ID

44601

Descrizione

PQ RTOG Phase III Multiple Brain Metastases Fact Subscale Radiation Therapy and Stereotactic Radiosurgery With or Without Temozolomide or Erlotinib in Treating Patients With Brain Metastases Secondary to Non-Small Cell Lung Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=D7FA7BFE-292F-6626-E034-0003BA12F5E7

collegamento

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=D7FA7BFE-292F-6626-E034-0003BA12F5E7

Keywords

versioni (3)
  1. 19/09/12 19/09/12 -
  2. 09/01/15 09/01/15 - Martin Dugas
  3. 27/09/21 27/09/21 -
Caricato su

27 settembre 2021

DOI

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Licenza

Creative Commons BY-NC 3.0 Legacy
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Lung Cancer NCT00096265 Quality of Life - PQ RTOG Phase III Multiple Brain Metastases Fact Subscale - 2277326v3.0

Inglese

No Instruction available.

1 moduli  
  1. StudyEvent: PQ RTOG Phase III Multiple Brain Metastases Fact Subscale
    1. No Instruction available.
Header
Descrizione

Header

[RTOG Study No.]
Descrizione

Protocol ID RTOG

Tipo di dati

text

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

Case#

Tipo di dati

text

Institution
Descrizione

Institution Name

Tipo di dati

text

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

Institution Number

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C1301943
NCI Thesaurus ObjectClass
C21541
UMLS CUI-2
C0805701
NCI Thesaurus Property
C25364
Participant's Initials
Descrizione

Patient Initials

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C2986440
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25536
Participant's I.D. No.
Descrizione

Patient Study ID

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C2348585
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25462
NCI Thesaurus Property-2
C25364
Physical Well-being
Descrizione

Physical Well-being

I am able to concentrate
Descrizione

Iamabletoconcentrate

Tipo di dati

text

I have had seizures (convulsions)
Descrizione

Ihavehadseizures(convulsions)

Tipo di dati

text

I can remember new things
Descrizione

Icanremembernewthings

Tipo di dati

text

I get frustrated that I cannot do things I used to
Descrizione

IgetfrustratedthatIcannotdothingsIusedto

Tipo di dati

text

I am afraid of having a seizure (convulsion)
Descrizione

Iamafraidofhavingaseizure(convulsion)

Tipo di dati

text

I have trouble with my eyesight
Descrizione

Ihavetroublewithmyeyesight

Tipo di dati

text

I feel independent
Descrizione

Ifeelindependent

Tipo di dati

text

I have trouble hearing
Descrizione

Ihavetroublehearing

Tipo di dati

text

I am able to find the right word(s) to say what I mean
Descrizione

Iamabletofindtherightword(s)tosaywhatImean

Tipo di dati

text

I have difficulty expressing my thoughts
Descrizione

Ihavedifficultyexpressingmythoughts

Tipo di dati

text

I am bothered by the change in my personality
Descrizione

Iambotheredbythechangeinmypersonality

Tipo di dati

text

I am able to make decisions and take responsibility
Descrizione

Iamabletomakedecisionsandtakeresponsibility

Tipo di dati

text

I am bothered by the drop in my contribution to the family
Descrizione

Iambotheredbythedropinmycontributiontothefamily

Tipo di dati

text

I am able to put my thoughts together
Descrizione

Iamabletoputmythoughtstogether

Tipo di dati

text

I need help in caring for myself (bathing, dressing, eating)
Descrizione

Ineedhelpincaringformyself(bathing,dressing,eating)

Tipo di dati

text

I am able to put my thoughts into action
Descrizione

Iamabletoputmythoughtsintoaction

Tipo di dati

text

I am able to read like I used to
Descrizione

IamabletoreadlikeIusedto

Tipo di dati

text

I am able to write like I used to
Descrizione

IamabletowritelikeIusedto

Tipo di dati

text

I am able to drive a vehicle (my car, truck, etc.)
Descrizione

Iamabletodriveavehicle(mycar,truck,etc.)

Tipo di dati

text

I have trouble feeling sensations in my arms, hands, or legs
Descrizione

Ihavetroublefeelingsensationsinmyarms,hands,orlegs

Tipo di dati

text

I have weakness in my arms or legs
Descrizione

Ihaveweaknessinmyarmsorlegs

Tipo di dati

text

I have trouble with coordination
Descrizione

Ihavetroublewithcoordination

Tipo di dati

text

I get headaches
Descrizione

Igetheadaches

Tipo di dati

text

Additional Concerns
Descrizione

Additional Concerns

I have been short of breath
Descrizione

QualityofLifeDyspneaEvaluationScale

Tipo di dati

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus Property
C25214
UMLS 2011AA Property
C0220825
NCI Thesaurus Property-2
C2998
UMLS 2011AA Property-2
C0013404
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
NCI Thesaurus ValueDomain-2
C17047
UMLS 2011AA ValueDomain-2
C0518214
I am losing weight
Descrizione

PatientWeightLossAssessmentQualityofLifeScale

Tipo di dati

text

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property-2
C3445
UMLS 2011AA Property-2
C1262477
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
NCI Thesaurus ValueDomain-2
C17047
UMLS 2011AA ValueDomain-2
C0518214
My thinking is clear
Descrizione

Mythinkingisclear

Tipo di dati

text

I have been coughing
Descrizione

Ihavebeencoughing

Tipo di dati

text

I am bothered by hair loss
Descrizione

Iambotheredbyhairloss

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
NCI Thesaurus ValueDomain-2
C17047
UMLS 2011AA ValueDomain-2
C0518214
I have a good appetite
Descrizione

PatientAppetiteAssessmentQualityofLifeScale

Tipo di dati

text

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property-2
C25152
UMLS 2011AA Property-2
C0003618
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
NCI Thesaurus ValueDomain-2
C17047
UMLS 2011AA ValueDomain-2
C0518214
I feel tightness in my chest
Descrizione

Ifeeltightnessinmychest

Tipo di dati

text

Breathing is easy for me
Descrizione

Breathingiseasyforme

Tipo di dati

text

Comments
Descrizione

Research Comments

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS CUI-1
C0947611
NCI Thesaurus ObjectClass
C15319
NCI Thesaurus Property
C25393
Date
Descrizione

ResponsiblePersonSignatureDate

Tipo di dati

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus ObjectClass-2
C25657
UMLS 2011AA ObjectClass-2
C1273518
NCI Thesaurus Property
C25678
UMLS 2011AA Property
C1519316
Have you ever smoked?
Descrizione

Haveyoueversmoked?

Tipo di dati

boolean

If yes
Descrizione

Ifyes

Tipo di dati

text

I regret smoking
Descrizione

Iregretsmoking

Tipo di dati

text

Patient's signature
Descrizione

Patient'ssignature

Tipo di dati

text

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No Instruction available.

1 moduli
  1. StudyEvent: PQ RTOG Phase III Multiple Brain Metastases Fact Subscale
    1. No Instruction available.
Name
genere
Description | Question | Decode (Coded Value)
Tipo di dati
Alias
Item Group
Header
Item
[RTOG Study No.]
text
C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1514695 (UMLS CUI-2)
C19778 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
CL.1
Code List
[RTOG Study No.]
CL Item
RTOG Study 0320 (RTOG Study 0320)
Case#
Item
Case #
text
Institution Name
Item
Institution
text
C25191 (NCI Thesaurus ValueDomain)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C21541 (NCI Thesaurus ValueDomain-2)
C25364 (NCI Thesaurus Property)
Institution Number
Item
Institution No.
text
C25337 (NCI Thesaurus ValueDomain)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C0805701 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
Patient Initials
Item
Participant's Initials
text
C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
Patient Study ID
Item
Participant's I.D. No.
text
C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25462 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
Item Group
Physical Well-being
Item
I am able to concentrate
text
CL.2
Code List
I am able to concentrate
CL Item
Not At All (Not at all)
CL Item
A Little Bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite A Bit (Quite a bit)
CL Item
Very Much (Very much)
Item
I have had seizures (convulsions)
text
CL.3
Code List
I have had seizures (convulsions)
CL Item
Not At All (Not at all)
CL Item
A Little Bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite A Bit (Quite a bit)
CL Item
Very Much (Very much)
Item
I can remember new things
text
CL.4
Code List
I can remember new things
CL Item
Not At All (Not at all)
CL Item
A Little Bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite A Bit (Quite a bit)
CL Item
Very Much (Very much)
Item
I get frustrated that I cannot do things I used to
text
CL.5
Code List
I get frustrated that I cannot do things I used to
CL Item
Not At All (Not at all)
CL Item
A Little Bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite A Bit (Quite a bit)
CL Item
Very Much (Very much)
Item
I am afraid of having a seizure (convulsion)
text
CL.6
Code List
I am afraid of having a seizure (convulsion)
CL Item
Not At All (Not at all)
CL Item
A Little Bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite A Bit (Quite a bit)
CL Item
Very Much (Very much)
Item
I have trouble with my eyesight
text
CL.7
Code List
I have trouble with my eyesight
CL Item
Not At All (Not at all)
CL Item
A Little Bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite A Bit (Quite a bit)
CL Item
Very Much (Very much)
Item
I feel independent
text
CL.8
Code List
I feel independent
CL Item
Not At All (Not at all)
CL Item
A Little Bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite A Bit (Quite a bit)
CL Item
Very Much (Very much)
Item
I have trouble hearing
text
CL.9
Code List
I have trouble hearing
CL Item
Not At All (Not at all)
CL Item
A Little Bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite A Bit (Quite a bit)
CL Item
Very Much (Very much)
Item
I am able to find the right word(s) to say what I mean
text
CL.10
Code List
I am able to find the right word(s) to say what I mean
CL Item
Not At All (Not at all)
CL Item
A Little Bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite A Bit (Quite a bit)
CL Item
Very Much (Very much)
Item
I have difficulty expressing my thoughts
text
CL.11
Code List
I have difficulty expressing my thoughts
CL Item
Not At All (Not at all)
CL Item
A Little Bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite A Bit (Quite a bit)
CL Item
Very Much (Very much)
Item
I am bothered by the change in my personality
text
CL.12
Code List
I am bothered by the change in my personality
CL Item
Not At All (Not at all)
CL Item
A Little Bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite A Bit (Quite a bit)
CL Item
Very Much (Very much)
Item
I am able to make decisions and take responsibility
text
CL.13
Code List
I am able to make decisions and take responsibility
CL Item
Not At All (Not at all)
CL Item
A Little Bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite A Bit (Quite a bit)
CL Item
Very Much (Very much)
Item
I am bothered by the drop in my contribution to the family
text
CL.14
Code List
I am bothered by the drop in my contribution to the family
CL Item
Not At All (Not at all)
CL Item
A Little Bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite A Bit (Quite a bit)
CL Item
Very Much (Very much)
Item
I am able to put my thoughts together
text
CL.15
Code List
I am able to put my thoughts together
CL Item
Not At All (Not at all)
CL Item
A Little Bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite A Bit (Quite a bit)
CL Item
Very Much (Very much)
Item
I need help in caring for myself (bathing, dressing, eating)
text
CL.16
Code List
I need help in caring for myself (bathing, dressing, eating)
CL Item
Not At All (Not at all)
CL Item
A Little Bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite A Bit (Quite a bit)
CL Item
Very Much (Very much)
Item
I am able to put my thoughts into action
text
CL.17
Code List
I am able to put my thoughts into action
CL Item
Not At All (Not at all)
CL Item
A Little Bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite A Bit (Quite a bit)
CL Item
Very Much (Very much)
Item
I am able to read like I used to
text
CL.18
Code List
I am able to read like I used to
CL Item
Not At All (Not at all)
CL Item
A Little Bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite A Bit (Quite a bit)
CL Item
Very Much (Very much)
Item
I am able to write like I used to
text
CL.19
Code List
I am able to write like I used to
CL Item
Not At All (Not at all)
CL Item
A Little Bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite A Bit (Quite a bit)
CL Item
Very Much (Very much)
Item
I am able to drive a vehicle (my car, truck, etc.)
text
CL.20
Code List
I am able to drive a vehicle (my car, truck, etc.)
CL Item
Not At All (Not at all)
CL Item
A Little Bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite A Bit (Quite a bit)
CL Item
Very Much (Very much)
Item
I have trouble feeling sensations in my arms, hands, or legs
text
CL.21
Code List
I have trouble feeling sensations in my arms, hands, or legs
CL Item
Not At All (Not at all)
CL Item
A Little Bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite A Bit (Quite a bit)
CL Item
Very Much (Very much)
Item
I have weakness in my arms or legs
text
CL.22
Code List
I have weakness in my arms or legs
CL Item
Not At All (Not at all)
CL Item
A Little Bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite A Bit (Quite a bit)
CL Item
Very Much (Very much)
Item
I have trouble with coordination
text
CL.23
Code List
I have trouble with coordination
CL Item
Not At All (Not at all)
CL Item
A Little Bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite A Bit (Quite a bit)
CL Item
Very Much (Very much)
Item
I get headaches
text
CL.24
Code List
I get headaches
CL Item
Not At All (Not at all)
CL Item
A Little Bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite A Bit (Quite a bit)
CL Item
Very Much (Very much)
Item Group
Additional Concerns
Item
I have been short of breath
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25214 (NCI Thesaurus Property)
C0220825 (UMLS 2011AA Property)
C2998 (NCI Thesaurus Property-2)
C0013404 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)
CL.25
Code List
I have been short of breath
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
C70543 (NCI Thesaurus-3)
C2003901 (UMLS 2011AA)
CL Item
A Little Bit (A little bit)
CL Item
Somewhat (Somewhat)
C91215 (NCI Thesaurus)
CL Item
Quite A Bit (Quite a bit)
C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus-2)
CL Item
Very Much (Very much)
C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus-2)
Item
I am losing weight
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C3445 (NCI Thesaurus Property-2)
C1262477 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)
CL.26
Code List
I am losing weight
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
C70543 (NCI Thesaurus-3)
C2003901 (UMLS 2011AA)
CL Item
A Little Bit (A little bit)
CL Item
Somewhat (Somewhat)
C91215 (NCI Thesaurus)
CL Item
Quite A Bit (Quite a bit)
C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus-2)
CL Item
Very Much (Very much)
C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus-2)
Item
My thinking is clear
text
CL.27
Code List
My thinking is clear
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
CL Item
A Little Bit (A little bit)
CL Item
Somewhat (Somewhat)
C91215 (NCI Thesaurus)
CL Item
Quite A Bit (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
Very Much (Very much)
C91217 (NCI Thesaurus)
Item
I have been coughing
text
CL.28
Code List
I have been coughing
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
CL Item
A Little Bit (A little bit)
CL Item
Somewhat (Somewhat)
C91215 (NCI Thesaurus)
CL Item
Quite A Bit (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
Very Much (Very much)
C91217 (NCI Thesaurus)
Item
I am bothered by hair loss
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)
CL.29
Code List
I am bothered by hair loss
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
C70543 (NCI Thesaurus-3)
C2003901 (UMLS 2011AA)
CL Item
A Little Bit (A little bit)
CL Item
Somewhat (Somewhat)
C91215 (NCI Thesaurus)
CL Item
Quite A Bit (Quite a bit)
C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus-2)
CL Item
Very Much (Very much)
C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus-2)
Item
I have a good appetite
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25152 (NCI Thesaurus Property-2)
C0003618 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)
CL.30
Code List
I have a good appetite
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
C70543 (NCI Thesaurus-3)
C2003901 (UMLS 2011AA)
CL Item
A Little Bit (A little bit)
CL Item
Somewhat (Somewhat)
C91215 (NCI Thesaurus)
CL Item
Quite A Bit (Quite a bit)
C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus-2)
CL Item
Very Much (Very much)
C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus-2)
Item
I feel tightness in my chest
text
CL.31
Code List
I feel tightness in my chest
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
CL Item
A Little Bit (A little bit)
CL Item
Somewhat (Somewhat)
C91215 (NCI Thesaurus)
CL Item
Quite A Bit (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
Very Much (Very much)
C91217 (NCI Thesaurus)
Item
Breathing is easy for me
text
CL.32
Code List
Breathing is easy for me
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
CL Item
A Little Bit (A little bit)
CL Item
Somewhat (Somewhat)
C91215 (NCI Thesaurus)
CL Item
Quite A Bit (Quite a bit)
C91216 (NCI Thesaurus)
CL Item
Very Much (Very much)
C91217 (NCI Thesaurus)
Research Comments
Item
Comments
text
C25704 (NCI Thesaurus ValueDomain)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
ResponsiblePersonSignatureDate
Item
Date
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25657 (NCI Thesaurus ObjectClass-2)
C1273518 (UMLS 2011AA ObjectClass-2)
C25678 (NCI Thesaurus Property)
C1519316 (UMLS 2011AA Property)
Haveyoueversmoked?
Item
Have you ever smoked?
boolean
Item
If yes
text
CL.34
Code List
If yes
CL Item
Not At All (Not at all)
CL Item
A Little Bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite A Bit (Quite a bit)
CL Item
Very Much (Very much)
Item
I regret smoking
text
CL.35
Code List
I regret smoking
CL Item
Not At All (Not at all)
CL Item
A Little Bit (A little bit)
CL Item
Somewhat (Somewhat)
CL Item
Quite A Bit (Quite a bit)
CL Item
Very Much (Very much)
Patient'ssignature
Item
Patient's signature
text
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