ID

10060

Descrição

CALGB: NEUROBEHAVOIRAL SCALES FORM Comparison of Combination Chemotherapy Regimens in Treating Older Women Who Have Undergone Surgery for Breast Cancer Breast Cancer NCT00024102 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A50CD25E-BDE1-371E-E034-080020C9C0E0

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A50CD25E-BDE1-371E-E034-080020C9C0E0

Palavras-chave

  1. 18/12/2014 18/12/2014 - Martin Dugas
  2. 23/03/2015 23/03/2015 - Martin Dugas
Transferido a

23 de março de 2015

DOI

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Licença

Creative Commons BY-NC 3.0 Legacy

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Breast Cancer CALGB NCT00024102

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  1. StudyEvent: CALGB: NEUROBEHAVOIRAL SCALES FORM
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Header
Descrição

Header

CALGB Form
Descrição

CALGBForm

Tipo de dados

text

CALGB Study No
Descrição

CALGBStudyNo

Tipo de dados

text

CALGB Patient ID
Descrição

CALGBPatientID

Tipo de dados

text

Date Completed (10.)
Descrição

DateCompleted

Tipo de dados

date

Amended data?
Descrição

Amended data?

Tipo de dados

boolean

Patient's Name
Descrição

Patient'sName

Tipo de dados

text

Participating Group
Descrição

ParticipatingGroup

Tipo de dados

text

Alias
NCI Thesaurus ObjectClass
C17005
UMLS 2011AA ObjectClass
C1257890
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Patient Hospital Number
Descrição

PatientHospitalNumber

Tipo de dados

text

Participating Group Protocol No.
Descrição

ParticipatingGroupProtocolNo.

Tipo de dados

text

Main Member Institution/Adjunct
Descrição

MainMemberInstitution/Adjunct

Tipo de dados

text

Participating Group Patient No.
Descrição

ParticipatingGroupPatientNo.

Tipo de dados

text

Responsible CRA
Descrição

ResponsibleCRA

Tipo de dados

text

Assessment Number
Descrição

AssessmentNumber

Tipo de dados

float

neurobehavioral problems
Descrição

neurobehavioral problems

Alias
UMLS CUI-1
C0815123
Ability to avoid losing train of thought; distractibility (2.)
Descrição

Abilitytoavoidlosingtrainofthought;distractibility

Tipo de dados

integer

Alias
UMLS CUI-1
C0437529
Ability to focus on goals; carry out a plan (3.)
Descrição

Abilitytofocusongoals;carryoutaplan

Tipo de dados

text

Remembering events from long ago (4.)
Descrição

Rememberingeventsfromlongago

Tipo de dados

text

Remembering new information told to you (5.)
Descrição

Rememberingnewinformationtoldtoyou

Tipo de dados

text

Attention and concentration (6.)
Descrição

Attentionandconcentration

Tipo de dados

text

Ability to reason through a complicated problem (7.)
Descrição

Abilitytoreasonthroughacomplicatedproblem

Tipo de dados

text

Self awareness of problems (8.)
Descrição

Selfawarenessofproblems

Tipo de dados

text

Remembering what you intended to do (9.)
Descrição

Rememberingwhatyouintendedtodo

Tipo de dados

text

Ability to shift easily from one activity to the next
Descrição

Abilitytoshifteasilyfromoneactivitytothenext

Tipo de dados

text

Remembering appointments or meetings (11.)
Descrição

Rememberingappointmentsormeetings

Tipo de dados

text

General alertness (12.)
Descrição

Generalalertness

Tipo de dados

text

Ability to think clearly (13.)
Descrição

Abilitytothinkclearly

Tipo de dados

text

Remembering new information you have read (14.)
Descrição

Rememberingnewinformationyouhaveread

Tipo de dados

text

Remembering where you put things (15.)
Descrição

Rememberingwhereyouputthings

Tipo de dados

text

Ease in initiating or starting activities by oneself (16.)
Descrição

Easeininitiatingorstartingactivitiesbyoneself

Tipo de dados

text

Ability to make decisions (17.)
Descrição

Abilitytomakedecisions

Tipo de dados

text

Remembering information learned long ago (18.)
Descrição

Rememberinginformationlearnedlongago

Tipo de dados

text

Ability to be flexible, rather than rigid or have an overly set manner
Descrição

Abilitytobeflexible,ratherthanrigidorhaveanoverlysetmanner

Tipo de dados

text

Similar models

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  1. StudyEvent: CALGB: NEUROBEHAVOIRAL SCALES FORM
    1. Continue to next page
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de dados
Alias
Item Group
Header
CALGBForm
Item
CALGB Form
text
CALGBStudyNo
Item
CALGB Study No
text
CALGBPatientID
Item
CALGB Patient ID
text
DateCompleted
Item
Date Completed (10.)
date
Amended data
Item
Amended data?
boolean
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)
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
ResponsibleCRA
Item
Responsible CRA
text
AssessmentNumber
Item
Assessment Number
float
Item Group
neurobehavioral problems
C0815123 (UMLS CUI-1)
Item
Ability to avoid losing train of thought; distractibility (2.)
integer
C0437529 (UMLS CUI-1)
Code List
Ability to avoid losing train of thought; distractibility (2.)
CL Item
Above Average (1)
CL Item
Normal Ability (2)
CL Item
Mild Problem (3)
CL Item
Mild to Moderate Problem (4)
CL Item
Moderate Problem (5)
CL Item
Moderate to Severe Problem (6)
CL Item
Severe Problem (7)
Item
Ability to focus on goals; carry out a plan (3.)
text
Code List
Ability to focus on goals; carry out a plan (3.)
CL Item
Above Average (1)
CL Item
Normal Ability (2)
CL Item
Mild Problem (3)
CL Item
Mild to Moderate Problem (4)
CL Item
Moderate Problem (5)
CL Item
Moderate to Severe Problem (6)
CL Item
Severe Problem (7)
Item
Remembering events from long ago (4.)
text
Code List
Remembering events from long ago (4.)
CL Item
Above Average (1)
CL Item
Normal Ability (2)
CL Item
Mild Problem (3)
CL Item
Mild to Moderate Problem (4)
CL Item
Moderate Problem (5)
CL Item
Moderate to Severe Problem (6)
CL Item
Severe Problem (7)
Item
Remembering new information told to you (5.)
text
Code List
Remembering new information told to you (5.)
CL Item
Above Average (1)
CL Item
Normal Ability (2)
CL Item
Mild Problem (3)
CL Item
Mild to Moderate Problem (4)
CL Item
Moderate Problem (5)
CL Item
Moderate to Severe Problem (6)
CL Item
Severe Problem (7)
Item
Attention and concentration (6.)
text
Code List
Attention and concentration (6.)
CL Item
Above Average (1)
CL Item
Normal Ability (2)
CL Item
Mild Problem (3)
CL Item
Mild to Moderate Problem (4)
CL Item
Moderate Problem (5)
CL Item
Moderate to Severe Problem (6)
CL Item
Severe Problem (7)
Item
Ability to reason through a complicated problem (7.)
text
Code List
Ability to reason through a complicated problem (7.)
CL Item
Above Average (Above Average)
CL Item
Normal Ability (Normal Ability)
CL Item
Mild Problem (Mild Problem)
CL Item
Mild To Moderate Problem (Mild to Moderate Problem)
CL Item
Moderate Problem (Moderate Problem)
CL Item
Moderate To Severe Problem (Moderate to Severe Problem)
CL Item
Severe Problem (Severe Problem)
Item
Self awareness of problems (8.)
text
Code List
Self awareness of problems (8.)
CL Item
Above Average (Above Average)
CL Item
Normal Ability (Normal Ability)
CL Item
Mild Problem (Mild Problem)
CL Item
Mild To Moderate Problem (Mild to Moderate Problem)
CL Item
Moderate Problem (Moderate Problem)
CL Item
Moderate To Severe Problem (Moderate to Severe Problem)
CL Item
Severe Problem (Severe Problem)
Item
Remembering what you intended to do (9.)
text
Code List
Remembering what you intended to do (9.)
CL Item
Above Average (Above Average)
CL Item
Normal Ability (Normal Ability)
CL Item
Mild Problem (Mild Problem)
CL Item
Mild To Moderate Problem (Mild to Moderate Problem)
CL Item
Moderate Problem (Moderate Problem)
CL Item
Moderate To Severe Problem (Moderate to Severe Problem)
CL Item
Severe Problem (Severe Problem)
Item
Ability to shift easily from one activity to the next
text
Code List
Ability to shift easily from one activity to the next
CL Item
Above Average (Above Average)
CL Item
Normal Ability (Normal Ability)
CL Item
Mild Problem (Mild Problem)
CL Item
Mild To Moderate Problem (Mild to Moderate Problem)
CL Item
Moderate Problem (Moderate Problem)
CL Item
Moderate To Severe Problem (Moderate to Severe Problem)
CL Item
Severe Problem (Severe Problem)
Item
Remembering appointments or meetings (11.)
text
Code List
Remembering appointments or meetings (11.)
CL Item
Above Average (Above Average)
CL Item
Normal Ability (Normal Ability)
CL Item
Mild Problem (Mild Problem)
CL Item
Mild To Moderate Problem (Mild to Moderate Problem)
CL Item
Moderate Problem (Moderate Problem)
CL Item
Moderate To Severe Problem (Moderate to Severe Problem)
CL Item
Severe Problem (Severe Problem)
Item
General alertness (12.)
text
Code List
General alertness (12.)
CL Item
Above Average (Above Average)
CL Item
Normal Ability (Normal Ability)
CL Item
Mild Problem (Mild Problem)
CL Item
Mild To Moderate Problem (Mild to Moderate Problem)
CL Item
Moderate Problem (Moderate Problem)
CL Item
Moderate To Severe Problem (Moderate to Severe Problem)
CL Item
Severe Problem (Severe Problem)
Item
Ability to think clearly (13.)
text
Code List
Ability to think clearly (13.)
CL Item
Above Average (Above Average)
CL Item
Normal Ability (Normal Ability)
CL Item
Mild Problem (Mild Problem)
CL Item
Mild To Moderate Problem (Mild to Moderate Problem)
CL Item
Moderate Problem (Moderate Problem)
CL Item
Moderate To Severe Problem (Moderate to Severe Problem)
CL Item
Severe Problem (Severe Problem)
Item
Remembering new information you have read (14.)
text
Code List
Remembering new information you have read (14.)
CL Item
Above Average (Above Average)
CL Item
Normal Ability (Normal Ability)
CL Item
Mild Problem (Mild Problem)
CL Item
Mild To Moderate Problem (Mild to Moderate Problem)
CL Item
Moderate Problem (Moderate Problem)
CL Item
Moderate To Severe Problem (Moderate to Severe Problem)
CL Item
Severe Problem (Severe Problem)
Item
Remembering where you put things (15.)
text
Code List
Remembering where you put things (15.)
CL Item
Above Average (Above Average)
CL Item
Normal Ability (Normal Ability)
CL Item
Mild Problem (Mild Problem)
CL Item
Mild To Moderate Problem (Mild to Moderate Problem)
CL Item
Moderate Problem (Moderate Problem)
CL Item
Moderate To Severe Problem (Moderate to Severe Problem)
CL Item
Severe Problem (Severe Problem)
Item
Ease in initiating or starting activities by oneself (16.)
text
Code List
Ease in initiating or starting activities by oneself (16.)
CL Item
Above Average (Above Average)
CL Item
Normal Ability (Normal Ability)
CL Item
Mild Problem (Mild Problem)
CL Item
Mild To Moderate Problem (Mild to Moderate Problem)
CL Item
Moderate Problem (Moderate Problem)
CL Item
Moderate To Severe Problem (Moderate to Severe Problem)
CL Item
Severe Problem (Severe Problem)
Item
Ability to make decisions (17.)
text
Code List
Ability to make decisions (17.)
CL Item
Above Average (Above Average)
CL Item
Normal Ability (Normal Ability)
CL Item
Mild Problem (Mild Problem)
CL Item
Mild To Moderate Problem (Mild to Moderate Problem)
CL Item
Moderate Problem (Moderate Problem)
CL Item
Moderate To Severe Problem (Moderate to Severe Problem)
CL Item
Severe Problem (Severe Problem)
Item
Remembering information learned long ago (18.)
text
Code List
Remembering information learned long ago (18.)
CL Item
Above Average (Above Average)
CL Item
Normal Ability (Normal Ability)
CL Item
Mild Problem (Mild Problem)
CL Item
Mild To Moderate Problem (Mild to Moderate Problem)
CL Item
Moderate Problem (Moderate Problem)
CL Item
Moderate To Severe Problem (Moderate to Severe Problem)
CL Item
Severe Problem (Severe Problem)
Item
Ability to be flexible, rather than rigid or have an overly set manner
text
Code List
Ability to be flexible, rather than rigid or have an overly set manner
CL Item
Above Average (Above Average)
CL Item
Normal Ability (Normal Ability)
CL Item
Mild Problem (Mild Problem)
CL Item
Mild To Moderate Problem (Mild to Moderate Problem)
CL Item
Moderate Problem (Moderate Problem)
CL Item
Moderate To Severe Problem (Moderate to Severe Problem)
CL Item
Severe Problem (Severe Problem)

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