ID

10961

Descrizione

E5204 Patient Bowel Function/Uniscale Questionnaire NCT00303628 Combination Chemotherapy With or Without Bevacizumab in Treating Patients Who Have Had Surgery for Stage II or Stage III Rectal Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=08ED057C-100B-64FF-E044-0003BA3F9857

collegamento

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=08ED057C-100B-64FF-E044-0003BA3F9857

Keywords

versioni (3)
  1. 27/08/12 27/08/12 -
  2. 09/01/15 09/01/15 - Martin Dugas
  3. 16/06/15 16/06/15 -
Caricato su

16 giugno 2015

DOI

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Licenza

Creative Commons BY-NC 3.0 Legacy
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E5204 Patient Bowel Function/Uniscale Questionnaire NCT00303628

Inglese

No Instruction available.

1 moduli  
  1. StudyEvent: E5204 Patient Bowel Function/Uniscale Questionnaire
    1. No Instruction available.
Header
Descrizione

Header

ECOG Protocol Number
Descrizione

Protocol Number ECOG

Tipo di dati

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
Descrizione

Protocol Number ECOG

Tipo di dati

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
Descrizione

Patient ID ECOG

Tipo di dati

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
Descrizione

Patient ID ECOG

Tipo di dati

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
Descrizione

Generic drug form

Tipo di dati

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
Descrizione

Registration Number

Tipo di dati

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
Reporting Period
Descrizione

Clinical Trial Period

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS CUI-1
C2347804
NCI Thesaurus ObjectClass
C25214
NCI Thesaurus Property
C25616
NCI Thesaurus ObjectClass-2
C25651
Patient Initials
Descrizione

Patient Initials

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C2986440
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25536
Participating Group Protocol No.
Descrizione

Study Number Participating Group

Tipo di dati

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
Descrizione

Trial subject ID Participating Group

Tipo di dati

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
Descrizione

Institution Name

Tipo di dati

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
Assessment Date
Descrizione

PatientAssessmentDate

Tipo di dati

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
Patient Bowel Function
Descrizione

Patient Bowel Function

Overall, would you say that you had problems with your bowel function in the last week?
Descrizione

BowelPatientProblemAssessmentInd-2

Tipo di dati

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
C28020
UMLS 2011AA Property-2
C0033213
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
In the past week, what is the greatest number of bowel movements you have had in a day?
Descrizione

BowelPatientFrequencyAssessmentCount

Tipo di dati

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?
Descrizione

BowelPatientInsomniaAssessmentInd-2

Tipo di dati

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?
Descrizione

BowelPatientIncontinenceAssessmentInd-2

Tipo di dati

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?
Descrizione

BowelPatientFrequencyAssessmentInd-2

Tipo di dati

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?
Descrizione

BowelPatientUndergarmentAssessmentInd-2

Tipo di dati

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?
Descrizione

BowelPatientFlatulenceAssessmentInd-2

Tipo di dati

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?
Descrizione

BowelPatientDiarrheaSeverityAssessmentInd-2

Tipo di dati

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?
Descrizione

BowelPatientDefecationUrgencyAssessmentInd-2

Tipo di dati

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?
Descrizione

BowelPatientAbdominalCrampAssessmentInd-2

Tipo di dati

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
Descrizione

BowelPatientAbdominalCrampAssessmentGrade

Tipo di dati

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?
Descrizione

BowelPatientBloodFecesAssessmentInd-2

Tipo di dati

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
Descrizione

BowelPatientBloodFecesAssessmentType

Tipo di dati

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?
Descrizione

BowelPatientRoutineActivityAssessmentGrade

Tipo di dati

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
Descrizione

BowelPatientSelfAssessmentQualityofLifeScale

Tipo di dati

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
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1 moduli
  1. StudyEvent: E5204 Patient Bowel Function/Uniscale Questionnaire
    1. No Instruction available.
Name
genere
Description | Question | Decode (Coded Value)
Tipo di dati
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)
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)
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
Reporting Period
text
C25284 (NCI Thesaurus ValueDomain)
C2347804 (UMLS CUI-1)
C25214 (NCI Thesaurus ObjectClass)
C25616 (NCI Thesaurus Property)
C25651 (NCI Thesaurus ObjectClass-2)
CL.1
Code List
Reporting Period
CL Item
Baseline (Baseline)
C25213 (NCI Thesaurus)
C1442488 (UMLS 2011AA)
CL Item
Cycle 4, Day 1 (Cycle 4, Day 1)
CL Item
3 Months Post-chemotherapy (3 months post-chemotherapy)
CL Item
12 Months Post-chemotherapy (12 months post-chemotherapy)
Patient Initials
Item
Patient Initials
text
C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
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)
PatientAssessmentDate
Item
Assessment Date
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
Item Group
Patient Bowel Function
BowelPatientProblemAssessmentInd-2
Item
Overall, would you say that you had problems with your bowel function in the last week?
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)
C28020 (NCI Thesaurus Property-2)
C0033213 (UMLS 2011AA Property-2)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
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.11
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.13
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.14
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)
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