ID

1345

Descrizione

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

collegamento

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

Keywords

versioni (2)
  1. 27/08/12 27/08/12 -
  2. 14/07/17 14/07/17 - Martin Dugas
Caricato su

27 agosto 2012

DOI

Per favore, per richiedere un accesso.

Licenza

Creative Commons BY-NC 3.0
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Colorectal Cancer NCT00077233 Quality of Life - CALGB: CES-D (SHORT FORM) - 2088990v3.0

Inglese

No Instruction available.

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

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

Patient Initials
Descrizione

PatientInitials

Tipo di dati

text

Patient Hospital No.
Descrizione

PatientHospitalNo.

Tipo di dati

text

Institution/Affiliate
Descrizione

Institution/Affiliate

Tipo di dati

text

Participating Group
Descrizione

ParticipatingGroup

Tipo di dati

text

Participating Group Protocol No.
Descrizione

ParticipatingGroupProtocolNo.

Tipo di dati

text

Participating Group Patient ID
Descrizione

ParticipatingGroupPatientID

Tipo di dati

text

Interviewer or CRA
Descrizione

InterviewerorCRA

Tipo di dati

text

Assessment Number
Descrizione

AssessmentNumber

Tipo di dati

text

You felt depressed
Descrizione

Youfeltdepressed

Tipo di dati

text

Your sleep was restless
Descrizione

Yoursleepwasrestless

Tipo di dati

text

You enjoyed life
Descrizione

Youenjoyedlife

Tipo di dati

text

You had bad crying spells
Descrizione

Youhadbadcryingspells

Tipo di dati

text

You felt sad
Descrizione

Youfeltsad

Tipo di dati

text

You felt that people disliked you
Descrizione

Youfeltthatpeopledislikedyou

Tipo di dati

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?
Descrizione

Inthepastyear,haveyouhad2weeksormoreduringwhichyoufeltsad,blue,ordepressed,orlostpleasureinthingsthatyouusuallycaredaboutorenjoyed?

Tipo di dati

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)
Descrizione

Haveyouhad2yearsormoreinyourlifewhenyoufeltdepressedorsadmostdays,evenifyoufeltokaysometimes?(markonewithanX)

Tipo di dati

text

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

Ifyes,haveyoufeltdepressedorsadmuchofthetimeinthepastyear?

Tipo di dati

text

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Similar models

No Instruction available.

1 moduli
  1. StudyEvent: CALGB: CES-D (SHORT FORM)
    1. No Instruction available.
Name
genere
Description | Question | Decode (Coded Value)
Tipo di dati
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
CL.1
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
CL.2
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
CL.3
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
CL.4
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
CL.5
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
CL.6
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
CL.7
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
CL.8
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.9
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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