2)
C0439793 (UMLS 2011AA Property-2)
C0011991 (NCI Metathesaurus Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
BowelPatientDefecationUrgencyAssessmentInd-2
Item
In the past week, have you found that once you feel the urge to have a bowel movement, you must do so within 15 minutes to avoid an accident?
boolean
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C12736 (NCI Thesaurus ObjectClass-2)
C0021853 (UMLS 2011AA ObjectClass-2)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0426636 (NCI Metathesaurus Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
BowelPatientAbdominalCrampAssessmentInd-2
Item
In the past week, have you had cramping with a bowel movement?
boolean
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C12736 (NCI Thesaurus ObjectClass-2)
C0021853 (UMLS 2011AA ObjectClass-2)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C34331 (NCI Thesaurus Property-2)
C0000729 (UMLS 2011AA Property-2)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
Item
Is your cramping
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C12736 (NCI Thesaurus ObjectClass-2)
C0021853 (UMLS 2011AA ObjectClass-2)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C34331 (NCI Thesaurus Property-2)
C0000729 (UMLS 2011AA Property-2)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
CL.13
Code List
Is your cramping
CL Item
Mild (mild)
C70666 (NCI Thesaurus)
C2945599 (UMLS 2011AA)
CL Item
Moderate (moderate)
CL Item
Severe (severe)
BowelPatientBloodFecesAssessmentInd-2
Item
In the past week, have you had blood in your bowel movement?
boolean
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C12736 (NCI Thesaurus ObjectClass-2)
C0021853 (UMLS 2011AA ObjectClass-2)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C12434 (NCI Thesaurus Property-2)
C0229664 (UMLS 2011AA Property-2)
C13234 (NCI Thesaurus Property-3)
C0015733 (UMLS 2011AA Property-3)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
Item
Check the description that best describes the amount of blood in your bowel movement
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C12736 (NCI Thesaurus ObjectClass-2)
C0021853 (UMLS 2011AA ObjectClass-2)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C12434 (NCI Thesaurus Property-2)
C0229664 (UMLS 2011AA Property-2)
C13234 (NCI Thesaurus Property-3)
C0015733 (UMLS 2011AA Property-3)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.15
Code List
Check the description that best describes the amount of blood in your bowel movement
CL Item
On Toliet Tissue Only (on toliet tissue only)
CL Item
Mixed With Or Coating Bowel Movement (mixed with or coating bowel movement)
CL Item
Enough To Turn Water In Toliet Bowel Red (enough to turn water in toliet bowel red)
Item
In the past week, how much have problems with bowel movements affected your normal activities?
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C12736 (NCI Thesaurus ObjectClass-2)
C0021853 (UMLS 2011AA ObjectClass-2)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C43431 (NCI Thesaurus Property-2)
C0441655 (UMLS 2011AA Property-2)
C47893 (NCI Thesaurus Property-3)
C0205547 (UMLS 2011AA Property-3)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
CL.16
Code List
In the past week, how much have problems with bowel movements affected your normal activities?
CL Item
No Problems (no problems)
CL Item
Mild - Not Interfering With Normal Life Activities (mild - not interfering with normal life activities)
CL Item
Moderate - Requires Changes In One's Life Activities Due To Bowel Function (Moderate - requires changes in one's life activities due to bowel function)
CL Item
Severe - Unable To Perform Normal Life Activities Due To Bowel Function (Severe - unable to perform normal life activities due to bowel function)
BowelPatientSelfAssessmentQualityofLifeScale
Item
Please circle a number below to indicate how you would rate your quality of life during the past week
float
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C12736 (NCI Thesaurus ObjectClass-2)
C0021853 (UMLS 2011AA ObjectClass-2)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25200 (NCI Thesaurus Property-2)
C0036588 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
Item Group
Ccrr Module For E3201 Patient Bowel Function/uniscale Questionnaire
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