ID

43108

Description

FACT-0 (Version 4), GOG-0202 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=BA8117F5-B6F7-2F74-E034-0003BA12F5E7

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=BA8117F5-B6F7-2F74-E034-0003BA12F5E7

Keywords

Clinical Trial

Ovarian Neoplasms

Quality of Life

9/19/12 9/19/12 -
9/20/21 9/20/21 -

Uploaded on

September 20, 2021

DOI

To request one please log in.

License

Creative Commons BY-NC 3.0 Legacy

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Ovarian Cancer null Quality of Life - FACT-0 (Version 4), GOG-0202 - 2101017v3.0

model
Details

Below is a list of statements that other people with your illness have said are important. By circling one (1) number per line, please indicate how true each statement has been for you during the past 7 days.

1 forms

StudyEvent: FACT-0 (Version 4), GOG-0202
1. Below is a list of statements that other people with your illness have said are important. By circling one (1) number per line, please indicate how true each statement has been for you during the past 7 days.

Name

Type

Description | Question | Decode (Coded Value)

Data type

Alias

Physical Well-Being

Item Group

Physical Well-being

PatientEnergyAssessmentQualityofLifeScale

Item

I have a lack of energy

text

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C48058 (NCI Thesaurus Property)
C0542479 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)

CL.1

Code List

I have a lack of energy

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
C2003901 (UMLS 2011AA)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

PatientNauseaAssessmentQualityofLifeScale

Item

I have nausea

text

C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C3258 (NCI Thesaurus Property)
C0027497 (UMLS 2011AA Property)

CL.2

Code List

I have nausea

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
C2003901 (UMLS 2011AA)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

PatientGeneralPhysicalConditionAssessmentQualityofLifeScale

Item

Because of my physical condition, I have trouble meeting the needs of my family

text

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
CL104641 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)

CL.3

Code List

Because of my physical condition, I have trouble meeting the needs of my family

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
C2003901 (UMLS 2011AA)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

PatientPainAssessmentQualityofLifeScale

Item

I have pain

text

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C3303 (NCI Thesaurus Property)
C0030193 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)

CL.4

Code List

I have pain

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
C2003901 (UMLS 2011AA)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

PatientAdverseEventAssessmentQualityofLifeScale

Item

I am bothered by side effects of treatment

text

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C41331 (NCI Thesaurus Property)
C0877248 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)

CL.5

Code List

I am bothered by side effects of treatment

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
C2003901 (UMLS 2011AA)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

PatientMalaiseAssessmentQualityofLifeScale

Item

I feel ill

text

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C3832 (NCI Thesaurus Property)
C0231218 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)

CL.6

Code List

I feel ill

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
C2003901 (UMLS 2011AA)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

PatientBedRestAssessmentQualityofLifeScale

Item

I am forced to spend time in bed

text

CL.7

Code List

I am forced to spend time in bed

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
C2003901 (UMLS 2011AA)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

SOCIAL/FAMILY WELL-BEING

Item Group

Social/family Well-being

Ifeelclosetomyfriends

Item

I feel close to my friends

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.8

Code List

I feel close to my friends

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

Igetemotionalsupportfrommyfamily

Item

I get emotional support from my family

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.9

Code List

I get emotional support from my family

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

Igetsupportfrommyfriends

Item

I get support from my friends

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.10

Code List

I get support from my friends

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

Myfamilyhasacceptedmyillness

Item

My family has accepted my illness

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.11

Code List

My family has accepted my illness

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

Iamsatisfiedwithfamilycommunicationaboutmyilless

Item

I am satisfied with family communication about my illess

text

C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)

CL.12

Code List

I am satisfied with family communication about my illess

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
C2003901 (UMLS 2011AA)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

Ifeelclosetomypartner(orthepersonwhoismymainsupport)

Item

I feel close to my partner

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.13

Code List

I feel close to my partner

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

Iamsatisfiedwithmysexlife

Item

I am satisfied with my sex life

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.14

Code List

I am satisfied with my sex life

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

EMOTIONAL WELL_BEING

Item Group

Emotional Well_being

Ifeelsad

Item

I feel sad

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.15

Code List

I feel sad

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

IamsatisfiedwithhowIamcopingwithmyillness

Item

I am satisfied with how I am coping with my illness

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.16

Code List

I am satisfied with how I am coping with my illness

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

Iamlosinghopeinthefightagainstmyillness

Item

I am losing hope in the fight against my illness

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.17

Code List

I am losing hope in the fight against my illness

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

Ifeelnervous

Item

I feel nervous

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.18

Code List

I feel nervous

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

Iworryaboutdying

Item

I worry about dying

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.19

Code List

I worry about dying

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

Iworrythatmyconditionwillgetworse

Item

I worry that my condition will get worse

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.20

Code List

I worry that my condition will get worse

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

FUNCTIONAL WELL-BEING

Item Group

Functional Well-being

AbilityPatientWorkAssessmentQualityofLifeScale

Item

Iam able to work (include work at home)

text

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C0085732 (NCI Metathesaurus ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0043227 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)

CL.21

Code List

Iam able to work (include work at home)

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
C2003901 (UMLS 2011AA)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

SatisfactionPatientWorkAssessmentQualityofLifeScale

Item

My work (include work at home) is fulfilling

text

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C62185 (NCI Thesaurus Property)
C0242428 (UMLS 2011AA Property)
C0043227 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)

CL.22

Code List

My work (include work at home) is fulfilling

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
C2003901 (UMLS 2011AA)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

PatientEnjoymentofLifeAssessmentQualityofLifeAssessment

Item

I am able to enjoy life

text

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
CL196329 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)

CL.23

Code List

I am able to enjoy life

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
C2003901 (UMLS 2011AA)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

Ihaveacceptedmyillness

Item

I have accepted my illness

text

C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)

CL.24

Code List

I have accepted my illness

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
C2003901 (UMLS 2011AA)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

Iamsleepingwell

Item

I am sleeping well

text

C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)

CL.25

Code List

I am sleeping well

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
C2003901 (UMLS 2011AA)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

PatientQualityofLifeAssessmentQualityofLifeScale

Item

I am content with the quality of my life right now

text

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C17047 (NCI Thesaurus Property)
C0518214 (UMLS 2011AA Property)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)

CL.27

Code List

I am content with the quality of my life right now

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
C2003901 (UMLS 2011AA)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

PatientQualityofLifeAssessmentQualityofLifeScale

Item

I am content with the quality of my life right now

text

CL.27

Code List

I am content with the quality of my life right now

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
C2003901 (UMLS 2011AA)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

Additional Concerns

Item Group

Additional Concerns

QualityofLifeStomachSwellingEvaluationScale

Item

I have swelling in my stomach area

text

C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25214 (NCI Thesaurus Property)
C0220825 (UMLS 2011AA Property)
C12391 (NCI Thesaurus Property)
C0038351 (UMLS 2011AA Property)
C3399 (NCI Thesaurus Property)
C0038999 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)

CL.28

Code List

I have swelling in my stomach area

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
C2003901 (UMLS 2011AA)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

PatientWeightLossAssessmentQualityofLifeScale

Item

I am losing weight

text

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C3445 (NCI Thesaurus Property)
C1262477 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)

CL.29

Code List

I am losing weight

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
C2003901 (UMLS 2011AA)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

BowelPatientIncontinenceAssessmentQualityofLifeScale

Item

I have control of my bowels

text

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C12736 (NCI Thesaurus ObjectClass)
C0021853 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0021167 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)

CL.30

Code List

I have control of my bowels

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
C2003901 (UMLS 2011AA)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

Ihavebeenvomiting

Item

I have been vomiting

text

C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)

CL.31

Code List

I have been vomiting

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
C2003901 (UMLS 2011AA)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

Iambotheredbyhairloss

Item

I am bothered by hair loss

text

C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)

CL.32

Code List

I am bothered by hair loss

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
C2003901 (UMLS 2011AA)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

PatientAppetiteAssessmentQualityofLifeScale

Item

I have a good appetite

text

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25152 (NCI Thesaurus Property)
C0003618 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)

CL.33

Code List

I have a good appetite

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
C2003901 (UMLS 2011AA)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

Iliketheappearanceofmybody

Item

I like the appearance of my body

text

C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)

CL.34

Code List

I like the appearance of my body

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
C2003901 (UMLS 2011AA)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

Iamabletogetaroundbymyself

Item

I am able to get around by myself

text

C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)

CL.35

Code List

I am able to get around by myself

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
C2003901 (UMLS 2011AA)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

Iamabletofeellikeawoman

Item

I am able to feel like a woman

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.36

Code List

I am able to feel like a woman

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

QualityofLifeStomachMuscleCrampEvaluationScale

Item

I have cramps in my stomach area

text

C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25214 (NCI Thesaurus Property)
C0220825 (UMLS 2011AA Property)
C12391 (NCI Thesaurus Property)
C0038351 (UMLS 2011AA Property)
C34827 (NCI Thesaurus Property)
C0026821 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)

CL.37

Code List

I have cramps in my stomach area

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
C2003901 (UMLS 2011AA)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

Iaminterestedinsex

Item

I am interested in sex

text

C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)

CL.38

Code List

I am interested in sex

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
C2003901 (UMLS 2011AA)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

Ihaveconcernsaboutmyabilitytohavechildren

Item

I have concerns about my ability to have children

text

C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)

CL.39

Code List

I have concerns about my ability to have children

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
C2003901 (UMLS 2011AA)

CL Item

A Little Bit (A little bit)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

CCRR MODULE

Item Group

Ccrr Module For Fact-0 (version 4), Gog-0202

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Description

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Keywords

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Model comments :

Itemgroup comments for :

Item comments for :

Ovarian Cancer null Quality of Life - FACT-0 (Version 4), GOG-0202 - 2101017v3.0

Below is a list of statements that other people with your illness have said are important. By circling one (1) number per line, please indicate how true each statement has been for you during the past 7 days.

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