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

Lien

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=BFC4896D-D687-0423-E034-0003BA12F5E7

Mots-clés

  1. 27/08/2012 27/08/2012 -
  2. 14/07/2017 14/07/2017 - Martin Dugas
Téléchargé le

27 août 2012

DOI

Pour une demande vous connecter.

Licence

Creative Commons BY-NC 3.0

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Colorectal Cancer NCT00077233 Quality of Life - CALGB: CES-D (SHORT FORM) - 2088990v3.0

No Instruction available.

  1. StudyEvent: CALGB: CES-D (SHORT FORM)
    1. No Instruction available.
Ccrr Module For Calgb: Ces-d (short Form)
Description

Ccrr Module For Calgb: Ces-d (short Form)

Patient Initials
Description

PatientInitials

Type de données

text

Patient Hospital No.
Description

PatientHospitalNo.

Type de données

text

Institution/Affiliate
Description

Institution/Affiliate

Type de données

text

Participating Group
Description

ParticipatingGroup

Type de données

text

Participating Group Protocol No.
Description

ParticipatingGroupProtocolNo.

Type de données

text

Participating Group Patient ID
Description

ParticipatingGroupPatientID

Type de données

text

Interviewer or CRA
Description

InterviewerorCRA

Type de données

text

Assessment Number
Description

AssessmentNumber

Type de données

text

You felt depressed
Description

Youfeltdepressed

Type de données

text

Your sleep was restless
Description

Yoursleepwasrestless

Type de données

text

You enjoyed life
Description

Youenjoyedlife

Type de données

text

You had bad crying spells
Description

Youhadbadcryingspells

Type de données

text

You felt sad
Description

Youfeltsad

Type de données

text

You felt that people disliked you
Description

Youfeltthatpeopledislikedyou

Type de données

text

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?
Description

Inthepastyear,haveyouhad2weeksormoreduringwhichyoufeltsad,blue,ordepressed,orlostpleasureinthingsthatyouusuallycaredaboutorenjoyed?

Type de données

text

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)
Description

Haveyouhad2yearsormoreinyourlifewhenyoufeltdepressedorsadmostdays,evenifyoufeltokaysometimes?(markonewithanX)

Type de données

text

If yes, have you felt depressed or sad much of the time in the past year?
Description

Ifyes,haveyoufeltdepressedorsadmuchofthetimeinthepastyear?

Type de données

text

Similar models

No Instruction available.

  1. StudyEvent: CALGB: CES-D (SHORT FORM)
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Type de données
Alias
Item Group
Ccrr Module For Calgb: Ces-d (short Form)
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
Item
You felt depressed
text
Code List
You felt depressed
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
Your sleep was restless
text
Code List
Your sleep was restless
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)
Item
You enjoyed life
text
Code List
You enjoyed life
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
You had bad crying spells
text
Code List
You had bad crying spells
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
You felt sad
text
Code List
You felt sad
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
You felt that people disliked you
text
Code List
You felt that people disliked you
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
Code List
If yes, have you felt depressed or sad much of the time in the past year?
CL Item
No (No)
CL Item
Yes (Yes)

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