ID

43498

Descripción

RTOG-00522 HP: Radiation Therapy Oncology Group Miscellaneous Patient Assessment Form NCT00265941 Radiation Therapy and Cisplatin With or Without Cetuximab in Treating Patients With Stage III or Stage IV Head and Neck Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=F5E8260F-4AEB-157F-E034-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=F5E8260F-4AEB-157F-E034-0003BA3F9857

Palabras clave

Versiones (6)
  1. 19/9/12 19/9/12 -
  2. 11/8/14 11/8/14 - Martin Dugas
  3. 11/8/14 11/8/14 - Martin Dugas
  4. 9/1/15 9/1/15 - Martin Dugas
  5. 21/6/15 21/6/15 -
  6. 20/9/21 20/9/21 -
Subido en

20 de septiembre de 2021

DOI

Para solicitar uno, por favor iniciar sesión.

Licencia

Creative Commons BY-NC 3.0 Legacy
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RTOG-0522 HP: Radiation Therapy Oncology Group Miscellaneous Patient Assessment Form NCT00265941

Inglés

No Instruction available.

1 formularios  
  1. StudyEvent: RTOG-0522 HP: Radiation Therapy Oncology Group Miscellaneous Patient Assessment Form
    1. No Instruction available.
RTOG clinical trial administrative data
Descripción

RTOG clinical trial administrative data

RTOG Study No.
Descripción

Protocol ID RTOG

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C3274381
NCI Thesaurus ObjectClass
C25320
UMLS CUI-2
C1514695
NCI Thesaurus Property
C19778
NCI Thesaurus Property-2
C25364
Case #
Descripción

RadiationTherapyOncologyGroupPatientCaseIdentifierNumber

Tipo de datos

text

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus ObjectClass-2
C19778
UMLS 2011AA ObjectClass-2
C1514695
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus Property-2
C49152
UMLS 2011AA Property-2
C1706256
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
Institution Name
Descripción

Institution Name

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C1301943
NCI Thesaurus ObjectClass
C21541
NCI Thesaurus ValueDomain-2
C21541
NCI Thesaurus Property
C25364
Institution No.
Descripción

Institution Number

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C1301943
NCI Thesaurus ObjectClass
C21541
UMLS CUI-2
C0805701
NCI Thesaurus Property
C25364
Patient Initials
Descripción

Patient Initials

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C2986440
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25536
RTOG Patient ID
Descripción

Trial subject ID RTOG

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C2348585
NCI Thesaurus ObjectClass
C16960
UMLS CUI-2
C1514695
NCI Thesaurus Property
C19778
NCI Thesaurus Property-2
C25364
Amended data
Descripción

Data amended

Tipo de datos

boolean

Alias
NCI Thesaurus ValueDomain
C38148
UMLS CUI-1
C0680532
NCI Thesaurus ObjectClass
C25474
NCI Thesaurus Property
C25416
Miscellaneous Patient Assessment
Descripción

Miscellaneous Patient Assessment

MOBILITY
Descripción

QOLMobilityAssessmentStatus

Tipo de datos

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus ValueDomain
C25688
UMLS 2011AA ValueDomain
C0449438
NCI Metathesaurus Property
C0449580
SELF CARE
Descripción

QualityofLifeSelfCareAssessmentStatus

Tipo de datos

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus ValueDomain
C25688
UMLS 2011AA ValueDomain
C0449438
NCI Thesaurus Property-2
C15324
UMLS 2011AA Property-2
C0518889
USUAL ACTIVITIES (e.g. work, study, housework, family, or leisure activities)
Descripción

QOLPhyscialActivityAssessmentStatus

Tipo de datos

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property-2
C17708
UMLS 2011AA Property-2
C0026606
NCI Thesaurus ValueDomain
C25688
UMLS 2011AA ValueDomain
C0449438
PAIN/DISCOMFORT
Descripción

QOLPainAssessmentStatus

Tipo de datos

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property-2
C3303
UMLS 2011AA Property-2
C0030193
NCI Thesaurus ValueDomain
C25688
UMLS 2011AA ValueDomain
C0449438
ANXIETY/DEPRESSION
Descripción

QOLAnxietyAssessmentStatus

Tipo de datos

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property-2
C26696
UMLS 2011AA Property-2
C0003467
NCI Thesaurus ValueDomain
C25688
UMLS 2011AA ValueDomain
C0449438
Score (Best Imaginable Health State)
Descripción

PatientHealthScore

Tipo de datos

float

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25178
UMLS 2011AA Property
C0018684
NCI Thesaurus ValueDomain
C25338
UMLS 2011AA ValueDomain
C0449820
HAVE YOU EXPERIENCED SERIOUS ILLNESS In yourself?
Descripción

PatientSeriousSicknessInd-2

Tipo de datos

boolean

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C54035
UMLS 2011AA Property
C0205404
NCI Metathesaurus Property
C0221423
HAVE YOU EXPERIENCED SERIOUS ILLNESS In your family?
Descripción

ImmediateSeriousSicknessInd-2

Tipo de datos

boolean

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus Property
C54035
UMLS 2011AA Property
C0205404
NCI Metathesaurus ObjectClass
CL282488
NCI Metathesaurus Property
C0221423
HAVE YOU EXPERIENCED SERIOUS ILLNESS In caring for others?
Descripción

CareAssistantPatientSeriousSicknessInd-2

Tipo de datos

boolean

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Metathesaurus ObjectClass
CL259930
NCI Thesaurus Property
C54035
UMLS 2011AA Property
C0205404
NCI Metathesaurus Property
C0221423
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
WHAT IS YOUR AGE IN YEARS?
Descripción

PatientAgeYearCount

Tipo de datos

float

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus ValueDomain
C29848
UMLS 2011AA ValueDomain
C0439234
NCI Thesaurus ValueDomain-2
C25463
UMLS 2011AA ValueDomain-2
C0750480
NCI Thesaurus Property
C25150
UMLS 2011AA Property
C0001779
Are you
Descripción

QualityofLifePatientGenderAssessmentCategory

Tipo de datos

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus ObjectClass-2
C16960
UMLS 2011AA ObjectClass-2
C0030705
NCI Thesaurus ObjectClass-3
C17357
UMLS 2011AA ObjectClass-3
C0079399
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus ValueDomain
C25372
UMLS 2011AA ValueDomain
C0683312
ARE YOU A current smoker
Descripción

Current Smoker

Tipo de datos

boolean

Alias
NCI Thesaurus ValueDomain
C38148
UMLS CUI-1
C3241966
NCI Thesaurus Property
C25471
NCI Thesaurus ObjectClass
C17934
NCI Metathesaurus Property
C0449865
ARE YOU An ex-smoker
Descripción

Smoking use

Tipo de datos

boolean

Alias
NCI Thesaurus ValueDomain
C38148
UMLS CUI-1
C3241966
NCI Thesaurus ObjectClass
C17934
NCI Thesaurus Property
C25340
ARE YOU A never smoker
Descripción

NoSmokingHistoryInd-2

Tipo de datos

boolean

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus ObjectClass
C49487
UMLS 2011AA ObjectClass
C1298908
NCI Thesaurus ObjectClass-2
C17934
UMLS 2011AA ObjectClass-2
C0453996
NCI Thesaurus Property
C18772
UMLS 2011AA Property
C0262926
DO YOU NOW, OR DID YOU EVER, WORK IN HEALTH OR SOCIAL SERVICES?
Descripción

SocialWorkHistoryInd-2

Tipo de datos

boolean

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus Property
C18772
UMLS 2011AA Property
C0262926
NCI Thesaurus ObjectClass
C17142
UMLS 2011AA ObjectClass
C0037441
IF SO, IN WHAT CAPACITY?
Descripción

SocialWorkHistoryRoleSpecify

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus Property
C18772
UMLS 2011AA Property
C0262926
NCI Thesaurus ObjectClass
C17142
UMLS 2011AA ObjectClass
C0037441
NCI Thesaurus ValueDomain-2
C25199
UMLS 2011AA ValueDomain-2
C0035820
WHICH OF THE FOLLOWING BEST DESCRIBES YOUR MAIN ACTIVITY?
Descripción

PersonOccupationType

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C25193
UMLS 2011AA Property
C0028811
Other
Descripción

PersonOccupationSpecify

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C25193
UMLS 2011AA Property
C0028811
DID YOUR EDUCATION CONTINUE AFTER THE MINIMUM SCHOOL LEAVING AGE?
Descripción

ContinuedEducationMinimumAgeatLeavingSchoolInd-2

Tipo de datos

boolean

Alias
NCI Thesaurus ObjectClass
C16529
UMLS 2011AA ObjectClass
C0013622
NCI Metathesaurus ObjectClass
C0750536
NCI Thesaurus Property
C25570
UMLS 2011AA Property
C1524031
NCI Metathesaurus Property
CL238333
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
DO YOU HAVE A DEGREE OR EQUIVALENT PROFESSIONAL QUALIFICATION?
Descripción

PatientEducationalStatusInd-2

Tipo de datos

boolean

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Metathesaurus Property
C0013658
IF YOU KNOW YOUR POSTCODE, WOULD YOU PLEASE WRITE IT HERE
Descripción

QualityofLifePatientAddressPostalCode

Tipo de datos

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus ObjectClass-2
C16960
UMLS 2011AA ObjectClass-2
C0030705
NCI Metathesaurus ObjectClass
C1442065
NCI Thesaurus Property
C25621
UMLS 2011AA Property
C1514254
NCI Thesaurus ValueDomain
C25162
UMLS 2011AA ValueDomain
C0805701
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No Instruction available.

1 formularios
  1. StudyEvent: RTOG-0522 HP: Radiation Therapy Oncology Group Miscellaneous Patient Assessment Form
    1. No Instruction available.
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
RTOG clinical trial administrative data
Protocol ID RTOG
Item
RTOG Study No.
text
C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1514695 (UMLS CUI-2)
C19778 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
RadiationTherapyOncologyGroupPatientCaseIdentifierNumber
Item
Case #
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C19778 (NCI Thesaurus ObjectClass-2)
C1514695 (UMLS 2011AA ObjectClass-2)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C49152 (NCI Thesaurus Property-2)
C1706256 (UMLS 2011AA Property-2)
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
Institution Name
Item
Institution Name
text
C25191 (NCI Thesaurus ValueDomain)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C21541 (NCI Thesaurus ValueDomain-2)
C25364 (NCI Thesaurus Property)
Institution Number
Item
Institution No.
text
C25337 (NCI Thesaurus ValueDomain)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C0805701 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
Patient Initials
Item
Patient Initials
text
C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
Trial subject ID RTOG
Item
RTOG Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1514695 (UMLS CUI-2)
C19778 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
Data amended
Item
Amended data
boolean
C38148 (NCI Thesaurus ValueDomain)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
Item Group
Miscellaneous Patient Assessment
Item
MOBILITY
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
C0449580 (NCI Metathesaurus Property)
CL.2
Code List
MOBILITY
CL Item
I Have No Problems In Walking About (I have no problems in walking about)
CL Item
I Have Some Problems In Walking About (I have some problems in walking about)
CL Item
I Am Confined To Bed (I am confined to bed)
Item
SELF CARE
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
C15324 (NCI Thesaurus Property-2)
C0518889 (UMLS 2011AA Property-2)
CL.3
Code List
SELF CARE
CL Item
I Have No Problems With Self Care (I have no problems with self care)
CL Item
I Have Some Problems Washing Or Dressing Myself (I have some problems washing or dressing myself)
CL Item
I Am Unable To Wash Or Dress Myself (I am unable to wash or dress myself)
Item
USUAL ACTIVITIES (e.g. work, study, housework, family, or leisure activities)
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C17708 (NCI Thesaurus Property-2)
C0026606 (UMLS 2011AA Property-2)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
CL.4
Code List
USUAL ACTIVITIES (e.g. work, study, housework, family, or leisure activities)
CL Item
I Have No Problems With Performing My Usual Activities (I have no problems with performing my usual activities)
CL Item
I Have Some Problems With Performing My Usual Activities (I have some problems with performing my usual activities)
CL Item
I Am Unable To Perform My Usual Activities (I am unable to perform my usual activities)
Item
PAIN/DISCOMFORT
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C3303 (NCI Thesaurus Property-2)
C0030193 (UMLS 2011AA Property-2)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
CL.5
Code List
PAIN/DISCOMFORT
CL Item
I Have No Pain Or Discomfort (I have no pain or discomfort)
CL Item
I Have Moderate Pain Or Discomfort (I have moderate pain or discomfort)
CL Item
I Have Extreme Pain Or Discomfort (I have extreme pain or discomfort)
Item
ANXIETY/DEPRESSION
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C26696 (NCI Thesaurus Property-2)
C0003467 (UMLS 2011AA Property-2)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
CL.6
Code List
ANXIETY/DEPRESSION
CL Item
I Am Not Anxious Or Depressed (I am not anxious or depressed)
CL Item
I Am Moderately Anxious Or Depressed (I am moderately anxious or depressed)
CL Item
I Am Extremely Anxious Or Depressed (I am extremely anxious or depressed)
PatientHealthScore
Item
Score (Best Imaginable Health State)
float
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25178 (NCI Thesaurus Property)
C0018684 (UMLS 2011AA Property)
C25338 (NCI Thesaurus ValueDomain)
C0449820 (UMLS 2011AA ValueDomain)
PatientSeriousSicknessInd-2
Item
HAVE YOU EXPERIENCED SERIOUS ILLNESS In yourself?
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C54035 (NCI Thesaurus Property)
C0205404 (UMLS 2011AA Property)
C0221423 (NCI Metathesaurus Property)
ImmediateSeriousSicknessInd-2
Item
HAVE YOU EXPERIENCED SERIOUS ILLNESS In your family?
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C54035 (NCI Thesaurus Property)
C0205404 (UMLS 2011AA Property)
CL282488 (NCI Metathesaurus ObjectClass)
C0221423 (NCI Metathesaurus Property)
CareAssistantPatientSeriousSicknessInd-2
Item
HAVE YOU EXPERIENCED SERIOUS ILLNESS In caring for others?
boolean
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
CL259930 (NCI Metathesaurus ObjectClass)
C54035 (NCI Thesaurus Property)
C0205404 (UMLS 2011AA Property)
C0221423 (NCI Metathesaurus Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
PatientAgeYearCount
Item
WHAT IS YOUR AGE IN YEARS?
float
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C29848 (NCI Thesaurus ValueDomain)
C0439234 (UMLS 2011AA ValueDomain)
C25463 (NCI Thesaurus ValueDomain-2)
C0750480 (UMLS 2011AA ValueDomain-2)
C25150 (NCI Thesaurus Property)
C0001779 (UMLS 2011AA Property)
Item
Are you
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C16960 (NCI Thesaurus ObjectClass-2)
C0030705 (UMLS 2011AA ObjectClass-2)
C17357 (NCI Thesaurus ObjectClass-3)
C0079399 (UMLS 2011AA ObjectClass-3)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25372 (NCI Thesaurus ValueDomain)
C0683312 (UMLS 2011AA ValueDomain)
CL.10
Code List
Are you
CL Item
Female (FEMALE)
C46110 (NCI Thesaurus)
C0086287 (UMLS 2011AA)
CL Item
Male (MALE)
C46109 (NCI Thesaurus)
C1706180 (UMLS 2011AA)
Current Smoker
Item
ARE YOU A current smoker
boolean
C38148 (NCI Thesaurus ValueDomain)
C3241966 (UMLS CUI-1)
C25471 (NCI Thesaurus Property)
C17934 (NCI Thesaurus ObjectClass)
C0449865 (NCI Metathesaurus Property)
Smoking use
Item
ARE YOU An ex-smoker
boolean
C38148 (NCI Thesaurus ValueDomain)
C3241966 (UMLS CUI-1)
C17934 (NCI Thesaurus ObjectClass)
C25340 (NCI Thesaurus Property)
NoSmokingHistoryInd-2
Item
ARE YOU A never smoker
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C49487 (NCI Thesaurus ObjectClass)
C1298908 (UMLS 2011AA ObjectClass)
C17934 (NCI Thesaurus ObjectClass-2)
C0453996 (UMLS 2011AA ObjectClass-2)
C18772 (NCI Thesaurus Property)
C0262926 (UMLS 2011AA Property)
SocialWorkHistoryInd-2
Item
DO YOU NOW, OR DID YOU EVER, WORK IN HEALTH OR SOCIAL SERVICES?
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C18772 (NCI Thesaurus Property)
C0262926 (UMLS 2011AA Property)
C17142 (NCI Thesaurus ObjectClass)
C0037441 (UMLS 2011AA ObjectClass)
SocialWorkHistoryRoleSpecify
Item
IF SO, IN WHAT CAPACITY?
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C18772 (NCI Thesaurus Property)
C0262926 (UMLS 2011AA Property)
C17142 (NCI Thesaurus ObjectClass)
C0037441 (UMLS 2011AA ObjectClass)
C25199 (NCI Thesaurus ValueDomain-2)
C0035820 (UMLS 2011AA ValueDomain-2)
Item
WHICH OF THE FOLLOWING BEST DESCRIBES YOUR MAIN ACTIVITY?
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25193 (NCI Thesaurus Property)
C0028811 (UMLS 2011AA Property)
CL.15
Code List
WHICH OF THE FOLLOWING BEST DESCRIBES YOUR MAIN ACTIVITY?
CL Item
Employed (In employment or self employment)
CL Item
Homemaker (Housework)
C0555052 (NCI Metathesaurus)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
CL Item
Retired (Retired)
CL Item
Unemployed (Seeking work)
C0425086 (NCI Metathesaurus)
CL Item
Student (Student)
PersonOccupationSpecify
Item
Other
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25193 (NCI Thesaurus Property)
C0028811 (UMLS 2011AA Property)
ContinuedEducationMinimumAgeatLeavingSchoolInd-2
Item
DID YOUR EDUCATION CONTINUE AFTER THE MINIMUM SCHOOL LEAVING AGE?
boolean
C16529 (NCI Thesaurus ObjectClass)
C0013622 (UMLS 2011AA ObjectClass)
C0750536 (NCI Metathesaurus ObjectClass)
C25570 (NCI Thesaurus Property)
C1524031 (UMLS 2011AA Property)
CL238333 (NCI Metathesaurus Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
PatientEducationalStatusInd-2
Item
DO YOU HAVE A DEGREE OR EQUIVALENT PROFESSIONAL QUALIFICATION?
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C0013658 (NCI Metathesaurus Property)
QualityofLifePatientAddressPostalCode
Item
IF YOU KNOW YOUR POSTCODE, WOULD YOU PLEASE WRITE IT HERE
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C16960 (NCI Thesaurus ObjectClass-2)
C0030705 (UMLS 2011AA ObjectClass-2)
C1442065 (NCI Metathesaurus ObjectClass)
C25621 (NCI Thesaurus Property)
C1514254 (UMLS 2011AA Property)
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
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