ID
5499
Description
Quality of Life Questionnaire Anastrozole or Tamoxifen in Treating Postmenopausal Women With Ductal Carcinoma in Situ Who Are Undergoing Lumpectomy and Radiation Therapy Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A0E240A0-FD2A-46A0-E034-080020C9C0E0
Link
Keywords
Versions (5)
- 8/26/12 8/26/12 -
- 8/7/14 8/7/14 - Martin Dugas
- 3/21/15 3/21/15 - Martin Dugas
- 4/10/21 4/10/21 - Ahmed Rafee, MD
- 9/20/21 9/20/21 -
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August 7, 2014
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Creative Commons BY-NC 3.0 Legacy
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Breast Cancer NCT00053898 Quality of Life - Quality of Life Questionnaire - 2035063v3.0
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.
Description
Unnamed3
Description
TimePointforthisQuestionnaire
Data type
text
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
- C25250
- UMLS 2011AA Property
- C0205197
Description
Unnamed4
Description
QualityofLifeDiscomfortNormalEventAssessmentDayFrequency
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C17047
- UMLS 2011AA ObjectClass
- C0518214
- NCI Thesaurus Property
- C25499
- UMLS 2011AA Property
- C0441471
- NCI Thesaurus Property
- C50535
- UMLS 2011AA Property
- C0234215
- NCI Thesaurus Property
- C14165
- UMLS 2011AA Property
- C0205307
- NCI Thesaurus Property
- C25217
- UMLS 2011AA Property
- C1516048
- NCI Thesaurus ValueDomain
- C25301
- UMLS 2011AA ValueDomain
- C0439228
- NCI Thesaurus ValueDomain
- C25515
- UMLS 2011AA ValueDomain
- C0439603
Description
IhadtroublekeepingmymindonwhatIwasdoing.
Data type
text
Description
Ifeltdepressed
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C17047
- UMLS 2011AA ObjectClass
- C0518214
- NCI Thesaurus Property
- C25217
- UMLS 2011AA Property
- C1516048
- NCI Thesaurus Property
- C2982
- UMLS 2011AA Property
- C0011570
Description
IfeltthateverythingIdidwasaneffort.IfeltthateverythingIdidwasaneffort.Text
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
Description
Ifelthopefulaboutthefuture.Ifelthopefulaboutthefuture.Text
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
Description
Ifeltfearful.Ifeltfearful.Text
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
Description
Mysleepwasrestless.
Data type
text
Description
Iwashappy.
Data type
text
Description
Ifeltlonely.
Data type
text
Description
Icouldnotget"going".
Data type
text
Description
Everyday Problems During The Past Four Weeks
Description
HotFlashes
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Description
HeadachesInd
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
- NCI Thesaurus Property
- C25626
- UMLS 2011AA Property
- C0150312
- NCI Thesaurus ObjectClass
- C34661
- UMLS 2011AA ObjectClass
- C0018681
Description
Difficultywithbladdercontrol
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Description
Difficultywithbladdercontrol
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Description
VaginaldischargeInd
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Description
Vaginalbleedingorspotting
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Description
Genitalitching/irritation
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Description
VaginaldrynessInd
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Description
Painwithintercourse
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Description
Breastpain
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Description
Difficultywithbreastskin
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Description
Breastsensitivity/tenderness
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Description
Generalachesandpains
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Description
Jointpains
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Description
Musclestiffness
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Description
Weightgain
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS
- C0043094
Description
WeightLossAssessmentResponseInd-2
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
- NCI Thesaurus ObjectClass
- C20989
- UMLS 2011AA ObjectClass
- C0031809
- NCI Thesaurus Property
- C25755
- UMLS 2011AA Property
- C0871261
- NCI Thesaurus ObjectClass
- C3445
- UMLS 2011AA ObjectClass
- C0043096
Description
Unhappywithappearanceofmybody
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Description
Decreasedappetite
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Description
Forgetfulness
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Description
Excitability
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Description
Shorttemper
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Description
Tendencytotakenaps;stayinbed
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Description
Nightsweats
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Description
Coldsweats
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Description
Difficultyconcentrating
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Description
Easilydistracted
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Description
Troublesleeping
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Description
Earlyawakening
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Description
Anyotherproblems
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Description
Severity
Data type
text
Description
Specifyotherproblems
Data type
text
Description
Unnamed5
Description
Unnamed6
Description
Moderateactivities,suchasmovingatable,pushingavacuumcleaner,bowling,orplayinggolf
Data type
text
Description
ClimbingStairsPhysicalActivityAssessmentScale
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Metathesaurus ObjectClass
- CL299704
- NCI Thesaurus ObjectClass
- C17708
- UMLS 2011AA ObjectClass
- C0026606
Description
Unnamed7
Description
ReducedProductivityHealthAssessmentInd-2
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C25640
- UMLS 2011AA ObjectClass
- C0392756
- NCI Metathesaurus ObjectClass
- C0033269
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Thesaurus Property
- C25178
- UMLS 2011AA Property
- C0018684
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Description
LimitedWorkHealthAssessmentInd-2
Data type
text
Alias
- NCI Metathesaurus ObjectClass
- CL110648
- NCI Metathesaurus ObjectClass
- C0043227
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Thesaurus Property
- C25178
- UMLS 2011AA Property
- C0018684
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Description
Unnamed8
Description
ReducedProductivityHealthAssessmentInd-2
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C25640
- UMLS 2011AA ObjectClass
- C0392756
- NCI Metathesaurus ObjectClass
- C0033269
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Thesaurus Property
- C25178
- UMLS 2011AA Property
- C0018684
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Description
Didn'tdoworkorotheractivitiesascarefullyasusual.
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Description
PainPatientWorkAssessmentStatus
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus ObjectClass
- C3303
- UMLS 2011AA ObjectClass
- C0030193
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Metathesaurus Property
- C0043227
- NCI Thesaurus ValueDomain
- C25688
- UMLS 2011AA ValueDomain
- C0449438
Description
Unnamed9
Description
PatientRelaxationAssessmentScale
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Metathesaurus Property
- C0035028
Description
PatientVitalityAssessmentScale
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Metathesaurus Property
- C0291944
Description
PatientEnergyAssessmentScale
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Thesaurus Property
- C48058
- UMLS 2011AA Property
- C0542479
Description
PatientFatigueAssessmentScale
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Thesaurus Property
- C3036
- UMLS 2011AA Property
- C0015672
Description
PatientLethargyAssessmentScale
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Metathesaurus Property
- C0023380
Description
PatientMoodAssessmentScale
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Metathesaurus Property
- C0026516
Description
SocialBehaviorAssessmentDuration
Data type
text
Alias
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Metathesaurus ObjectClass
- C0037397
- NCI Thesaurus ValueDomain
- C25330
- UMLS 2011AA ValueDomain
- C0449238
Description
Pleasescoreyouroverallqualityoflifeasoftodayonan11-pointscalewhere0indicatesbeingintheworstpossiblehealthand10indicatesbeinginperfecthealth.
Data type
text
Description
HaveyoubeensexuallyactiveduringthepastSIXMONTHS?
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Description
Unnamed10
Description
Lackofsexualinterest
Data type
text
Description
Difficultyinbecomingsexuallyaroused
Data type
text
Description
Unabletorelaxandenjoysex
Data type
text
Description
Difficultyinhavingorgasm
Data type
text
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C3036 (NCI Thesaurus Property)
C0015672 (UMLS 2011AA Property)
C0349674 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0023380 (NCI Metathesaurus Property)
C0349674 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0026516 (NCI Metathesaurus Property)
C0031809 (UMLS 2011AA Property)
C0037397 (NCI Metathesaurus ObjectClass)
C25330 (NCI Thesaurus ValueDomain)
C0449238 (UMLS 2011AA ValueDomain)
C0205448 (UMLS 2011AA)
C1522602 (UMLS 2011AA ValueDomain)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
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