ID

44046

Beschrijving

Participation Restrictions in Breast Cancer Survivors; ODM derived from: https://clinicaltrials.gov/show/NCT01225328

Link

https://clinicaltrials.gov/show/NCT01225328

Trefwoorden

  1. 30-08-19 30-08-19 -
  2. 20-09-21 20-09-21 -
Houder van rechten

See clinicaltrials.gov

Geüploaded op

20 september 2021

DOI

Voor een aanvraag inloggen.

Licentie

Creative Commons BY 4.0

Model Commentaren :

Hier kunt u commentaar leveren op het model. U kunt de tekstballonnen bij de itemgroepen en items gebruiken om er specifiek commentaar op te geven.

Itemgroep Commentaren voor :

Item Commentaren voor :

U moet ingelogd zijn om formulieren te downloaden. AUB inloggen of schrijf u gratis in.

Eligibility Breast Cancer NCT01225328

Eligibility Breast Cancer NCT01225328

Inclusion Criteria
Beschrijving

Inclusion Criteria

Alias
UMLS CUI
C1512693
1. female breast cancer patient stages i-iii.
Beschrijving

Gender | Breast Carcinoma TNM Breast tumor staging

Datatype

boolean

Alias
UMLS CUI [1]
C0079399
UMLS CUI [2,1]
C0678222
UMLS CUI [2,2]
C0474926
2. age 18-59.
Beschrijving

Age

Datatype

boolean

Alias
UMLS CUI [1]
C0001779
3. completion of definitive breast cancer treatment (i.e., subsequent to loco-regional surgical treatment and completion of adjuvant or neo-adjuvant chemotherapy with or without radiation) within the past 3-6 months.
Beschrijving

Treatment completed Breast Carcinoma | Status post Operative Surgical Procedure Local-Regional | Adjuvant Chemotherapy Completed | Neoadjuvant Chemotherapy Completed | Therapeutic radiology procedure | Therapeutic radiology procedure Absent

Datatype

boolean

Alias
UMLS CUI [1,1]
C0580352
UMLS CUI [1,2]
C0678222
UMLS CUI [2,1]
C0231290
UMLS CUI [2,2]
C0543467
UMLS CUI [2,3]
C1947913
UMLS CUI [3,1]
C0085533
UMLS CUI [3,2]
C0205197
UMLS CUI [4,1]
C0600558
UMLS CUI [4,2]
C3665472
UMLS CUI [4,3]
C0205197
UMLS CUI [5]
C1522449
UMLS CUI [6,1]
C1522449
UMLS CUI [6,2]
C0332197
4. screen positive for a moderate or worse level of participation restriction (work and social adjustment scale score > 10) within 6 months following cancer treatment.
Beschrijving

Study Subject Participation Status Restricted Moderate | Study Subject Participation Status Restricted Severe | Other Coding | Status post Cancer treatment

Datatype

boolean

Alias
UMLS CUI [1,1]
C2348568
UMLS CUI [1,2]
C0443288
UMLS CUI [1,3]
C0205081
UMLS CUI [2,1]
C2348568
UMLS CUI [2,2]
C0443288
UMLS CUI [2,3]
C0205082
UMLS CUI [3]
C3846158
UMLS CUI [4,1]
C0231290
UMLS CUI [4,2]
C0920425
5. english speaking.
Beschrijving

Able to speak English Language

Datatype

boolean

Alias
UMLS CUI [1,1]
C0564215
UMLS CUI [1,2]
C0376245
6. have a land-based phone or reliable cell phone reception.
Beschrijving

Availability of Telephone | Availability of Cell Phone

Datatype

boolean

Alias
UMLS CUI [1,1]
C0470187
UMLS CUI [1,2]
C0039457
UMLS CUI [2,1]
C0470187
UMLS CUI [2,2]
C1136359
Exclusion Criteria
Beschrijving

Exclusion Criteria

Alias
UMLS CUI
C0680251
1. non-correctable hearing loss.
Beschrijving

Hearing loss | Correction Unsuccessful

Datatype

boolean

Alias
UMLS CUI [1]
C0011053
UMLS CUI [2,1]
C1947976
UMLS CUI [2,2]
C1272705
2. moderate-severe cognitive impairment indicated by a score < 3 on a 6-item cognitive screener.
Beschrijving

Moderate cognitive impairment Cognitive Assessment Score | Severe cognitive impairment Cognitive Assessment Score

Datatype

boolean

Alias
UMLS CUI [1,1]
C3839816
UMLS CUI [1,2]
C0870300
UMLS CUI [1,3]
C0449820
UMLS CUI [2,1]
C3554639
UMLS CUI [2,2]
C0870300
UMLS CUI [2,3]
C0449820
3. medical record documentation of severe mental illness (i.e., schizophrenia or bipolar disorder) or active substance abuse.
Beschrijving

Mental Disorders, Severe | Schizophrenia | Bipolar Disorder | Substance Use Disorders

Datatype

boolean

Alias
UMLS CUI [1]
C4046029
UMLS CUI [2]
C0036341
UMLS CUI [3]
C0005586
UMLS CUI [4]
C0038586
4. medical record documentation of a physical disorder with associated functional impairment (e.g., parkinson's disease, stroke, congestive heart failure, etc.).
Beschrijving

Physical illness Associated with Functional impairment | Parkinson Disease | Cerebrovascular accident | Congestive heart failure

Datatype

boolean

Alias
UMLS CUI [1,1]
C0683323
UMLS CUI [1,2]
C0332281
UMLS CUI [1,3]
C4062321
UMLS CUI [2]
C0030567
UMLS CUI [3]
C0038454
UMLS CUI [4]
C0018802

Similar models

Eligibility Breast Cancer NCT01225328

Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
C1512693 (UMLS CUI)
Gender | Breast Carcinoma TNM Breast tumor staging
Item
1. female breast cancer patient stages i-iii.
boolean
C0079399 (UMLS CUI [1])
C0678222 (UMLS CUI [2,1])
C0474926 (UMLS CUI [2,2])
Age
Item
2. age 18-59.
boolean
C0001779 (UMLS CUI [1])
Treatment completed Breast Carcinoma | Status post Operative Surgical Procedure Local-Regional | Adjuvant Chemotherapy Completed | Neoadjuvant Chemotherapy Completed | Therapeutic radiology procedure | Therapeutic radiology procedure Absent
Item
3. completion of definitive breast cancer treatment (i.e., subsequent to loco-regional surgical treatment and completion of adjuvant or neo-adjuvant chemotherapy with or without radiation) within the past 3-6 months.
boolean
C0580352 (UMLS CUI [1,1])
C0678222 (UMLS CUI [1,2])
C0231290 (UMLS CUI [2,1])
C0543467 (UMLS CUI [2,2])
C1947913 (UMLS CUI [2,3])
C0085533 (UMLS CUI [3,1])
C0205197 (UMLS CUI [3,2])
C0600558 (UMLS CUI [4,1])
C3665472 (UMLS CUI [4,2])
C0205197 (UMLS CUI [4,3])
C1522449 (UMLS CUI [5])
C1522449 (UMLS CUI [6,1])
C0332197 (UMLS CUI [6,2])
Study Subject Participation Status Restricted Moderate | Study Subject Participation Status Restricted Severe | Other Coding | Status post Cancer treatment
Item
4. screen positive for a moderate or worse level of participation restriction (work and social adjustment scale score > 10) within 6 months following cancer treatment.
boolean
C2348568 (UMLS CUI [1,1])
C0443288 (UMLS CUI [1,2])
C0205081 (UMLS CUI [1,3])
C2348568 (UMLS CUI [2,1])
C0443288 (UMLS CUI [2,2])
C0205082 (UMLS CUI [2,3])
C3846158 (UMLS CUI [3])
C0231290 (UMLS CUI [4,1])
C0920425 (UMLS CUI [4,2])
Able to speak English Language
Item
5. english speaking.
boolean
C0564215 (UMLS CUI [1,1])
C0376245 (UMLS CUI [1,2])
Availability of Telephone | Availability of Cell Phone
Item
6. have a land-based phone or reliable cell phone reception.
boolean
C0470187 (UMLS CUI [1,1])
C0039457 (UMLS CUI [1,2])
C0470187 (UMLS CUI [2,1])
C1136359 (UMLS CUI [2,2])
Item Group
C0680251 (UMLS CUI)
Hearing loss | Correction Unsuccessful
Item
1. non-correctable hearing loss.
boolean
C0011053 (UMLS CUI [1])
C1947976 (UMLS CUI [2,1])
C1272705 (UMLS CUI [2,2])
Moderate cognitive impairment Cognitive Assessment Score | Severe cognitive impairment Cognitive Assessment Score
Item
2. moderate-severe cognitive impairment indicated by a score < 3 on a 6-item cognitive screener.
boolean
C3839816 (UMLS CUI [1,1])
C0870300 (UMLS CUI [1,2])
C0449820 (UMLS CUI [1,3])
C3554639 (UMLS CUI [2,1])
C0870300 (UMLS CUI [2,2])
C0449820 (UMLS CUI [2,3])
Mental Disorders, Severe | Schizophrenia | Bipolar Disorder | Substance Use Disorders
Item
3. medical record documentation of severe mental illness (i.e., schizophrenia or bipolar disorder) or active substance abuse.
boolean
C4046029 (UMLS CUI [1])
C0036341 (UMLS CUI [2])
C0005586 (UMLS CUI [3])
C0038586 (UMLS CUI [4])
Physical illness Associated with Functional impairment | Parkinson Disease | Cerebrovascular accident | Congestive heart failure
Item
4. medical record documentation of a physical disorder with associated functional impairment (e.g., parkinson's disease, stroke, congestive heart failure, etc.).
boolean
C0683323 (UMLS CUI [1,1])
C0332281 (UMLS CUI [1,2])
C4062321 (UMLS CUI [1,3])
C0030567 (UMLS CUI [2])
C0038454 (UMLS CUI [3])
C0018802 (UMLS CUI [4])

Gebruik dit formulier voor feedback, vragen en verbeteringsvoorstellen.

Velden gemarkeerd met een * zijn verplicht.

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial