ID
37463
Descrição
ICHOM Breast Cancer data collection Version 1.0.1 Revised: March 30, 2017 International Consortium for Health Outcomes Measurement (ICHOM), Source: http://www.ichom.org/ For Breast Cancer, the following treatment approaches (or interventions) are covered by our Standard Set. Conditions*: All patients (men and women) with newly pathologically diagnosed invasive breast cancer (stage I-IV) and ductal carcinoma in situ (DCIS). *Excluded Conditions: Rare tumors (e.g. phyllodes tumor), lobular carcinoma in situ (LCIS) and patients with recurrent disease at baseline will be excluded. Treatment approaches: (Reconstructive) Surgery | Radiotherapy | Chemotherapy | Hormonal Therapy | Targeted Therapy | This document contains the Baseline - Patient-reported form. It has to be filled in before first doctor's visit. Collecting Patient-Reported Outcome Measures: European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30, EORTC QLQ-BR23, EORTC QLQ-LMC21). As a permission is needed for use of these questionnaires, only the total score of each will be included in this version of the standard set. More information can be found at http://groups.eortc.be/qol/eortc-qlq-c30 BREAST-Q Patient Reported Outcomes Instrument (BREAST-Q). As a license is needed for use of this questionnaire, only the total score will be included in this version of the standard set. For more information, please visit: https:// eprovide.mapi-trust.org/instruments/ breast-q#contact_and_conditions_of_ use Functional Assessment of Cancer Therapy Endocrine Subscale (FACT-ES). As a permission is needed for use of this questionnaire, only the total score of each will be included in this version of the standard set. For more information see http://www.facit.org/facitorg/ questionnaires. Reference: Ong WL, Schouwenburg MG, van Bommel AC, et al. A Standard Set of Value-Based Patient-Centered Outcomes for Breast Cancer: The International Consortium for Health Outcomes Measurement (ICHOM) Initiative. JAMA Oncol. 2017;3(5):677–685. doi:10.1001/jamaoncol.2016.4851 The Standard set of ICHOM was supported by the Dutch Dnstitute for Clinical Auditing, Onderlinge Waarborgmaatschappij Centrale Zorgverzekeraars group, Ramsay Health Care and Karolinska Institute.
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Versões (4)
- 30/07/2019 30/07/2019 -
- 30/07/2019 30/07/2019 -
- 30/04/2020 30/04/2020 - Sarah Riepenhausen
- 20/09/2021 20/09/2021 -
Titular dos direitos
ICHOM
Transferido a
30 de julho de 2019
DOI
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Licença
Creative Commons BY-NC 3.0
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ICHOM Breast Cancer
Baseline - Patient-reported
- StudyEvent: ODM
Descrição
Demographic factors
Alias
- UMLS CUI-1
- C1704791
Descrição
INCLUSION CRITERIA: All patients TIMING: Baseline REPORTING SOURCE: Patient-reported TYPE: Single answer
Tipo de dados
integer
Alias
- UMLS CUI [1]
- C0079399
Descrição
INCLUSION CRITERIA: All patients TIMING: Baseline REPORTING SOURCE: Patient-reported and clinical TYPE: Single answer
Tipo de dados
date
Unidades de medida
- DD/MM/YYYY
Alias
- UMLS CUI [1]
- C0421451
Descrição
INCLUSION CRITERIA: All patients TIMING: Baseline REPORTING SOURCE: Patient-reported TYPE: Single answer
Tipo de dados
text
Alias
- UMLS CUI [1]
- C0454664
Descrição
In the original Form response option is N/A. A codelist is not supplemented because it varies by country and should be determined by country (not for cross country comparison) INCLUSION CRITERIA: All patients TIMING: Baseline REPORTING SOURCE: Patient-reported TYPE: Single answer
Tipo de dados
text
Alias
- UMLS CUI [1]
- C0015031
Descrição
"This is based upon the International Standard Classification of Education for the United States, and reflects standards in the U.S. Please adapt questions according to your country’s guidelines. Primary refers to the first 8 years of formal education in elementary school in the US. Secondary school refers to the last four years of statutory formal education (grade 9-12) at high school in the US. Tertiary refers to colleges or universities, including undergraduate and postgraduate education in the US." INCLUSION CRITERIA: All patients TIMING: Baseline REPORTING SOURCE: Patient-reported TYPE: Single answer
Tipo de dados
integer
Alias
- UMLS CUI [1]
- C0013658
Descrição
INCLUSION CRITERIA: All patients TIMING: Baseline REPORTING SOURCE: Patient-reported TYPE: Single answer
Tipo de dados
integer
Alias
- UMLS CUI [1]
- C0439849
Descrição
INCLUSION CRITERIA: All patients TIMING: Baseline REPORTING SOURCE: Patient-reported TYPE: Single answer
Tipo de dados
integer
Alias
- UMLS CUI [1]
- C0455962
Descrição
Baseline clinical factors
Alias
- UMLS CUI-1
- C0449440
- UMLS CUI-2
- C1442488
Descrição
SUPPROTING DEFINITION: Based upon the Self-administered Comorbidity Questionnaire (Sangha et al, 2003) INCLUSION CRITERIA: All patients TIMING: Baseline and after 5 years REPORTING SOURCE: Patient-reported TYPE: Multiple answer, Separate multiple entries with "";""
Tipo de dados
boolean
Alias
- UMLS CUI [1]
- C0009488
- UMLS CUI [2]
- C1298908
Descrição
SUPPROTING DEFINITION: Based upon the Self-administered Comorbidity Questionnaire (Sangha et al, 2003) INCLUSION CRITERIA: All patients TIMING: Baseline and after 5 years REPORTING SOURCE: Patient-reported TYPE: Multiple answer, Separate multiple entries with "";""
Tipo de dados
boolean
Alias
- UMLS CUI [1]
- C0009488
- UMLS CUI [2]
- C0018799
- UMLS CUI [3]
- C0002962
- UMLS CUI [4]
- C0027051
- UMLS CUI [5]
- C0018801
Descrição
SUPPROTING DEFINITION: Based upon the Self-administered Comorbidity Questionnaire (Sangha et al, 2003) INCLUSION CRITERIA: All patients TIMING: Baseline and after 5 years REPORTING SOURCE: Patient-reported TYPE: Multiple answer, Separate multiple entries with "";""
Tipo de dados
boolean
Alias
- UMLS CUI [1]
- C0009488
- UMLS CUI [2]
- C0020538
Descrição
SUPPROTING DEFINITION: Based upon the Self-administered Comorbidity Questionnaire (Sangha et al, 2003) INCLUSION CRITERIA: All patients TIMING: Baseline and after 5 years REPORTING SOURCE: Patient-reported TYPE: Multiple answer, Separate multiple entries with "";""
Tipo de dados
boolean
Alias
- UMLS CUI [1]
- C0009488
- UMLS CUI [2]
- C1306889
Descrição
SUPPROTING DEFINITION: Based upon the Self-administered Comorbidity Questionnaire (Sangha et al, 2003) INCLUSION CRITERIA: All patients TIMING: Baseline and after 5 years REPORTING SOURCE: Patient-reported TYPE: Multiple answer, Separate multiple entries with "";""
Tipo de dados
boolean
Alias
- UMLS CUI [1]
- C0009488
- UMLS CUI [2]
- C0024115
- UMLS CUI [3]
- C0004096
- UMLS CUI [4]
- C0008677
- UMLS CUI [5]
- C0034067
Descrição
SUPPROTING DEFINITION: Based upon the Self-administered Comorbidity Questionnaire (Sangha et al, 2003) INCLUSION CRITERIA: All patients TIMING: Baseline and after 5 years REPORTING SOURCE: Patient-reported TYPE: Multiple answer, Separate multiple entries with "";""
Tipo de dados
boolean
Alias
- UMLS CUI [1]
- C0009488
- UMLS CUI [2]
- C0011849
Descrição
SUPPROTING DEFINITION: Based upon the Self-administered Comorbidity Questionnaire (Sangha et al, 2003) INCLUSION CRITERIA: All patients TIMING: Baseline and after 5 years REPORTING SOURCE: Patient-reported TYPE: Multiple answer, Separate multiple entries with "";""
Tipo de dados
boolean
Alias
- UMLS CUI [1]
- C0009488
- UMLS CUI [2]
- C0022658
Descrição
SUPPROTING DEFINITION: Based upon the Self-administered Comorbidity Questionnaire (Sangha et al, 2003) INCLUSION CRITERIA: All patients TIMING: Baseline and after 5 years REPORTING SOURCE: Patient-reported TYPE: Multiple answer, Separate multiple entries with "";""
Tipo de dados
boolean
Alias
- UMLS CUI [1]
- C0009488
- UMLS CUI [2]
- C0023895
Descrição
SUPPROTING DEFINITION: Based upon the Self-administered Comorbidity Questionnaire (Sangha et al, 2003) INCLUSION CRITERIA: All patients TIMING: Baseline and after 5 years REPORTING SOURCE: Patient-reported TYPE: Multiple answer, Separate multiple entries with "";""
Tipo de dados
boolean
Alias
- UMLS CUI [1]
- C0009488
- UMLS CUI [2,1]
- C0038454
- UMLS CUI [2,2]
- C0678227
- UMLS CUI [2,3]
- C0033213
Descrição
SUPPROTING DEFINITION: Based upon the Self-administered Comorbidity Questionnaire (Sangha et al, 2003) INCLUSION CRITERIA: All patients TIMING: Baseline and after 5 years REPORTING SOURCE: Patient-reported TYPE: Multiple answer, Separate multiple entries with "";""
Tipo de dados
boolean
Alias
- UMLS CUI [1]
- C0009488
- UMLS CUI [2]
- C0027765
- UMLS CUI [3]
- C0030567
- UMLS CUI [4]
- C0026769
Descrição
SUPPROTING DEFINITION: Based upon the Self-administered Comorbidity Questionnaire (Sangha et al, 2003) INCLUSION CRITERIA: All patients TIMING: Baseline and after 5 years REPORTING SOURCE: Patient-reported TYPE: Multiple answer, Separate multiple entries with "";""
Tipo de dados
boolean
Alias
- UMLS CUI [1]
- C0009488
- UMLS CUI [2]
- C1707251
Descrição
SUPPROTING DEFINITION: Based upon the Self-administered Comorbidity Questionnaire (Sangha et al, 2003) INCLUSION CRITERIA: All patients TIMING: Baseline and after 5 years REPORTING SOURCE: Patient-reported TYPE: Multiple answer, Separate multiple entries with "";""
Tipo de dados
boolean
Alias
- UMLS CUI [1]
- C0009488
- UMLS CUI [2]
- C0011581
Descrição
SUPPROTING DEFINITION: Based upon the Self-administered Comorbidity Questionnaire (Sangha et al, 2003) INCLUSION CRITERIA: All patients TIMING: Baseline and after 5 years REPORTING SOURCE: Patient-reported TYPE: Multiple answer, Separate multiple entries with "";""
Tipo de dados
boolean
Alias
- UMLS CUI [1]
- C0009488
- UMLS CUI [2]
- C0003864
Descrição
Degree of health
Descrição
As a permission is needed for use of this questionnaire, the actual 30 questions are not part of this version of the standard set. Instead you can note the total score. The ICHOM OID's are: EORTC QLQ-C30_Q01 to EORTC QLQ-C30_Q30. INCLUSION CRITERIA: All patients TIMING: Baseline, 6 months, 1 year post treatment, tracked annually up to 10 years REPORTING SOURCE: Patient-reported TYPE: Single answer
Tipo de dados
integer
Alias
- UMLS CUI [1,1]
- C4055104
- UMLS CUI [1,2]
- C2964552
Descrição
As a permission is needed for use of this questionnaire, the actual 23 questions are not part of this version of the standard set. Instead you can note the total score. The ICHOM OID's are: EORTCQLQBR23_Q31 to EORTCQLQBR23_Q53. INCLUSION CRITERIA: All patients TIMING: Baseline, 6 months, 1 year post treatment, tracked annually up to 10 years REPORTING SOURCE: Patient-reported TYPE: Single answer
Tipo de dados
integer
Alias
- UMLS CUI [1,1]
- C4724921
- UMLS CUI [1,2]
- C0451149
- UMLS CUI [1,3]
- C2964552
Descrição
As a license is needed for use of this questionnaire, the actual 4 questions of BREAST-Q (to Mastectomy) are not part of this version of the standard set. Instead you can note the total score. The ICHOM OID's are: BREASTQMAST_Q01 to BREASTQMAST_Q04 INCLUSION CRITERIA: Patients with mastectomy TIMING: Baseline REPORTING SOURCE: Patient-reported TYPE: Single answer
Tipo de dados
integer
Alias
- UMLS CUI [1,1]
- C4683551
- UMLS CUI [1,2]
- C0024881
- UMLS CUI [1,3]
- C2964552
Descrição
As a license is needed for use of this questionnaire, the actual 4 questions of BREAST-Q (to Breast conserving therapy) are not part of this version of the standard set. Instead you can note the total score. The ICHOM OID's are: BREASTQBCT_Q01 to BREASTQBCT_Q04 INCLUSION CRITERIA: Patients with breast conserving therapy TIMING: Baseline REPORTING SOURCE: Patient-reported TYPE: Single answer
Tipo de dados
integer
Alias
- UMLS CUI [1,1]
- C4683551
- UMLS CUI [1,2]
- C0917927
- UMLS CUI [1,3]
- C2964552
Descrição
As a license is needed for use of this questionnaire, the actual 4 questions of BREAST-Q (to Reconstruction) are not part of this version of the standard set. Instead you can note the total score. T The ICHOM OID's are: BREASTQREC_Q01 to BREASTQREC_Q04 INCLUSION CRITERIA: Patients with reconstruction TIMING: Baseline REPORTING SOURCE: Patient-reported TYPE: Single answer
Tipo de dados
integer
Alias
- UMLS CUI [1,1]
- C4683551
- UMLS CUI [1,2]
- C0524865
- UMLS CUI [1,3]
- C2964552
Descrição
European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-LMC21): A license is needed for use of this questionnaire as well, however only one question is used. The ICHOM OID's is: EORTC QLQ-LMC21 INCLUSION CRITERIA: All patients TIMING: Baseline, 6 months, 1 year post treatment, tracked annually up to 10 years REPORTING SOURCE: Patient-reported TYPE: Single answer
Tipo de dados
integer
Alias
- UMLS CUI [1,1]
- C0451149
- UMLS CUI [1,2]
- C2116350
- UMLS CUI [1,3]
- C0347984
- UMLS CUI [1,4]
- C2987125
- UMLS CUI [2,1]
- C0451149
- UMLS CUI [2,2]
- C2116331
- UMLS CUI [2,3]
- C0347984
- UMLS CUI [2,4]
- C2987125
Descrição
As a permission is needed for use of this questionnaire, the actual 6 questions are not part of this version of the standard set. Instead you can note the total score. The ICHOM OID's are: FACTES_Q01 (BRM1), FACTES_Q02 to FACTES_Q06 (ES4-ES8) INCLUSION CRITERIA: All patients TIMING: Baseline, 6 months, 1 year post treatment, tracked annually up to 10 years REPORTING SOURCE: Patient-reported TYPE: Single answer
Tipo de dados
integer
Alias
- UMLS CUI [1,1]
- C3889662
- UMLS CUI [1,2]
- C0449820
Similar models
Baseline - Patient-reported
- StudyEvent: ODM
(Comment:en)
(Comment:en)
(Comment:en)
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C0033145 (UMLS CUI-2)
(Comment:en)
(Comment:en)
(Comment:en)
C2003901 (UMLS CUI-2)
C1546497 (UMLS CUI-3)
(Comment:en)
C0682323 (UMLS CUI-2)
(Comment:en)
(Comment:en)
(Comment:en)
C0025320 (UMLS CUI-2)
(Comment:en)
C0543467 (UMLS CUI-2)
C0232970 (UMLS CUI-3)
C0205296 (UMLS CUI-4)
(Comment:en)
C1513126 (UMLS CUI-2)
(Comment:en)
C1442488 (UMLS CUI-2)
C1298908 (UMLS CUI [2])
C0018799 (UMLS CUI [2])
C0002962 (UMLS CUI [3])
C0027051 (UMLS CUI [4])
C0018801 (UMLS CUI [5])
C0020538 (UMLS CUI [2])
C1306889 (UMLS CUI [2])
C0024115 (UMLS CUI [2])
C0004096 (UMLS CUI [3])
C0008677 (UMLS CUI [4])
C0034067 (UMLS CUI [5])
C0011849 (UMLS CUI [2])
C0022658 (UMLS CUI [2])
C0023895 (UMLS CUI [2])
C0038454 (UMLS CUI [2,1])
C0678227 (UMLS CUI [2,2])
C0033213 (UMLS CUI [2,3])
C0027765 (UMLS CUI [2])
C0030567 (UMLS CUI [3])
C0026769 (UMLS CUI [4])
C1707251 (UMLS CUI [2])
C0011581 (UMLS CUI [2])
C0003864 (UMLS CUI [2])
C2964552 (UMLS CUI [1,2])
C0451149 (UMLS CUI [1,2])
C2964552 (UMLS CUI [1,3])
C0024881 (UMLS CUI [1,2])
C2964552 (UMLS CUI [1,3])
C0917927 (UMLS CUI [1,2])
C2964552 (UMLS CUI [1,3])
C0524865 (UMLS CUI [1,2])
C2964552 (UMLS CUI [1,3])
C2116350 (UMLS CUI [1,2])
C0347984 (UMLS CUI [1,3])
C2987125 (UMLS CUI [1,4])
C0451149 (UMLS CUI [2,1])
C2116331 (UMLS CUI [2,2])
C0347984 (UMLS CUI [2,3])
C2987125 (UMLS CUI [2,4])
(Comment:en)
(Comment:en)
(Comment:en)
(Comment:en)
C0449820 (UMLS CUI [1,2])