Description:

AMC-045 Quality of Life Instruments (QLQ) Phase II Trial Of Combined Modality Therapy Plus Cetuximab in HIV-Associated Anal Carcinoma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=7288A090-8102-4969-E040-BB89AD433657

Link:

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=7288A090-8102-4969-E040-BB89AD433657

Keywords:

Clinical Trial

Anus Neoplasms

Quality of Life

Versions (2) ▾

5/9/12
8/11/14

Uploaded on:

August 11, 2014

DOI:

No DOI assigned. To request one pleaselog in.

License:

Creative Commons BY-NC 3.0 Legacy

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Anal Cancer NCT00324415 Quality of Life - AMC-045 Quality of Life Instruments (QLQ)_2937315v1_0

Details

No Instruction available.

StudyEvent: AMC-045 Quality of Life Instruments (QLQ)
1. No Instruction available.

Unnamed1

Visit number

Date Questionnaire Completed (mm/dd/yyyy)

Stoma

Do you have a stoma (colostomy bag)?

No (No)

Yes (Yes)

Supplemental Quality Of Life Questions

How satisfied are you with your current degree of anal or anal/rectal function (on a scale of 1-10 with 1 being totally dissatisfied to 10 totally satisfied)

0 (0)

1 (1)

10 (10)

2 (2)

3 (3)

7 more items in the detailed view.

How well does your anus function (MEMORIAL SLOAN KETTERING ANAL FUNCTION SCALE)

Excellent; Typically 1-2 Bowel Movements Per Day And No Soilage (Excellent; Typically 1-2 bowel movements per day and no soilage)

Good; Typically 3-4 Bowel Movements Per Day And/or Mild Soilage (Good; Typically 3-4 bowel movements per day and/or mild soilage)

Fair; >4 Bowel Movements A Day At Least At Times And/or Moderate Soilage (Fair; >4 bowel movements a day at least at times and/or moderate soilage)

Poor; Incontinence (Poor; Incontinence)

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