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
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)
ClinicalResearchAssociateResponsiblePersonName
Item
Responsible CRA
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C25657 (NCI Thesaurus ObjectClass)
C1273518 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C25465 (NCI Thesaurus ObjectClass-2)
C1516627 (UMLS 2011AA ObjectClass-2)
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)
Visit number
Item
Visit number
float
C25337 (NCI Thesaurus ValueDomain)
C1549755 (UMLS CUI-1)
C16696 (NCI Thesaurus ObjectClass)
C25385 (NCI Thesaurus Property)
Item
I feel tense or wound up (Mark one with an X.)
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C26696 (NCI Thesaurus ObjectClass-2)
C0003467 (UMLS 2011AA ObjectClass-2)
C17047 (NCI Thesaurus Property)
C0518214 (UMLS 2011AA Property)
C25367 (NCI Thesaurus Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
Code List
I feel tense or wound up (Mark one with an X.)
CL Item
Most Of The Time (Most of the time)
CL Item
A Lot Of The Time (A lot of the time)
CL Item
From Time To Time, Occasionally (From time to time, occasionally)
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
Item
I still enjoy the things I used to enjoy (Mark one with an X.)
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C54266 (NCI Thesaurus ObjectClass-2)
C0013987 (UMLS 2011AA ObjectClass-2)
C48190 (NCI Thesaurus ObjectClass-3)
C0332197 (UMLS 2011AA ObjectClass-3)
C62184 (NCI Thesaurus ObjectClass-4)
C0870433 (UMLS 2011AA ObjectClass-4)
C17047 (NCI Thesaurus Property)
C0518214 (UMLS 2011AA Property)
C25367 (NCI Thesaurus Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
Code List
I still enjoy the things I used to enjoy (Mark one with an X.)
CL Item
Definitely As Much (Definitely as much)
CL Item
Not Quite So Much (Not quite so much)
CL Item
Only A Little (Only a little)
CL Item
Hardly At All (Hardly at all)
Item
I get a sort of frightened feeling as if something awful is about to happen (Mark one with an X.)
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C26696 (NCI Thesaurus ObjectClass-2)
C0003467 (UMLS 2011AA ObjectClass-2)
C37942 (NCI Thesaurus ObjectClass-3)
C0231303 (UMLS 2011AA ObjectClass-3)
C17047 (NCI Thesaurus Property)
C0518214 (UMLS 2011AA Property)
C25367 (NCI Thesaurus Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
Code List
I get a sort of frightened feeling as if something awful is about to happen (Mark one with an X.)
CL Item
Very Definitely And Quite Badly (Very definitely and quite badly)
CL Item
Yes, But Not Too Badly (Yes, but not too badly)
CL Item
A Little, But It Doesn't Worry Me (A little, but it doesn't worry me)
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
Item
I can laugh and see the funny side of things (Mark one with an X.)
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C54266 (NCI Thesaurus ObjectClass-2)
C0013987 (UMLS 2011AA ObjectClass-2)
C25246 (NCI Thesaurus ObjectClass-3)
C1446409 (UMLS 2011AA ObjectClass-3)
C62592 (NCI Thesaurus ObjectClass-4)
C2939186 (UMLS 2011AA ObjectClass-4)
C17047 (NCI Thesaurus Property)
C0518214 (UMLS 2011AA Property)
C25367 (NCI Thesaurus Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
Code List
I can laugh and see the funny side of things (Mark one with an X.)
CL Item
As Much As I Always Could (As much as I always could)
CL Item
Not Quite So Much Now (Not quite so much now)
CL Item
Definitely Not So Much Now (Definitely not so much now)
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
Item
Worrying thoughts go through my mind (Mark one with an X.)
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C26696 (NCI Thesaurus ObjectClass-2)
C0003467 (UMLS 2011AA ObjectClass-2)
C54226 (NCI Thesaurus ObjectClass-3)
C0039869 (UMLS 2011AA ObjectClass-3)
C17047 (NCI Thesaurus Property)
C0518214 (UMLS 2011AA Property)
C25367 (NCI Thesaurus Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
Code List
Worrying thoughts go through my mind (Mark one with an X.)
CL Item
A Great Deal Of The Time (A great deal of the time)
CL Item
A Lot Of The Time (A lot of the time)
CL Item
From Time To Time But Not Too Often (From time to time but not too often)
CL Item
Only Occasionally (Only occasionally)
Item
I feel cheerful (Mark one with an X.)
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C54266 (NCI Thesaurus ObjectClass-2)
C0013987 (UMLS 2011AA ObjectClass-2)
C25246 (NCI Thesaurus ObjectClass-3)
C1446409 (UMLS 2011AA ObjectClass-3)
C17047 (NCI Thesaurus Property)
C0518214 (UMLS 2011AA Property)
C25367 (NCI Thesaurus Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
Code List
I feel cheerful (Mark one with an X.)
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
CL Item
Not Often (Not often)
CL Item
Sometimes (Sometimes)
CL Item
Most Of The Time (Most of the time)
Item
I can sit at ease and feel relaxed (Mark one with an X.)
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C62188 (NCI Thesaurus ObjectClass-2)
C0035028 (UMLS 2011AA ObjectClass-2)
C17047 (NCI Thesaurus Property)
C0518214 (UMLS 2011AA Property)
C25367 (NCI Thesaurus Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
Code List
I can sit at ease and feel relaxed (Mark one with an X.)
CL Item
Definitely (Definitely)
CL Item
Usually (Usually)
CL Item
Not Often (Not often)
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
Item
I feel as if I am slowed down (Mark one with an X.)
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C3036 (NCI Thesaurus ObjectClass-2)
C0015672 (UMLS 2011AA ObjectClass-2)
C2982 (NCI Thesaurus ObjectClass-3)
C0011570 (UMLS 2011AA ObjectClass-3)
C17047 (NCI Thesaurus Property)
C0518214 (UMLS 2011AA Property)
C25367 (NCI Thesaurus Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
Code List
I feel as if I am slowed down (Mark one with an X.)
CL Item
Nearly All The Time (Nearly all the time)
CL Item
Very Often (Very often)
CL Item
Sometimes (Sometimes)
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
Item
I get a sort of frightened feeling like butterflies in my stomach (Mark one with an X.)
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C26696 (NCI Thesaurus ObjectClass-2)
C0003467 (UMLS 2011AA ObjectClass-2)
C3258 (NCI Thesaurus ObjectClass-3)
C0027497 (UMLS 2011AA ObjectClass-3)
C17047 (NCI Thesaurus Property)
C0518214 (UMLS 2011AA Property)
C25367 (NCI Thesaurus Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
Code List
I get a sort of frightened feeling like butterflies in my stomach (Mark one with an X.)
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
CL Item
Occasionally (Occasionally)
CL Item
Quite Often (Quite often)
CL Item
Very Often (Very often)
Item
I have lost interest in my appearance (Mark one with an X.)
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25377 (NCI Thesaurus ObjectClass-2)
C0700364 (UMLS 2011AA ObjectClass-2)
C2982 (NCI Thesaurus ObjectClass-3)
C0011570 (UMLS 2011AA ObjectClass-3)
C17047 (NCI Thesaurus Property)
C0518214 (UMLS 2011AA Property)
C25367 (NCI Thesaurus Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
Code List
I have lost interest in my appearance (Mark one with an X.)
CL Item
Definitely (Definitely)
CL Item
I Don't Take So Much Care As I Should (I don't take so much care as I should)
CL Item
I May Not Take Quite As Much Care (I may not take quite as much care)
CL Item
I Take Just As Much Care As Ever (I take just as much care as ever)
Item
I feel restless as if I have to be on the move (Mark one with an X.)
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C26696 (NCI Thesaurus ObjectClass-2)
C0003467 (UMLS 2011AA ObjectClass-2)
C37994 (NCI Thesaurus ObjectClass-3)
C0026649 (UMLS 2011AA ObjectClass-3)
C17047 (NCI Thesaurus Property)
C0518214 (UMLS 2011AA Property)
C25367 (NCI Thesaurus Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
Code List
I feel restless as if I have to be on the move (Mark one with an X.)
CL Item
Very Much Indeed (Very much indeed)
CL Item
Not Very Much (Not very much)
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
Item
I look forward with enjoyment to things (Mark one with an X.)
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C54266 (NCI Thesaurus ObjectClass-2)
C0013987 (UMLS 2011AA ObjectClass-2)
C43367 (NCI Thesaurus ObjectClass-3)
C1704726 (UMLS 2011AA ObjectClass-3)
C17047 (NCI Thesaurus Property)
C0518214 (UMLS 2011AA Property)
C25367 (NCI Thesaurus Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
Code List
I look forward with enjoyment to things (Mark one with an X.)
CL Item
As Much As I Ever Did (As much as I ever did)
CL Item
Rather Less Than I Used To (Rather less than I used to)
CL Item
Definitely Less Than I Used To (Definitely less than I used to)
CL Item
Hardly At All (Hardly at all)
Item
I get sudden feelings of panic (Mark one with an X.)
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C26696 (NCI Thesaurus ObjectClass-2)
C0003467 (UMLS 2011AA ObjectClass-2)
C14140 (NCI Thesaurus ObjectClass-3)
C0205178 (UMLS 2011AA ObjectClass-3)
C37942 (NCI Thesaurus ObjectClass-4)
C0231303 (UMLS 2011AA ObjectClass-4)
C17047 (NCI Thesaurus Property)
C0518214 (UMLS 2011AA Property)
C25367 (NCI Thesaurus Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
Code List
I get sudden feelings of panic (Mark one with an X.)
CL Item
Very Often Indeed (Very often indeed)
CL Item
Quite Often (Quite often)
CL Item
Not Very Often (Not very often)
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
Item
I can enjoy a good book or radio or TV program (Mark one with an X.)
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C54266 (NCI Thesaurus ObjectClass-2)
C0013987 (UMLS 2011AA ObjectClass-2)
C43431 (NCI Thesaurus ObjectClass-3)
C0441655 (UMLS 2011AA ObjectClass-3)
C17047 (NCI Thesaurus Property)
C0518214 (UMLS 2011AA Property)
C25367 (NCI Thesaurus Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
Code List
I can enjoy a good book or radio or TV program (Mark one with an X.)
CL Item
Sometimes (Sometimes)
CL Item
Not Often (Not often)
CL Item
Very Seldom (Very seldom)