ID

33137

Descripción

ADVANCED PROSTATE CANCER DATA COLLECTION Version 2.3.1 Revised: April 10th, 2017 International Consortium for Health Outcomes Measurement (ICHOM), Source: http://www.ichom.org/ Conditions: All patients with advanced prostate cancer, either having metastatic disease or biochemical recurrence progressing after salvage treatment or ineligible for salvage treatment. Patients with biochemical recurrence treated with salvage therapy are referred to the localized prostate cancer set. Treatment Approaches: Hormonal Therapy | Chemotherapy | Immunotherapy | Radiopharmaceuticals | Radiation | Interventions for Complications of Local Progression This form contains patient-reported outcome variables. To be assessed 6 months and 1 year post (initial) treatment and annually for life from then on. Questionnaires used in this form: Expanded Prostate Cancer Index Composite (EPIC-26): The EPIC-26 is free for all health care organizations, and a license is not needed. The scoring guide may be found at http://www.med.umich.edu/urology/research/EPIC/EPIC-26-Scoring-1.2007.pdf ; Wei J, Dunn R, Litwin M, Sandler H, and Sanda M. "Development and Validation of the Expanded Prostate Cancer Index Composite (EPIC) for Comprehensive Assessment of Health-Related Quality of Life in Men with Prostate Cancer", Urology. 56: 899-905, 2000. For registries choosing to implement the EPIC‐CP rather than the EPIC‐26, we recommend using the same variable IDs as the corresponding EPIC‐26 questions. This means that only questions 2, 3, 4a, 4b, 4d, 4e, 5, 6e, 6b, 7, 8b, 9, 12, 13a, 13c, and 13d of the EPIC-26 are administered. Utilization of Sexual Medications/Devices: The Utilization of Sexual Medications/Devices is free for all health care organizations, and a license is not needed (according to ICHOM). Refer to http://dx.doi.org/10.1016/j.urology.2006.01.077 for more information European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30): For use of the EORTC QLQ-C30 a license is needed, therefore the questions will not be part of this version of the standard set. (eortc.be) The following paper has been published about development of this standard set: Morgans AK, van Bommel ACM, Stowell C, Abrahm JL, Basch E, Bekelman JE, et al. Development of a Standardized Set of Patient-centered Outcomes for Advanced Prostate Cancer: An International Effort for a Unified Approach. Eur Urol. 2015 Nov;68(5):891–8. For the standard set ICHOM has been supported by the Movember Foundation.

Link

http://www.ichom.org/

Palabras clave

  1. 29/11/18 29/11/18 - Sarah Riepenhausen
  2. 30/4/20 30/4/20 - Sarah Riepenhausen
Titular de derechos de autor

ICHOM

Subido en

29 de noviembre de 2018

DOI

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Licencia

Creative Commons BY-NC 3.0

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ICHOM Advanced Prostate Cancer

Follow-Up Patient-reported Form

Administrative Data
Descripción

Administrative Data

Alias
UMLS CUI-1
C1320722
Indicate the patient's medical record number
Descripción

This number will not be shared with ICHOM. In the case patient-level data is submitted to ICHOM for benchmarking or research purposes, a separate ICHOM Patient Identifier will be created and cross-linking between the ICHOM Patient Identifier and the medical record number will only be known at the treating institution INCLUSION CRITERIA: All patients TIMING: On all forms REPORTING SOURCE: Administrative or clinical RESPONSE OPTIONS: According to institution

Tipo de datos

integer

Alias
UMLS CUI [1]
C1269815
Time Relative to Baseline (e.g. Baseline, 6 months follow-up, 1 year follow-up, ...)
Descripción

This Item does not exist in the original standard set, instead it is asked to do the following: Please timestamp all variables. Some Standard Set variables are collected at multiple timepoints, and we will ask you to submit these variables in a concatenated VARIABLEID_TIMESTAMP form for future analyses. For example, VARIABLEID_BASE (baseline); VARIABLEID_6MO (6 month follow-up); VARIABLEID_1YR (1 year follow-up), etc.

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0439564
UMLS CUI [1,2]
C1442488
Degree of health
Descripción

Degree of health

Alias
UMLS CUI-1
C0018759
Use of over-the-counter pain medicine or strong pain medicine 0 = No
Descripción

Over the counter pain medicine is for example paracetamol, NSAIDS INCLUSION CRITERIA: All patients TIMING: Baseline, 3 months post initiation of treatment, 6 months post initiation of treatment, 1 year post initiation of treatment, Tracked ongoing annually for life REPORTING SOURCE: Patient-reported TYPE: Multiple answer

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0002771
UMLS CUI [1,2]
C1298908
Use of over-the-counter pain medicine or strong pain medicine 1 = Yes, over the counter or non-prescription pain medication
Descripción

Over the counter pain medicine is for example paracetamol, NSAIDS INCLUSION CRITERIA: All patients TIMING: Baseline, 3 months post initiation of treatment, 6 months post initiation of treatment, 1 year post initiation of treatment, Tracked ongoing annually for life REPORTING SOURCE: Patient-reported TYPE: Multiple answer

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0002771
UMLS CUI [1,2]
C2709201
UMLS CUI [2,1]
C0002771
UMLS CUI [2,2]
C0013231
Use of over-the-counter pain medicine or strong pain medicine 2 = Yes, prescription pain medications (opioid or narcotic medications)
Descripción

Over the counter pain medicine is for example paracetamol, NSAIDS INCLUSION CRITERIA: All patients TIMING: Baseline, 3 months post initiation of treatment, 6 months post initiation of treatment, 1 year post initiation of treatment, Tracked ongoing annually for life REPORTING SOURCE: Patient-reported TYPE: Multiple answer

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0002771
UMLS CUI [1,2]
C0304227
UMLS CUI [2]
C0027409
UMLS CUI [3]
C0002772
EORTC QLQ-C30 Total Score
Descripción

As a license is needed for use of this questionnaire, the 30 actual questions are not included in this version of the standard set. ICHOM IDs are EORTCQLQC30_Q01 up to EORTCQLQC30_Q30. INCLUSION CRITERIA: All patients TIMING: Baseline, 30 days + annually up to 5 years after index event REPORTING SOURCE: Patient-reported TYPE: Numerical (each question is single answer in original set)

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C4055104
UMLS CUI [1,2]
C2964552
This questionnaire is designed to measure Quality of Life issues in patients with Prostate cancer. To help us get the most accurate measurement, it is important that you answer all questions honestly and completely. Remember, as with all medical records, information contained within this survey will remain strictly confidential. 1: Over the past 4 weeks, how often have you leaked urine?
Descripción

INCLUSION CRITERIA: All patients TIMING: Baseline, 3 months post initiation of treatment, 6 months post initiation of treatment, 1 year post initiation of treatment, Tracked ongoing annually for life REPORTING SOURCE: Patient-reported TYPE: Single answer

Tipo de datos

integer

Alias
UMLS CUI [1]
C4289637
2: Which of the following best describes your urinary control during the last 4 weeks?
Descripción

INCLUSION CRITERIA: All patients TIMING: Baseline, 3 months post initiation of treatment, 6 months post initiation of treatment, 1 year post initiation of treatment, Tracked ongoing annually for life REPORTING SOURCE: Patient-reported TYPE: Single answer

Tipo de datos

integer

Alias
UMLS CUI [1]
C4289645
3: How many pads or adult diapers per day did you usually use to control leakage during the last 4 weeks?
Descripción

INCLUSION CRITERIA: All patients TIMING: Baseline, 3 months post initiation of treatment, 6 months post initiation of treatment, 1 year post initiation of treatment, Tracked ongoing annually for life REPORTING SOURCE: Patient-reported TYPE: Single answer

Tipo de datos

integer

Alias
UMLS CUI [1]
C4289630
4a: How big a problem, if any, has the following been for you during the last 4 weeks? Dripping or leaking urine
Descripción

INCLUSION CRITERIA: All patients TIMING: Baseline, 3 months post initiation of treatment, 6 months post initiation of treatment, 1 year post initiation of treatment, Tracked ongoing annually for life REPORTING SOURCE: Patient-reported TYPE: Single answer

Tipo de datos

integer

Alias
UMLS CUI [1]
C4289641
4b: Pain or burning on urination
Descripción

INCLUSION CRITERIA: All patients TIMING: Baseline, 3 months post initiation of treatment, 6 months post initiation of treatment, 1 year post initiation of treatment, Tracked ongoing annually for life REPORTING SOURCE: Patient-reported TYPE: Single answer

Tipo de datos

integer

Alias
UMLS CUI [1]
C4289629
4c: Bleeding with urination
Descripción

INCLUSION CRITERIA: All patients TIMING: Baseline, 3 months post initiation of treatment, 6 months post initiation of treatment, 1 year post initiation of treatment, Tracked ongoing annually for life REPORTING SOURCE: Patient-reported TYPE: Single answer

Tipo de datos

integer

Alias
UMLS CUI [1]
C4289644
4d: Weak urine stream or incomplete emptying
Descripción

INCLUSION CRITERIA: All patients TIMING: Baseline, 3 months post initiation of treatment, 6 months post initiation of treatment, 1 year post initiation of treatment, Tracked ongoing annually for life REPORTING SOURCE: Patient-reported TYPE: Single answer

Tipo de datos

integer

Alias
UMLS CUI [1]
C4289625
4e: Need to urinate frequently during the day
Descripción

INCLUSION CRITERIA: All patients TIMING: Baseline, 3 months post initiation of treatment, 6 months post initiation of treatment, 1 year post initiation of treatment, Tracked ongoing annually for life REPORTING SOURCE: Patient-reported TYPE: Single answer

Tipo de datos

integer

Alias
UMLS CUI [1]
C4289626
5: Overall, how big a problem has your urinary function been for you during the last 4 weeks?
Descripción

INCLUSION CRITERIA: All patients TIMING: Baseline, 3 months post initiation of treatment, 6 months post initiation of treatment, 1 year post initiation of treatment, Tracked ongoing annually for life REPORTING SOURCE: Patient-reported TYPE: Single answer

Tipo de datos

integer

Alias
UMLS CUI [1]
C4289631
6a: How big a problem, if any, has the following been for you? Urgency to have a bowel movement
Descripción

INCLUSION CRITERIA: All patients TIMING: Baseline, 3 months post initiation of treatment, 6 months post initiation of treatment, 1 year post initiation of treatment, Tracked ongoing annually for life REPORTING SOURCE: Patient-reported TYPE: Single answer

Tipo de datos

integer

Alias
UMLS CUI [1]
C4289627
6b: Increased frequency of bowel movements
Descripción

INCLUSION CRITERIA: All patients TIMING: Baseline, 3 months post initiation of treatment, 6 months post initiation of treatment, 1 year post initiation of treatment, Tracked ongoing annually for life REPORTING SOURCE: Patient-reported TYPE: Single answer

Tipo de datos

integer

Alias
UMLS CUI [1]
C4289636
6c: Losing control of your stools
Descripción

INCLUSION CRITERIA: All patients TIMING: Baseline, 3 months post initiation of treatment, 6 months post initiation of treatment, 1 year post initiation of treatment, Tracked ongoing annually for life REPORTING SOURCE: Patient-reported TYPE: Single answer

Tipo de datos

integer

Alias
UMLS CUI [1]
C4289634
6d: Bloody stools
Descripción

INCLUSION CRITERIA: All patients TIMING: Baseline, 3 months post initiation of treatment, 6 months post initiation of treatment, 1 year post initiation of treatment, Tracked ongoing annually for life REPORTING SOURCE: Patient-reported TYPE: Single answer

Tipo de datos

integer

Alias
UMLS CUI [1]
C4287870
6e: Abdominal/Pelvic/Rectal pain
Descripción

INCLUSION CRITERIA: All patients TIMING: Baseline, 3 months post initiation of treatment, 6 months post initiation of treatment, 1 year post initiation of treatment, Tracked ongoing annually for life REPORTING SOURCE: Patient-reported TYPE: Single answer

Tipo de datos

integer

Alias
UMLS CUI [1]
C4289649
7: Overall, how big a problem have your bowel habits been for you during the last 4 weeks?
Descripción

INCLUSION CRITERIA: All patients TIMING: Baseline, 3 months post initiation of treatment, 6 months post initiation of treatment, 1 year post initiation of treatment, Tracked ongoing annually for life REPORTING SOURCE: Patient-reported TYPE: Single answer

Tipo de datos

integer

Alias
UMLS CUI [1]
C4289633
8a: How would you rate the following during the last 4 weeks? Your ability to have an erection?
Descripción

INCLUSION CRITERIA: All patients TIMING: Baseline, 3 months post initiation of treatment, 6 months post initiation of treatment, 1 year post initiation of treatment, Tracked ongoing annually for life REPORTING SOURCE: Patient-reported TYPE: Single answer

Tipo de datos

integer

Alias
UMLS CUI [1]
C4289647
8b: Your ability to reach orgasm (climax)?
Descripción

INCLUSION CRITERIA: All patients TIMING: Baseline, 3 months post initiation of treatment, 6 months post initiation of treatment, 1 year post initiation of treatment, Tracked ongoing annually for life REPORTING SOURCE: Patient-reported TYPE: Single answer

Tipo de datos

integer

Alias
UMLS CUI [1]
C4289646
9: How would you describe the usual QUALITY of your erections during the last 4 weeks?
Descripción

INCLUSION CRITERIA: All patients TIMING: Baseline, 3 months post initiation of treatment, 6 months post initiation of treatment, 1 year post initiation of treatment, Tracked ongoing annually for life REPORTING SOURCE: Patient-reported TYPE: Single answer

Tipo de datos

integer

Alias
UMLS CUI [1]
C4289628
10: How would you describe the FREQUENCY of your erections during the last 4 weeks?
Descripción

INCLUSION CRITERIA: All patients TIMING: Baseline, 3 months post initiation of treatment, 6 months post initiation of treatment, 1 year post initiation of treatment, Tracked ongoing annually for life REPORTING SOURCE: Patient-reported TYPE: Single answer

Tipo de datos

integer

Alias
UMLS CUI [1]
C4289639
11: Overall, how would you rate your ability to function sexually during the last 4 weeks?
Descripción

INCLUSION CRITERIA: All patients TIMING: Baseline, 3 months post initiation of treatment, 6 months post initiation of treatment, 1 year post initiation of treatment, Tracked ongoing annually for life REPORTING SOURCE: Patient-reported TYPE: Single answer

Tipo de datos

integer

Alias
UMLS CUI [1]
C4289648
12: Overall, how big a problem has your sexual function or lack of sexual function been for you during the last 4 weeks?
Descripción

INCLUSION CRITERIA: All patients TIMING: Baseline, 3 months post initiation of treatment, 6 months post initiation of treatment, 1 year post initiation of treatment, Tracked ongoing annually for life REPORTING SOURCE: Patient-reported TYPE: Single answer

Tipo de datos

integer

Alias
UMLS CUI [1]
C4289632
13a: How big a problem during the last 4 weeks, if any, has the following been for you? Hot flashes
Descripción

INCLUSION CRITERIA: All patients TIMING: Baseline, 3 months post initiation of treatment, 6 months post initiation of treatment, 1 year post initiation of treatment, Tracked ongoing annually for life REPORTING SOURCE: Patient-reported TYPE: Single answer

Tipo de datos

integer

Alias
UMLS CUI [1]
C4289638
13b: Breast tenderness/enlargement
Descripción

INCLUSION CRITERIA: All patients TIMING: Baseline, 3 months post initiation of treatment, 6 months post initiation of treatment, 1 year post initiation of treatment, Tracked ongoing annually for life REPORTING SOURCE: Patient-reported TYPE: Single answer

Tipo de datos

integer

Alias
UMLS CUI [1]
C4289643
13c: Feeling depressed
Descripción

INCLUSION CRITERIA: All patients TIMING: Baseline, 3 months post initiation of treatment, 6 months post initiation of treatment, 1 year post initiation of treatment, Tracked ongoing annually for life REPORTING SOURCE: Patient-reported TYPE: Single answer

Tipo de datos

integer

Alias
UMLS CUI [1]
C4289640
13d: Lack of energy
Descripción

INCLUSION CRITERIA: All patients TIMING: Baseline, 3 months post initiation of treatment, 6 months post initiation of treatment, 1 year post initiation of treatment, Tracked ongoing annually for life REPORTING SOURCE: Patient-reported TYPE: Single answer

Tipo de datos

integer

Alias
UMLS CUI [1]
C4289635
13e: Change in body weight
Descripción

INCLUSION CRITERIA: All patients TIMING: Baseline, 3 months post initiation of treatment, 6 months post initiation of treatment, 1 year post initiation of treatment, Tracked ongoing annually for life REPORTING SOURCE: Patient-reported TYPE: Single answer

Tipo de datos

integer

Alias
UMLS CUI [1]
C4289642
During the last 4 weeks, to what extent were you interested in sex?
Descripción

INCLUSION CRITERIA: All patients TIMING: Baseline, 3 months post initiation of treatment, 6 months post initiation of treatment, 1 year post initiation of treatment, Tracked ongoing annually for life REPORTING SOURCE: Patient-reported TYPE: Single answer

Tipo de datos

integer

Alias
UMLS CUI [1]
C3899191
Have you used any medications or devices to aid or improve erections?
Descripción

INCLUSION CRITERIA: All patients TIMING: Baseline, 3 months post initiation of treatment, 6 months post initiation of treatment, 1 year post initiation of treatment, Tracked ongoing annually for life REPORTING SOURCE: Patient-reported TYPE: Single answer

Tipo de datos

integer

Alias
UMLS CUI [1]
C3827672
For each of the following medicines or devices, please indicate whether or not you have tried or currently use it to improve your erections: Viagra or another pill
Descripción

INCLUSION CRITERIA: All patients, If answered 'yes' to using medications or devices to aid or improve erections (LIBID_Q02) TIMING: Baseline, 3 months post initiation of treatment, 6 months post initiation of treatment, 1 year post initiation of treatment, Tracked ongoing annually for life REPORTING SOURCE: Patient-reported TYPE: Single answer

Tipo de datos

integer

Alias
UMLS CUI [1]
C0663448
Muse (intra-urethral alprostadil suppository)
Descripción

INCLUSION CRITERIA: All patients, If answered 'yes' to using medications or devices to aid or improve erections (LIBID_Q02) TIMING: Baseline, 3 months post initiation of treatment, 6 months post initiation of treatment, 1 year post initiation of treatment, Tracked ongoing annually for life REPORTING SOURCE: Patient-reported TYPE: Single answer

Tipo de datos

integer

Alias
UMLS CUI [1]
C2366566
Penile injection therapy (such as caverject)
Descripción

INCLUSION CRITERIA: All patients, If answered 'yes' to using medications or devices to aid or improve erections (LIBID_Q02) TIMING: Baseline, 3 months post initiation of treatment, 6 months post initiation of treatment, 1 year post initiation of treatment, Tracked ongoing annually for life REPORTING SOURCE: Patient-reported TYPE: Single answer

Tipo de datos

integer

Alias
UMLS CUI [1]
C3828613
Vacuum erection device (such as erect-aid)
Descripción

INCLUSION CRITERIA: All patients, If answered 'yes' to using medications or devices to aid or improve erections (LIBID_Q02) TIMING: Baseline, 3 months post initiation of treatment, 6 months post initiation of treatment, 1 year post initiation of treatment, Tracked ongoing annually for life REPORTING SOURCE: Patient-reported TYPE: Single answer

Tipo de datos

integer

Alias
UMLS CUI [1]
C3827672
Other medication/device
Descripción

INCLUSION CRITERIA: All patients, If answered 'yes' to using medications or devices to aid or improve erections (LIBID_Q02) TIMING: Baseline, 3 months post initiation of treatment, 6 months post initiation of treatment, 1 year post initiation of treatment, Tracked ongoing annually for life REPORTING SOURCE: Patient-reported TYPE: Single answer

Tipo de datos

integer

Alias
UMLS CUI [1]
C1115771

Similar models

Follow-Up Patient-reported Form

Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
Administrative Data
C1320722 (UMLS CUI-1)
Patient ID
Item
Indicate the patient's medical record number
integer
C1269815 (UMLS CUI [1])
Time Relative to Baseline
Item
Time Relative to Baseline (e.g. Baseline, 6 months follow-up, 1 year follow-up, ...)
text
C0439564 (UMLS CUI [1,1])
C1442488 (UMLS CUI [1,2])
Item Group
Degree of health
C0018759 (UMLS CUI-1)
Pain medication use: No
Item
Use of over-the-counter pain medicine or strong pain medicine 0 = No
boolean
C0002771 (UMLS CUI [1,1])
C1298908 (UMLS CUI [1,2])
Pain medication use: Over the counter or non-prescription
Item
Use of over-the-counter pain medicine or strong pain medicine 1 = Yes, over the counter or non-prescription pain medication
boolean
C0002771 (UMLS CUI [1,1])
C2709201 (UMLS CUI [1,2])
C0002771 (UMLS CUI [2,1])
C0013231 (UMLS CUI [2,2])
Pain medication use: Prescription, opioid, narcotic
Item
Use of over-the-counter pain medicine or strong pain medicine 2 = Yes, prescription pain medications (opioid or narcotic medications)
boolean
C0002771 (UMLS CUI [1,1])
C0304227 (UMLS CUI [1,2])
C0027409 (UMLS CUI [2])
C0002772 (UMLS CUI [3])
EORTC QLQ-C30 Total Score
Item
EORTC QLQ-C30 Total Score
integer
C4055104 (UMLS CUI [1,1])
C2964552 (UMLS CUI [1,2])
Item
This questionnaire is designed to measure Quality of Life issues in patients with Prostate cancer. To help us get the most accurate measurement, it is important that you answer all questions honestly and completely. Remember, as with all medical records, information contained within this survey will remain strictly confidential. 1: Over the past 4 weeks, how often have you leaked urine?
integer
C4289637 (UMLS CUI [1])
Code List
This questionnaire is designed to measure Quality of Life issues in patients with Prostate cancer. To help us get the most accurate measurement, it is important that you answer all questions honestly and completely. Remember, as with all medical records, information contained within this survey will remain strictly confidential. 1: Over the past 4 weeks, how often have you leaked urine?
CL Item
More than once a day (1)
C3853132 (UMLS CUI-1)
(Comment:en)
CL Item
About once a day (2)
C3843680 (UMLS CUI-1)
(Comment:en)
CL Item
More than once a week (3)
C0439093 (UMLS CUI-1)
C0558293 (UMLS CUI-2)
(Comment:en)
CL Item
About once a week (4)
C3900130 (UMLS CUI-1)
(Comment:en)
CL Item
Rarely or never (5)
C3843074 (UMLS CUI-1)
C2003901 (UMLS CUI-2)
(Comment:en)
Item
2: Which of the following best describes your urinary control during the last 4 weeks?
integer
C4289645 (UMLS CUI [1])
Code List
2: Which of the following best describes your urinary control during the last 4 weeks?
CL Item
No urinary control whatsoever (1)
C4528708 (UMLS CUI-1)
(Comment:en)
CL Item
Frequent dribbling (2)
C4527381 (UMLS CUI-1)
(Comment:en)
CL Item
Occasional dribbling (3)
C4527382 (UMLS CUI-1)
(Comment:en)
CL Item
Total control (4)
C4527383 (UMLS CUI-1)
(Comment:en)
Item
3: How many pads or adult diapers per day did you usually use to control leakage during the last 4 weeks?
integer
C4289630 (UMLS CUI [1])
Code List
3: How many pads or adult diapers per day did you usually use to control leakage during the last 4 weeks?
CL Item
1 pad per day (1)
C4527378 (UMLS CUI-1)
(Comment:en)
CL Item
2 pads per day (2)
C4527379 (UMLS CUI-1)
(Comment:en)
CL Item
3 or more pads per day (3)
C4527380 (UMLS CUI-1)
(Comment:en)
CL Item
None (0)
C0549184 (UMLS CUI-1)
(Comment:en)
Item
4a: How big a problem, if any, has the following been for you during the last 4 weeks? Dripping or leaking urine
integer
C4289641 (UMLS CUI [1])
Code List
4a: How big a problem, if any, has the following been for you during the last 4 weeks? Dripping or leaking urine
CL Item
Very small problem (1)
C0033213 (UMLS CUI-1)
C0442811 (UMLS CUI-2)
(Comment:en)
CL Item
Small problem (2)
C0033213 (UMLS CUI-1)
C0700321 (UMLS CUI-2)
(Comment:en)
CL Item
Moderate problem (3)
C0033213 (UMLS CUI-1)
C0205081 (UMLS CUI-2)
(Comment:en)
CL Item
No problem (0)
C0033213 (UMLS CUI-1)
C1298908 (UMLS CUI-2)
(Comment:en)
CL Item
Big problem (4)
C0033213 (UMLS CUI-1)
C0549177 (UMLS CUI-2)
(Comment:en)
Item
4b: Pain or burning on urination
integer
C4289629 (UMLS CUI [1])
Code List
4b: Pain or burning on urination
CL Item
Very small problem (1)
C0033213 (UMLS CUI-1)
C0442811 (UMLS CUI-2)
(Comment:en)
CL Item
Small problem (2)
C0033213 (UMLS CUI-1)
C0700321 (UMLS CUI-2)
(Comment:en)
CL Item
Moderate problem (3)
C0033213 (UMLS CUI-1)
C0205081 (UMLS CUI-2)
(Comment:en)
CL Item
No problem (0)
C0033213 (UMLS CUI-1)
C1298908 (UMLS CUI-2)
(Comment:en)
CL Item
Big problem (4)
C0033213 (UMLS CUI-1)
C0549177 (UMLS CUI-2)
(Comment:en)
Item
4c: Bleeding with urination
integer
C4289644 (UMLS CUI [1])
Code List
4c: Bleeding with urination
CL Item
Very small problem (1)
C0033213 (UMLS CUI-1)
C0442811 (UMLS CUI-2)
(Comment:en)
CL Item
Small problem (2)
C0033213 (UMLS CUI-1)
C0700321 (UMLS CUI-2)
(Comment:en)
CL Item
Moderate problem (3)
C0033213 (UMLS CUI-1)
C0205081 (UMLS CUI-2)
(Comment:en)
CL Item
No problem (0)
C0033213 (UMLS CUI-1)
C1298908 (UMLS CUI-2)
(Comment:en)
CL Item
Big problem (4)
C0033213 (UMLS CUI-1)
C0549177 (UMLS CUI-2)
(Comment:en)
Item
4d: Weak urine stream or incomplete emptying
integer
C4289625 (UMLS CUI [1])
Code List
4d: Weak urine stream or incomplete emptying
CL Item
Very small problem (1)
C0033213 (UMLS CUI-1)
C0442811 (UMLS CUI-2)
(Comment:en)
CL Item
Small problem (2)
C0033213 (UMLS CUI-1)
C0700321 (UMLS CUI-2)
(Comment:en)
CL Item
Moderate problem (3)
C0033213 (UMLS CUI-1)
C0205081 (UMLS CUI-2)
(Comment:en)
CL Item
No problem (0)
C0033213 (UMLS CUI-1)
C1298908 (UMLS CUI-2)
(Comment:en)
CL Item
Big problem (4)
C0033213 (UMLS CUI-1)
C0549177 (UMLS CUI-2)
(Comment:en)
Item
4e: Need to urinate frequently during the day
integer
C4289626 (UMLS CUI [1])
Code List
4e: Need to urinate frequently during the day
CL Item
Very small problem (1)
C0033213 (UMLS CUI-1)
C0442811 (UMLS CUI-2)
(Comment:en)
CL Item
Small problem (2)
C0033213 (UMLS CUI-1)
C0700321 (UMLS CUI-2)
(Comment:en)
CL Item
Moderate problem (3)
C0033213 (UMLS CUI-1)
C0205081 (UMLS CUI-2)
(Comment:en)
CL Item
No problem (0)
C0033213 (UMLS CUI-1)
C1298908 (UMLS CUI-2)
(Comment:en)
CL Item
Big problem (4)
C0033213 (UMLS CUI-1)
C0549177 (UMLS CUI-2)
(Comment:en)
Item
5: Overall, how big a problem has your urinary function been for you during the last 4 weeks?
integer
C4289631 (UMLS CUI [1])
Code List
5: Overall, how big a problem has your urinary function been for you during the last 4 weeks?
CL Item
Very small problem (1)
C0033213 (UMLS CUI-1)
C0442811 (UMLS CUI-2)
(Comment:en)
CL Item
Small problem (2)
C0033213 (UMLS CUI-1)
C0700321 (UMLS CUI-2)
(Comment:en)
CL Item
Moderate problem (3)
C0033213 (UMLS CUI-1)
C0205081 (UMLS CUI-2)
(Comment:en)
CL Item
No problem (0)
C0033213 (UMLS CUI-1)
C1298908 (UMLS CUI-2)
(Comment:en)
CL Item
Big problem (4)
C0033213 (UMLS CUI-1)
C0549177 (UMLS CUI-2)
(Comment:en)
Item
6a: How big a problem, if any, has the following been for you? Urgency to have a bowel movement
integer
C4289627 (UMLS CUI [1])
Code List
6a: How big a problem, if any, has the following been for you? Urgency to have a bowel movement
CL Item
Very small problem (1)
C0033213 (UMLS CUI-1)
C0442811 (UMLS CUI-2)
(Comment:en)
CL Item
Small problem (2)
C0033213 (UMLS CUI-1)
C0700321 (UMLS CUI-2)
(Comment:en)
CL Item
Moderate problem (3)
C0033213 (UMLS CUI-1)
C0205081 (UMLS CUI-2)
(Comment:en)
CL Item
No problem (0)
C0033213 (UMLS CUI-1)
C1298908 (UMLS CUI-2)
(Comment:en)
CL Item
Big problem (4)
C0033213 (UMLS CUI-1)
C0549177 (UMLS CUI-2)
(Comment:en)
Item
6b: Increased frequency of bowel movements
integer
C4289636 (UMLS CUI [1])
Code List
6b: Increased frequency of bowel movements
CL Item
Very small problem (1)
C0033213 (UMLS CUI-1)
C0442811 (UMLS CUI-2)
(Comment:en)
CL Item
Small problem (2)
C0033213 (UMLS CUI-1)
C0700321 (UMLS CUI-2)
(Comment:en)
CL Item
Moderate problem (3)
C0033213 (UMLS CUI-1)
C0205081 (UMLS CUI-2)
(Comment:en)
CL Item
No problem (0)
C0033213 (UMLS CUI-1)
C1298908 (UMLS CUI-2)
(Comment:en)
CL Item
Big problem (4)
C0033213 (UMLS CUI-1)
C0549177 (UMLS CUI-2)
(Comment:en)
Item
6c: Losing control of your stools
integer
C4289634 (UMLS CUI [1])
Code List
6c: Losing control of your stools
CL Item
Very small problem (1)
C0033213 (UMLS CUI-1)
C0442811 (UMLS CUI-2)
(Comment:en)
CL Item
Small problem (2)
C0033213 (UMLS CUI-1)
C0700321 (UMLS CUI-2)
(Comment:en)
CL Item
Moderate problem (3)
C0033213 (UMLS CUI-1)
C0205081 (UMLS CUI-2)
(Comment:en)
CL Item
No problem (0)
C0033213 (UMLS CUI-1)
C1298908 (UMLS CUI-2)
(Comment:en)
CL Item
Big problem (4)
C0033213 (UMLS CUI-1)
C0549177 (UMLS CUI-2)
(Comment:en)
Item
6d: Bloody stools
integer
C4287870 (UMLS CUI [1])
Code List
6d: Bloody stools
CL Item
Very small problem (1)
C0033213 (UMLS CUI-1)
C0442811 (UMLS CUI-2)
(Comment:en)
CL Item
Small problem (2)
C0033213 (UMLS CUI-1)
C0700321 (UMLS CUI-2)
(Comment:en)
CL Item
Moderate problem (3)
C0033213 (UMLS CUI-1)
C0205081 (UMLS CUI-2)
(Comment:en)
CL Item
No problem (0)
C0033213 (UMLS CUI-1)
C1298908 (UMLS CUI-2)
(Comment:en)
CL Item
Big problem (4)
C0033213 (UMLS CUI-1)
C0549177 (UMLS CUI-2)
(Comment:en)
Item
6e: Abdominal/Pelvic/Rectal pain
integer
C4289649 (UMLS CUI [1])
Code List
6e: Abdominal/Pelvic/Rectal pain
CL Item
Very small problem (1)
C0033213 (UMLS CUI-1)
C0442811 (UMLS CUI-2)
(Comment:en)
CL Item
Small problem (2)
C0033213 (UMLS CUI-1)
C0700321 (UMLS CUI-2)
(Comment:en)
CL Item
Moderate problem (3)
C0033213 (UMLS CUI-1)
C0205081 (UMLS CUI-2)
(Comment:en)
CL Item
No problem (0)
C0033213 (UMLS CUI-1)
C1298908 (UMLS CUI-2)
(Comment:en)
CL Item
Big problem (4)
C0033213 (UMLS CUI-1)
C0549177 (UMLS CUI-2)
(Comment:en)
Item
7: Overall, how big a problem have your bowel habits been for you during the last 4 weeks?
integer
C4289633 (UMLS CUI [1])
Code List
7: Overall, how big a problem have your bowel habits been for you during the last 4 weeks?
CL Item
Very small problem (1)
C0033213 (UMLS CUI-1)
C0442811 (UMLS CUI-2)
(Comment:en)
CL Item
Small problem (2)
C0033213 (UMLS CUI-1)
C0700321 (UMLS CUI-2)
(Comment:en)
CL Item
Moderate problem (3)
C0033213 (UMLS CUI-1)
C0205081 (UMLS CUI-2)
(Comment:en)
CL Item
No problem (0)
C0033213 (UMLS CUI-1)
C1298908 (UMLS CUI-2)
(Comment:en)
CL Item
Big problem (4)
C0033213 (UMLS CUI-1)
C0549177 (UMLS CUI-2)
(Comment:en)
Item
8a: How would you rate the following during the last 4 weeks? Your ability to have an erection?
integer
C4289647 (UMLS CUI [1])
Code List
8a: How would you rate the following during the last 4 weeks? Your ability to have an erection?
CL Item
Very poor to none (1)
C3641766 (UMLS CUI-1)
C0549184 (UMLS CUI-2)
(Comment:en)
CL Item
Poor (2)
C2700379 (UMLS CUI-1)
(Comment:en)
CL Item
Fair (3)
C2911689 (UMLS CUI-1)
(Comment:en)
CL Item
Good (4)
C0205170 (UMLS CUI-1)
(Comment:en)
CL Item
Very good (5)
C3641222 (UMLS CUI-1)
(Comment:en)
Item
8b: Your ability to reach orgasm (climax)?
integer
C4289646 (UMLS CUI [1])
Code List
8b: Your ability to reach orgasm (climax)?
CL Item
Very poor to none (1)
C3641766 (UMLS CUI-1)
C0549184 (UMLS CUI-2)
(Comment:en)
CL Item
Poor (2)
C2700379 (UMLS CUI-1)
(Comment:en)
CL Item
Fair (3)
C2911689 (UMLS CUI-1)
(Comment:en)
CL Item
Good (4)
C0205170 (UMLS CUI-1)
(Comment:en)
CL Item
Very good (5)
C3641222 (UMLS CUI-1)
(Comment:en)
Item
9: How would you describe the usual QUALITY of your erections during the last 4 weeks?
integer
C4289628 (UMLS CUI [1])
Code List
9: How would you describe the usual QUALITY of your erections during the last 4 weeks?
CL Item
None at all (1)
C0549184 (UMLS CUI-1)
(Comment:en)
CL Item
Not firm enough for any sexual activity (2)
C3828773 (UMLS CUI-1)
(Comment:en)
CL Item
Firm enough for masturbation and foreplay only (3)
C3830112 (UMLS CUI-1)
(Comment:en)
CL Item
Firm enough for intercourse (4)
C3830113 (UMLS CUI-1)
(Comment:en)
Item
10: How would you describe the FREQUENCY of your erections during the last 4 weeks?
integer
C4289639 (UMLS CUI [1])
Code List
10: How would you describe the FREQUENCY of your erections during the last 4 weeks?
CL Item
I NEVER had an erection when I wanted one (1)
C4527372 (UMLS CUI-1)
(Comment:en)
CL Item
I had an erection LESS THAN HALF the time I wanted one (2)
C4527373 (UMLS CUI-1)
(Comment:en)
CL Item
I had an erection ABOUT HALF the time I wanted one (3)
C4527374 (UMLS CUI-1)
(Comment:en)
CL Item
I had an erection MORE THAN HALF the time I wanted one (4)
C4527375 (UMLS CUI-1)
(Comment:en)
CL Item
I had an erection WHENEVER I wanted one (5)
C4527376 (UMLS CUI-1)
(Comment:en)
Item
11: Overall, how would you rate your ability to function sexually during the last 4 weeks?
integer
C4289648 (UMLS CUI [1])
Code List
11: Overall, how would you rate your ability to function sexually during the last 4 weeks?
CL Item
Very poor (1)
C3641766 (UMLS CUI-1)
(Comment:en)
CL Item
Poor (2)
C2700379 (UMLS CUI-1)
(Comment:en)
CL Item
Fair (3)
C2911689 (UMLS CUI-1)
(Comment:en)
CL Item
Good (4)
C0205170 (UMLS CUI-1)
(Comment:en)
CL Item
Very good (5)
C3641222 (UMLS CUI-1)
(Comment:en)
Item
12: Overall, how big a problem has your sexual function or lack of sexual function been for you during the last 4 weeks?
integer
C4289632 (UMLS CUI [1])
Code List
12: Overall, how big a problem has your sexual function or lack of sexual function been for you during the last 4 weeks?
CL Item
Very small problem (1)
C0033213 (UMLS CUI-1)
C0442811 (UMLS CUI-2)
(Comment:en)
CL Item
Small problem (2)
C0033213 (UMLS CUI-1)
C0700321 (UMLS CUI-2)
(Comment:en)
CL Item
Moderate problem (3)
C0033213 (UMLS CUI-1)
C0205081 (UMLS CUI-2)
(Comment:en)
CL Item
No problem (0)
C0033213 (UMLS CUI-1)
C1298908 (UMLS CUI-2)
(Comment:en)
CL Item
Big problem (4)
C0033213 (UMLS CUI-1)
C0549177 (UMLS CUI-2)
(Comment:en)
Item
13a: How big a problem during the last 4 weeks, if any, has the following been for you? Hot flashes
integer
C4289638 (UMLS CUI [1])
Code List
13a: How big a problem during the last 4 weeks, if any, has the following been for you? Hot flashes
CL Item
Very small problem (1)
C0033213 (UMLS CUI-1)
C0442811 (UMLS CUI-2)
(Comment:en)
CL Item
Small problem (2)
C0033213 (UMLS CUI-1)
C0700321 (UMLS CUI-2)
(Comment:en)
CL Item
Moderate problem (3)
C0033213 (UMLS CUI-1)
C0205081 (UMLS CUI-2)
(Comment:en)
CL Item
No problem (0)
C0033213 (UMLS CUI-1)
C1298908 (UMLS CUI-2)
(Comment:en)
CL Item
Big problem (4)
C0033213 (UMLS CUI-1)
C0549177 (UMLS CUI-2)
(Comment:en)
Item
13b: Breast tenderness/enlargement
integer
C4289643 (UMLS CUI [1])
Code List
13b: Breast tenderness/enlargement
CL Item
Very small problem (1)
C0033213 (UMLS CUI-1)
C0442811 (UMLS CUI-2)
(Comment:en)
CL Item
Small problem (2)
C0033213 (UMLS CUI-1)
C0700321 (UMLS CUI-2)
(Comment:en)
CL Item
Moderate problem (3)
C0033213 (UMLS CUI-1)
C0205081 (UMLS CUI-2)
(Comment:en)
CL Item
No problem (0)
C0033213 (UMLS CUI-1)
C1298908 (UMLS CUI-2)
(Comment:en)
CL Item
Big problem (4)
C0033213 (UMLS CUI-1)
C0549177 (UMLS CUI-2)
(Comment:en)
Item
13c: Feeling depressed
integer
C4289640 (UMLS CUI [1])
Code List
13c: Feeling depressed
CL Item
Very small problem (1)
C0033213 (UMLS CUI-1)
C0442811 (UMLS CUI-2)
(Comment:en)
CL Item
Small problem (2)
C0033213 (UMLS CUI-1)
C0700321 (UMLS CUI-2)
(Comment:en)
CL Item
Moderate problem (3)
C0033213 (UMLS CUI-1)
C0205081 (UMLS CUI-2)
(Comment:en)
CL Item
No problem (0)
C0033213 (UMLS CUI-1)
C1298908 (UMLS CUI-2)
(Comment:en)
CL Item
Big problem (4)
C0033213 (UMLS CUI-1)
C0549177 (UMLS CUI-2)
(Comment:en)
Item
13d: Lack of energy
integer
C4289635 (UMLS CUI [1])
Code List
13d: Lack of energy
CL Item
Very small problem (1)
C0033213 (UMLS CUI-1)
C0442811 (UMLS CUI-2)
(Comment:en)
CL Item
Small problem (2)
C0033213 (UMLS CUI-1)
C0700321 (UMLS CUI-2)
(Comment:en)
CL Item
Moderate problem (3)
C0033213 (UMLS CUI-1)
C0205081 (UMLS CUI-2)
(Comment:en)
CL Item
No problem (0)
C0033213 (UMLS CUI-1)
C1298908 (UMLS CUI-2)
(Comment:en)
CL Item
Big problem (4)
C0033213 (UMLS CUI-1)
C0549177 (UMLS CUI-2)
(Comment:en)
Item
13e: Change in body weight
integer
C4289642 (UMLS CUI [1])
Code List
13e: Change in body weight
CL Item
Very small problem (1)
C0033213 (UMLS CUI-1)
C0442811 (UMLS CUI-2)
(Comment:en)
CL Item
Small problem (2)
C0033213 (UMLS CUI-1)
C0700321 (UMLS CUI-2)
(Comment:en)
CL Item
Moderate problem (3)
C0033213 (UMLS CUI-1)
C0205081 (UMLS CUI-2)
(Comment:en)
CL Item
No problem (0)
C0033213 (UMLS CUI-1)
C1298908 (UMLS CUI-2)
(Comment:en)
CL Item
Big problem (4)
C0033213 (UMLS CUI-1)
C0549177 (UMLS CUI-2)
(Comment:en)
Item
During the last 4 weeks, to what extent were you interested in sex?
integer
C3899191 (UMLS CUI [1])
Code List
During the last 4 weeks, to what extent were you interested in sex?
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
(Comment:en)
CL Item
A little (1)
C2984078 (UMLS CUI-1)
(Comment:en)
CL Item
Quite a bit (2)
C2984080 (UMLS CUI-1)
(Comment:en)
CL Item
Very much (3)
C2984081 (UMLS CUI-1)
(Comment:en)
Item
Have you used any medications or devices to aid or improve erections?
integer
C3827672 (UMLS CUI [1])
Code List
Have you used any medications or devices to aid or improve erections?
CL Item
No (0)
C1298908 (UMLS CUI-1)
(Comment:en)
CL Item
Yes (1)
C1705108 (UMLS CUI-1)
(Comment:en)
Item
For each of the following medicines or devices, please indicate whether or not you have tried or currently use it to improve your erections: Viagra or another pill
integer
C0663448 (UMLS CUI [1])
Code List
For each of the following medicines or devices, please indicate whether or not you have tried or currently use it to improve your erections: Viagra or another pill
CL Item
Have not tried it (0)
C3844323 (UMLS CUI-1)
(Comment:en)
CL Item
Tried it but was not helpful (1)
C3827771 (UMLS CUI-1)
(Comment:en)
CL Item
It helped but I am not using it now (2)
C3829718 (UMLS CUI-1)
(Comment:en)
CL Item
It helped and I use it sometimes (3)
C3829719 (UMLS CUI-1)
(Comment:en)
CL Item
It helped and I use it always (4)
C3829720 (UMLS CUI-1)
(Comment:en)
Item
Muse (intra-urethral alprostadil suppository)
integer
C2366566 (UMLS CUI [1])
Code List
Muse (intra-urethral alprostadil suppository)
CL Item
Have not tried it (0)
C3844323 (UMLS CUI-1)
(Comment:en)
CL Item
Tried it but was not helpful (1)
C3827771 (UMLS CUI-1)
(Comment:en)
CL Item
It helped but I am not using it now (2)
C3829718 (UMLS CUI-1)
(Comment:en)
CL Item
It helped and I use it sometimes (3)
C3829719 (UMLS CUI-1)
(Comment:en)
CL Item
It helped and I use it always (4)
C3829720 (UMLS CUI-1)
(Comment:en)
Item
Penile injection therapy (such as caverject)
integer
C3828613 (UMLS CUI [1])
Code List
Penile injection therapy (such as caverject)
CL Item
Have not tried it (0)
C3844323 (UMLS CUI-1)
(Comment:en)
CL Item
Tried it but was not helpful (1)
C3827771 (UMLS CUI-1)
(Comment:en)
CL Item
It helped but I am not using it now (2)
C3829718 (UMLS CUI-1)
(Comment:en)
CL Item
It helped and I use it sometimes (3)
C3829719 (UMLS CUI-1)
(Comment:en)
CL Item
It helped and I use it always (4)
C3829720 (UMLS CUI-1)
(Comment:en)
Item
Vacuum erection device (such as erect-aid)
integer
C3827672 (UMLS CUI [1])
Code List
Vacuum erection device (such as erect-aid)
CL Item
Have not tried it (0)
C3844323 (UMLS CUI-1)
(Comment:en)
CL Item
Tried it but was not helpful (1)
C3827771 (UMLS CUI-1)
(Comment:en)
CL Item
It helped but I am not using it now (2)
C3829718 (UMLS CUI-1)
(Comment:en)
CL Item
It helped and I use it sometimes (3)
C3829719 (UMLS CUI-1)
(Comment:en)
CL Item
It helped and I use it always (4)
C3829720 (UMLS CUI-1)
(Comment:en)
Item
Other medication/device
integer
C1115771 (UMLS CUI [1])
CL Item
Have not tried it (0)
C3844323 (UMLS CUI-1)
(Comment:en)
CL Item
Tried it but was not helpful (1)
C3827771 (UMLS CUI-1)
(Comment:en)
CL Item
It helped but I am not using it now (2)
C3829718 (UMLS CUI-1)
(Comment:en)
CL Item
It helped and I use it sometimes (3)
C3829719 (UMLS CUI-1)
(Comment:en)
CL Item
It helped and I use it always (4)
C3829720 (UMLS CUI-1)
(Comment:en)

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