English

PATIENT INSTRUCTIONS: By marking one box per line with an X, indicating how true each statement has been for you during the past 7 days.

1 forms  
FACT/GOG-Ntx Questionnaire
Description

FACT/GOG-Ntx Questionnaire

Alias
UMLS CUI-1
C3899177
I have numbness or tingling in my hands
Description

numbness or tingling in my hands

Data type

integer

Alias
UMLS CUI [1]
C3829780
I have numbness or tingling in my feet
Description

numbness or tingling in my feet

Data type

integer

Alias
UMLS CUI [1]
C3829781
I feel discomfort in my hands
Description

discomfort in my hands

Data type

integer

Alias
UMLS CUI [1]
C3830164
I have discomfort in my feet
Description

discomfort in my feet

Data type

integer

Alias
UMLS CUI [1]
C3475710
I have joint pain or muscle cramps
Description

joint pain or muscle cramps

Data type

integer

Alias
UMLS CUI [1]
C3475885
I feel weak all over
Description

feel weak

Data type

integer

Alias
UMLS CUI [1]
C3274923
I have trouble hearing
Description

trouble hearing

Data type

integer

Alias
UMLS CUI [1]
C3475949
I get ringing or buzzing in my ears
Description

ringing or buzzing in my ears

Data type

integer

Alias
UMLS CUI [1]
C3475771
I have trouble buttoning buttons
Description

trouble buttoning buttons

Data type

integer

Alias
UMLS CUI [1]
C3829762
I have trouble feeling the shape of small objects when they are in my hand.
Description

trouble feeling the shape of small objects

Data type

integer

Alias
UMLS CUI [1]
C3475944
I have trouble walking
Description

trouble walking

Data type

integer

Alias
UMLS CUI [1]
C3475963
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Similar models

PATIENT INSTRUCTIONS: By marking one box per line with an X, indicating how true each statement has been for you during the past 7 days.

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
FACT/GOG-Ntx Questionnaire
C3899177 (UMLS CUI-1)
Item
I have numbness or tingling in my hands
integer
C3829780 (UMLS CUI [1])
CL.2
Code List
I have numbness or tingling in my hands
CL Item
Not at all (1)
C2984077 (UMLS CUI-1)
CL Item
A little bit (2)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (3)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (4)
C2984080 (UMLS CUI-1)
CL Item
Very much (5)
C2984081 (UMLS CUI-1)
Item
I have numbness or tingling in my feet
integer
C3829781 (UMLS CUI [1])
CL.2
Code List
I have numbness or tingling in my feet
CL Item
Not at all (1)
C2984077 (UMLS CUI-1)
CL Item
A little bit (2)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (3)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (4)
C2984080 (UMLS CUI-1)
CL Item
Very much (5)
C2984081 (UMLS CUI-1)
Item
I feel discomfort in my hands
integer
C3830164 (UMLS CUI [1])
CL.2
Code List
I feel discomfort in my hands
CL Item
Not at all (1)
C2984077 (UMLS CUI-1)
CL Item
A little bit (2)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (3)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (4)
C2984080 (UMLS CUI-1)
CL Item
Very much (5)
C2984081 (UMLS CUI-1)
Item
I have discomfort in my feet
integer
C3475710 (UMLS CUI [1])
CL.2
Code List
I have discomfort in my feet
CL Item
Not at all (1)
C2984077 (UMLS CUI-1)
CL Item
A little bit (2)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (3)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (4)
C2984080 (UMLS CUI-1)
CL Item
Very much (5)
C2984081 (UMLS CUI-1)
Item
I have joint pain or muscle cramps
integer
C3475885 (UMLS CUI [1])
CL.2
Code List
I have joint pain or muscle cramps
CL Item
Not at all (1)
C2984077 (UMLS CUI-1)
CL Item
A little bit (2)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (3)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (4)
C2984080 (UMLS CUI-1)
CL Item
Very much (5)
C2984081 (UMLS CUI-1)
Item
I feel weak all over
integer
C3274923 (UMLS CUI [1])
CL.2
Code List
I feel weak all over
CL Item
Not at all (1)
C2984077 (UMLS CUI-1)
CL Item
A little bit (2)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (3)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (4)
C2984080 (UMLS CUI-1)
CL Item
Very much (5)
C2984081 (UMLS CUI-1)
Item
I have trouble hearing
integer
C3475949 (UMLS CUI [1])
CL.2
Code List
I have trouble hearing
CL Item
Not at all (1)
C2984077 (UMLS CUI-1)
CL Item
A little bit (2)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (3)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (4)
C2984080 (UMLS CUI-1)
CL Item
Very much (5)
C2984081 (UMLS CUI-1)
Item
I get ringing or buzzing in my ears
integer
C3475771 (UMLS CUI [1])
CL.2
Code List
I get ringing or buzzing in my ears
CL Item
Not at all (1)
C2984077 (UMLS CUI-1)
CL Item
A little bit (2)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (3)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (4)
C2984080 (UMLS CUI-1)
CL Item
Very much (5)
C2984081 (UMLS CUI-1)
Item
I have trouble buttoning buttons
integer
C3829762 (UMLS CUI [1])
CL.2
Code List
I have trouble buttoning buttons
CL Item
Not at all (1)
C2984077 (UMLS CUI-1)
CL Item
A little bit (2)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (3)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (4)
C2984080 (UMLS CUI-1)
CL Item
Very much (5)
C2984081 (UMLS CUI-1)
Item
I have trouble feeling the shape of small objects when they are in my hand.
integer
C3475944 (UMLS CUI [1])
CL.2
Code List
I have trouble feeling the shape of small objects when they are in my hand.
CL Item
Not at all (1)
C2984077 (UMLS CUI-1)
CL Item
A little bit (2)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (3)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (4)
C2984080 (UMLS CUI-1)
CL Item
Very much (5)
C2984081 (UMLS CUI-1)
Item
I have trouble walking
integer
C3475963 (UMLS CUI [1])
CL.2
Code List
I have trouble walking
CL Item
Not at all (1)
C2984077 (UMLS CUI-1)
CL Item
A little bit (2)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (3)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (4)
C2984080 (UMLS CUI-1)
CL Item
Very much (5)
C2984081 (UMLS CUI-1)
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