ID
2470
Description
ACOSOG-Z4099 USCD Shortness of Breath Form Surgery With or Without Internal Radiation Therapy Compared With Stereotactic Body Radiation Therapy in Treating Patients With High-Risk Stage I Non-Small Cell Lung Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=9869A599-BD3E-139E-E040-BB89AD432862
Lien
Mots-clés
Versions (2)
- 19/09/2012 19/09/2012 -
- 09/01/2015 09/01/2015 - Martin Dugas
Téléchargé le
19 septembre 2012
DOI
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Licence
Creative Commons BY-NC 3.0 Legacy
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Lung Cancer NCT01336894 Quality of Life - ACOSOG-Z4099 USCD Shortness of Breath Form - 3178502v1.0
Instructions: For each activity listed below, please rate your breathlessness on a scale between zero and five where 0 is not at all breathless and 5 is maximally breathless or too breathless to do the activity. If the activity is one that you do not perform, please give your best estimate of breathlessness. Your responses should be for an "average" day during the past week. Please respond to all times
- StudyEvent: ACOSOG-Z4099 USCD Shortness of Breath Form
Description
How Short Of Breath Do You Get
Description
RestBreathShortnessAssessmentScale
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Metathesaurus ObjectClass
- C0392680
- NCI Metathesaurus ObjectClass
- C0443144
Description
WalkFlatBreathShortnessAssessmentScale
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Metathesaurus ObjectClass
- C0392680
- NCI Metathesaurus ObjectClass
- C0560049
Description
WalkingBreathShortnessAssessmentScale
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Metathesaurus ObjectClass
- C0080331
- NCI Metathesaurus ObjectClass
- C0392680
Description
WalkHillBreathShortnessAssessmentScale
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Metathesaurus ObjectClass
- C0392680
- NCI Metathesaurus ObjectClass
- C0580809
Description
ClimbingStairsBreathShortnessAssessmentScale
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Metathesaurus ObjectClass
- CL299704
- NCI Metathesaurus ObjectClass
- C0392680
Description
EatingBreathShortnessAssessmentScale
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Metathesaurus ObjectClass
- C0392680
- NCI Metathesaurus ObjectClass
- C0013470
Description
StandingUpBreathShortnessAssessmentScale
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Metathesaurus ObjectClass
- C0392680
- NCI Metathesaurus ObjectClass
- C0444796
Description
ToothbrushingBreathShortnessAssessmentScale
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Metathesaurus ObjectClass
- C0392680
- NCI Thesaurus ObjectClass
- C63734
- UMLS 2011AA ObjectClass
- C0040461
Description
ShavingBreathShortnessAssessmentScale
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Metathesaurus ObjectClass
- C0392680
- NCI Metathesaurus ObjectClass
- C0522772
Description
BathingBreathShortnessAssessmentScale
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Metathesaurus ObjectClass
- C0150141
- NCI Metathesaurus ObjectClass
- C0392680
Description
DressingBreathShortnessAssessmentScale
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Metathesaurus ObjectClass
- C0392680
- NCI Metathesaurus ObjectClass
- CL313791
Description
HouseCleaningBreathShortnessAssessmentScale
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Metathesaurus ObjectClass
- C0392680
- NCI Metathesaurus ObjectClass
- C0564042
Description
KitchenBreathShortnessAssessmentScale
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Metathesaurus ObjectClass
- C0392680
- NCI Metathesaurus ObjectClass
- C0557653
Description
VacuumCleanerBreathShortnessAssessmentScale
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Metathesaurus ObjectClass
- C0392680
- NCI Metathesaurus ObjectClass
- C0392308
Description
MakeBedBreathShortnessAssessmentScale
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Metathesaurus ObjectClass
- C0392680
- NCI Metathesaurus ObjectClass
- C0564030
Description
ShoppingBreathShortnessAssessmentScale
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Metathesaurus ObjectClass
- C0392680
- NCI Metathesaurus ObjectClass
- CL112583
Description
LaundryBreathShortnessAssessmentScale
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Metathesaurus ObjectClass
- C0392680
- NCI Metathesaurus ObjectClass
- C0542293
Description
WashingBreathShortnessAssessmentScale
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Metathesaurus ObjectClass
- C0392680
- NCI Metathesaurus ObjectClass
- C0563947
Description
LawnmowerBreathShortnessAssessmentScale
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Metathesaurus ObjectClass
- C0392680
- NCI Metathesaurus ObjectClass
- C0441054
Description
WaterBreathShortnessAssessmentScale
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Metathesaurus ObjectClass
- C0597678
- NCI Metathesaurus ObjectClass
- C0392680
Description
SexualActivityBreathShortnessAssessmentScale
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Metathesaurus ObjectClass
- C0392680
- NCI Metathesaurus ObjectClass
- CL197653
Description
How Much Do These Limit Your Daily Life
Description
BreathShortnessAssessmentScale
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Metathesaurus ObjectClass
- C0392680
Description
OverexertionBreathShortnessAssessmentScale
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Metathesaurus ObjectClass
- C0392680
- NCI Metathesaurus ObjectClass
- C0301616
Description
FearBreathShortnessAssessmentScale
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Metathesaurus ObjectClass
- C0392680
- NCI Metathesaurus ObjectClass
- C0015726
Similar models
Instructions: For each activity listed below, please rate your breathlessness on a scale between zero and five where 0 is not at all breathless and 5 is maximally breathless or too breathless to do the activity. If the activity is one that you do not perform, please give your best estimate of breathlessness. Your responses should be for an "average" day during the past week. Please respond to all times
- StudyEvent: ACOSOG-Z4099 USCD Shortness of Breath Form
C0237753 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25462 (NCI Thesaurus Property)
C0700114 (UMLS 2011AA Property)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C1547383 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25536 (NCI Thesaurus Property)
C1555582 (UMLS 2011AA Property)
C0011008 (UMLS 2011AA ValueDomain)
C40988 (NCI Thesaurus ObjectClass)
C1516308 (UMLS 2011AA ObjectClass)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0392680 (NCI Metathesaurus ObjectClass)
C0443144 (NCI Metathesaurus ObjectClass)
C0205448 (UMLS 2011AA)
C0806909 (UMLS 2011AA)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0392680 (NCI Metathesaurus ObjectClass)
C0560049 (NCI Metathesaurus ObjectClass)
C0205448 (UMLS 2011AA)
C0806909 (UMLS 2011AA)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0080331 (NCI Metathesaurus ObjectClass)
C0392680 (NCI Metathesaurus ObjectClass)
C0205448 (UMLS 2011AA)
C0806909 (UMLS 2011AA)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0392680 (NCI Metathesaurus ObjectClass)
C0580809 (NCI Metathesaurus ObjectClass)
C0205448 (UMLS 2011AA)
C0806909 (UMLS 2011AA)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
CL299704 (NCI Metathesaurus ObjectClass)
C0392680 (NCI Metathesaurus ObjectClass)
C0205448 (UMLS 2011AA)
C0806909 (UMLS 2011AA)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0392680 (NCI Metathesaurus ObjectClass)
C0013470 (NCI Metathesaurus ObjectClass)
C0205448 (UMLS 2011AA)
C0806909 (UMLS 2011AA)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0392680 (NCI Metathesaurus ObjectClass)
C0444796 (NCI Metathesaurus ObjectClass)
C0205448 (UMLS 2011AA)
C0806909 (UMLS 2011AA)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0392680 (NCI Metathesaurus ObjectClass)
C63734 (NCI Thesaurus ObjectClass)
C0040461 (UMLS 2011AA ObjectClass)
C0205448 (UMLS 2011AA)
C0806909 (UMLS 2011AA)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0392680 (NCI Metathesaurus ObjectClass)
C0522772 (NCI Metathesaurus ObjectClass)
C0205448 (UMLS 2011AA)
C0806909 (UMLS 2011AA)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0150141 (NCI Metathesaurus ObjectClass)
C0392680 (NCI Metathesaurus ObjectClass)
C0205448 (UMLS 2011AA)
C0806909 (UMLS 2011AA)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0392680 (NCI Metathesaurus ObjectClass)
CL313791 (NCI Metathesaurus ObjectClass)
C0205448 (UMLS 2011AA)
C0806909 (UMLS 2011AA)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0392680 (NCI Metathesaurus ObjectClass)
C0564042 (NCI Metathesaurus ObjectClass)
C0205448 (UMLS 2011AA)
C0806909 (UMLS 2011AA)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0392680 (NCI Metathesaurus ObjectClass)
C0557653 (NCI Metathesaurus ObjectClass)
C0205448 (UMLS 2011AA)
C0806909 (UMLS 2011AA)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0392680 (NCI Metathesaurus ObjectClass)
C0392308 (NCI Metathesaurus ObjectClass)
C0205448 (UMLS 2011AA)
C0806909 (UMLS 2011AA)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0392680 (NCI Metathesaurus ObjectClass)
C0564030 (NCI Metathesaurus ObjectClass)
C0205448 (UMLS 2011AA)
C0806909 (UMLS 2011AA)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0392680 (NCI Metathesaurus ObjectClass)
CL112583 (NCI Metathesaurus ObjectClass)
C0205448 (UMLS 2011AA)
C0806909 (UMLS 2011AA)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0392680 (NCI Metathesaurus ObjectClass)
C0542293 (NCI Metathesaurus ObjectClass)
C0205448 (UMLS 2011AA)
C0806909 (UMLS 2011AA)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0392680 (NCI Metathesaurus ObjectClass)
C0563947 (NCI Metathesaurus ObjectClass)
C0205448 (UMLS 2011AA)
C0806909 (UMLS 2011AA)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0392680 (NCI Metathesaurus ObjectClass)
C0441054 (NCI Metathesaurus ObjectClass)
C0205448 (UMLS 2011AA)
C0806909 (UMLS 2011AA)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0597678 (NCI Metathesaurus ObjectClass)
C0392680 (NCI Metathesaurus ObjectClass)
C0205448 (UMLS 2011AA)
C0806909 (UMLS 2011AA)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0392680 (NCI Metathesaurus ObjectClass)
CL197653 (NCI Metathesaurus ObjectClass)
C0205448 (UMLS 2011AA)
C0806909 (UMLS 2011AA)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0392680 (NCI Metathesaurus ObjectClass)
C0205448 (UMLS 2011AA)
C0806909 (UMLS 2011AA)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0392680 (NCI Metathesaurus ObjectClass)
C0301616 (NCI Metathesaurus ObjectClass)
C0205448 (UMLS 2011AA)
C0806909 (UMLS 2011AA)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0392680 (NCI Metathesaurus ObjectClass)
C0015726 (NCI Metathesaurus ObjectClass)
C0205448 (UMLS 2011AA)
C0806909 (UMLS 2011AA)