ID

44121

Beschreibung

NSABP Protocol B-36 Quality of Life Questionnaire (English Version) Comparison of Two Combination Chemotherapy Regimens in Treating Women With Breast Cancer NCT00087178 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=C907A026-1DAB-1D7C-E034-0003BA12F5E7

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=C907A026-1DAB-1D7C-E034-0003BA12F5E7

Stichworte

Klinische Studie [Dokumenttyp]

Lebensqualität

Mammatumoren, Mensch

Rechteinhaber

folgt

Hochgeladen am

20. September 2021

DOI

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Lizenz

Creative Commons BY 4.0

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Breast Cancer Chemotherapy (NCT00087178)

Modell
Details

No Instruction available.

1 Formulare

StudyEvent: NSABP Protocol B-36 Quality of Life Questionnaire (English Version)
1. No Instruction available.

Name

Typ

Description | Question | Decode (Coded Value)

Datentyp

Alias

Header

Item Group

Header

C1320722 (UMLS CUI-1)

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 Name

text

C25191 (NCI Thesaurus ValueDomain)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C21541 (NCI Thesaurus ValueDomain-2)
C25364 (NCI Thesaurus Property)

Affiliate Name

Item

Affiliate Name

text

C21541 (NCI Thesaurus ObjectClass)
C1510825 (UMLS CUI-1)
C25413 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C25191 (NCI Thesaurus ValueDomain)
C21541 (NCI Thesaurus ValueDomain-2)

PersonFormAdministrationLastName

Item

Staff member administering form (Last Name)

text

C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C19464 (NCI Thesaurus Property)
C0376315 (UMLS 2011AA Property)
C25551 (NCI Thesaurus ValueDomain-2)
C1517741 (UMLS 2011AA ValueDomain-2)
C25409 (NCI Thesaurus Property-2)
C1533734 (UMLS 2011AA Property-2)

PersonFormAdministrationFirstName

Item

Staff member administering form, first name

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)

PersonFormAdministrationPhoneNumber

Item

Staff Member Administering Form, Phone

text

C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
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)

Today'sDate

Item

Today's Date (Month Day Year)

text

AssessmentPeriodType

Item

Time point

text

C25284 (NCI Thesaurus ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C25616 (NCI Thesaurus Property)
C0031809 (UMLS CUI-1)
C1948053 (UMLS CUI-2)

CL.1

Code List

Time point

CL Item

12 Months (12 months)

CL Item

18 Months (18 months)

CL Item

24 Months (24 months)

CL Item

30 Months (30 months)

CL Item

36 Months (36 months)

CL Item

6 Months (6 months)

CL Item

Baseline (baseline)

C25213 (NCI Thesaurus)
C1442488 (UMLS 2011AA)

CL Item

Day 1 Of Cycle 4 (Day 1 of Cycle 4)

CaseReportFormPersonCompleteType

Item

This form is being filled out

text

C25284 (NCI Thesaurus ValueDomain)
C25190 (NCI Thesaurus Property)
C40988 (NCI Thesaurus ObjectClass)
C25250 (NCI Thesaurus Property-2)
C0027361 (UMLS CUI-1)
C1516308 (UMLS CUI-2)
C0205197 (UMLS CUI-3)

CL.2

Code List

This form is being filled out

CL Item

0 By Patient In Office (By patient in doctor's office)

CL Item

By patient not in doctor's office (By patient not in doctor's office)

CL Item

1 By Clinical Staff On Phone With Patient (By clinical staff on phone with patient)

CL Item

Other (Other)

C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)

Questionnaire date

Item

Date this questionnaire is completed (For example, if you were completing the questionnaire on September 8, 2003, you would write 09 08 2003 in the boxes.)

date

C25164 (NCI Thesaurus ValueDomain)
C2826959 (UMLS CUI-1)

Quality of life

Item Group

Quality of life

C0451401 (UMLS CUI-1)

Fatigue

Item

I have a lack of energy.

text

C25664 (NCI Thesaurus ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C25755 (NCI Thesaurus Property)
C3036 (NCI Thesaurus ObjectClass-2)
C0015672 (UMLS CUI-1)

CL.3

Code List

I have a lack of energy.

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Nausea

Item

I have nausea.

text

C25664 (NCI Thesaurus ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C25755 (NCI Thesaurus Property)
C3258 (NCI Thesaurus ObjectClass-2)
C0027497 (UMLS CUI-1)

CL.3

Code List

I have nausea.

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Family Need

Item

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

text

C25284 (NCI Thesaurus ValueDomain)

CL.3

Code List

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

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Pain

Item

I have pain.

text

C25664 (NCI Thesaurus ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C25755 (NCI Thesaurus Property)
C3303 (NCI Thesaurus ObjectClass-2)
C0030193 (UMLS CUI-1)

CL.3

Code List

I have pain.

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Adverse Event

Item

I am bothered by side effects of treatment.

text

C25284 (NCI Thesaurus ValueDomain)
C20989 (NCI Thesaurus Property)
C41331 (NCI Thesaurus ObjectClass)
C38757 (NCI Thesaurus Property-2)
C0877248 (UMLS CUI-1)

CL.3

Code List

I am bothered by side effects of treatment.

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Feel ill

Item

I feel ill.

text

C25284 (NCI Thesaurus ValueDomain)
C2987492 (UMLS CUI-1)

CL.3

Code List

I feel ill.

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Bed rest

Item

I am forced to spend time in bed.

text

C0004910 (UMLS CUI-1)

CL.3

Code List

I am forced to spend time in bed.

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Feel Close to Friends

Item

I feel close to my friends.

text

C25284 (NCI Thesaurus ValueDomain)
C2984048 (UMLS CUI-1)

CL.3

Code List

I feel close to my friends.

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Emotional Support from Family

Item

I get emotional support from my family.

text

C16960 (NCI Thesaurus ObjectClass)
C25173 (NCI Thesaurus ObjectClass-2)
C20989 (NCI Thesaurus Property)
C0600015 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C2984050 (UMLS CUI-1)

CL.3

Code List

I get emotional support from my family.

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Receive Support from Friends

Item

I get support from my friends.

text

C25284 (NCI Thesaurus ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C25755 (NCI Thesaurus Property)
C2984072 (UMLS CUI-1)

CL.3

Code List

I get support from my friends.

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Family Accepts Illness

Item

My family has accepted my illness.

text

C2984053 (UMLS CUI-1)

CL.3

Code List

My family has accepted my illness.

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Satisfied with Family Communication

Item

I am satisfied with family communication about my illness.

text

C25284 (NCI Thesaurus ValueDomain)
C2984054 (UMLS CUI-1)

CL.3

Code List

I am satisfied with family communication about my illness.

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Feel Close to Partner

Item

I feel close to my partner. (or the person who is my main support)

text

C25284 (NCI Thesaurus ValueDomain)
C2984059 (UMLS CUI-1)

CL.3

Code List

I feel close to my partner. (or the person who is my main support)

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Question no response

Item

If you prefer not to answer it, please check this box and go to the next section. (Regardless of your current level of sexual activity, please answer the following question.)

boolean

sexual satisfaction

Item

I am satisfied with my sex life.

text

C25284 (NCI Thesaurus ValueDomain)
C0871356 (UMLS CUI-1)

CL.3

Code List

I am satisfied with my sex life.

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Depression

Item

I feel sad.

text

C16960 (NCI Thesaurus ObjectClass)
C20989 (NCI Thesaurus Property)
C2982 (NCI Thesaurus Property-2)
C25664 (NCI Thesaurus ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0011581 (UMLS CUI-1)

CL.3

Code List

I feel sad.

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Coping

Item

I am satisfied with how I am coping with my illness.

text

C16960 (NCI Thesaurus ObjectClass)
C20989 (NCI Thesaurus Property)
CL140183 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0009967 (UMLS CUI-1)

CL.3

Code List

I am satisfied with how I am coping with my illness.

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Losing Hope Against Illness

Item

I am losing hope in the fight against my illness.

text

C25284 (NCI Thesaurus ValueDomain)
C2984056 (UMLS CUI-1)

CL.3

Code List

I am losing hope in the fight against my illness.

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Nervousness

Item

I feel nervous.

text

C16960 (NCI Thesaurus ObjectClass)
C20989 (NCI Thesaurus Property)
C25584 (NCI Thesaurus Property-2)
C25664 (NCI Thesaurus ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0027769 (UMLS CUI-1)

CL.3

Code List

I feel nervous.

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Worry About Dying

Item

I worry about dying.

text

C16960 (NCI Thesaurus ObjectClass)
C0233481 (NCI Metathesaurus ObjectClass)
C20989 (NCI Thesaurus Property)
C28554 (NCI Thesaurus Property-2)
C25664 (NCI Thesaurus ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C2984076 (UMLS CUI-1)

CL.3

Code List

I worry about dying.

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Worry About Worsening Condition

Item

I worry that my condition will get worse.

text

C25284 (NCI Thesaurus ValueDomain)
C2984075 (UMLS CUI-1)

CL.3

Code List

I worry that my condition will get worse.

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Able to Work

Item

I am able to work. (include work at home)

text

C25284 (NCI Thesaurus ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C25755 (NCI Thesaurus Property)
C2984044 (UMLS CUI-1)

CL.3

Code List

I am able to work. (include work at home)

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Work is Fulfilling

Item

My work is fulfilling. (include work at home)

text

C25284 (NCI Thesaurus ValueDomain)
C2984074 (UMLS CUI-1)

CL.3

Code List

My work is fulfilling. (include work at home)

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Able to Enjoy Life

Item

I am able to enjoy life.

text

C25284 (NCI Thesaurus ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C25755 (NCI Thesaurus Property)
C2984051 (UMLS CUI-1)

CL.3

Code List

I am able to enjoy life.

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Accepted Illness

Item

I have accepted my illness.

text

C2984045 (UMLS CUI-1)

CL.3

Code List

I have accepted my illness.

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Sleeping Well

Item

I am sleeping well.

text

C16960 (NCI Thesaurus ObjectClass)
C20989 (NCI Thesaurus Property)
C0037313 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C2984071 (UMLS CUI-1)

CL.3

Code List

I am sleeping well.

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Enjoy Things for Fun

Item

I am enjoying the things I usually do.

text

C17047 (NCI Thesaurus ObjectClass)
C25367 (NCI Thesaurus Property)
C62185 (NCI Thesaurus Property-2)
C73426 (NCI Thesaurus Property-3)
C25284 (NCI Thesaurus ValueDomain)
C2984052 (UMLS CUI-1)

CL.3

Code List

I am enjoying the things I usually do.

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Content with Quality of Life

Item

I am content with the quality of my life right now.

text

C25284 (NCI Thesaurus ValueDomain)
C2984049 (UMLS CUI-1)

CL.3

Code List

I am content with the quality of my life right now.

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Dyspnea

Item

I have been short of breath.

text

C25284 (NCI Thesaurus ValueDomain)
C0013404 (UMLS CUI-1)

CL.3

Code List

I have been short of breath.

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Self-conscious about the way I dress

Item

I am self-conscious about the way I dress.

text

C25284 (NCI Thesaurus ValueDomain)
C3475654 (UMLS CUI-1)

CL.3

Code List

I am self-conscious about the way I dress.

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Swollen arm

Item

One or both of my arms are swollen or tender.

text

C25284 (NCI Thesaurus ValueDomain)
C0577598 (UMLS CUI-1)

CL.3

Code List

One or both of my arms are swollen or tender.

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Feel Sexually Attractive

Item

I feel sexually attractive.

text

C3274934 (UMLS CUI-1)

CL.3

Code List

I feel sexually attractive.

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Bothered by Hair Loss

Item

I am bothered by hair loss.

text

C25284 (NCI Thesaurus ValueDomain)
C3831302 (UMLS CUI-1)

CL.3

Code List

I am bothered by hair loss.

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Worry that other family members get same illness

Item

I worry that other members of my family might someday get the same illness I have.

text

C3476047 (UMLS CUI [1])
C25284 (NCI Thesaurus ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C25755 (NCI Thesaurus Property)

CL.3

Code List

I worry that other members of my family might someday get the same illness I have.

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Worry About Effect of Stress on Illness

Item

I worry about the effect of stress on my illness.

text

C25284 (NCI Thesaurus ValueDomain)
C3274929 (UMLS CUI-1)

CL.3

Code List

I worry about the effect of stress on my illness.

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Bothered by Change in Weight

Item

I am bothered by a change in weight.

text

C25284 (NCI Thesaurus ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C25755 (NCI Thesaurus Property)
C3274921 (UMLS CUI-1)

CL.3

Code List

I am bothered by a change in weight.

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Able to feel like a woman

Item

I am able to feel like a woman.

text

C3475547 (UMLS CUI [1])
C25284 (NCI Thesaurus ValueDomain)

CL.3

Code List

I am able to feel like a woman.

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Headaches

Item

headaches

text

C25626 (NCI Thesaurus Property)
C34661 (NCI Thesaurus ObjectClass)
C25688 (NCI Thesaurus ValueDomain)
C0018681 (UMLS CUI-1)

CL.3

Code List

headaches

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Dyspepsia

Item

indigestion

text

C25284 (NCI Thesaurus ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C25755 (NCI Thesaurus Property)
C0013395 (UMLS CUI-1)

CL.3

Code List

indigestion

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Nausea

Item

nausea

text

C0027497 (UMLS CUI-1)

CL.3

Code List

nausea

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

heartburn

Item

heartburn

text

C25284 (NCI Thesaurus ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C25755 (NCI Thesaurus Property)
C0018834 (UMLS CUI-1)

CL.3

Code List

heartburn

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Vomiting

Item

vomiting

text

C25284 (NCI Thesaurus ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C25755 (NCI Thesaurus Property)
C0042963 (UMLS CUI-1)

CL.3

Code List

vomiting

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Flatulence

Item

passing a lot of gas (flatulence)

text

C25284 (NCI Thesaurus ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C25755 (NCI Thesaurus Property)
C0016204 (UMLS CUI-1)

CL.3

Code List

passing a lot of gas (flatulence)

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

mouth sores

Item

mouth sores

text

C25284 (NCI Thesaurus ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C25755 (NCI Thesaurus Property)
C0149745 (UMLS CUI-1)

CL.3

Code List

mouth sores

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Diarrhea

Item

diarrhea

text

C25284 (NCI Thesaurus ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C25755 (NCI Thesaurus Property)
C0011991 (UMLS CUI-1)

CL.3

Code List

diarrhea

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

skin problems

Item

skin problems (including rash, dry skin, itching, irritation or redness)

text

C25284 (NCI Thesaurus ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C25755 (NCI Thesaurus Property)
C0281822 (UMLS CUI-1)

CL.3

Code List

skin problems (including rash, dry skin, itching, irritation or redness)

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

numbness or tingling in hands or feet

Item

numbness or tingling in hands or feet

text

C25284 (NCI Thesaurus ValueDomain)
C3828645 (UMLS CUI-1)

CL.3

Code List

numbness or tingling in hands or feet

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Fever

Item

fever or shivering (shaking, chills)

text

C25284 (NCI Thesaurus ValueDomain)
C0015967 (UMLS CUI-1)

CL.3

Code List

fever or shivering (shaking, chills)

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Bladder Control Difficulty

Item

difficulty with bladder control

text

C25180 (NCI Thesaurus ValueDomain)
C3639680 (UMLS CUI-1)

CL.3

Code List

difficulty with bladder control

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

constipation

Item

constipation

text

C25284 (NCI Thesaurus ValueDomain)
C0009806 (UMLS CUI-1)

CL.3

Code List

constipation

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Hot Flashes

Item

hot flashes

text

C25180 (NCI Thesaurus ValueDomain)
C0600142 (UMLS CUI-1)

CL.3

Code List

hot flashes

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Pruritus of genital organs

Item

genital itching or irritation

text

C25284 (NCI Thesaurus ValueDomain)
C0033777 (UMLS CUI-1)

CL.3

Code List

genital itching or irritation

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Mood swings

Item

mood swings

text

C25284 (NCI Thesaurus ValueDomain)
C0085633 (UMLS CUI-1)

CL.3

Code List

mood swings

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

vaginal discharge

Item

vaginal discharge

text

C25284 (NCI Thesaurus ValueDomain)
C0227791 (UMLS CUI-1)

CL.3

Code List

vaginal discharge

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

vaginal bleeding or spotting

Item

vaginal bleeding or spotting

text

C25180 (NCI Thesaurus ValueDomain)
C3475970 (UMLS CUI-1)

CL.3

Code List

vaginal bleeding or spotting

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

vaginal dryness

Item

vaginal dryness

text

C25284 (NCI Thesaurus ValueDomain)
C0241633 (UMLS CUI-1)

CL.3

Code List

vaginal dryness

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Painful intercourse female

Item

pain with intercourse

text

C25180 (NCI Thesaurus ValueDomain)
C0423742 (UMLS CUI-1)

CL.3

Code List

pain with intercourse

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

cramps

Item

cramps

text

C25284 (NCI Thesaurus ValueDomain)
C0026821 (UMLS CUI-1)

CL.3

Code List

cramps

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Generalized aches and pains

Item

general aches and pains

text

C25180 (NCI Thesaurus ValueDomain)
C0281856 (UMLS CUI-1)

CL.3

Code List

general aches and pains

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Arthralgia

Item

joint pains

text

C25180 (NCI Thesaurus ValueDomain)
C0003862 (UMLS CUI-1)

CL.3

Code List

joint pains

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

swelling of hands

Item

swelling of hands

text

C25284 (NCI Thesaurus ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C25755 (NCI Thesaurus Property)
C0575805 (UMLS CUI-1)

CL.3

Code List

swelling of hands

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Muscular stiffness

Item

muscle stiffness

text

C25180 (NCI Thesaurus ValueDomain)
C0221170 (UMLS CUI-1)

CL.3

Code List

muscle stiffness

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Weight gain

Item

weight gain

text

C25180 (NCI Thesaurus ValueDomain)
C0043094 (UMLS CUI-1)

CL.3

Code List

weight gain

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

weight loss

Item

weight loss

text

C38147 (NCI Thesaurus ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C25755 (NCI Thesaurus Property)
C3445 (NCI Thesaurus ObjectClass-2)
C1262477 (UMLS CUI-1)

CL.3

Code List

weight loss

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Unhappy With Appearance

Item

unhappy with appearance of my body

text

C25180 (NCI Thesaurus ValueDomain)
C3274925 (UMLS CUI-1)

CL.3

Code List

unhappy with appearance of my body

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Forgetfulness

Item

forgetfulness

text

C25180 (NCI Thesaurus ValueDomain)
C0542476 (UMLS CUI-1)

CL.3

Code List

forgetfulness

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Night sweats

Item

night sweats

text

C25180 (NCI Thesaurus ValueDomain)
C0028081 (UMLS CUI-1)

CL.3

Code List

night sweats

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Cold sweats

Item

cold sweats

text

C25180 (NCI Thesaurus ValueDomain)
C0232431 (UMLS CUI-1)

CL.3

Code List

cold sweats

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Difficulty concentrating

Item

difficulty concentrating

text

C25180 (NCI Thesaurus ValueDomain)
C0947509 (UMLS CUI-1)

CL.3

Code List

difficulty concentrating

CL Item

Not at all (1)

C2984077 (UMLS CUI-1)

CL Item

A little bit (2)

C2984078 (UMLS CUI-1)

CL Item

Somewhat (3)

C2984079 (UMLS CUI-1)

CL Item

Quite a bit (4)

C2984080 (UMLS CUI-1)

CL Item

Very much (5)

C2984081 (UMLS CUI-1)

Limitations regarding vigorous activities

Item

Vigorous activities, such as running, lifting heavy objects, participating in strenuous sports

text

C25284 (NCI Thesaurus ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C25755 (NCI Thesaurus Property)
C2963465 (UMLS CUI-1)

CL.71

Code List

Vigorous activities, such as running, lifting heavy objects, participating in strenuous sports

CL Item

Yes, limited a lot (4)

C3829282 (UMLS CUI-1)

CL Item

Yes, limited a little (2)

C3829283 (UMLS CUI-1)

CL Item

No, not limited at all (1)

C3845941 (UMLS CUI-1)

Moderate activities

Item

Moderate activities, such as moving a table, pushing a vacuum cleaner, bowling, or playing golf

text

C3833417 (UMLS CUI-1)

CL.71

Code List

Moderate activities, such as moving a table, pushing a vacuum cleaner, bowling, or playing golf

CL Item

Yes, limited a lot (4)

C3829282 (UMLS CUI-1)

CL Item

Yes, limited a little (2)

C3829283 (UMLS CUI-1)

CL Item

No, not limited at all (1)

C3845941 (UMLS CUI-1)

Lifting or Carrying Groceries

Item

Lifting or carrying groceries

text

C17047 (NCI Thesaurus ObjectClass)
C25367 (NCI Thesaurus Property)
C17708 (NCI Thesaurus Property-2)
C62189 (NCI Thesaurus Property-3)
C25664 (NCI Thesaurus ValueDomain)
C3829286 (UMLS CUI-1)

CL.71

Code List

Lifting or carrying groceries

CL Item

Yes, limited a lot (4)

C3829282 (UMLS CUI-1)

CL Item

Yes, limited a little (2)

C3829283 (UMLS CUI-1)

CL Item

No, not limited at all (1)

C3845941 (UMLS CUI-1)

Climbing Several Flights of Stairs

Item

Climbing several flights of stairs

text

C25664 (NCI Thesaurus ValueDomain)
C20989 (NCI Thesaurus Property)
CL299704 (NCI Metathesaurus ObjectClass)
C17708 (NCI Thesaurus ObjectClass)
C3831080 (UMLS CUI-1)

CL.71

Code List

Climbing several flights of stairs

CL Item

Yes, limited a lot (4)

C3829282 (UMLS CUI-1)

CL Item

Yes, limited a little (2)

C3829283 (UMLS CUI-1)

CL Item

No, not limited at all (1)

C3845941 (UMLS CUI-1)

Bending, Kneeling or Stooping

Item

Bending, kneeling, or stooping

text

C25284 (NCI Thesaurus ValueDomain)
C3831371 (UMLS CUI-1)

CL.71

Code List

Bending, kneeling, or stooping

CL Item

Yes, limited a lot (4)

C3829282 (UMLS CUI-1)

CL Item

Yes, limited a little (2)

C3829283 (UMLS CUI-1)

CL Item

No, not limited at all (1)

C3845941 (UMLS CUI-1)

Walking More Than a Mile

Item

Walking more than a mile

text

C25284 (NCI Thesaurus ValueDomain)
C3827523 (UMLS CUI-1)

CL.71

Code List

Walking more than a mile

CL Item

Yes, limited a lot (4)

C3829282 (UMLS CUI-1)

CL Item

Yes, limited a little (2)

C3829283 (UMLS CUI-1)

CL Item

No, not limited at all (1)

C3845941 (UMLS CUI-1)

Walking several hundred yards

Item

Walking several hundred yards

text

C25284 (NCI Thesaurus ValueDomain)
C2963458 (UMLS CUI-1)

CL.71

Code List

Walking several hundred yards

CL Item

Yes, limited a lot (4)

C3829282 (UMLS CUI-1)

CL Item

Yes, limited a little (2)

C3829283 (UMLS CUI-1)

CL Item

No, not limited at all (1)

C3845941 (UMLS CUI-1)

Walking one hundred yards

Item

Walking one hundred yards

text

C25284 (NCI Thesaurus ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C25755 (NCI Thesaurus Property)
C2963456 (UMLS CUI-1)

CL.71

Code List

Walking one hundred yards

CL Item

Yes, limited a lot (4)

C3829282 (UMLS CUI-1)

CL Item

Yes, limited a little (2)

C3829283 (UMLS CUI-1)

CL Item

No, not limited at all (1)

C3845941 (UMLS CUI-1)

Bathing or dressing yourself

Item

Bathing or dressing yourself

text

C25284 (NCI Thesaurus ValueDomain)
C3831396 (UMLS CUI-1)

CL.71

Code List

Bathing or dressing yourself

CL Item

Yes, limited a lot (4)

C3829282 (UMLS CUI-1)

CL Item

Yes, limited a little (2)

C3829283 (UMLS CUI-1)

CL Item

No, not limited at all (1)

C3845941 (UMLS CUI-1)

Feel full of life

Item

Did you feel full of life?

integer

C3829819 (UMLS CUI-1)

CL.80

Code List

Did you feel full of life?

CL Item

None of the time (1)

C3812882 (UMLS CUI-1)

CL Item

A little of the time (2)

C3831570 (UMLS CUI-1)

CL Item

Some of the time (3)

C3827992 (UMLS CUI-1)

CL Item

Most of the time (4)

C3828954 (UMLS CUI-1)

CL Item

All of the time (5)

C3812891 (UMLS CUI-1)

A lot of energy

Item

Did you have a lot of energy?

text

C25284 (NCI Thesaurus ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C25755 (NCI Thesaurus Property)
C3828394 (UMLS CUI-1)

CL.80

Code List

Did you have a lot of energy?

CL Item

None of the time (1)

C3812882 (UMLS CUI-1)

CL Item

A little of the time (2)

C3831570 (UMLS CUI-1)

CL Item

Some of the time (3)

C3827992 (UMLS CUI-1)

CL Item

Most of the time (4)

C3828954 (UMLS CUI-1)

CL Item

All of the time (5)

C3812891 (UMLS CUI-1)

feel worn out

Item

Did you feel worn out?

text

C25284 (NCI Thesaurus ValueDomain)
C3828399 (UMLS CUI-1)

CL.80

Code List

Did you feel worn out?

CL Item

None of the time (1)

C3812882 (UMLS CUI-1)

CL Item

A little of the time (2)

C3831570 (UMLS CUI-1)

CL Item

Some of the time (3)

C3827992 (UMLS CUI-1)

CL Item

Most of the time (4)

C3828954 (UMLS CUI-1)

CL Item

All of the time (5)

C3812891 (UMLS CUI-1)

feel tired

Item

Did you feel tired?

text

C25284 (NCI Thesaurus ValueDomain)
C3539029 (UMLS CUI-1)

CL.80

Code List

Did you feel tired?

CL Item

None of the time (1)

C3812882 (UMLS CUI-1)

CL Item

A little of the time (2)

C3831570 (UMLS CUI-1)

CL Item

Some of the time (3)

C3827992 (UMLS CUI-1)

CL Item

Most of the time (4)

C3828954 (UMLS CUI-1)

CL Item

All of the time (5)

C3812891 (UMLS CUI-1)

Overall quality of life

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.

integer

C0451401 (UMLS CUI-1)

CL.84

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

1 (1)

CL Item

2 (2)

C66833 (NCI Thesaurus)

CL Item

3 (3)

CL Item

4 (4)

CL Item

5 (5)

CL Item

6 (6)

CL Item

7 (7)

CL Item

8 (8)

CL Item

9 (9)

CL Item

10 (10)

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Modell Kommentare :

Itemgroup Kommentare für :

Item Kommentare für :

Breast Cancer Chemotherapy (NCT00087178)

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