ID

11160

Descrizione

RTOG-0421 QP: Radiation Therapy Oncology Group Performance Status Scale Miscellaneous Patient Assessment Form NCT00113399 Combination Chemotherapy With or Without Radiation Therapy in Treating Patients With Recurrent Head and Neck Cancer That Cannot Be Removed By Surgery Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=EB3722D1-7299-70BB-E034-0003BA3F9857

collegamento

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=EB3722D1-7299-70BB-E034-0003BA3F9857

Keywords

  1. 19/09/12 19/09/12 -
  2. 09/01/15 09/01/15 - Martin Dugas
  3. 21/06/15 21/06/15 -
Caricato su

21 giugno 2015

DOI

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Licenza

Creative Commons BY-NC 3.0 Legacy

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    RTOG-0421 QP: Radiation Therapy Oncology Group Performance Status Scale Miscellaneous Patient Assessment Form NCT00113399

    No Instruction available.

    1. StudyEvent: RTOG-0421 QP: Radiation Therapy Oncology Group Performance Status Scale Miscellaneous Patient Assessment Form
      1. No Instruction available.
    RTOG clinical trial administrative data
    Descrizione

    RTOG clinical trial administrative data

    RTOG Study
    Descrizione

    Protocol ID RTOG

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C3274381
    NCI Thesaurus ObjectClass
    C25320
    UMLS CUI-2
    C1514695
    NCI Thesaurus Property
    C19778
    NCI Thesaurus Property-2
    C25364
    Case #
    Descrizione

    RadiationTherapyOncologyGroupPatientCaseIdentifierNumber

    Tipo di dati

    text

    Alias
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus ObjectClass-2
    C19778
    UMLS 2011AA ObjectClass-2
    C1514695
    NCI Thesaurus Property
    C25364
    UMLS 2011AA Property
    C0600091
    NCI Thesaurus Property-2
    C49152
    UMLS 2011AA Property-2
    C1706256
    NCI Thesaurus ValueDomain
    C25337
    UMLS 2011AA ValueDomain
    C0237753
    Institution Name
    Descrizione

    Institution Name

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS CUI-1
    C1301943
    NCI Thesaurus ObjectClass
    C21541
    NCI Thesaurus ValueDomain-2
    C21541
    NCI Thesaurus Property
    C25364
    Institution No.
    Descrizione

    Institution Number

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C1301943
    NCI Thesaurus ObjectClass
    C21541
    UMLS CUI-2
    C0805701
    NCI Thesaurus Property
    C25364
    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
    Patient Study No.
    Descrizione

    Trial subject ID RTOG

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C2348585
    NCI Thesaurus ObjectClass
    C16960
    UMLS CUI-2
    C1514695
    NCI Thesaurus Property
    C19778
    NCI Thesaurus Property-2
    C25364
    Miscellaneous Patient Assessment
    Descrizione

    Miscellaneous Patient Assessment

    SCHEDULED DATA POINT (CHECK ONE)
    Descrizione

    DataAssessmentTimePeriodType

    Tipo di dati

    text

    Alias
    NCI Thesaurus ObjectClass
    C20989
    UMLS 2011AA ObjectClass
    C0031809
    NCI Thesaurus ObjectClass-2
    C25474
    UMLS 2011AA ObjectClass-2
    C1511726
    NCI Thesaurus Property
    C25616
    UMLS 2011AA Property
    C1948053
    NCI Thesaurus Property-2
    C25207
    UMLS 2011AA Property-2
    C0040223
    NCI Thesaurus ValueDomain
    C25284
    UMLS 2011AA ValueDomain
    C0332307
    other followup
    Descrizione

    DataAssessmentTimePeriodUnspecifiedText

    Tipo di dati

    text

    Alias
    NCI Thesaurus ObjectClass
    C20989
    UMLS 2011AA ObjectClass
    C0031809
    NCI Thesaurus ObjectClass-2
    C25474
    UMLS 2011AA ObjectClass-2
    C1511726
    NCI Thesaurus Property
    C25616
    UMLS 2011AA Property
    C1948053
    NCI Thesaurus Property-2
    C25207
    UMLS 2011AA Property-2
    C0040223
    NCI Thesaurus ValueDomain
    C25704
    UMLS 2011AA ValueDomain
    C1527021
    Other, specify
    Descrizione

    DataAssessmentTimePeriodOtherText

    Tipo di dati

    text

    Alias
    NCI Thesaurus ObjectClass
    C20989
    UMLS 2011AA ObjectClass
    C0031809
    NCI Thesaurus ObjectClass-2
    C25474
    UMLS 2011AA ObjectClass-2
    C1511726
    NCI Thesaurus Property
    C25616
    UMLS 2011AA Property
    C1948053
    NCI Thesaurus Property-2
    C25207
    UMLS 2011AA Property-2
    C0040223
    NCI Thesaurus ValueDomain
    C25704
    UMLS 2011AA ValueDomain
    C1527021
    NCI Thesaurus ValueDomain-2
    C17649
    UMLS 2011AA ValueDomain-2
    C0205394
    IF NO PATIENT ASSESSMENT, SPECIFY REASON (CHECK ONE)
    Descrizione

    AssessmentNotPerformedReason

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25638
    UMLS 2011AA ValueDomain
    C0392360
    NCI Thesaurus Property
    C49487
    UMLS 2011AA Property
    C1298908
    NCI Thesaurus ObjectClass
    C25217
    UMLS 2011AA ObjectClass
    C1516048
    NCI Thesaurus Property-2
    C38000
    UMLS 2011AA Property-2
    C0884358
    Patient refused, including attempts by telephone interview, specify reason for refusal
    Descrizione

    PatientTelephoneAssessmentRefusaltoParticipateReason

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25638
    UMLS 2011AA ValueDomain
    C0392360
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C20989
    UMLS 2011AA Property
    C0031809
    NCI Thesaurus Property-2
    C25395
    UMLS 2011AA Property-2
    C0039457
    Patient refused, telephone interview not attempted, specify reason for refusal
    Descrizione

    PatientAssessmentRefusaltoParticipateReason

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25638
    UMLS 2011AA ValueDomain
    C0392360
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C20989
    UMLS 2011AA Property
    C0031809
    Other reason, specify
    Descrizione

    OtherPatientAssessmentRefusaltoParticipateReason

    Tipo di dati

    text

    Alias
    NCI Thesaurus ObjectClass
    C17649
    UMLS 2011AA ObjectClass
    C0205394
    NCI Thesaurus ValueDomain
    C25638
    UMLS 2011AA ValueDomain
    C0392360
    NCI Thesaurus ObjectClass-2
    C16960
    UMLS 2011AA ObjectClass-2
    C0030705
    NCI Thesaurus Property
    C25367
    WAS INFORMATION OBTAINED BY TELEPHONE INTERVIEW (CHECK ONE)
    Descrizione

    PatientTelephoneAssessmentInd-2

    Tipo di dati

    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 Property-2
    C25395
    UMLS 2011AA Property-2
    C0039457
    DATE OF EVALUATION
    Descrizione

    LesionAssessmentDate

    Tipo di dati

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ObjectClass
    C3824
    UMLS 2011AA ObjectClass
    C0221198
    NCI Thesaurus Property
    C20989
    UMLS 2011AA Property
    C0031809
    NCI Thesaurus ValueDomain-2
    C25367
    RATER'S NAME
    Descrizione

    PatientTelephoneAssessmentInterviewersName

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS 2011AA ValueDomain
    C1547383
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C20989
    UMLS 2011AA Property
    C0031809
    NCI Thesaurus Property-2
    C25395
    UMLS 2011AA Property-2
    C0039457
    NORMALCY OF DIET RATING (CHECK ONE)
    Descrizione

    RTOGDietIntakePerformanceScale

    Tipo di dati

    text

    Alias
    NCI Thesaurus ObjectClass
    C19778
    UMLS 2011AA ObjectClass
    C1514695
    NCI Thesaurus ObjectClass-2
    C15222
    UMLS 2011AA ObjectClass-2
    C0012155
    NCI Thesaurus Property
    C25361
    UMLS 2011AA Property
    C0597198
    NCI Thesaurus Property-2
    C25538
    UMLS 2011AA Property-2
    C1512806
    NCI Thesaurus ValueDomain
    C25664
    UMLS 2011AA ValueDomain
    C0349674
    PUBLIC EATING RATING (CHECK ONE)
    Descrizione

    DietaryAssessmentLocationPerformanceScale

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25664
    UMLS 2011AA ValueDomain
    C0349674
    NCI Thesaurus Property
    C25341
    UMLS 2011AA Property
    C0450429
    NCI Thesaurus ValueDomain-2
    C25361
    UMLS 2011AA ValueDomain-2
    C0597198
    NCI Metathesaurus ObjectClass
    C0814244
    UNDERSTANDABILITY OF SPEECH RATING (CHECK ONE)
    Descrizione

    SpeechAssessmentPerformanceScale

    Tipo di dati

    text

    Alias
    NCI Thesaurus ObjectClass
    C38025
    UMLS 2011AA ObjectClass
    C0037817
    NCI Metathesaurus ObjectClass
    CL092952
    NCI Thesaurus Property
    C20989
    UMLS 2011AA Property
    C0031809
    NCI Thesaurus ValueDomain
    C25664
    UMLS 2011AA ValueDomain
    C0349674
    NCI Thesaurus ValueDomain-2
    C25361
    UMLS 2011AA ValueDomain-2
    C0597198
    Comments
    Descrizione

    Comments

    COMMENTS
    Descrizione

    Research Comments

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704
    UMLS CUI-1
    C0947611
    NCI Thesaurus ObjectClass
    C15319
    NCI Thesaurus Property
    C25393
    Signature
    Descrizione

    Signature

    Tipo di dati

    text

    Date
    Descrizione

    ResponsiblePersonSignatureDate

    Tipo di dati

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ObjectClass
    C25190
    UMLS 2011AA ObjectClass
    C0027361
    NCI Thesaurus ObjectClass-2
    C25657
    UMLS 2011AA ObjectClass-2
    C1273518
    NCI Thesaurus Property
    C25678
    UMLS 2011AA Property
    C1519316

    Similar models

    No Instruction available.

    1. StudyEvent: RTOG-0421 QP: Radiation Therapy Oncology Group Performance Status Scale Miscellaneous Patient Assessment Form
      1. No Instruction available.
    Name
    genere
    Description | Question | Decode (Coded Value)
    Tipo di dati
    Alias
    Item Group
    RTOG clinical trial administrative data
    Protocol ID RTOG
    Item
    RTOG Study
    text
    C25337 (NCI Thesaurus ValueDomain)
    C3274381 (UMLS CUI-1)
    C25320 (NCI Thesaurus ObjectClass)
    C1514695 (UMLS CUI-2)
    C19778 (NCI Thesaurus Property)
    C25364 (NCI Thesaurus Property-2)
    RadiationTherapyOncologyGroupPatientCaseIdentifierNumber
    Item
    Case #
    text
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C19778 (NCI Thesaurus ObjectClass-2)
    C1514695 (UMLS 2011AA ObjectClass-2)
    C25364 (NCI Thesaurus Property)
    C0600091 (UMLS 2011AA Property)
    C49152 (NCI Thesaurus Property-2)
    C1706256 (UMLS 2011AA Property-2)
    C25337 (NCI Thesaurus ValueDomain)
    C0237753 (UMLS 2011AA ValueDomain)
    Institution Name
    Item
    Institution Name
    text
    C25191 (NCI Thesaurus ValueDomain)
    C1301943 (UMLS CUI-1)
    C21541 (NCI Thesaurus ObjectClass)
    C21541 (NCI Thesaurus ValueDomain-2)
    C25364 (NCI Thesaurus Property)
    Institution Number
    Item
    Institution No.
    text
    C25337 (NCI Thesaurus ValueDomain)
    C1301943 (UMLS CUI-1)
    C21541 (NCI Thesaurus ObjectClass)
    C0805701 (UMLS CUI-2)
    C25364 (NCI Thesaurus Property)
    Patient Initials
    Item
    Patient Initials
    text
    C25191 (NCI Thesaurus ValueDomain)
    C2986440 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C25536 (NCI Thesaurus Property)
    Trial subject ID RTOG
    Item
    Patient Study No.
    text
    C25337 (NCI Thesaurus ValueDomain)
    C2348585 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C1514695 (UMLS CUI-2)
    C19778 (NCI Thesaurus Property)
    C25364 (NCI Thesaurus Property-2)
    Item Group
    Miscellaneous Patient Assessment
    Item
    SCHEDULED DATA POINT (CHECK ONE)
    text
    C20989 (NCI Thesaurus ObjectClass)
    C0031809 (UMLS 2011AA ObjectClass)
    C25474 (NCI Thesaurus ObjectClass-2)
    C1511726 (UMLS 2011AA ObjectClass-2)
    C25616 (NCI Thesaurus Property)
    C1948053 (UMLS 2011AA Property)
    C25207 (NCI Thesaurus Property-2)
    C0040223 (UMLS 2011AA Property-2)
    C25284 (NCI Thesaurus ValueDomain)
    C0332307 (UMLS 2011AA ValueDomain)
    Code List
    SCHEDULED DATA POINT (CHECK ONE)
    CL Item
    Pre Treatment Assessment (Pre treatment assessment)
    CL Item
    At Completion Of Radiotherapy (At completion of radiotherapy)
    CL Item
    Four Weeks Followup (Four weeks followup)
    CL Item
    Other Followup (other followup)
    CL Item
    Other (Other)
    C17649 (NCI Thesaurus)
    C0205394 (UMLS 2011AA)
    DataAssessmentTimePeriodUnspecifiedText
    Item
    other followup
    text
    C20989 (NCI Thesaurus ObjectClass)
    C0031809 (UMLS 2011AA ObjectClass)
    C25474 (NCI Thesaurus ObjectClass-2)
    C1511726 (UMLS 2011AA ObjectClass-2)
    C25616 (NCI Thesaurus Property)
    C1948053 (UMLS 2011AA Property)
    C25207 (NCI Thesaurus Property-2)
    C0040223 (UMLS 2011AA Property-2)
    C25704 (NCI Thesaurus ValueDomain)
    C1527021 (UMLS 2011AA ValueDomain)
    DataAssessmentTimePeriodOtherText
    Item
    Other, specify
    text
    C20989 (NCI Thesaurus ObjectClass)
    C0031809 (UMLS 2011AA ObjectClass)
    C25474 (NCI Thesaurus ObjectClass-2)
    C1511726 (UMLS 2011AA ObjectClass-2)
    C25616 (NCI Thesaurus Property)
    C1948053 (UMLS 2011AA Property)
    C25207 (NCI Thesaurus Property-2)
    C0040223 (UMLS 2011AA Property-2)
    C25704 (NCI Thesaurus ValueDomain)
    C1527021 (UMLS 2011AA ValueDomain)
    C17649 (NCI Thesaurus ValueDomain-2)
    C0205394 (UMLS 2011AA ValueDomain-2)
    Item
    IF NO PATIENT ASSESSMENT, SPECIFY REASON (CHECK ONE)
    text
    C25638 (NCI Thesaurus ValueDomain)
    C0392360 (UMLS 2011AA ValueDomain)
    C49487 (NCI Thesaurus Property)
    C1298908 (UMLS 2011AA Property)
    C25217 (NCI Thesaurus ObjectClass)
    C1516048 (UMLS 2011AA ObjectClass)
    C38000 (NCI Thesaurus Property-2)
    C0884358 (UMLS 2011AA Property-2)
    Code List
    IF NO PATIENT ASSESSMENT, SPECIFY REASON (CHECK ONE)
    CL Item
    Patient Was Too Ill (Patient was too ill)
    CL Item
    Patient Unable To Be Contacted (Patient unable to be contacted)
    CL Item
    Questionnaire Not Completed Due To Institutional Error (Questionnaire not completed due to institutional error)
    CL Item
    Patient Refused, Including Attempts By Telephone Interview (Patient refused, including attempts by telephone interview)
    CL Item
    Patient Refused, Telephone Interview Not Attempted (Patient refused, telephone interview not attempted)
    CL Item
    Other Reason (Other reason)
    PatientTelephoneAssessmentRefusaltoParticipateReason
    Item
    Patient refused, including attempts by telephone interview, specify reason for refusal
    text
    C25638 (NCI Thesaurus ValueDomain)
    C0392360 (UMLS 2011AA ValueDomain)
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C20989 (NCI Thesaurus Property)
    C0031809 (UMLS 2011AA Property)
    C25395 (NCI Thesaurus Property-2)
    C0039457 (UMLS 2011AA Property-2)
    PatientAssessmentRefusaltoParticipateReason
    Item
    Patient refused, telephone interview not attempted, specify reason for refusal
    text
    C25638 (NCI Thesaurus ValueDomain)
    C0392360 (UMLS 2011AA ValueDomain)
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C20989 (NCI Thesaurus Property)
    C0031809 (UMLS 2011AA Property)
    OtherPatientAssessmentRefusaltoParticipateReason
    Item
    Other reason, specify
    text
    C17649 (NCI Thesaurus ObjectClass)
    C0205394 (UMLS 2011AA ObjectClass)
    C25638 (NCI Thesaurus ValueDomain)
    C0392360 (UMLS 2011AA ValueDomain)
    C16960 (NCI Thesaurus ObjectClass-2)
    C0030705 (UMLS 2011AA ObjectClass-2)
    C25367 (NCI Thesaurus Property)
    PatientTelephoneAssessmentInd-2
    Item
    WAS INFORMATION OBTAINED BY TELEPHONE INTERVIEW (CHECK ONE)
    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)
    C25395 (NCI Thesaurus Property-2)
    C0039457 (UMLS 2011AA Property-2)
    LesionAssessmentDate
    Item
    DATE OF EVALUATION
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C3824 (NCI Thesaurus ObjectClass)
    C0221198 (UMLS 2011AA ObjectClass)
    C20989 (NCI Thesaurus Property)
    C0031809 (UMLS 2011AA Property)
    C25367 (NCI Thesaurus ValueDomain-2)
    PatientTelephoneAssessmentInterviewersName
    Item
    RATER'S NAME
    text
    C25191 (NCI Thesaurus ValueDomain)
    C1547383 (UMLS 2011AA ValueDomain)
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C20989 (NCI Thesaurus Property)
    C0031809 (UMLS 2011AA Property)
    C25395 (NCI Thesaurus Property-2)
    C0039457 (UMLS 2011AA Property-2)
    Item
    NORMALCY OF DIET RATING (CHECK ONE)
    text
    C19778 (NCI Thesaurus ObjectClass)
    C1514695 (UMLS 2011AA ObjectClass)
    C15222 (NCI Thesaurus ObjectClass-2)
    C0012155 (UMLS 2011AA ObjectClass-2)
    C25361 (NCI Thesaurus Property)
    C0597198 (UMLS 2011AA Property)
    C25538 (NCI Thesaurus Property-2)
    C1512806 (UMLS 2011AA Property-2)
    C25664 (NCI Thesaurus ValueDomain)
    C0349674 (UMLS 2011AA ValueDomain)
    Code List
    NORMALCY OF DIET RATING (CHECK ONE)
    CL Item
    100= Full Diet (no Restrictions) (Full diet)
    CL Item
    90= Peanuts (Peanuts)
    CL Item
    80= All Meat (All meat)
    CL Item
    70= Carrots, Celery (Carrots, celery)
    CL Item
    60= Dry Bread And Crackers (Dry bread and crackers)
    CL Item
    50= Soft, Chewable Foods (e.g., Macaroni, Canned/soft Fruits, Cooked Vegetables, Fish, Hamburger, Small Pieces Of Meat) (Soft, chewable foods)
    CL Item
    40= Soft Foods Requiring No Chewing (e.g., Mashed Potatoes, Apple Sauce, Pudding) (Soft foods requiring no chewing)
    CL Item
    30= Pureed Foods (in Blender) (Pureed foods)
    CL Item
    20= Warm Liquids (Warm liquids)
    CL Item
    10= Cold Liquids (Cold liquids)
    CL Item
    0= Non-oral Feeding (tube Fed) (Non-oral feeding)
    Item
    PUBLIC EATING RATING (CHECK ONE)
    text
    C25664 (NCI Thesaurus ValueDomain)
    C0349674 (UMLS 2011AA ValueDomain)
    C25341 (NCI Thesaurus Property)
    C0450429 (UMLS 2011AA Property)
    C25361 (NCI Thesaurus ValueDomain-2)
    C0597198 (UMLS 2011AA ValueDomain-2)
    C0814244 (NCI Metathesaurus ObjectClass)
    Code List
    PUBLIC EATING RATING (CHECK ONE)
    CL Item
    100= No Restriction Of Place, Food Or Companion (eats Out At Any Opportunity) (No restriction of place, food or companion)
    CL Item
    75= No Restriction Of Place, But Restricts Diet When In Public (eats Anywhere, But May Limit Intake To Less "messy" Foods, E.g., Liquids) (No restriction of place, but restricts diet when in public)
    CL Item
    50= Eats Only In Presence Of Selected Persons In Selected Places (Eats only in presence of selected persons in selected places)
    CL Item
    25= Eats Only At Home In Presence Of Selected Persons (Eats only at home in presence of selected persons)
    CL Item
    0= Always Eats Alone (Always eats alone)
    Item
    UNDERSTANDABILITY OF SPEECH RATING (CHECK ONE)
    text
    C38025 (NCI Thesaurus ObjectClass)
    C0037817 (UMLS 2011AA ObjectClass)
    CL092952 (NCI Metathesaurus ObjectClass)
    C20989 (NCI Thesaurus Property)
    C0031809 (UMLS 2011AA Property)
    C25664 (NCI Thesaurus ValueDomain)
    C0349674 (UMLS 2011AA ValueDomain)
    C25361 (NCI Thesaurus ValueDomain-2)
    C0597198 (UMLS 2011AA ValueDomain-2)
    Code List
    UNDERSTANDABILITY OF SPEECH RATING (CHECK ONE)
    CL Item
    100= Always Understandable (Always understandable)
    CL Item
    75= Understandable Most Of The Time; Occasional Repetition Necessary (Understandable most of the time; occasional repetition necessary)
    CL Item
    50= Usually Understandable; Face-to-face Contact Necessary (Usually understandable; face-to-face contact necessary)
    CL Item
    25= Difficult To Understand (Difficult to understand)
    CL Item
    0= Never Understandable; May Use Written Communication (Never understandable; may use written communication)
    Item Group
    Comments
    Research Comments
    Item
    COMMENTS
    text
    C25704 (NCI Thesaurus ValueDomain)
    C0947611 (UMLS CUI-1)
    C15319 (NCI Thesaurus ObjectClass)
    C25393 (NCI Thesaurus Property)
    Signature
    Item
    Signature
    text
    ResponsiblePersonSignatureDate
    Item
    Date
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C25190 (NCI Thesaurus ObjectClass)
    C0027361 (UMLS 2011AA ObjectClass)
    C25657 (NCI Thesaurus ObjectClass-2)
    C1273518 (UMLS 2011AA ObjectClass-2)
    C25678 (NCI Thesaurus Property)
    C1519316 (UMLS 2011AA Property)

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