Patient Initials
Item
Patient Initials (Last First Middle)
text
C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
Patient ID NSABP
Item
NSABP Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1513905 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C15818 (NCI Thesaurus Property-2)
Institution Name
Item
Institution/Affiliate
text
C25454 (NCI Thesaurus ObjectClass)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C25191 (NCI Thesaurus ValueDomain)
C21541 (NCI Thesaurus ValueDomain-2)
PersonFormAdministrationFirstName
Item
Staff member administering form
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C19464 (NCI Thesaurus Property)
C0376315 (UMLS 2011AA Property)
C25409 (NCI Thesaurus Property-2)
C1533734 (UMLS 2011AA Property-2)
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C25509 (NCI Thesaurus ValueDomain-2)
C1279901 (UMLS 2011AA ValueDomain-2)
PersonFormAdministrationLastName
Item
Staff member administering form
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C19464 (NCI Thesaurus Property)
C0376315 (UMLS 2011AA Property)
C25409 (NCI Thesaurus Property-2)
C1533734 (UMLS 2011AA Property-2)
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C25551 (NCI Thesaurus ValueDomain-2)
C1517741 (UMLS 2011AA ValueDomain-2)
QualityofLifeContactPersonTelephoneNumber
Item
Phone
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C17047 (NCI Thesaurus ObjectClass-2)
C0518214 (UMLS 2011AA ObjectClass-2)
C25461 (NCI Thesaurus ObjectClass-3)
C0337611 (UMLS 2011AA ObjectClass-3)
C40978 (NCI Thesaurus Property)
C1515258 (UMLS 2011AA Property)
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C25395 (NCI Thesaurus ValueDomain-2)
C0039457 (UMLS 2011AA ValueDomain-2)
Data amended
Item
Are data amended
boolean
C38148 (NCI Thesaurus ValueDomain)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
Item
Time point (mark one)
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25616 (NCI Thesaurus Property)
C1948053 (UMLS 2011AA Property)
Code List
Time point (mark one)
CL Item
Within 2 Weeks Prior To Randomization (Within 2 weeks prior to randomization)
CL Item
3 Months After Randomization (3 months after randomization)
CL Item
6 Months After Randomization (6 months after randomization)
CL Item
12 Months After Randomization (12 months after randomization)
CL Item
18 Months After Randomization (18 months after randomization)
CL Item
24 Months After Randomization (24 months after randomization)
Item
This form is being filled out (mark one)
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C25190 (NCI Thesaurus Property)
C0027361 (UMLS 2011AA Property)
C40988 (NCI Thesaurus ObjectClass)
C1516308 (UMLS 2011AA ObjectClass)
C25250 (NCI Thesaurus Property-2)
C0205197 (UMLS 2011AA Property-2)
Code List
This form is being filled out (mark one)
CL Item
By Clinical Staff On Phone With Participant (By clinical staff on phone with participant)
CL Item
By Patient In Doctor's Office (By participant in doctor's office)
CL Item
By Participant Not In Doctor's Office (By participant not in doctor's office)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
QualityofLifeCompleteAssessmentDate
Item
Date Questionnaire Completed (MM DD YYYY)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C25367 (NCI Thesaurus Property-2)
Item
Nausea
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
C3258 (NCI Thesaurus ObjectClass-2)
C0027497 (UMLS 2011AA ObjectClass-2)
CL Item
Not At All Bothered (Not at all bothered)
CL Item
Bothered A Little Bit (Bothered a little bit)
CL Item
Somewhat Bothered (Somewhat bothered)
CL Item
Bothered Quite A Bit (Bothered quite a bit)
CL Item
Bothered Very Much (Bothered very much)
Item
vomiting
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
CL Item
Not At All Bothered (Not at all bothered)
CL Item
Bothered A Little Bit (Bothered a little bit)
CL Item
Somewhat Bothered (Somewhat bothered)
CL Item
Bothered Quite A Bit (Bothered quite a bit)
CL Item
Bothered Very Much (Bothered very much)
Item
diarrhea
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
CL Item
Not At All Bothered (Not at all bothered)
CL Item
Bothered A Little Bit (Bothered a little bit)
CL Item
Somewhat Bothered (Somewhat bothered)
CL Item
Bothered Quite A Bit (Bothered quite a bit)
CL Item
Bothered Very Much (Bothered very much)
Item
Difficulty with bladder control (when laughing or crying)
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C12439 (NCI Thesaurus ObjectClass-2)
C0006104 (UMLS 2011AA ObjectClass-2)
C25367 (NCI Thesaurus Property)
C3429 (NCI Thesaurus Property-2)
C0021167 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
Code List
Difficulty with bladder control (when laughing or crying)
CL Item
Not At All Bothered (Not at all bothered)
CL Item
Bothered A Little Bit (Bothered a little bit)
CL Item
Somewhat Bothered (Somewhat bothered)
CL Item
Bothered Quite A Bit (Bothered quite a bit)
CL Item
Bothered Very Much (Bothered very much)
Item
Difficulty with bladder control (at other times)
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C26906 (NCI Thesaurus Property-2)
C0677481 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)
Code List
Difficulty with bladder control (at other times)
CL Item
Not At All Bothered (Not at all bothered)
CL Item
Bothered A Little Bit (Bothered a little bit)
CL Item
Somewhat Bothered (Somewhat bothered)
CL Item
Bothered Quite A Bit (Bothered quite a bit)
CL Item
Bothered Very Much (Bothered very much)
Item
Hot flashes
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25214 (NCI Thesaurus Property)
C0220825 (UMLS 2011AA Property)
C3109 (NCI Thesaurus Property-2)
C0600142 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)
CL Item
Not At All Bothered (Not at all bothered)
CL Item
Bothered A Little Bit (Bothered a little bit)
CL Item
Somewhat Bothered (Somewhat bothered)
CL Item
Bothered Quite A Bit (Bothered quite a bit)
CL Item
Bothered Very Much (Bothered very much)
Item
genital itching or irritation
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
Code List
genital itching or irritation
CL Item
Not At All Bothered (Not at all bothered)
CL Item
Bothered A Little Bit (Bothered a little bit)
CL Item
Somewhat Bothered (Somewhat bothered)
CL Item
Bothered Quite A Bit (Bothered quite a bit)
CL Item
Bothered Very Much (Bothered very much)
Item
vaginal discharge
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
Code List
vaginal discharge
CL Item
Not At All Bothered (Not at all bothered)
CL Item
Bothered A Little Bit (Bothered a little bit)
CL Item
Somewhat Bothered (Somewhat bothered)
CL Item
Bothered Quite A Bit (Bothered quite a bit)
CL Item
Bothered Very Much (Bothered very much)
Item
Vaginal bleeding or spotting
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25214 (NCI Thesaurus Property)
C0220825 (UMLS 2011AA Property)
C26791 (NCI Thesaurus Property-2)
C0019080 (UMLS 2011AA Property-2)
C12407 (NCI Thesaurus Property-3)
C0042232 (UMLS 2011AA Property-3)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)
Code List
Vaginal bleeding or spotting
CL Item
Not At All Bothered (Not at all bothered)
CL Item
Bothered A Little Bit (Bothered a little bit)
CL Item
Somewhat Bothered (Somewhat bothered)
CL Item
Bothered Quite A Bit (Bothered quite a bit)
CL Item
Bothered Very Much (Bothered very much)
Item
vaginal dryness
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
Code List
vaginal dryness
CL Item
Not At All Bothered (Not at all bothered)
CL Item
Bothered A Little Bit (Bothered a little bit)
CL Item
Somewhat Bothered (Somewhat bothered)
CL Item
Bothered Quite A Bit (Bothered quite a bit)
CL Item
Bothered Very Much (Bothered very much)
Item
Pain with intercourse
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25214 (NCI Thesaurus Property)
C0220825 (UMLS 2011AA Property)
C3303 (NCI Thesaurus Property-2)
C0030193 (UMLS 2011AA Property-2)
C72881 (NCI Thesaurus Property-3)
C0009253 (UMLS 2011AA Property-3)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)
Code List
Pain with intercourse
CL Item
Not At All Bothered (Not at all bothered)
CL Item
Bothered A Little Bit (Bothered a little bit)
CL Item
Somewhat Bothered (Somewhat bothered)
CL Item
Bothered Quite A Bit (Bothered quite a bit)
CL Item
Bothered Very Much (Bothered very much)
Item
Easily distracted
text
C15584 (NCI Thesaurus ObjectClass)
C0281588 (UMLS 2011AA ObjectClass)
C16960 (NCI Thesaurus Property)
C0030705 (UMLS 2011AA Property)
C62189 (NCI Thesaurus Property-2)
C1299586 (UMLS 2011AA Property-2)
C41209 (NCI Thesaurus Property-3)
C0004268 (UMLS 2011AA Property-3)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)
Code List
Easily distracted
CL Item
Not At All Bothered (Not at all bothered)
CL Item
Bothered A Little Bit (Bothered a little bit)
CL Item
Somewhat Bothered (Somewhat bothered)
CL Item
Bothered Quite A Bit (Bothered quite a bit)
CL Item
Bothered Very Much (Bothered very much)
Item
General aches and pains
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0234238 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)
Code List
General aches and pains
CL Item
Not At All Bothered (Not at all bothered)
CL Item
Bothered A Little Bit (Bothered a little bit)
CL Item
Somewhat Bothered (Somewhat bothered)
CL Item
Bothered Quite A Bit (Bothered quite a bit)
CL Item
Bothered Very Much (Bothered very much)
Item
Joint pains
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C27961 (NCI Thesaurus ObjectClass-2)
C0235032 (UMLS 2011AA ObjectClass-2)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0003862 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)
CL Item
Not At All Bothered (Not at all bothered)
CL Item
Bothered A Little Bit (Bothered a little bit)
CL Item
Somewhat Bothered (Somewhat bothered)
CL Item
Bothered Quite A Bit (Bothered quite a bit)
CL Item
Bothered Very Much (Bothered very much)
Item
Muscle stiffness
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
C34827 (NCI Thesaurus ObjectClass-2)
C0026821 (UMLS 2011AA ObjectClass-2)
Code List
Muscle stiffness
CL Item
Not At All Bothered (Not at all bothered)
CL Item
Bothered A Little Bit (Bothered a little bit)
CL Item
Somewhat Bothered (Somewhat bothered)
CL Item
Bothered Quite A Bit (Bothered quite a bit)
CL Item
Bothered Very Much (Bothered very much)
Item
Weight gain
text
C15584 (NCI Thesaurus ObjectClass)
C0281588 (UMLS 2011AA ObjectClass)
C16960 (NCI Thesaurus Property)
C0030705 (UMLS 2011AA Property)
C62754 (NCI Thesaurus Property-2)
C0043094 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)
CL Item
Not At All Bothered (Not at all bothered)
CL Item
Bothered A Little Bit (Bothered a little bit)
CL Item
Somewhat Bothered (Somewhat bothered)
CL Item
Bothered Quite A Bit (Bothered quite a bit)
CL Item
Bothered Very Much (Bothered very much)
Item
Weight loss
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
C3445 (NCI Thesaurus ObjectClass-2)
C1262477 (UMLS 2011AA ObjectClass-2)
CL Item
Not At All Bothered (Not at all bothered)
CL Item
Bothered A Little Bit (Bothered a little bit)
CL Item
Somewhat Bothered (Somewhat bothered)
CL Item
Bothered Quite A Bit (Bothered quite a bit)
CL Item
Bothered Very Much (Bothered very much)
Item
Decreased appetite
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
C25152 (NCI Thesaurus ObjectClass-2)
C0003618 (UMLS 2011AA ObjectClass-2)
Code List
Decreased appetite
CL Item
Not At All Bothered (Not at all bothered)
CL Item
Bothered A Little Bit (Bothered a little bit)
CL Item
Somewhat Bothered (Somewhat bothered)
CL Item
Bothered Quite A Bit (Bothered quite a bit)
CL Item
Bothered Very Much (Bothered very much)
Item
Unhappy with appearance of my body
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25214 (NCI Thesaurus Property)
C0220825 (UMLS 2011AA Property)
C25377 (NCI Thesaurus Property-2)
C0700364 (UMLS 2011AA Property-2)
C25446 (NCI Thesaurus Property-3)
C0392747 (UMLS 2011AA Property-3)
C62184 (NCI Thesaurus Property-4)
C0870433 (UMLS 2011AA Property-4)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)
Code List
Unhappy with appearance of my body
CL Item
Not At All Bothered (Not at all bothered)
CL Item
Bothered A Little Bit (Bothered a little bit)
CL Item
Somewhat Bothered (Somewhat bothered)
CL Item
Bothered Quite A Bit (Bothered quite a bit)
CL Item
Bothered Very Much (Bothered very much)
Item
Forgetfulness
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
C25367 (NCI Thesaurus ObjectClass)
C46084 (NCI Thesaurus ObjectClass-2)
C0233794 (UMLS 2011AA ObjectClass)
CL Item
Not At All Bothered (Not at all bothered)
CL Item
Bothered A Little Bit (Bothered a little bit)
CL Item
Somewhat Bothered (Somewhat bothered)
CL Item
Bothered Quite A Bit (Bothered quite a bit)
CL Item
Bothered Very Much (Bothered very much)
Item
Night sweats
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25214 (NCI Thesaurus Property)
C0220825 (UMLS 2011AA Property)
C3279 (NCI Thesaurus Property-2)
C0028081 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)
CL Item
Not At All Bothered (Not at all bothered)
CL Item
Bothered A Little Bit (Bothered a little bit)
CL Item
Somewhat Bothered (Somewhat bothered)
CL Item
Bothered Quite A Bit (Bothered quite a bit)
CL Item
Bothered Very Much (Bothered very much)
Item
Cold sweats
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25214 (NCI Thesaurus Property)
C0220825 (UMLS 2011AA Property)
C62180 (NCI Thesaurus Property-2)
C0009264 (UMLS 2011AA Property-2)
C13280 (NCI Thesaurus Property-3)
C0038984 (UMLS 2011AA Property-3)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)
CL Item
Not At All Bothered (Not at all bothered)
CL Item
Bothered A Little Bit (Bothered a little bit)
CL Item
Somewhat Bothered (Somewhat bothered)
CL Item
Bothered Quite A Bit (Bothered quite a bit)
CL Item
Bothered Very Much (Bothered very much)
Item
Difficulty concentrating
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C16446 (NCI Thesaurus ObjectClass-2)
C0009240 (UMLS 2011AA ObjectClass-2)
C25367 (NCI Thesaurus Property)
C43431 (NCI Thesaurus Property-2)
C0441655 (UMLS 2011AA Property)
C62189 (NCI Thesaurus Property-3)
C1299586 (UMLS 2011AA Property-2)
C41209 (NCI Thesaurus Property-4)
C0004268 (UMLS 2011AA Property-3)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
Code List
Difficulty concentrating
CL Item
Not At All Bothered (Not at all bothered)
CL Item
Bothered A Little Bit (Bothered a little bit)
CL Item
Somewhat Bothered (Somewhat bothered)
CL Item
Bothered Quite A Bit (Bothered quite a bit)
CL Item
Bothered Very Much (Bothered very much)
Item
Abdominal pain or cramping
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C12736 (NCI Thesaurus ObjectClass-2)
C0021853 (UMLS 2011AA ObjectClass-2)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C34331 (NCI Thesaurus Property-2)
C0000729 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)
Code List
Abdominal pain or cramping
CL Item
Not At All Bothered (Not at all bothered)
CL Item
Bothered A Little Bit (Bothered a little bit)
CL Item
Somewhat Bothered (Somewhat bothered)
CL Item
Bothered Quite A Bit (Bothered quite a bit)
CL Item
Bothered Very Much (Bothered very much)
Item
mouth sores
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
CL Item
Not At All Bothered (Not at all bothered)
CL Item
Bothered A Little Bit (Bothered a little bit)
CL Item
Somewhat Bothered (Somewhat bothered)
CL Item
Bothered Quite A Bit (Bothered quite a bit)
CL Item
Bothered Very Much (Bothered very much)
Item
Numbness or tingling in the hands or feet
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
Code List
Numbness or tingling in the hands or feet
CL Item
Not At All Bothered (Not at all bothered)
CL Item
Bothered A Little Bit (Bothered a little bit)
CL Item
Somewhat Bothered (Somewhat bothered)
CL Item
Bothered Quite A Bit (Bothered quite a bit)
CL Item
Bothered Very Much (Bothered very much)
Item
Gas pain
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25214 (NCI Thesaurus Property)
C0220825 (UMLS 2011AA Property)
C3303 (NCI Thesaurus Property-2)
C0030193 (UMLS 2011AA Property-2)
C12391 (NCI Thesaurus Property-3)
C0038351 (UMLS 2011AA Property-3)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)
CL Item
Not At All Bothered (Not at all bothered)
CL Item
Bothered A Little Bit (Bothered a little bit)
CL Item
Somewhat Bothered (Somewhat bothered)
CL Item
Bothered Quite A Bit (Bothered quite a bit)
CL Item
Bothered Very Much (Bothered very much)
Item
constipation
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
CL Item
Not At All Bothered (Not at all bothered)
CL Item
Bothered A Little Bit (Bothered a little bit)
CL Item
Somewhat Bothered (Somewhat bothered)
CL Item
Bothered Quite A Bit (Bothered quite a bit)
CL Item
Bothered Very Much (Bothered very much)
Item
skin problems (rash, irritation, redness)
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
Code List
skin problems (rash, irritation, redness)
CL Item
Not At All Bothered (Not at all bothered)
CL Item
Bothered A Little Bit (Bothered a little bit)
CL Item
Somewhat Bothered (Somewhat bothered)
CL Item
Bothered Quite A Bit (Bothered quite a bit)
CL Item
Bothered Very Much (Bothered very much)
Item
Skin redness or peeling on hands and feet
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C12470 (NCI Thesaurus ObjectClass-2)
C1123023 (UMLS 2011AA ObjectClass-2)
C25367 (NCI Thesaurus Property)
C50535 (NCI Thesaurus Property-2)
C0234215 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
Code List
Skin redness or peeling on hands and feet
CL Item
Not At All Bothered (Not at all bothered)
CL Item
Bothered A Little Bit (Bothered a little bit)
CL Item
Somewhat Bothered (Somewhat bothered)
CL Item
Bothered Quite A Bit (Bothered quite a bit)
CL Item
Bothered Very Much (Bothered very much)
Item
fever or shivering (shaking, chills)
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
Code List
fever or shivering (shaking, chills)
CL Item
Not At All Bothered (Not at all bothered)
CL Item
Bothered A Little Bit (Bothered a little bit)
CL Item
Somewhat Bothered (Somewhat bothered)
CL Item
Bothered Quite A Bit (Bothered quite a bit)
CL Item
Bothered Very Much (Bothered very much)
Item
Hair loss
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C12439 (NCI Thesaurus ObjectClass-2)
C0006104 (UMLS 2011AA ObjectClass-2)
C25367 (NCI Thesaurus Property)
C2865 (NCI Thesaurus Property-2)
C35041 (NCI Thesaurus Property-3)
C0038435 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL Item
Not At All Bothered (Not at all bothered)
CL Item
Bothered A Little Bit (Bothered a little bit)
CL Item
Somewhat Bothered (Somewhat bothered)
CL Item
Bothered Quite A Bit (Bothered quite a bit)
CL Item
Bothered Very Much (Bothered very much)
Item
Chest pain
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
C3303 (NCI Thesaurus ObjectClass-2)
C0030193 (UMLS 2011AA ObjectClass-2)
CL Item
Not At All Bothered (Not at all bothered)
CL Item
Bothered A Little Bit (Bothered a little bit)
CL Item
Somewhat Bothered (Somewhat bothered)
CL Item
Bothered Quite A Bit (Bothered quite a bit)
CL Item
Bothered Very Much (Bothered very much)
Item
Shortness of breath
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
C2998 (NCI Thesaurus ObjectClass-2)
C0013404 (UMLS 2011AA ObjectClass-2)
Code List
Shortness of breath
CL Item
Not At All Bothered (Not at all bothered)
CL Item
Bothered A Little Bit (Bothered a little bit)
CL Item
Somewhat Bothered (Somewhat bothered)
CL Item
Bothered Quite A Bit (Bothered quite a bit)
CL Item
Bothered Very Much (Bothered very much)
Item
Other problems
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C17649 (NCI Thesaurus Property)
C0205394 (UMLS 2011AA Property)
C25214 (NCI Thesaurus Property-2)
C0220825 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)
CL Item
Not At All Bothered (Not at all bothered)
CL Item
Bothered A Little Bit (Bothered a little bit)
CL Item
Somewhat Bothered (Somewhat bothered)
CL Item
Bothered Quite A Bit (Bothered quite a bit)
CL Item
Bothered Very Much (Bothered very much)
QualityofLifeEvaluationSpecify
Item
Please specify other problems
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25214 (NCI Thesaurus Property)
C0220825 (UMLS 2011AA Property)
Item
In general, would you say your health is
text
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25178 (NCI Thesaurus ObjectClass)
C0018684 (UMLS 2011AA ObjectClass)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
Code List
In general, would you say your health is
CL Item
Excellent (Excellent)
CL Item
Very Good (Very good)
CL Item
Good (Good)
C0205170 (NCI Metathesaurus)
Item
Compared to one year ago, how would you rate your health in general now
text
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25629 (NCI Thesaurus ObjectClass)
C0332152 (UMLS 2011AA ObjectClass)
C25178 (NCI Thesaurus ObjectClass-2)
C0018684 (UMLS 2011AA ObjectClass-2)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
Code List
Compared to one year ago, how would you rate your health in general now
CL Item
Much Better Now Than One Year Ago (Much better now than one year ago)
CL Item
Somewhat Better Now Than One Year Ago (Somewhat better now than one year ago)
CL Item
About The Same As One Year Ago (About the same as one year ago)
CL Item
Somewhat Worse Now Than One Year Ago (Somewhat worse now than one year ago)
CL Item
Much Worse Now Than One Year Ago (Much worse now than one year ago)
Item
Vigorous activities, such as running, lifting heavy objects, participating in strenuous sports
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C17708 (NCI Thesaurus ObjectClass)
C0026606 (UMLS 2011AA ObjectClass)
CL192338 (NCI Metathesaurus ObjectClass)
Code List
Vigorous activities, such as running, lifting heavy objects, participating in strenuous sports
CL Item
Yes, Limited A Lot (Yes, limited a lot)
CL Item
Yes, Limited A Little (Yes, limited a little)
CL Item
No, Not Limited At All (No, not limited at all)
Item
Moderate activities, such as moving a table, pushing a vacuum cleaner, bowling, or playing golf
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
CL323823 (NCI Metathesaurus ObjectClass)
C0221187 (NCI Metathesaurus ObjectClass-2)
Code List
Moderate activities, such as moving a table, pushing a vacuum cleaner, bowling, or playing golf
CL Item
Yes, Limited A Lot (Yes, limited a lot)
CL Item
Yes, Limited A Little (Yes, limited a little)
CL Item
No, Not Limited At All (No, not limited at all)
Item
Lifting or carrying groceries
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C17708 (NCI Thesaurus ObjectClass)
C0026606 (UMLS 2011AA ObjectClass)
C0206244 (NCI Metathesaurus ObjectClass)
Code List
Lifting or carrying groceries
CL Item
Yes, Limited A Lot (Yes, limited a lot)
CL Item
Yes, Limited A Little (Yes, limited a little)
CL Item
No, Not Limited At All (No, not limited at all)
Item
Climbing several flights of stairs
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
CL299704 (NCI Metathesaurus ObjectClass)
C17708 (NCI Thesaurus ObjectClass)
C0026606 (UMLS 2011AA ObjectClass)
Code List
Climbing several flights of stairs
CL Item
Yes, Limited A Lot (Yes, limited a lot)
CL Item
Yes, Limited A Little (Yes, limited a little)
CL Item
No, Not Limited At All (No, not limited at all)
Item
Climbing one flight of stairs
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C17708 (NCI Thesaurus ObjectClass)
C0026606 (UMLS 2011AA ObjectClass)
CL240714 (NCI Metathesaurus ObjectClass)
Code List
Climbing one flight of stairs
CL Item
Yes, Limited A Lot (Yes, limited a lot)
CL Item
Yes, Limited A Little (Yes, limited a little)
CL Item
No, Not Limited At All (No, not limited at all)
Item
Bending, kneeling or stooping
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C17708 (NCI Thesaurus ObjectClass)
C0026606 (UMLS 2011AA ObjectClass)
CL241453 (NCI Metathesaurus ObjectClass)
Code List
Bending, kneeling or stooping
CL Item
Yes, Limited A Lot (Yes, limited a lot)
CL Item
Yes, Limited A Little (Yes, limited a little)
CL Item
No, Not Limited At All (No, not limited at all)
Item
Walking more than a mile
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C17708 (NCI Thesaurus ObjectClass)
C0026606 (UMLS 2011AA ObjectClass)
CL201237 (NCI Metathesaurus ObjectClass)
Code List
Walking more than a mile
CL Item
Yes, Limited A Lot (Yes, limited a lot)
CL Item
Yes, Limited A Little (Yes, limited a little)
CL Item
No, Not Limited At All (No, not limited at all)
Item
Walking several hundred yards
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C17708 (NCI Thesaurus ObjectClass)
C0026606 (UMLS 2011AA ObjectClass)
CL201235 (NCI Metathesaurus ObjectClass)
Code List
Walking several hundred yards
CL Item
Yes, Limited A Lot (Yes, limited a lot)
CL Item
Yes, Limited A Little (Yes, limited a little)
CL Item
No, Not Limited At All (No, not limited at all)
Item
Walking one hundred yards
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0080331 (NCI Metathesaurus ObjectClass)
C17708 (NCI Thesaurus ObjectClass)
C0026606 (UMLS 2011AA ObjectClass)
Code List
Walking one hundred yards
CL Item
Yes, Limited A Lot (Yes, limited a lot)
CL Item
Yes, Limited A Little (Yes, limited a little)
CL Item
No, Not Limited At All (No, not limited at all)
Item
Bathing or dressing yourself
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C17708 (NCI Thesaurus ObjectClass)
C0026606 (UMLS 2011AA ObjectClass)
C0150141 (NCI Metathesaurus ObjectClass)
Code List
Bathing or dressing yourself
CL Item
Yes, Limited A Lot (Yes, limited a lot)
CL Item
Yes, Limited A Little (Yes, limited a little)
CL Item
No, Not Limited At All (No, not limited at all)
Item
Cut down on the amount of time you spent on work or other activities (as a result of any emotional problems such as feeling depressed or anxious)
text
C25640 (NCI Thesaurus ObjectClass)
C0392756 (UMLS 2011AA ObjectClass)
C0043227 (NCI Metathesaurus ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25178 (NCI Thesaurus Property-2)
C0018684 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
Code List
Cut down on the amount of time you spent on work or other activities (as a result of any emotional problems such as feeling depressed or anxious)
CL Item
All Of The Time (All of the time)
CL Item
Most Of The Time (Most of the time)
CL Item
Some Of The Time (Some of the time)
CL Item
A Little Of The Time (A little of the time)
CL Item
None Of The Time (None of the time)
Item
Cut down on the amount of time you spent on work or other activities (as a result of any emotional problems such as feeling depressed or anxious)
text
C25640 (NCI Thesaurus ObjectClass)
C0392756 (UMLS 2011AA ObjectClass)
C0043227 (NCI Metathesaurus ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25178 (NCI Thesaurus Property-2)
C0018684 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
Code List
Cut down on the amount of time you spent on work or other activities (as a result of any emotional problems such as feeling depressed or anxious)
CL Item
All Of The Time (All of the time)
CL Item
Most Of The Time (Most of the time)
CL Item
Some Of The Time (Some of the time)
CL Item
A Little Of The Time (A little of the time)
CL Item
None Of The Time (None of the time)
Item
Accomplished less than you would like (as a result of any emotional problems such as feeling depressed or anxious)
text
C25640 (NCI Thesaurus ObjectClass)
C0392756 (UMLS 2011AA ObjectClass)
C0033269 (NCI Metathesaurus ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25178 (NCI Thesaurus Property-2)
C0018684 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
Code List
Accomplished less than you would like (as a result of any emotional problems such as feeling depressed or anxious)
CL Item
All Of The Time (All of the time)
CL Item
Most Of The Time (Most of the time)
CL Item
Some Of The Time (Some of the time)
CL Item
A Little Of The Time (A little of the time)
CL Item
None Of The Time (None of the time)
Item
Accomplished less than you would like (as a result of any emotional problems such as feeling depressed or anxious)
text
C25640 (NCI Thesaurus ObjectClass)
C0392756 (UMLS 2011AA ObjectClass)
C0033269 (NCI Metathesaurus ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25178 (NCI Thesaurus Property-2)
C0018684 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
Code List
Accomplished less than you would like (as a result of any emotional problems such as feeling depressed or anxious)
CL Item
All Of The Time (All of the time)
CL Item
Most Of The Time (Most of the time)
CL Item
Some Of The Time (Some of the time)
CL Item
A Little Of The Time (A little of the time)
CL Item
None Of The Time (None of the time)
Item
Were limited in the kind of work or other activities (as a result of your physical health)
text
CL110648 (NCI Metathesaurus ObjectClass)
C0043227 (NCI Metathesaurus ObjectClass-2)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25178 (NCI Thesaurus Property-2)
C0018684 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
Code List
Were limited in the kind of work or other activities (as a result of your physical health)
CL Item
All Of The Time (All of the time)
CL Item
Most Of The Time (Most of the time)
CL Item
Some Of The Time (Some of the time)
CL Item
A Little Of The Time (A little of the time)
CL Item
None Of The Time (None of the time)
Item
Had difficulty performing the work or other activities (as a result of your physical health)
text
C0043227 (NCI Metathesaurus ObjectClass)
CL308262 (NCI Metathesaurus ObjectClass-2)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25178 (NCI Thesaurus Property-2)
C0018684 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
Code List
Had difficulty performing the work or other activities (as a result of your physical health)
CL Item
All Of The Time (All of the time)
CL Item
Most Of The Time (Most of the time)
CL Item
Some Of The Time (Some of the time)
CL Item
A Little Of The Time (A little of the time)
CL Item
None Of The Time (None of the time)
Item
Did work or other activities less carefully than usual (as a result of any emotional problems such as feeling depressed or anxious)
text
C25640 (NCI Thesaurus ObjectClass)
C0392756 (UMLS 2011AA ObjectClass)
CL238443 (NCI Metathesaurus ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25178 (NCI Thesaurus Property-2)
C0018684 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
Code List
Did work or other activities less carefully than usual (as a result of any emotional problems such as feeling depressed or anxious)
CL Item
All Of The Time (All of the time)
CL Item
Most Of The Time (Most of the time)
CL Item
Some Of The Time (Some of the time)
CL Item
A Little Of The Time (A little of the time)
CL Item
None Of The Time (None of the time)
Item
During the past 4 weeks, to what extent has your physical health or emotional problems interfered with your normal social activities with family, friends, neighbors, or groups
text
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25173 (NCI Thesaurus ObjectClass)
C0015576 (UMLS 2011AA ObjectClass)
C0037397 (NCI Metathesaurus ObjectClass)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
Code List
During the past 4 weeks, to what extent has your physical health or emotional problems interfered with your normal social activities with family, friends, neighbors, or groups
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
CL Item
Slightly (Slightly)
CL Item
Moderately (Moderately)
CL Item
Quite A Bit (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
Extremely (Extremely)
Item
How much bodily pain have you had during the past 4 weeks
text
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C3303 (NCI Thesaurus ObjectClass)
C0030193 (UMLS 2011AA ObjectClass)
C13041 (NCI Thesaurus ObjectClass-2)
C1268086 (UMLS 2011AA ObjectClass-2)
C25417 (NCI Thesaurus ValueDomain)
Code List
How much bodily pain have you had during the past 4 weeks
CL Item
None (None)
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
Very Mild (Very mild)
CL Item
Mild (Mild)
C70666 (NCI Thesaurus)
C2945599 (UMLS 2011AA)
CL Item
Moderate (Moderate)
CL Item
Very Severe (Very severe)
Item
During the past 4 weeks, how much did pain interfere with your normal work (including both work outside the home and housework)
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C3303 (NCI Thesaurus ObjectClass-2)
C0030193 (UMLS 2011AA ObjectClass-2)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0043227 (NCI Metathesaurus Property)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
Code List
During the past 4 weeks, how much did pain interfere with your normal work (including both work outside the home and housework)
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
CL Item
A Little Bit (A little bit)
CL Item
Moderately (Moderately)
CL Item
Quite A Bit (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
Extremely (Extremely)
Item
Did you feel full of life
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0291944 (NCI Metathesaurus Property)
Code List
Did you feel full of life
CL Item
All Of The Time (All of the time)
CL Item
Most Of The Time (Most of the time)
CL Item
Some Of The Time (Some of the time)
CL Item
A Little Of The Time (A little of the time)
CL Item
None Of The Time (None of the time)
Item
Have you been very nervous
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0027769 (NCI Metathesaurus Property)
Code List
Have you been very nervous
CL Item
All Of The Time (All of the time)
CL Item
Most Of The Time (Most of the time)
CL Item
Some Of The Time (Some of the time)
CL Item
A Little Of The Time (A little of the time)
CL Item
None Of The Time (None of the time)
Item
Have you felt so down in the dumps that nothing could cheer you up
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C2982 (NCI Thesaurus Property-2)
C0011570 (UMLS 2011AA Property-2)
Code List
Have you felt so down in the dumps that nothing could cheer you up
CL Item
All Of The Time (All of the time)
CL Item
Most Of The Time (Most of the time)
CL Item
Some Of The Time (Some of the time)
CL Item
A Little Of The Time (A little of the time)
CL Item
None Of The Time (None of the time)
Item
Have you felt calm and peaceful
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0035028 (NCI Metathesaurus Property)
Code List
Have you felt calm and peaceful
CL Item
All Of The Time (All of the time)
CL Item
Most Of The Time (Most of the time)
CL Item
Some Of The Time (Some of the time)
CL Item
A Little Of The Time (A little of the time)
CL Item
None Of The Time (None of the time)
Item
Did you have a lot of energy
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C48058 (NCI Thesaurus Property-2)
C0542479 (UMLS 2011AA Property-2)
Code List
Did you have a lot of energy
CL Item
All Of The Time (All of the time)
CL Item
Most Of The Time (Most of the time)
CL Item
Some Of The Time (Some of the time)
CL Item
A Little Of The Time (A little of the time)
CL Item
None Of The Time (None of the time)
Item
Have you felt downhearted and depressed
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0026516 (NCI Metathesaurus Property)
Code List
Have you felt downhearted and depressed
CL Item
All Of The Time (All of the time)
CL Item
Most Of The Time (Most of the time)
CL Item
Some Of The Time (Some of the time)
CL Item
A Little Of The Time (A little of the time)
CL Item
None Of The Time (None of the time)
Item
Did you feel worn out
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C3036 (NCI Thesaurus Property-2)
C0015672 (UMLS 2011AA Property-2)
Code List
Did you feel worn out
CL Item
All Of The Time (All of the time)
CL Item
Most Of The Time (Most of the time)
CL Item
Some Of The Time (Some of the time)
CL Item
A Little Of The Time (A little of the time)
CL Item
None Of The Time (None of the time)
Item
Have you been happy
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0018592 (NCI Metathesaurus Property)
Code List
Have you been happy
CL Item
All Of The Time (All of the time)
CL Item
Most Of The Time (Most of the time)
CL Item
Some Of The Time (Some of the time)
CL Item
A Little Of The Time (A little of the time)
CL Item
None Of The Time (None of the time)
Item
Did you feel tired
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0023380 (NCI Metathesaurus Property)
Code List
Did you feel tired
CL Item
All Of The Time (All of the time)
CL Item
Most Of The Time (Most of the time)
CL Item
Some Of The Time (Some of the time)
CL Item
A Little Of The Time (A little of the time)
CL Item
None Of The Time (None of the time)
Item
During the past 4 weeks, how much of the time has your physical health or emotional problems interfered with your social activities (like visiting friends, relatives, etc.)
text
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0037397 (NCI Metathesaurus ObjectClass)
C25330 (NCI Thesaurus ValueDomain)
C0449238 (UMLS 2011AA ValueDomain)
Code List
During the past 4 weeks, how much of the time has your physical health or emotional problems interfered with your social activities (like visiting friends, relatives, etc.)
CL Item
All Of The Time (All of the time)
CL Item
Most Of The Time (Most of the time)
CL Item
Some Of The Time (Some of the time)
CL Item
A Little Of The Time (A little of the time)
CL Item
None Of The Time (None of the time)
Item
I seem to get sick a little easier than other people
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0221423 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C25178 (NCI Thesaurus ValueDomain-2)
C0018684 (UMLS 2011AA ValueDomain-2)
Code List
I seem to get sick a little easier than other people
CL Item
Definitely True (Definitely true)
CL Item
Mostly True (Mostly true)
CL Item
Don't Know (Don't know)
CL Item
Mostly False (Mostly false)
CL Item
Definitely False (Definitely false)
Item
I am as healthy as anybody I know
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25178 (NCI Thesaurus Property-2)
C0018684 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C25178 (NCI Thesaurus ValueDomain-2)
C0018684 (UMLS 2011AA ValueDomain-2)
Code List
I am as healthy as anybody I know
CL Item
Definitely True (Definitely true)
CL Item
Mostly True (Mostly true)
CL Item
Don't Know (Don't know)
CL Item
Mostly False (Mostly false)
CL Item
Definitely False (Definitely false)
Item
I expect my health to get worse
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
CL288707 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C25178 (NCI Thesaurus ValueDomain-2)
C0018684 (UMLS 2011AA ValueDomain-2)
Code List
I expect my health to get worse
CL Item
Definitely True (Definitely true)
CL Item
Mostly True (Mostly true)
CL Item
Don't Know (Don't know)
CL Item
Mostly False (Mostly false)
CL Item
Definitely False (Definitely false)
Item
My health is excellent
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
CL286081 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C25178 (NCI Thesaurus ValueDomain-2)
C0018684 (UMLS 2011AA ValueDomain-2)
Code List
My health is excellent
CL Item
Definitely True (Definitely true)
CL Item
Mostly True (Mostly true)
CL Item
Don't Know (Don't know)
CL Item
Mostly False (Mostly false)
CL Item
Definitely False (Definitely false)
PatientFatigueMostAssessmentScale
Item
Rate your level of fatigue on the day you felt most fatigued during the past week
float
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C3036 (NCI Thesaurus Property-2)
C0015672 (UMLS 2011AA Property)
C25258 (NCI Thesaurus Property-3)
C0205393 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
PatientFatigueLowestAssessmentScale
Item
Rate your level of fatigue on the day you felt least fatigued during the past week
float
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C3036 (NCI Thesaurus Property-2)
C0015672 (UMLS 2011AA Property)
C43517 (NCI Thesaurus Property-3)
C1708760 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
PatientFatigueAverageAssessmentScale
Item
Rate your level of fatigue on the average during the past week
float
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C3036 (NCI Thesaurus Property-2)
C0015672 (UMLS 2011AA Property)
C37917 (NCI Thesaurus Property-3)
C1510992 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
PatientFatigueCurrentAssessmentScale
Item
Rate your level of fatigue right now
float
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C25471 (NCI Thesaurus Property-2)
C0521116 (UMLS 2011AA Property)
C3036 (NCI Thesaurus Property-3)
C0015672 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
PatientGeneralizedActivityInterferenceSymptomScale
Item
Rate how much, in the past week, fatigue interfered with your general level of activity
float
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C43431 (NCI Thesaurus Property)
C0441655 (UMLS 2011AA Property)
C4876 (NCI Thesaurus Property-2)
C1457887 (UMLS 2011AA Property-2)
C63764 (NCI Thesaurus Property-3)
C0205246 (UMLS 2011AA Property-3)
C72886 (NCI Thesaurus Property-4)
C0521102 (UMLS 2011AA Property-4)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
QualityofLifeFatigueWashEvaluationScale
Item
Rate how much, in the past week, fatigue interfered with your ability to bathe and dress yourself
float
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25214 (NCI Thesaurus Property)
C0220825 (UMLS 2011AA Property)
C3036 (NCI Thesaurus Property-2)
C0015672 (UMLS 2011AA Property-2)
C65077 (NCI Thesaurus Property-3)
C0441648 (UMLS 2011AA Property-3)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
PatientWorkInterferenceSymptomScale
Item
Rate how much, in the past week, fatigue interfered with your normal work activity (includes both work outside the home and housework)
float
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C4876 (NCI Thesaurus Property)
C1457887 (UMLS 2011AA Property)
C74299 (NCI Thesaurus Property-2)
C0043227 (UMLS 2011AA Property-2)
C72886 (NCI Thesaurus Property-3)
C0521102 (UMLS 2011AA Property-3)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
Quality-of-LifeAssessmentPatientDifficultyAttentionConcentrationSymptomScale
Item
Rate how much, in the past week, fatigue interfered with your ability to concentrate
float
C15584 (NCI Thesaurus ObjectClass)
C0281588 (UMLS 2011AA ObjectClass)
C16960 (NCI Thesaurus Property)
C0030705 (UMLS 2011AA Property)
C62189 (NCI Thesaurus Property-2)
C1299586 (UMLS 2011AA Property-2)
C41209 (NCI Thesaurus Property-3)
C0004268 (UMLS 2011AA Property-3)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
PatientRelationshipInterferenceSymptomScale
Item
Rate how much, in the past week, fatigue interfered with your relations with other people
float
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25648 (NCI Thesaurus Property)
C0439849 (UMLS 2011AA Property)
C4876 (NCI Thesaurus Property-2)
C1457887 (UMLS 2011AA Property-2)
C72886 (NCI Thesaurus Property-3)
C0521102 (UMLS 2011AA Property-3)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
PatientLifeJoyInterferenceSymptomScale
Item
Rate how much, in the past week, fatigue interfered with your enjoyment of life
float
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C37987 (NCI Thesaurus Property)
C0376558 (UMLS 2011AA Property)
C4876 (NCI Thesaurus Property-2)
C1457887 (UMLS 2011AA Property-2)
C77961 (NCI Thesaurus Property-3)
C0018592 (UMLS 2011AA Property-3)
C72886 (NCI Thesaurus Property-4)
C0521102 (UMLS 2011AA Property-4)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
PatientMoodInterferenceSymptomScale
Item
Rate how much, in the past week, fatigue interfered with your mood
float
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C4876 (NCI Thesaurus Property)
C1457887 (UMLS 2011AA Property)
C72886 (NCI Thesaurus Property-2)
C0521102 (UMLS 2011AA Property-2)
C72883 (NCI Thesaurus Property-3)
C0026516 (UMLS 2011AA Property-3)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
PatientFatigueDayDurationAssessmentScale
Item
Indicate how many days, in the past week, you felt fatigued for any part of the day
float
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C3036 (NCI Thesaurus Property-2)
C0015672 (UMLS 2011AA Property)
C25301 (NCI Thesaurus Property-3)
C0439228 (UMLS 2011AA Property-2)
C25330 (NCI Thesaurus Property-4)
C0449238 (UMLS 2011AA Property-3)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
PatientFatigueDurationTimeAssessmentScale
Item
Rate how much of the day, on average, you felt fatigued in the past week
float
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C3036 (NCI Thesaurus Property-2)
C0015672 (UMLS 2011AA Property)
C25207 (NCI Thesaurus Property-3)
C0040223 (UMLS 2011AA Property-2)
C25330 (NCI Thesaurus Property-4)
C0449238 (UMLS 2011AA Property-3)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
Item
Please score your overall quality of life as of today on an 11-point scale where 0 indicates being in the worst possible health and 10 indicates being in perfect health
text
C17047 (NCI Thesaurus Property)
C0518214 (UMLS 2011AA Property)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property-2)
C0031809 (UMLS 2011AA Property-2)
C25338 (NCI Thesaurus ValueDomain)
C0449820 (UMLS 2011AA ValueDomain)
Code List
Please score your overall quality of life as of today on an 11-point scale where 0 indicates being in the worst possible health and 10 indicates being in perfect health
CL Item
0 (0)
C0919414 (NCI Metathesaurus)
CL Item
2 (2)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)