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ID
1345
Description
CALGB: CES-D (SHORT FORM) Fluorouracil and Leucovorin Plus Either Irinotecan or Oxaliplatin With or Without Cetuximab in Treating Patients With Previously Untreated Metastatic Adenocarcinoma of the Colon or Rectum Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=BFC4896D-D687-0423-E034-0003BA12F5E7
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Versions (2)
- 8/27/12 8/27/12 -
- 7/14/17 7/14/17 - Martin Dugas
Uploaded on
August 27, 2012
DOI
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License
Creative Commons BY-NC 3.0
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Colorectal Cancer NCT00077233 Quality of Life - CALGB: CES-D (SHORT FORM) - 2088990v3.0
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- StudyEvent: CALGB: CES-D (SHORT FORM)
Similar models
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- StudyEvent: CALGB: CES-D (SHORT FORM)
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
PatientInitials
Item
Patient Initials
text
PatientHospitalNo.
Item
Patient Hospital No.
text
Institution/Affiliate
Item
Institution/Affiliate
text
ParticipatingGroup
Item
Participating Group
text
ParticipatingGroupProtocolNo.
Item
Participating Group Protocol No.
text
ParticipatingGroupPatientID
Item
Participating Group Patient ID
text
InterviewerorCRA
Item
Interviewer or CRA
text
AssessmentNumber
Item
Assessment Number
text
CL Item
Rarely or none of the time (Rarely or none of the time)
CL Item
Some or a little of the time (Some or a little of the time)
CL Item
Occasinally or a moderate amount of time (Occasinally or a moderate amount of time)
CL Item
Most or all of the time (Most or all of the time)
CL Item
You felt depressed (blue or down) (You felt depressed (blue or down))
CL Item
Rarely or none of the time (Rarely or none of the time)
CL Item
Some or a little of the time (Some or a little of the time)
CL Item
Occasinally or a moderate amount of time (Occasinally or a moderate amount of time)
CL Item
Most or all of the time (Most or all of the time)
CL Item
Rarely or none of the time (Rarely or none of the time)
CL Item
Some or a little of the time (Some or a little of the time)
CL Item
Occasinally or a moderate amount of time (Occasinally or a moderate amount of time)
CL Item
Most or all of the time (Most or all of the time)
CL Item
Rarely or none of the time (Rarely or none of the time)
CL Item
Some or a little of the time (Some or a little of the time)
CL Item
Occasinally or a moderate amount of time (Occasinally or a moderate amount of time)
CL Item
Most or all of the time (Most or all of the time)
CL Item
Rarely or none of the time (Rarely or none of the time)
CL Item
Some or a little of the time (Some or a little of the time)
CL Item
Occasinally or a moderate amount of time (Occasinally or a moderate amount of time)
CL Item
Most or all of the time (Most or all of the time)
CL Item
Rarely or none of the time (Rarely or none of the time)
CL Item
Some or a little of the time (Some or a little of the time)
CL Item
Occasinally or a moderate amount of time (Occasinally or a moderate amount of time)
CL Item
Most or all of the time (Most or all of the time)
Item
In the past year, have you had 2 weeks or more during which you felt sad, blue, or depressed, or lost pleasure in things that you usually cared about or enjoyed?
text
Code List
In the past year, have you had 2 weeks or more during which you felt sad, blue, or depressed, or lost pleasure in things that you usually cared about or enjoyed?
CL Item
No (No)
CL Item
Yes (Yes)
Item
Have you had 2 years or more in your life when you felt depressed or sad most days, even if you felt okay sometimes? (mark one with an X)
text
Code List
Have you had 2 years or more in your life when you felt depressed or sad most days, even if you felt okay sometimes? (mark one with an X)
CL Item
No (No)
CL Item
Yes (Yes)
Item
If yes, have you felt depressed or sad much of the time in the past year?
text
CL Item
No (No)
CL Item
Yes (Yes)