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1 forms  
  1. StudyEvent: CALGB: 80203 CHANGES IN FUNCTION FORM-Rev
    1. No Instruction available.
Ccrr Module For Calgb: 80203 Changes In Function Form-rev
Description

Ccrr Module For Calgb: 80203 Changes In Function Form-rev

Patient Initials
Description

PatientInitials

Data type

text

Patient Hospital No.
Description

PatientHospitalNo.

Data type

text

Institution/Affiliate
Description

Institution/Affiliate

Data type

text

Participating Group
Description

ParticipatingGroup

Data type

text

Participating Group Protocol No.
Description

ParticipatingGroupProtocolNo.

Data type

text

Participating Group Patient ID
Description

ParticipatingGroupPatientID

Data type

text

Interviewer or CRA
Description

InterviewerorCRA

Data type

text

Assessment Number
Description

AssessmentNumber

Data type

text

Has your physical condition gotten
Description

Hasyourphysicalconditiongotten

Data type

text

Has your emotional state gotten
Description

Hasyouremotionalstategotten

Data type

text

Has your ability to enjoy social life gotten
Description

Hasyourabilitytoenjoysociallifegotten

Data type

text

Has your overall quality of life gotten
Description

Hasyouroverallqualityoflifegotten

Data type

text

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No Instruction available.

1 forms
  1. StudyEvent: CALGB: 80203 CHANGES IN FUNCTION FORM-Rev
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Ccrr Module For Calgb: 80203 Changes In Function Form-rev
Item
Patient Initials
text
CL.1
Code List
Patient Initials
CL Item
Last (Last)
CL Item
First (First)
CL Item
Middle (Middle)
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
Item
Assessment Number
text
CL.2
Code List
Assessment Number
CL Item
7 Day (7 Day)
CL Item
30 Day (30 Day)
Item
Has your physical condition gotten
text
CL.3
Code List
Has your physical condition gotten
CL Item
Very much worse (Very much worse)
CL Item
Moderatly worse (Moderatly worse)
CL Item
A little worse (A little worse)
CL Item
About the same (About the same)
CL Item
A little better (A little better)
CL Item
Moderatly better (Moderatly better)
CL Item
Very much better (Very much better)
Item
Has your emotional state gotten
text
CL.4
Code List
Has your emotional state gotten
CL Item
Very much worse (Very much worse)
CL Item
Moderatly worse (Moderatly worse)
CL Item
A little worse (A little worse)
CL Item
About the same (About the same)
CL Item
A little better (A little better)
CL Item
Moderatly better (Moderatly better)
CL Item
Very much better (Very much better)
Item
Has your ability to enjoy social life gotten
text
CL.5
Code List
Has your ability to enjoy social life gotten
CL Item
Very much worse (Very much worse)
CL Item
Moderatly worse (Moderatly worse)
CL Item
A little worse (A little worse)
CL Item
About the same (About the same)
CL Item
A little better (A little better)
CL Item
Moderatly better (Moderatly better)
CL Item
Very much better (Very much better)
Item
Has your overall quality of life gotten
text
CL.6
Code List
Has your overall quality of life gotten
CL Item
Very much worse (Very much worse)
CL Item
Moderatly worse (Moderatly worse)
CL Item
A little worse (A little worse)
CL Item
About the same (About the same)
CL Item
A little better (A little better)
CL Item
Moderatly better (Moderatly better)
CL Item
Very much better (Very much better)
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