ID

44125

Description

Quality of Life Questionnaire Anastrozole or Tamoxifen in Treating Postmenopausal Women With Ductal Carcinoma in Situ Who Are Undergoing Lumpectomy and Radiation Therapy NCT00053898 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A0E240A0-FD2A-46A0-E034-080020C9C0E0

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A0E240A0-FD2A-46A0-E034-080020C9C0E0

Keywords

Versions (5)
  1. 8/26/12 8/26/12 -
  2. 8/7/14 8/7/14 - Martin Dugas
  3. 3/21/15 3/21/15 - Martin Dugas
  4. 4/10/21 4/10/21 - Ahmed Rafee, MD
  5. 9/20/21 9/20/21 -
Copyright Holder

folgt

Uploaded on

September 20, 2021

DOI

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License

Creative Commons BY 4.0
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Breast Cancer (NCT00053898)

English

NSABP Protocol B-35 [At bottom ] Record the first three letters of patient's last name and study ID on each of the remaining pages before giving the questionnaire to the patient.

1 forms  
Header
Description

Header

First Three Letters of Patient?s Last Name
Description

FirstThreeLettersofPatient?sLastName

Data type

text

Patient Study ID
Description

PatientStudyID

Data type

text

Institution Name
Description

InstitutionName

Data type

text

Affiliate Name
Description

AffiliateName

Data type

text

Staff member administering form
Description

PersonFormAdministrationLastName

Data type

text

Alias
NCI Thesaurus ObjectClass
C25190
NCI Thesaurus Property
C19464
NCI Thesaurus Property-2
C25409
NCI Thesaurus ValueDomain
C25191
NCI Thesaurus ValueDomain-2
C25551
UMLS CUI-1
C1550483
Phone
Description

Phone

Data type

text

Are data amended? (If yes, circle amended items in red.)
Description

AmendedDataInd

Data type

boolean

Alias
NCI Thesaurus ObjectClass
C25474
UMLS 2011AA ObjectClass
C1511726
NCI Thesaurus Property
C25416
UMLS 2011AA Property
C1691222
Time Point for this Questionnaire (Check One)
Description

TimePointforthisQuestionnaire

Data type

text

This form is being filled out
Description

CaseReportFormPersonCompleteType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus Property
C25190
UMLS 2011AA Property
C0027361
NCI Thesaurus ObjectClass
C40988
UMLS 2011AA ObjectClass
C1516308
NCI Thesaurus Property-2
C25250
UMLS 2011AA Property-2
C0205197
Symptom frequency
Description

Symptom frequency

Alias
UMLS CUI-1
C0436350
I was bothered by things that don't usually bother me.
Description

QualityofLifeDiscomfortNormalEventAssessmentDayFrequency

Data type

text

Alias
UMLS CUI [1]
C3174325
NCI Thesaurus ObjectClass
C17047
NCI Thesaurus Property
C25499
NCI Thesaurus Property-2
C50535
NCI Thesaurus Property-3
C14165
NCI Thesaurus Property-4
C25217
NCI Thesaurus ValueDomain
C25301
NCI Thesaurus ValueDomain-2
C25515
I had trouble keeping my mind on what I was doing.
Description

IhadtroublekeepingmymindonwhatIwasdoing.

Data type

text

Alias
UMLS CUI-1
C0235198
I felt depressed
Description

Ifeltdepressed

Data type

text

Alias
NCI Thesaurus ObjectClass
C17047
NCI Thesaurus Property
C25217
NCI Thesaurus Property-2
C2982
UMLS CUI-1
C0011581
I felt that everything I did was an effort.
Description

IfeltthateverythingIdidwasaneffort.IfeltthateverythingIdidwasaneffort.Text

Data type

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS CUI-1
C3174029
I felt hopeful about the future.
Description

Ifelthopefulaboutthefuture.Ifelthopefulaboutthefuture

Data type

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS CUI-1
C3274937
I felt fearful.
Description

I felt fearful.

Data type

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS CUI-1
C1288289
My sleep was restless.
Description

My sleep was restless.

Data type

text

Alias
UMLS CUI-1
C0235160
I was happy.
Description

I was happy.

Data type

text

Alias
UMLS CUI-1
C0018592
I felt lonely.
Description

I felt lonely.

Data type

text

Alias
UMLS CUI-1
C3175808
I could not get ´going´
Description

I could not get ´going´

Data type

text

Everyday Problems During The Past Four Weeks
Description

Everyday Problems During The Past Four Weeks

Alias
UMLS CUI-1
C0033213
UMLS CUI-2
C3828653
Hot Flashes
Description

Hot Flashes

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0600142
Headaches
Description

Headaches

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C25180
NCI Thesaurus Property
C25626
NCI Thesaurus ObjectClass
C34661
UMLS CUI-1
C0018681
Difficulty with bladder control (at other times)
Description

Difficultywithbladdercontrol

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C25180
Vaginal discharge
Description

Vaginal discharge

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0227791
Vaginal bleeding or spotting
Description

Vaginal bleeding or spotting

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C3475970
Genital itching/irritation
Description

Genital itching/irritation

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0033777
Vaginal dryness
Description

Vaginal dryness

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0241633
Pain with intercourse
Description

Painwithintercourse

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0423742
Breast pain
Description

Breast pain

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0024902
Difficulty with breast skin
Description

Difficultywithbreastskin

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C25180
Breast sensitivity/tenderness
Description

Breastsensitivity/tenderness

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0262397
General aches and pains
Description

Generalachesandpains

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0150930
Joint pains
Description

Joint pains

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0003862
Muscle stiffness
Description

Muscle stiffness

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0427008
Weight gain
Description

Weightgain

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS
C0043094
Weight loss
Description

Weight loss

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C38147
NCI Thesaurus ObjectClass
C20989
NCI Thesaurus Property
C25755
NCI Thesaurus ObjectClass-2
C3445
UMLS CUI-1
C1262477
Unhappy with appearance of my body
Description

Unhappywithappearanceofmybody

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C3274925
Decreased appetite
Description

Decreasedappetite

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0232462
Forgetfulness
Description

Forgetfulness

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0542476
Excitability
Description

Excitability

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0235169
Short temper
Description

Short temper

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0424331
Tendency to take naps; stay in bed
Description

Tendencytotakenaps;stayinbed

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0013144
Night sweats
Description

Night sweats

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0028081
Cold sweats
Description

Cold sweats

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0232431
Difficulty concentrating
Description

Difficulty concentrating

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0947509
Easily distracted
Description

Easily distracted

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0424102
Trouble sleeping
Description

Trouble sleeping

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C3641752
Early awakening
Description

Early awakening

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C0541798
Any other problems
Description

Anyotherproblems (Specify below)

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C1273828
Severity
Description

Severity

Data type

text

Alias
UMLS CUI-1
C0439793
Specify other problems
Description

Specifyotherproblems

Data type

text

Alias
UMLS CUI-1
C1273828
Overall health
Description

Overall health

In general, would you say your health is
Description

In general, would you say your health is

Data type

text

Alias
NCI Thesaurus Property
C20989
NCI Thesaurus ObjectClass
C25178
NCI Thesaurus ValueDomain
C25688
UMLS CUI-1
C0018759
Moderate activities, such as moving a table, pushing a vacuum cleaner, bowling, or playing golf (2)
Description

Moderateactivities,suchasmovingatable,pushingavacuumcleaner,bowling,orplayinggolf

Data type

text

Alias
UMLS CUI-1
C0449295
UMLS CUI-2
C3833417
Climbing several flights of stairs (3)
Description

ClimbingStairsPhysicalActivityAssessmentScale

Data type

text

Alias
NCI Thesaurus ValueDomain
C25664
NCI Thesaurus Property
C20989
NCI Metathesaurus ObjectClass
CL299704
NCI Thesaurus ObjectClass
C17708
UMLS CUI-1
C0449295
UMLS CUI-2
C3831080
Accomplished less than you would like. (6)
Description

ReducedProductivityHealthAssessmentInd-2

Data type

boolean

Alias
NCI Thesaurus ObjectClass
C25640
NCI Metathesaurus ObjectClass
C0033269
NCI Thesaurus Property
C20989
NCI Thesaurus Property-2
C25178
NCI Thesaurus ValueDomain
C38147
UMLS CUI-1
C3828382
Were limited in the kind of work or other activities. (5)
Description

LimitedWorkHealthAssessmentInd-2

Data type

boolean

Alias
NCI Metathesaurus ObjectClass
CL110648
NCI Metathesaurus ObjectClass-2
C0043227
NCI Thesaurus Property
C20989
NCI Thesaurus Property-2
C25178
NCI Thesaurus ValueDomain
C38147
UMLS CUI-1
C3641747
Didn't do work or other activities as carefully as usual. (7)
Description

Didn'tdoworkorotheractivitiesascarefullyasusual.

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C3828404
During the past 4 weeks, how much did pain interfere with your normal work? (8. including both work outside the home and housework)
Description

PainPatientWorkAssessmentStatus

Data type

text

Alias
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus ObjectClass-2
C3303
NCI Thesaurus Property
C20989
NCI Metathesaurus Property
C0043227
NCI Thesaurus ValueDomain
C25688
UMLS CUI-1
C3828383
Mood
Description

Mood

Alias
UMLS CUI-1
C0026516
Have you felt calm and peaceful? (9)
Description

PatientRelaxationAssessmentScale

Data type

text

Alias
NCI Thesaurus ValueDomain
C25664
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C20989
NCI Metathesaurus Property
C0035028
UMLS CUI-1
C3261651
Did you feel full of pep? (10)
Description

PatientVitalityAssessmentScale

Data type

text

Alias
NCI Thesaurus ValueDomain
C25664
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C20989
NCI Metathesaurus Property
C0291944
UMLS CUI-1
C3828401
Did you have a lot of energy? (11)
Description

PatientEnergyAssessmentScale

Data type

text

Alias
UMLS CUI [1]
C3828394
NCI Thesaurus ValueDomain
C25664
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C20989
NCI Thesaurus Property-2
C48058
Did you feel worn out? (12)
Description

PatientFatigueAssessmentScale

Data type

text

Alias
NCI Thesaurus ValueDomain
C25664
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C20989
NCI Thesaurus Property-2
C3036
UMLS CUI-1
C3828399
Did you feel tired? (13)
Description

PatientLethargyAssessmentScale

Data type

text

Alias
NCI Thesaurus ValueDomain
C25664
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C20989
NCI Metathesaurus Property
C0023380
UMLS CUI-1
C3539029
Have you felt downhearted and blue? (14)
Description

Have you felt downhearted and blue? (14)

Data type

text

Alias
NCI Thesaurus ValueDomain
C25664
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C20989
NCI Metathesaurus Property
C0026516
UMLS CUI-1
C3828397
During the past 4 weeks, how much of the time has your physical health or emotional problems interfered with your social activities? (15. like visiting with friends, relatives, etc.)
Description

SocialBehaviorAssessmentDuration

Data type

text

Alias
NCI Thesaurus Property
C20989
NCI Metathesaurus ObjectClass
C0037397
NCI Thesaurus ValueDomain
C25330
UMLS CUI-1
C3484327
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. (16)
Description

Pleasescoreyouroverallqualityoflifeasoftodayonan11-pointscalewhere0indicatesbeingintheworstpossiblehealthand10indicatesbeinginperfecthealth.

Data type

text

Alias
UMLS CUI-1
C0451401
Sexual activity
Description

Sexual activity

Alias
UMLS CUI-1
C0036864
Have you been sexually active during the past SIX MONTHS? (17)
Description

HaveyoubeensexuallyactiveduringthepastSIXMONTHS?

Data type

boolean

Alias
UMLS CUI [1,1]
C0241028
UMLS CUI [1,2]
C3828652
NCI Thesaurus ValueDomain
C25180
Lack of sexual interest
Description

Lackofsexualinterest

Data type

text

Alias
UMLS CUI-1
C3828902
Difficulty in becoming sexually aroused
Description

Difficultyinbecomingsexuallyaroused

Data type

text

Alias
UMLS CUI-1
C1314759
Unable to relax and enjoy sex
Description

Unabletorelaxandenjoysex

Data type

text

Alias
UMLS CUI-1
C3174543
Difficulty in having orgasm
Description

Difficultyinhavingorgasm

Data type

text

Alias
UMLS CUI-1
C0029261
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Similar models

NSABP Protocol B-35 [At bottom ] Record the first three letters of patient's last name and study ID on each of the remaining pages before giving the questionnaire to the patient.

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Header
First 3 Letters Last Name
Item
First Three Letters of Patient?s Last Name
text
PatientStudyID
Item
Patient Study ID
text
InstitutionName
Item
Institution Name
text
AffiliateName
Item
Affiliate Name
text
Person Form Administration Name
Item
Staff member administering form
text
C25190 (NCI Thesaurus ObjectClass)
C19464 (NCI Thesaurus Property)
C25409 (NCI Thesaurus Property-2)
C25191 (NCI Thesaurus ValueDomain)
C25551 (NCI Thesaurus ValueDomain-2)
C1550483 (UMLS CUI-1)
Phone
Item
Phone
text
AmendedDataInd
Item
Are data amended? (If yes, circle amended items in red.)
boolean
C25474 (NCI Thesaurus ObjectClass)
C1511726 (UMLS 2011AA ObjectClass)
C25416 (NCI Thesaurus Property)
C1691222 (UMLS 2011AA Property)
Item
Time Point for this Questionnaire (Check One)
text
CL.2
Code List
Time Point for this Questionnaire (Check One)
CL Item
Baseline (Baseline)
C25213 (NCI Thesaurus)
C1442488 (UMLS 2011AA)
CL Item
6 Month Follow-up (6 month follow-up)
CL Item
12 Month Follow-up (12 month follow-up)
CL Item
18 Month Follow-up (18 month follow-up)
CL Item
2 Year Follow-up (2 year follow-up)
CL Item
30 Month Follow-up (30 month follow-up)
CL Item
3 Year Follow-up (3 year follow-up)
CL Item
42 Month Follow-up (42 month follow-up)
CL Item
4 Year Follow-up (4 year follow-up)
CL Item
54 Month Follow-up (54 month follow-up)
CL Item
5 Year Follow-up (5 year follow-up)
CL Item
66 Month Follow-up (66 month follow-up)
CL Item
6 Year Follow-up (6 year follow-up)
Item
This form is being filled out
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C25190 (NCI Thesaurus Property)
C0027361 (UMLS 2011AA Property)
C40988 (NCI Thesaurus ObjectClass)
C1516308 (UMLS 2011AA ObjectClass)
C25250 (NCI Thesaurus Property-2)
C0205197 (UMLS 2011AA Property-2)
CL.3
Code List
This form is being filled out
CL Item
0 By Patient In Office (0 By patient in office)
CL Item
1 By Clinical Staff On Phone With Patient (1 By clinical staff on phone with patient)
CL Item
2 By Patient, Mailed To Office (2 By patient, mailed to office)
Item Group
Symptom frequency
C0436350 (UMLS CUI-1)
Item
I was bothered by things that don't usually bother me.
text
C3174325 (UMLS CUI [1])
C17047 (NCI Thesaurus ObjectClass)
C25499 (NCI Thesaurus Property)
C50535 (NCI Thesaurus Property-2)
C14165 (NCI Thesaurus Property-3)
C25217 (NCI Thesaurus Property-4)
C25301 (NCI Thesaurus ValueDomain)
C25515 (NCI Thesaurus ValueDomain-2)
CL.4
Code List
I was bothered by things that don't usually bother me.
CL Item
Rarely Or None Of The Time (less Than 1 Day) (1)
C0522498 (UMLS CUI-1)
CL Item
Some Of The Time (1-2 Days) (2)
C1998882 (UMLS CUI-1)
CL Item
Occasion (3-4 Days) (3)
C0521114 (UMLS CUI-1)
CL Item
Most Of The Time (5-7 Days) (4)
C3828954 (UMLS CUI-1)
Item
I had trouble keeping my mind on what I was doing.
text
C0235198 (UMLS CUI-1)
CL.4
Code List
I had trouble keeping my mind on what I was doing.
CL Item
Rarely Or None Of The Time (less Than 1 Day) (1)
C0522498 (UMLS CUI-1)
CL Item
Some Of The Time (1-2 Days) (2)
C1998882 (UMLS CUI-1)
CL Item
Occasion (3-4 Days) (3)
C0521114 (UMLS CUI-1)
CL Item
Most Of The Time (5-7 Days) (4)
C3828954 (UMLS CUI-1)
Item
I felt depressed
text
C17047 (NCI Thesaurus ObjectClass)
C25217 (NCI Thesaurus Property)
C2982 (NCI Thesaurus Property-2)
C0011581 (UMLS CUI-1)
CL.4
Code List
I felt depressed
CL Item
Rarely Or None Of The Time (less Than 1 Day) (1)
C0522498 (UMLS CUI-1)
CL Item
Some Of The Time (1-2 Days) (2)
C1998882 (UMLS CUI-1)
CL Item
Occasion (3-4 Days) (3)
C0521114 (UMLS CUI-1)
CL Item
Most Of The Time (5-7 Days) (4)
C3828954 (UMLS CUI-1)
Item
I felt that everything I did was an effort.
text
C25704 (NCI Thesaurus ValueDomain)
C3174029 (UMLS CUI-1)
CL.4
Code List
I felt that everything I did was an effort.
CL Item
Rarely Or None Of The Time (less Than 1 Day) (1)
C0522498 (UMLS CUI-1)
CL Item
Some Of The Time (1-2 Days) (2)
C1998882 (UMLS CUI-1)
CL Item
Occasion (3-4 Days) (3)
C0521114 (UMLS CUI-1)
CL Item
Most Of The Time (5-7 Days) (4)
C3828954 (UMLS CUI-1)
Item
I felt hopeful about the future.
text
C25704 (NCI Thesaurus ValueDomain)
C3274937 (UMLS CUI-1)
CL.4
Code List
I felt hopeful about the future.
CL Item
Rarely Or None Of The Time (less Than 1 Day) (1)
C0522498 (UMLS CUI-1)
CL Item
Some Of The Time (1-2 Days) (2)
C1998882 (UMLS CUI-1)
CL Item
Occasion (3-4 Days) (3)
C0521114 (UMLS CUI-1)
CL Item
Most Of The Time (5-7 Days) (4)
C3828954 (UMLS CUI-1)
Item
I felt fearful.
text
C25704 (NCI Thesaurus ValueDomain)
C1288289 (UMLS CUI-1)
CL.4
Code List
I felt fearful.
CL Item
Rarely Or None Of The Time (less Than 1 Day) (1)
C0522498 (UMLS CUI-1)
CL Item
Some Of The Time (1-2 Days) (2)
C1998882 (UMLS CUI-1)
CL Item
Occasion (3-4 Days) (3)
C0521114 (UMLS CUI-1)
CL Item
Most Of The Time (5-7 Days) (4)
C3828954 (UMLS CUI-1)
Item
My sleep was restless.
text
C0235160 (UMLS CUI-1)
CL.4
Code List
My sleep was restless.
CL Item
Rarely Or None Of The Time (less Than 1 Day) (1)
C0522498 (UMLS CUI-1)
CL Item
Some Of The Time (1-2 Days) (2)
C1998882 (UMLS CUI-1)
CL Item
Occasion (3-4 Days) (3)
C0521114 (UMLS CUI-1)
CL Item
Most Of The Time (5-7 Days) (4)
C3828954 (UMLS CUI-1)
Item
I was happy.
text
C0018592 (UMLS CUI-1)
CL.4
Code List
I was happy.
CL Item
Rarely Or None Of The Time (less Than 1 Day) (1)
C0522498 (UMLS CUI-1)
CL Item
Some Of The Time (1-2 Days) (2)
C1998882 (UMLS CUI-1)
CL Item
Occasion (3-4 Days) (3)
C0521114 (UMLS CUI-1)
CL Item
Most Of The Time (5-7 Days) (4)
C3828954 (UMLS CUI-1)
Item
I felt lonely.
text
C3175808 (UMLS CUI-1)
CL.4
Code List
I felt lonely.
CL Item
Rarely Or None Of The Time (less Than 1 Day) (1)
C0522498 (UMLS CUI-1)
CL Item
Some Of The Time (1-2 Days) (2)
C1998882 (UMLS CUI-1)
CL Item
Occasion (3-4 Days) (3)
C0521114 (UMLS CUI-1)
CL Item
Most Of The Time (5-7 Days) (4)
C3828954 (UMLS CUI-1)
Item
I could not get ´going´
text
CL.4
Code List
I could not get ´going´
CL Item
Rarely Or None Of The Time (less Than 1 Day) (1)
C0522498 (UMLS CUI-1)
CL Item
Some Of The Time (1-2 Days) (2)
C1998882 (UMLS CUI-1)
CL Item
Occasion (3-4 Days) (3)
C0521114 (UMLS CUI-1)
CL Item
Most Of The Time (5-7 Days) (4)
C3828954 (UMLS CUI-1)
Item Group
Everyday Problems During The Past Four Weeks
C0033213 (UMLS CUI-1)
C3828653 (UMLS CUI-2)
HotFlashes
Item
Hot Flashes
boolean
C25180 (NCI Thesaurus ValueDomain)
C0600142 (UMLS CUI-1)
Headaches
Item
Headaches
boolean
C25180 (NCI Thesaurus ValueDomain)
C25626 (NCI Thesaurus Property)
C34661 (NCI Thesaurus ObjectClass)
C0018681 (UMLS CUI-1)
Difficuly bladder control
Item
Difficulty with bladder control (at other times)
boolean
C25180 (NCI Thesaurus ValueDomain)
Vaginaldischarge
Item
Vaginal discharge
boolean
C25180 (NCI Thesaurus ValueDomain)
C0227791 (UMLS CUI-1)
vaginal bleeding or spotting
Item
Vaginal bleeding or spotting
boolean
C25180 (NCI Thesaurus ValueDomain)
C3475970 (UMLS CUI-1)
Genital itching/irritation
Item
Genital itching/irritation
boolean
C25180 (NCI Thesaurus ValueDomain)
C0033777 (UMLS CUI-1)
Vaginaldryness
Item
Vaginal dryness
boolean
C25180 (NCI Thesaurus ValueDomain)
C0241633 (UMLS CUI-1)
Painwithintercourse
Item
Pain with intercourse
boolean
C25180 (NCI Thesaurus ValueDomain)
C0423742 (UMLS CUI-1)
Breastpain
Item
Breast pain
boolean
C25180 (NCI Thesaurus ValueDomain)
C0024902 (UMLS CUI-1)
Difficultywithbreastskin
Item
Difficulty with breast skin
boolean
C25180 (NCI Thesaurus ValueDomain)
Breast tenderness
Item
Breast sensitivity/tenderness
boolean
C25180 (NCI Thesaurus ValueDomain)
C0262397 (UMLS CUI-1)
Generalachesandpains
Item
General aches and pains
boolean
C25180 (NCI Thesaurus ValueDomain)
C0150930 (UMLS CUI-1)
Jointpains
Item
Joint pains
boolean
C25180 (NCI Thesaurus ValueDomain)
C0003862 (UMLS CUI-1)
Muscle stiffness
Item
Muscle stiffness
boolean
C25180 (NCI Thesaurus ValueDomain)
C0427008 (UMLS CUI-1)
Weightgain
Item
Weight gain
boolean
C25180 (NCI Thesaurus ValueDomain)
C0043094 (UMLS)
WeightLoss
Item
Weight loss
boolean
C38147 (NCI Thesaurus ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C25755 (NCI Thesaurus Property)
C3445 (NCI Thesaurus ObjectClass-2)
C1262477 (UMLS CUI-1)
Unhappywithappearanceofmybody
Item
Unhappy with appearance of my body
boolean
C25180 (NCI Thesaurus ValueDomain)
C3274925 (UMLS CUI-1)
Decrease in appetite
Item
Decreased appetite
boolean
C25180 (NCI Thesaurus ValueDomain)
C0232462 (UMLS CUI-1)
Forgetfulness
Item
Forgetfulness
boolean
C25180 (NCI Thesaurus ValueDomain)
C0542476 (UMLS CUI-1)
Excitability
Item
Excitability
boolean
C25180 (NCI Thesaurus ValueDomain)
C0235169 (UMLS CUI-1)
Temper problem
Item
Short temper
boolean
C25180 (NCI Thesaurus ValueDomain)
C0424331 (UMLS CUI-1)
Drowsiness
Item
Tendency to take naps; stay in bed
boolean
C25180 (NCI Thesaurus ValueDomain)
C0013144 (UMLS CUI-1)
Night sweats
Item
Night sweats
boolean
C25180 (NCI Thesaurus ValueDomain)
C0028081 (UMLS CUI-1)
Cold sweats
Item
Cold sweats
boolean
C25180 (NCI Thesaurus ValueDomain)
C0232431 (UMLS CUI-1)
Difficulty concentrating
Item
Difficulty concentrating
boolean
C25180 (NCI Thesaurus ValueDomain)
C0947509 (UMLS CUI-1)
Easily distracted
Item
Easily distracted
boolean
C25180 (NCI Thesaurus ValueDomain)
C0424102 (UMLS CUI-1)
Trouble sleeping
Item
Trouble sleeping
boolean
C25180 (NCI Thesaurus ValueDomain)
C3641752 (UMLS CUI-1)
Early awakening
Item
Early awakening
boolean
C25180 (NCI Thesaurus ValueDomain)
C0541798 (UMLS CUI-1)
Unspecified problem
Item
Any other problems
boolean
C25180 (NCI Thesaurus ValueDomain)
C1273828 (UMLS CUI-1)
Item
Severity
text
C0439793 (UMLS CUI-1)
CL.44
Code List
Severity
CL Item
Not At All (Not at all)
C2984077 (UMLS CUI-1)
CL Item
Slightly (Slightly)
C0750482 (UMLS CUI-1)
CL Item
Moderately (Moderately)
C1881878 (UMLS CUI-1)
CL Item
Quite A Bit (Quite a bit)
C2984080 (UMLS CUI-1)
CL Item
Extremely (Extremely)
C0205403 (UMLS CUI-1)
other problems
Item
Specify other problems
text
C1273828 (UMLS CUI-1)
Item Group
Overall health
Item
In general, would you say your health is
text
C20989 (NCI Thesaurus Property)
C25178 (NCI Thesaurus ObjectClass)
C25688 (NCI Thesaurus ValueDomain)
C0018759 (UMLS CUI-1)
CL.45
Code List
In general, would you say your health is
CL Item
Excellent (Excellent)
C1961136 (UMLS CUI-1)
CL Item
Very Good (Very good)
C3641222 (UMLS CUI-1)
CL Item
Good (Good)
C0205170 (NCI Metathesaurus)
C0205170 (UMLS CUI-1)
CL Item
Fair (Fair)
C2911689 (UMLS CUI-1)
CL Item
Poor (Poor)
C2700379 (UMLS CUI-1)
Item
Moderate activities, such as moving a table, pushing a vacuum cleaner, bowling, or playing golf (2)
text
C0449295 (UMLS CUI-1)
C3833417 (UMLS CUI-2)
CL.46
Code List
Moderate activities, such as moving a table, pushing a vacuum cleaner, bowling, or playing golf (2)
CL Item
Yes, Limited A Lot (2)
C3829282 (UMLS CUI-1)
CL Item
Yes, Limited A Little (1)
C3829283 (UMLS CUI-1)
CL Item
No, Not Limited At All (0)
C3845941 (UMLS CUI-1)
Item
Climbing several flights of stairs (3)
text
C25664 (NCI Thesaurus ValueDomain)
C20989 (NCI Thesaurus Property)
CL299704 (NCI Metathesaurus ObjectClass)
C17708 (NCI Thesaurus ObjectClass)
C0449295 (UMLS CUI-1)
C3831080 (UMLS CUI-2)
CL.46
Code List
Climbing several flights of stairs (3)
CL Item
Yes, Limited A Lot (2)
C3829282 (UMLS CUI-1)
CL Item
Yes, Limited A Little (1)
C3829283 (UMLS CUI-1)
CL Item
No, Not Limited At All (0)
C3845941 (UMLS CUI-1)
Accomplish less than you would like
Item
Accomplished less than you would like. (6)
boolean
C25640 (NCI Thesaurus ObjectClass)
C0033269 (NCI Metathesaurus ObjectClass)
C20989 (NCI Thesaurus Property)
C25178 (NCI Thesaurus Property-2)
C38147 (NCI Thesaurus ValueDomain)
C3828382 (UMLS CUI-1)
Limitation regarding work
Item
Were limited in the kind of work or other activities. (5)
boolean
CL110648 (NCI Metathesaurus ObjectClass)
C0043227 (NCI Metathesaurus ObjectClass-2)
C20989 (NCI Thesaurus Property)
C25178 (NCI Thesaurus Property-2)
C38147 (NCI Thesaurus ValueDomain)
C3641747 (UMLS CUI-1)
Did Not Do Work as Carefully
Item
Didn't do work or other activities as carefully as usual. (7)
boolean
C25180 (NCI Thesaurus ValueDomain)
C3828404 (UMLS CUI-1)
Item
During the past 4 weeks, how much did pain interfere with your normal work? (8. including both work outside the home and housework)
text
C16960 (NCI Thesaurus ObjectClass)
C3303 (NCI Thesaurus ObjectClass-2)
C20989 (NCI Thesaurus Property)
C0043227 (NCI Metathesaurus Property)
C25688 (NCI Thesaurus ValueDomain)
C3828383 (UMLS CUI-1)
CL.52
Code List
During the past 4 weeks, how much did pain interfere with your normal work? (8. including both work outside the home and housework)
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
C2984077 (UMLS CUI-1)
CL Item
A Little Bit (A little bit)
C2984078 (UMLS CUI-1)
CL Item
Moderately (Moderately)
C1881878 (UMLS CUI-1)
CL Item
Quite A Bit (Quite a bit)
C91216 (NCI Thesaurus)
C2984080 (UMLS CUI-1)
CL Item
Extremely (Extremely)
C0205403 (UMLS CUI-1)
Item Group
Mood
C0026516 (UMLS CUI-1)
Item
Have you felt calm and peaceful? (9)
text
C25664 (NCI Thesaurus ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C20989 (NCI Thesaurus Property)
C0035028 (NCI Metathesaurus Property)
C3261651 (UMLS CUI-1)
CL.53
Code List
Have you felt calm and peaceful? (9)
CL Item
All Of The Time (5)
C3812891 (UMLS CUI-1)
CL Item
Most Of The Time (4)
C3828954 (UMLS CUI-1)
CL Item
A Good Bit Of The Time (3)
C3831592 (UMLS CUI-1)
CL Item
Some Of The Time (2)
C3827992 (UMLS CUI-1)
CL Item
A Little Of The Time (1)
C3831570 (UMLS CUI-1)
CL Item
None Of The Time (0)
C3812882 (UMLS CUI-1)
Item
Did you feel full of pep? (10)
text
C25664 (NCI Thesaurus ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C20989 (NCI Thesaurus Property)
C0291944 (NCI Metathesaurus Property)
C3828401 (UMLS CUI-1)
CL.53
Code List
Did you feel full of pep? (10)
CL Item
All Of The Time (5)
C3812891 (UMLS CUI-1)
CL Item
Most Of The Time (4)
C3828954 (UMLS CUI-1)
CL Item
A Good Bit Of The Time (3)
C3831592 (UMLS CUI-1)
CL Item
Some Of The Time (2)
C3827992 (UMLS CUI-1)
CL Item
A Little Of The Time (1)
C3831570 (UMLS CUI-1)
CL Item
None Of The Time (0)
C3812882 (UMLS CUI-1)
Item
Did you have a lot of energy? (11)
text
C3828394 (UMLS CUI [1])
C25664 (NCI Thesaurus ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C20989 (NCI Thesaurus Property)
C48058 (NCI Thesaurus Property-2)
CL.53
Code List
Did you have a lot of energy? (11)
CL Item
All Of The Time (5)
C3812891 (UMLS CUI-1)
CL Item
Most Of The Time (4)
C3828954 (UMLS CUI-1)
CL Item
A Good Bit Of The Time (3)
C3831592 (UMLS CUI-1)
CL Item
Some Of The Time (2)
C3827992 (UMLS CUI-1)
CL Item
A Little Of The Time (1)
C3831570 (UMLS CUI-1)
CL Item
None Of The Time (0)
C3812882 (UMLS CUI-1)
Item
Did you feel worn out? (12)
text
C25664 (NCI Thesaurus ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C20989 (NCI Thesaurus Property)
C3036 (NCI Thesaurus Property-2)
C3828399 (UMLS CUI-1)
CL.53
Code List
Did you feel worn out? (12)
CL Item
All Of The Time (5)
C3812891 (UMLS CUI-1)
CL Item
Most Of The Time (4)
C3828954 (UMLS CUI-1)
CL Item
A Good Bit Of The Time (3)
C3831592 (UMLS CUI-1)
CL Item
Some Of The Time (2)
C3827992 (UMLS CUI-1)
CL Item
A Little Of The Time (1)
C3831570 (UMLS CUI-1)
CL Item
None Of The Time (0)
C3812882 (UMLS CUI-1)
Item
Did you feel tired? (13)
text
C25664 (NCI Thesaurus ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C20989 (NCI Thesaurus Property)
C0023380 (NCI Metathesaurus Property)
C3539029 (UMLS CUI-1)
CL.53
Code List
Did you feel tired? (13)
CL Item
All Of The Time (5)
C3812891 (UMLS CUI-1)
CL Item
Most Of The Time (4)
C3828954 (UMLS CUI-1)
CL Item
A Good Bit Of The Time (3)
C3831592 (UMLS CUI-1)
CL Item
Some Of The Time (2)
C3827992 (UMLS CUI-1)
CL Item
A Little Of The Time (1)
C3831570 (UMLS CUI-1)
CL Item
None Of The Time (0)
C3812882 (UMLS CUI-1)
Item
Have you felt downhearted and blue? (14)
text
C25664 (NCI Thesaurus ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C20989 (NCI Thesaurus Property)
C0026516 (NCI Metathesaurus Property)
C3828397 (UMLS CUI-1)
CL.53
Code List
Have you felt downhearted and blue? (14)
CL Item
All Of The Time (5)
C3812891 (UMLS CUI-1)
CL Item
Most Of The Time (4)
C3828954 (UMLS CUI-1)
CL Item
A Good Bit Of The Time (3)
C3831592 (UMLS CUI-1)
CL Item
Some Of The Time (2)
C3827992 (UMLS CUI-1)
CL Item
A Little Of The Time (1)
C3831570 (UMLS CUI-1)
CL Item
None Of The Time (0)
C3812882 (UMLS CUI-1)
Item
During the past 4 weeks, how much of the time has your physical health or emotional problems interfered with your social activities? (15. like visiting with friends, relatives, etc.)
text
C20989 (NCI Thesaurus Property)
C0037397 (NCI Metathesaurus ObjectClass)
C25330 (NCI Thesaurus ValueDomain)
C3484327 (UMLS CUI-1)
CL.53
Code List
During the past 4 weeks, how much of the time has your physical health or emotional problems interfered with your social activities? (15. like visiting with friends, relatives, etc.)
CL Item
All Of The Time (5)
C3812891 (UMLS CUI-1)
CL Item
Most Of The Time (4)
C3828954 (UMLS CUI-1)
CL Item
A Good Bit Of The Time (3)
C3831592 (UMLS CUI-1)
CL Item
Some Of The Time (2)
C3827992 (UMLS CUI-1)
CL Item
A Little Of The Time (1)
C3831570 (UMLS CUI-1)
CL Item
None Of The Time (0)
C3812882 (UMLS CUI-1)
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. (16)
text
C0451401 (UMLS CUI-1)
CL.60
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. (16)
CL Item
0 (0)
C0919414 (NCI Metathesaurus)
CL Item
1 (1)
CL Item
2 (2)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
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)
Item Group
Sexual activity
C0036864 (UMLS CUI-1)
Sexually active past 6 months
Item
Have you been sexually active during the past SIX MONTHS? (17)
boolean
C0241028 (UMLS CUI [1,1])
C3828652 (UMLS CUI [1,2])
C25180 (NCI Thesaurus ValueDomain)
Item
Lack of sexual interest
text
C3828902 (UMLS CUI-1)
CL.62
Code List
Lack of sexual interest
CL Item
Not A Problem (0)
C0549184 (UMLS CUI-1)
CL Item
A Little Problem (1)
C2984078 (UMLS CUI-1)
CL Item
A Definite Problem (2)
C0439544 (UMLS CUI-1)
CL Item
A Serious Problem (3)
C0205404 (UMLS CUI-1)
Item
Difficulty in becoming sexually aroused
text
C1314759 (UMLS CUI-1)
CL.62
Code List
Difficulty in becoming sexually aroused
CL Item
Not A Problem (0)
C0549184 (UMLS CUI-1)
CL Item
A Little Problem (1)
C2984078 (UMLS CUI-1)
CL Item
A Definite Problem (2)
C0439544 (UMLS CUI-1)
CL Item
A Serious Problem (3)
C0205404 (UMLS CUI-1)
Item
Unable to relax and enjoy sex
text
C3174543 (UMLS CUI-1)
CL.62
Code List
Unable to relax and enjoy sex
CL Item
Not A Problem (0)
C0549184 (UMLS CUI-1)
CL Item
A Little Problem (1)
C2984078 (UMLS CUI-1)
CL Item
A Definite Problem (2)
C0439544 (UMLS CUI-1)
CL Item
A Serious Problem (3)
C0205404 (UMLS CUI-1)
Item
Difficulty in having orgasm
text
C0029261 (UMLS CUI-1)
CL.62
Code List
Difficulty in having orgasm
CL Item
Not A Problem (0)
C0549184 (UMLS CUI-1)
CL Item
A Little Problem (1)
C2984078 (UMLS CUI-1)
CL Item
A Definite Problem (2)
C0439544 (UMLS CUI-1)
CL Item
A Serious Problem (3)
C0205404 (UMLS CUI-1)
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