ID

1345

Beschrijving

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

Link

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

Trefwoorden

  1. 27-08-12 27-08-12 -
  2. 14-07-17 14-07-17 - Martin Dugas
Geüploaded op

27 augustus 2012

DOI

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Licentie

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)
Beschrijving

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

Patient Initials
Beschrijving

PatientInitials

Datatype

text

Patient Hospital No.
Beschrijving

PatientHospitalNo.

Datatype

text

Institution/Affiliate
Beschrijving

Institution/Affiliate

Datatype

text

Participating Group
Beschrijving

ParticipatingGroup

Datatype

text

Participating Group Protocol No.
Beschrijving

ParticipatingGroupProtocolNo.

Datatype

text

Participating Group Patient ID
Beschrijving

ParticipatingGroupPatientID

Datatype

text

Interviewer or CRA
Beschrijving

InterviewerorCRA

Datatype

text

Assessment Number
Beschrijving

AssessmentNumber

Datatype

text

You felt depressed
Beschrijving

Youfeltdepressed

Datatype

text

Your sleep was restless
Beschrijving

Yoursleepwasrestless

Datatype

text

You enjoyed life
Beschrijving

Youenjoyedlife

Datatype

text

You had bad crying spells
Beschrijving

Youhadbadcryingspells

Datatype

text

You felt sad
Beschrijving

Youfeltsad

Datatype

text

You felt that people disliked you
Beschrijving

Youfeltthatpeopledislikedyou

Datatype

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?
Beschrijving

Inthepastyear,haveyouhad2weeksormoreduringwhichyoufeltsad,blue,ordepressed,orlostpleasureinthingsthatyouusuallycaredaboutorenjoyed?

Datatype

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)
Beschrijving

Haveyouhad2yearsormoreinyourlifewhenyoufeltdepressedorsadmostdays,evenifyoufeltokaysometimes?(markonewithanX)

Datatype

text

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

Ifyes,haveyoufeltdepressedorsadmuchofthetimeinthepastyear?

Datatype

text

Similar models

No Instruction available.

  1. StudyEvent: CALGB: CES-D (SHORT FORM)
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Datatype
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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