Form ID CALGB
Item
CALGB Form
text
C25337 (NCI Thesaurus ValueDomain)
C3262252 (UMLS CUI-1)
C19464 (NCI Thesaurus ObjectClass)
C1516238 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25442 (NCI Thesaurus ObjectClass-2)
Protocol ID CALGB
Item
CALGB Study No
text
C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1516238 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25442 (NCI Thesaurus Property-2)
Trial subject ID CALGB
Item
CALGB Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1516238 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25442 (NCI Thesaurus Property-2)
Date Form Completed
Item
Date form completed (MM DD YYYY)
date
C25164 (NCI Thesaurus ValueDomain)
C1115437 (UMLS CUI-1)
C40988 (NCI Thesaurus ObjectClass)
C25250 (NCI Thesaurus Property)
C25367 (NCI Thesaurus ValueDomain-2)
Data amended
Item
Are data amended
boolean
C38148 (NCI Thesaurus ValueDomain)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
Patient Initials
Item
Patient Initials (Last, First Middle)
text
C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
Medical Record Number
Item
Patient Hospital No.
text
C25337 (NCI Thesaurus ValueDomain)
C1301894 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25261 (NCI Thesaurus Property)
C25198 (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)
Participating Group
Item
Participating Group
text
C25191 (NCI Thesaurus ValueDomain)
C2347449 (UMLS CUI-1)
C25608 (NCI Thesaurus ObjectClass)
C17005 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
Study Number Participating Group
Item
Participating Group Study 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)
Item
Walking for exercise or walking to work
text
C17708 (NCI Thesaurus ObjectClass)
C0026606 (UMLS 2011AA ObjectClass)
C25217 (NCI Thesaurus Property)
C1516048 (UMLS 2011AA Property)
C16567 (NCI Thesaurus Property-2)
C0015259 (UMLS 2011AA Property-2)
C73554 (NCI Thesaurus Property-3)
C0080331 (UMLS 2011AA Property-3)
C29846 (NCI Thesaurus ValueDomain)
C0439231 (UMLS 2011AA ValueDomain)
C29844 (NCI Thesaurus ValueDomain-2)
C0439230 (UMLS 2011AA ValueDomain-2)
C25330 (NCI Thesaurus ValueDomain-3)
C0449238 (UMLS 2011AA ValueDomain-3)
Code List
Walking for exercise or walking to work
CL Item
1 To 1.5 Hours (1 to 1.5 hours)
CL Item
1 To 4 Minutes (1 to 4 min.)
CL Item
11 Or More Hours (11 or more hours)
CL Item
2 To 3 Hours (2 to 3 hours)
CL Item
20 To 59 Minutes (20 to 59 min.)
CL Item
4 To 6 Hours (4 to 6 hours)
CL Item
5 To 19 Minutes (5 to 19 min.)
CL Item
7 To 10 Hours (7 to 10 hours)
CL Item
Zero (Zero)
C70430 (NCI Thesaurus)
C0919414 (UMLS 2011AA)
Item
Jogging (slower than 10-minute mile)
text
C17708 (NCI Thesaurus ObjectClass)
C0026606 (UMLS 2011AA ObjectClass)
C25217 (NCI Thesaurus Property)
C1516048 (UMLS 2011AA Property)
C64655 (NCI Thesaurus Property-2)
C0439834 (UMLS 2011AA Property-2)
C85398 (NCI Thesaurus Property-3)
C0022400 (UMLS 2011AA Property-3)
C29846 (NCI Thesaurus ValueDomain)
C0439231 (UMLS 2011AA ValueDomain)
C29844 (NCI Thesaurus ValueDomain-2)
C0439230 (UMLS 2011AA ValueDomain-2)
C25330 (NCI Thesaurus ValueDomain-3)
C0449238 (UMLS 2011AA ValueDomain-3)
Code List
Jogging (slower than 10-minute mile)
CL Item
1 To 1.5 Hours (1 to 1.5 hours)
CL Item
1 To 4 Minutes (1 to 4 min.)
CL Item
11 Or More Hours (11 or more hours)
CL Item
2 To 3 Hours (2 to 3 hours)
CL Item
20 To 59 Minutes (20 to 59 min.)
CL Item
4 To 6 Hours (4 to 6 hours)
CL Item
5 To 19 Minutes (5 to 19 min.)
CL Item
7 To 10 Hours (7 to 10 hours)
CL Item
Zero (Zero)
C70430 (NCI Thesaurus)
C0919414 (UMLS 2011AA)
Item
Running (10-minute miles or faster)
text
C17708 (NCI Thesaurus ObjectClass)
C0026606 (UMLS 2011AA ObjectClass)
C25217 (NCI Thesaurus Property)
C1516048 (UMLS 2011AA Property)
C25533 (NCI Thesaurus Property-2)
C0442805 (UMLS 2011AA Property-2)
C85398 (NCI Thesaurus Property-3)
C0022400 (UMLS 2011AA Property-3)
C29846 (NCI Thesaurus ValueDomain)
C0439231 (UMLS 2011AA ValueDomain)
C29844 (NCI Thesaurus ValueDomain-2)
C0439230 (UMLS 2011AA ValueDomain-2)
C25330 (NCI Thesaurus ValueDomain-3)
C0449238 (UMLS 2011AA ValueDomain-3)
Code List
Running (10-minute miles or faster)
CL Item
1 To 1.5 Hours (1 to 1.5 hours)
CL Item
1 To 4 Minutes (1 to 4 min.)
CL Item
11 Or More Hours (11 or more hours)
CL Item
2 To 3 Hours (2 to 3 hours)
CL Item
20 To 59 Minutes (20 to 59 min.)
CL Item
4 To 6 Hours (4 to 6 hours)
CL Item
5 To 19 Minutes (5 to 19 min.)
CL Item
7 To 10 Hours (7 to 10 hours)
CL Item
Zero (Zero)
C70430 (NCI Thesaurus)
C0919414 (UMLS 2011AA)
Item
Bicycling (including stationary bicycle)
text
C17708 (NCI Thesaurus ObjectClass)
C0026606 (UMLS 2011AA ObjectClass)
C25217 (NCI Thesaurus Property)
C1516048 (UMLS 2011AA Property)
C85401 (NCI Thesaurus Property-2)
C0005377 (UMLS 2011AA Property-2)
C29846 (NCI Thesaurus ValueDomain)
C0439231 (UMLS 2011AA ValueDomain)
C29844 (NCI Thesaurus ValueDomain-2)
C0439230 (UMLS 2011AA ValueDomain-2)
C25330 (NCI Thesaurus ValueDomain-3)
C0449238 (UMLS 2011AA ValueDomain-3)
Code List
Bicycling (including stationary bicycle)
CL Item
1 To 1.5 Hours (1 to 1.5 hours)
CL Item
1 To 4 Minutes (1 to 4 min.)
CL Item
11 Or More Hours (11 or more hours)
CL Item
2 To 3 Hours (2 to 3 hours)
CL Item
20 To 59 Minutes (20 to 59 min.)
CL Item
4 To 6 Hours (4 to 6 hours)
CL Item
5 To 19 Minutes (5 to 19 min.)
CL Item
7 To 10 Hours (7 to 10 hours)
CL Item
Zero (Zero)
C70430 (NCI Thesaurus)
C0919414 (UMLS 2011AA)
Item
Tennis, squash, racquetball
text
C17708 (NCI Thesaurus ObjectClass)
C0026606 (UMLS 2011AA ObjectClass)
C25217 (NCI Thesaurus Property)
C1516048 (UMLS 2011AA Property)
C85400 (NCI Thesaurus Property-2)
C0034512 (UMLS 2011AA Property-2)
C29846 (NCI Thesaurus ValueDomain)
C0439231 (UMLS 2011AA ValueDomain)
C29844 (NCI Thesaurus ValueDomain-2)
C0439230 (UMLS 2011AA ValueDomain-2)
C25330 (NCI Thesaurus ValueDomain-3)
C0449238 (UMLS 2011AA ValueDomain-3)
Code List
Tennis, squash, racquetball
CL Item
1 To 1.5 Hours (1 to 1.5 hours)
CL Item
1 To 4 Minutes (1 to 4 min.)
CL Item
11 Or More Hours (11 or more hours)
CL Item
2 To 3 Hours (2 to 3 hours)
CL Item
20 To 59 Minutes (20 to 59 min.)
CL Item
4 To 6 Hours (4 to 6 hours)
CL Item
5 To 19 Minutes (5 to 19 min.)
CL Item
7 To 10 Hours (7 to 10 hours)
CL Item
Zero (Zero)
C70430 (NCI Thesaurus)
C0919414 (UMLS 2011AA)
Item
Lap swimming
text
C17708 (NCI Thesaurus ObjectClass)
C0026606 (UMLS 2011AA ObjectClass)
C25217 (NCI Thesaurus Property)
C1516048 (UMLS 2011AA Property)
C16567 (NCI Thesaurus Property-2)
C0015259 (UMLS 2011AA Property-2)
C65147 (NCI Thesaurus Property-3)
C0043047 (UMLS 2011AA Property-3)
C29846 (NCI Thesaurus ValueDomain)
C0439231 (UMLS 2011AA ValueDomain)
C29844 (NCI Thesaurus ValueDomain-2)
C0439230 (UMLS 2011AA ValueDomain-2)
C25330 (NCI Thesaurus ValueDomain-3)
C0449238 (UMLS 2011AA ValueDomain-3)
CL Item
1 To 1.5 Hours (1 to 1.5 hours)
CL Item
1 To 4 Minutes (1 to 4 min.)
CL Item
11 Or More Hours (11 or more hours)
CL Item
2 To 3 Hours (2 to 3 hours)
CL Item
20 To 59 Minutes (20 to 59 min.)
CL Item
4 To 6 Hours (4 to 6 hours)
CL Item
5 To 19 Minutes (5 to 19 min.)
CL Item
7 To 10 Hours (7 to 10 hours)
CL Item
Zero (Zero)
C70430 (NCI Thesaurus)
C0919414 (UMLS 2011AA)
Item
Other aerobic exercise (aerobic dancing, ski or stair machine, etc.)
text
C17708 (NCI Thesaurus ObjectClass)
C0026606 (UMLS 2011AA ObjectClass)
C25217 (NCI Thesaurus Property)
C1516048 (UMLS 2011AA Property)
C39774 (NCI Thesaurus Property-2)
C0001701 (UMLS 2011AA Property-2)
C29846 (NCI Thesaurus ValueDomain)
C0439231 (UMLS 2011AA ValueDomain)
C29844 (NCI Thesaurus ValueDomain-2)
C0439230 (UMLS 2011AA ValueDomain-2)
C25330 (NCI Thesaurus ValueDomain-3)
C0449238 (UMLS 2011AA ValueDomain-3)
Code List
Other aerobic exercise (aerobic dancing, ski or stair machine, etc.)
CL Item
1 To 1.5 Hours (1 to 1.5 hours)
CL Item
1 To 4 Minutes (1 to 4 min.)
CL Item
11 Or More Hours (11 or more hours)
CL Item
2 To 3 Hours (2 to 3 hours)
CL Item
20 To 59 Minutes (20 to 59 min.)
CL Item
4 To 6 Hours (4 to 6 hours)
CL Item
5 To 19 Minutes (5 to 19 min.)
CL Item
7 To 10 Hours (7 to 10 hours)
CL Item
Zero (Zero)
C70430 (NCI Thesaurus)
C0919414 (UMLS 2011AA)
Item
Any other vigorous activities (lawn mowing, etc.)
text
C17708 (NCI Thesaurus ObjectClass)
C0026606 (UMLS 2011AA ObjectClass)
C17649 (NCI Thesaurus Property)
C0205394 (UMLS 2011AA Property)
C43431 (NCI Thesaurus Property-2)
C0441655 (UMLS 2011AA Property-2)
C25217 (NCI Thesaurus Property-3)
C1516048 (UMLS 2011AA Property-3)
C29846 (NCI Thesaurus ValueDomain)
C0439231 (UMLS 2011AA ValueDomain)
C29844 (NCI Thesaurus ValueDomain-2)
C0439230 (UMLS 2011AA ValueDomain-2)
C25330 (NCI Thesaurus ValueDomain-3)
C0449238 (UMLS 2011AA ValueDomain-3)
Code List
Any other vigorous activities (lawn mowing, etc.)
CL Item
1 To 1.5 Hours (1 to 1.5 hours)
CL Item
1 To 4 Minutes (1 to 4 min.)
CL Item
11 Or More Hours (11 or more hours)
CL Item
2 To 3 Hours (2 to 3 hours)
CL Item
20 To 59 Minutes (20 to 59 min.)
CL Item
4 To 6 Hours (4 to 6 hours)
CL Item
5 To 19 Minutes (5 to 19 min.)
CL Item
7 To 10 Hours (7 to 10 hours)
CL Item
Zero (Zero)
C70430 (NCI Thesaurus)
C0919414 (UMLS 2011AA)
Item
Lower intensity exercise (yoga, stretching, Pilates, toning)
text
C17708 (NCI Thesaurus ObjectClass)
C0026606 (UMLS 2011AA ObjectClass)
C25217 (NCI Thesaurus Property)
C1516048 (UMLS 2011AA Property)
C54722 (NCI Thesaurus Property-2)
C0205251 (UMLS 2011AA Property-2)
C25539 (NCI Thesaurus Property-3)
C0522510 (UMLS 2011AA Property-3)
C16567 (NCI Thesaurus Property-4)
C0015259 (UMLS 2011AA Property-4)
C29846 (NCI Thesaurus ValueDomain)
C0439231 (UMLS 2011AA ValueDomain)
C29844 (NCI Thesaurus ValueDomain-2)
C0439230 (UMLS 2011AA ValueDomain-2)
C25330 (NCI Thesaurus ValueDomain-3)
C0449238 (UMLS 2011AA ValueDomain-3)
Code List
Lower intensity exercise (yoga, stretching, Pilates, toning)
CL Item
1 To 1.5 Hours (1 to 1.5 hours)
CL Item
1 To 4 Minutes (1 to 4 min.)
CL Item
11 Or More Hours (11 or more hours)
CL Item
2 To 3 Hours (2 to 3 hours)
CL Item
20 To 59 Minutes (20 to 59 min.)
CL Item
4 To 6 Hours (4 to 6 hours)
CL Item
5 To 19 Minutes (5 to 19 min.)
CL Item
7 To 10 Hours (7 to 10 hours)
CL Item
Zero (Zero)
C70430 (NCI Thesaurus)
C0919414 (UMLS 2011AA)
Item
Weight training or resistance exercises (including free weights or machines such as Nautilus)
text
C17708 (NCI Thesaurus ObjectClass)
C0026606 (UMLS 2011AA ObjectClass)
C25217 (NCI Thesaurus Property)
C1516048 (UMLS 2011AA Property)
C25208 (NCI Thesaurus Property-2)
C0043100 (UMLS 2011AA Property-2)
C16567 (NCI Thesaurus Property-3)
C0015259 (UMLS 2011AA Property-3)
C29846 (NCI Thesaurus ValueDomain)
C0439231 (UMLS 2011AA ValueDomain)
C29844 (NCI Thesaurus ValueDomain-2)
C0439230 (UMLS 2011AA ValueDomain-2)
C25330 (NCI Thesaurus ValueDomain-3)
C0449238 (UMLS 2011AA ValueDomain-3)
Code List
Weight training or resistance exercises (including free weights or machines such as Nautilus)
CL Item
1 To 1.5 Hours (1 to 1.5 hours)
CL Item
1 To 4 Minutes (1 to 4 min.)
CL Item
11 Or More Hours (11 or more hours)
CL Item
2 To 3 Hours (2 to 3 hours)
CL Item
20 To 59 Minutes (20 to 59 min.)
CL Item
4 To 6 Hours (4 to 6 hours)
CL Item
5 To 19 Minutes (5 to 19 min.)
CL Item
7 To 10 Hours (7 to 10 hours)
CL Item
Zero (Zero)
C70430 (NCI Thesaurus)
C0919414 (UMLS 2011AA)
Item
Standing or walking around at work or away from home
text
C17708 (NCI Thesaurus ObjectClass)
C0026606 (UMLS 2011AA ObjectClass)
C25217 (NCI Thesaurus Property)
C1516048 (UMLS 2011AA Property)
C73554 (NCI Thesaurus Property-2)
C0080331 (UMLS 2011AA Property-2)
C62166 (NCI Thesaurus Property-3)
C0231472 (UMLS 2011AA Property-3)
C29846 (NCI Thesaurus ValueDomain)
C0439231 (UMLS 2011AA ValueDomain)
C25529 (NCI Thesaurus ValueDomain-2)
C0439227 (UMLS 2011AA ValueDomain-2)
C29844 (NCI Thesaurus ValueDomain-3)
C0439230 (UMLS 2011AA ValueDomain-3)
C25330 (NCI Thesaurus ValueDomain-4)
C0449238 (UMLS 2011AA ValueDomain-4)
Code List
Standing or walking around at work or away from home
CL Item
0 Hours (0 hours)
CL Item
11 To 20 Hours (11 to 20 hours)
CL Item
2 To 5 Hours (2 to 5 hours)
CL Item
21 To 40 Hours (21 to 40 hours)
CL Item
40 To 60 Hours (40 to 60 hours)
CL Item
6 To 10 Hours (6 to 10 hours)
CL Item
61 To 90 Hours (61 to 90 hours)
CL Item
Over 90 Hours (over 90 hours)
Item
Standing or walking around at home
text
C17708 (NCI Thesaurus ObjectClass)
C0026606 (UMLS 2011AA ObjectClass)
C25217 (NCI Thesaurus Property)
C1516048 (UMLS 2011AA Property)
C18002 (NCI Thesaurus Property-2)
C0442519 (UMLS 2011AA Property-2)
C73554 (NCI Thesaurus Property-3)
C0080331 (UMLS 2011AA Property-3)
C62166 (NCI Thesaurus Property-4)
C0231472 (UMLS 2011AA Property-4)
C29846 (NCI Thesaurus ValueDomain)
C0439231 (UMLS 2011AA ValueDomain)
C25529 (NCI Thesaurus ValueDomain-2)
C0439227 (UMLS 2011AA ValueDomain-2)
C29844 (NCI Thesaurus ValueDomain-3)
C0439230 (UMLS 2011AA ValueDomain-3)
C25330 (NCI Thesaurus ValueDomain-4)
C0449238 (UMLS 2011AA ValueDomain-4)
Code List
Standing or walking around at home
CL Item
0 Hours (0 hours)
CL Item
11 To 20 Hours (11 to 20 hours)
CL Item
2 To 5 Hours (2 to 5 hours)
CL Item
21 To 40 Hours (21 to 40 hours)
CL Item
40 To 60 Hours (40 to 60 hours)
CL Item
6 To 10 Hours (6 to 10 hours)
CL Item
61 To 90 Hours (61 to 90 hours)
CL Item
Over 90 Hours (over 90 hours)
Item
Sitting at work or away from home or while driving
text
C17708 (NCI Thesaurus ObjectClass)
C0026606 (UMLS 2011AA ObjectClass)
C25217 (NCI Thesaurus Property)
C1516048 (UMLS 2011AA Property)
C62122 (NCI Thesaurus Property-2)
C0277814 (UMLS 2011AA Property-2)
C29846 (NCI Thesaurus ValueDomain)
C0439231 (UMLS 2011AA ValueDomain)
C25529 (NCI Thesaurus ValueDomain-2)
C0439227 (UMLS 2011AA ValueDomain-2)
C29844 (NCI Thesaurus ValueDomain-3)
C0439230 (UMLS 2011AA ValueDomain-3)
C25330 (NCI Thesaurus ValueDomain-4)
C0449238 (UMLS 2011AA ValueDomain-4)
Code List
Sitting at work or away from home or while driving
CL Item
0 Hours (0 hours)
CL Item
11 To 20 Hours (11 to 20 hours)
CL Item
2 To 5 Hours (2 to 5 hours)
CL Item
21 To 40 Hours (21 to 40 hours)
CL Item
40 To 60 Hours (40 to 60 hours)
CL Item
6 To 10 Hours (6 to 10 hours)
CL Item
61 To 90 Hours (61 to 90 hours)
CL Item
Over 90 Hours (over 90 hours)
Item
Sitting at home while watching TV/videos/DVDs
text
C17708 (NCI Thesaurus ObjectClass)
C0026606 (UMLS 2011AA ObjectClass)
C25217 (NCI Thesaurus Property)
C1516048 (UMLS 2011AA Property)
C18002 (NCI Thesaurus Property-2)
C0442519 (UMLS 2011AA Property-2)
C62122 (NCI Thesaurus Property-3)
C0277814 (UMLS 2011AA Property-3)
C29846 (NCI Thesaurus ValueDomain)
C0439231 (UMLS 2011AA ValueDomain)
C25529 (NCI Thesaurus ValueDomain-2)
C0439227 (UMLS 2011AA ValueDomain-2)
C29844 (NCI Thesaurus ValueDomain-3)
C0439230 (UMLS 2011AA ValueDomain-3)
C25330 (NCI Thesaurus ValueDomain-4)
C0449238 (UMLS 2011AA ValueDomain-4)
Code List
Sitting at home while watching TV/videos/DVDs
CL Item
0 Hours (0 hours)
CL Item
11 To 20 Hours (11 to 20 hours)
CL Item
2 To 5 Hours (2 to 5 hours)
CL Item
21 To 40 Hours (21 to 40 hours)
CL Item
40 To 60 Hours (40 to 60 hours)
CL Item
6 To 10 Hours (6 to 10 hours)
CL Item
61 To 90 Hours (61 to 90 hours)
CL Item
Over 90 Hours (over 90 hours)
Item
Other sitting at home (that is, not watching TV/videos/DVDs)
text
C17708 (NCI Thesaurus ObjectClass)
C0026606 (UMLS 2011AA ObjectClass)
C17649 (NCI Thesaurus Property)
C0205394 (UMLS 2011AA Property)
C25217 (NCI Thesaurus Property-2)
C1516048 (UMLS 2011AA Property-2)
C18002 (NCI Thesaurus Property-3)
C0442519 (UMLS 2011AA Property-3)
C62122 (NCI Thesaurus Property-4)
C0277814 (UMLS 2011AA Property-4)
C29846 (NCI Thesaurus ValueDomain)
C0439231 (UMLS 2011AA ValueDomain)
C25529 (NCI Thesaurus ValueDomain-2)
C0439227 (UMLS 2011AA ValueDomain-2)
C29844 (NCI Thesaurus ValueDomain-3)
C0439230 (UMLS 2011AA ValueDomain-3)
C25330 (NCI Thesaurus ValueDomain-4)
C0449238 (UMLS 2011AA ValueDomain-4)
Code List
Other sitting at home (that is, not watching TV/videos/DVDs)
CL Item
0 Hours (0 hours)
CL Item
11 To 20 Hours (11 to 20 hours)
CL Item
2 To 5 Hours (2 to 5 hours)
CL Item
21 To 40 Hours (21 to 40 hours)
CL Item
40 To 60 Hours (40 to 60 hours)
CL Item
6 To 10 Hours (6 to 10 hours)
CL Item
61 To 90 Hours (61 to 90 hours)
CL Item
Over 90 Hours (over 90 hours)
Item
What is your usual walking pace outdoors
text
C17708 (NCI Thesaurus ObjectClass)
C0026606 (UMLS 2011AA ObjectClass)
C25217 (NCI Thesaurus Property)
C1516048 (UMLS 2011AA Property)
C16567 (NCI Thesaurus Property-2)
C0015259 (UMLS 2011AA Property-2)
C73554 (NCI Thesaurus Property-3)
C0080331 (UMLS 2011AA Property-3)
C25636 (NCI Thesaurus ValueDomain)
C1521828 (UMLS 2011AA ValueDomain)
Code List
What is your usual walking pace outdoors
CL Item
Brisk Pace (3 To 3.9 Mph) (Brisk pace (3 to 3.9 mph))
CL Item
Easy, Casual (less Than 2 Mph) (Easy, casual (less than 2 mph))
CL Item
Normal, Average (Normal, average)
CL Item
Unable To Walk (Unable to walk)
CL Item
Very Brisk/striding (4 Mph Or Faster) (Very brisk/striding (4 mph or faster))
Item
How many flights of stairs (not individual steps) do you climb daily
text
C17708 (NCI Thesaurus ObjectClass)
C0026606 (UMLS 2011AA ObjectClass)
C25217 (NCI Thesaurus Property)
C1516048 (UMLS 2011AA Property)
C48960 (NCI Thesaurus Property-2)
C1710179 (UMLS 2011AA Property-2)
C81002 (NCI Thesaurus Property-3)
C2584300 (UMLS 2011AA Property-3)
C25473 (NCI Thesaurus ValueDomain)
C0332173 (UMLS 2011AA ValueDomain)
C25463 (NCI Thesaurus ValueDomain-2)
C0750480 (UMLS 2011AA ValueDomain-2)
Code List
How many flights of stairs (not individual steps) do you climb daily
CL Item
10 To 14 Flights Of Stairs (10 to 14 flights)
CL Item
15 Or More Flights Of Stairs (15 or more flights)
CL Item
2 Flights Of Stairs Or Less (2 flights or less)
CL Item
3 To 4 Flights Of Stairs (3 to 4 flights)
CL Item
5 To 9 Flights Of Stairs (5 to 9 flights)
Research Comments
Item
Comments
text
C25704 (NCI Thesaurus ValueDomain)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
Person Completing Form
Item
Completed by (Last name, First name)
text
C25191 (NCI Thesaurus ValueDomain)
C1550483 (UMLS CUI-1)
C25657 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)
Date Form Completed
Item
Date form completed (MM DD YYYY)
date
C25164 (NCI Thesaurus ValueDomain)
C1115437 (UMLS CUI-1)
C40988 (NCI Thesaurus ObjectClass)
C25250 (NCI Thesaurus Property)
C25367 (NCI Thesaurus ValueDomain-2)