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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

Lien

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

Mots-clés

  1. 26/08/2012 26/08/2012 -
  2. 07/08/2014 07/08/2014 - Martin Dugas
  3. 21/03/2015 21/03/2015 - Martin Dugas
  4. 10/04/2021 10/04/2021 - Ahmed Rafee, MD
  5. 20/09/2021 20/09/2021 -
Détendeur de droits

folgt

Téléchargé le

20 septembre 2021

DOI

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Licence

Creative Commons BY 4.0

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    Breast Cancer (NCT00053898)

    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.

    Header
    Description

    Header

    First Three Letters of Patient?s Last Name
    Description

    FirstThreeLettersofPatient?sLastName

    Type de données

    text

    Patient Study ID
    Description

    PatientStudyID

    Type de données

    text

    Institution Name
    Description

    InstitutionName

    Type de données

    text

    Affiliate Name
    Description

    AffiliateName

    Type de données

    text

    Staff member administering form
    Description

    PersonFormAdministrationLastName

    Type de données

    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

    Type de données

    text

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

    AmendedDataInd

    Type de données

    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

    Type de données

    text

    This form is being filled out
    Description

    CaseReportFormPersonCompleteType

    Type de données

    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

    Type de données

    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.

    Type de données

    text

    Alias
    UMLS CUI-1
    C0235198
    I felt depressed
    Description

    Ifeltdepressed

    Type de données

    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

    Type de données

    text

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

    Ifelthopefulaboutthefuture.Ifelthopefulaboutthefuture

    Type de données

    text

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

    I felt fearful.

    Type de données

    text

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

    My sleep was restless.

    Type de données

    text

    Alias
    UMLS CUI-1
    C0235160
    I was happy.
    Description

    I was happy.

    Type de données

    text

    Alias
    UMLS CUI-1
    C0018592
    I felt lonely.
    Description

    I felt lonely.

    Type de données

    text

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

    I could not get ´going´

    Type de données

    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

    Type de données

    boolean

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

    Headaches

    Type de données

    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

    Type de données

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C25180
    Vaginal discharge
    Description

    Vaginal discharge

    Type de données

    boolean

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

    Vaginal bleeding or spotting

    Type de données

    boolean

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

    Genital itching/irritation

    Type de données

    boolean

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

    Vaginal dryness

    Type de données

    boolean

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

    Painwithintercourse

    Type de données

    boolean

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

    Breast pain

    Type de données

    boolean

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

    Difficultywithbreastskin

    Type de données

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C25180
    Breast sensitivity/tenderness
    Description

    Breastsensitivity/tenderness

    Type de données

    boolean

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

    Generalachesandpains

    Type de données

    boolean

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

    Joint pains

    Type de données

    boolean

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

    Muscle stiffness

    Type de données

    boolean

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

    Weightgain

    Type de données

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C25180
    UMLS
    C0043094
    Weight loss
    Description

    Weight loss

    Type de données

    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

    Type de données

    boolean

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

    Decreasedappetite

    Type de données

    boolean

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

    Forgetfulness

    Type de données

    boolean

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

    Excitability

    Type de données

    boolean

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

    Short temper

    Type de données

    boolean

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

    Tendencytotakenaps;stayinbed

    Type de données

    boolean

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

    Night sweats

    Type de données

    boolean

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

    Cold sweats

    Type de données

    boolean

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

    Difficulty concentrating

    Type de données

    boolean

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

    Easily distracted

    Type de données

    boolean

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

    Trouble sleeping

    Type de données

    boolean

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

    Early awakening

    Type de données

    boolean

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

    Anyotherproblems (Specify below)

    Type de données

    boolean

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

    Severity

    Type de données

    text

    Alias
    UMLS CUI-1
    C0439793
    Specify other problems
    Description

    Specifyotherproblems

    Type de données

    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

    Type de données

    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

    Type de données

    text

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

    ClimbingStairsPhysicalActivityAssessmentScale

    Type de données

    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

    Type de données

    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

    Type de données

    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.

    Type de données

    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

    Type de données

    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

    Type de données

    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

    Type de données

    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

    Type de données

    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

    Type de données

    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

    Type de données

    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)

    Type de données

    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

    Type de données

    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.

    Type de données

    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?

    Type de données

    boolean

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

    Lackofsexualinterest

    Type de données

    text

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

    Difficultyinbecomingsexuallyaroused

    Type de données

    text

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

    Unabletorelaxandenjoysex

    Type de données

    text

    Alias
    UMLS CUI-1
    C3174543
    Difficulty in having orgasm
    Description

    Difficultyinhavingorgasm

    Type de données

    text

    Alias
    UMLS CUI-1
    C0029261

    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.

    Name
    Type
    Description | Question | Decode (Coded Value)
    Type de données
    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
    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)
    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)
    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)
    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)
    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)
    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)
    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)
    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)
    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)
    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)
    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
    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)
    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)
    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)
    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)
    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)
    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)
    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)
    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)
    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)
    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)
    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)
    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)
    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)
    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)
    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)
    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)
    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)
    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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