ID

5614

Descripción

Gynecologic Oncology Group Smoking History Questionnaire (Form SHQ) Radiation Therapy With or Without Chemotherapy in Patients With Stage I or Stage II Cervical Cancer Who Previously Underwent Surgery Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=572CCDFB-3AD6-1370-E044-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=572CCDFB-3AD6-1370-E044-0003BA3F9857

Palabras clave

Versiones (3)
  1. 27/8/12 27/8/12 -
  2. 11/8/14 11/8/14 - Martin Dugas
  3. 9/1/15 9/1/15 - Martin Dugas
Subido en

11 de agosto de 2014

DOI

Para solicitar uno, por favor iniciar sesión.

Licencia

Creative Commons BY-NC 3.0 Legacy
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Cervical Cancer NCT01101451 Quality of Life - Gynecologic Oncology Group Smoking History Questionnaire (Form SHQ) - 2785914v1.0

Inglés

No Instruction available.

1 formularios  
  1. StudyEvent: Gynecologic Oncology Group Smoking History Questionnaire (Form SHQ)
    1. No Instruction available.
Header Module
Descripción

Header Module

Date form originally completed (m d y)
Descripción

FormOriginalCompleteDate

Tipo de datos

date

Alias
NCI Thesaurus ObjectClass
C19464
UMLS 2011AA ObjectClass
C0376315
NCI Thesaurus Property
C25250
UMLS 2011AA Property
C0205197
NCI Thesaurus Property
C25604
UMLS 2011AA Property
C0205313
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ValueDomain
C25367
Date form amended (m d y)
Descripción

FormAmendedCompleteDate

Tipo de datos

date

Alias
NCI Thesaurus ObjectClass
C19464
UMLS 2011AA ObjectClass
C0376315
NCI Thesaurus Property
C25250
UMLS 2011AA Property
C0205197
NCI Thesaurus Property
C25416
UMLS 2011AA Property
C1691222
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ValueDomain
C25367
Person amending form, last name
Descripción

ResponsiblePersonReportingChangeLastName

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Patient Name, Last
Descripción

PatientLastName

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus Property
C25551
UMLS 2011AA Property
C1517741
Patient Name, First
Descripción

PatientFirstName

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus Property
C25509
UMLS 2011AA Property
C1279901
Patient Study ID
Descripción

PatientGynecologicOncologyGroupIdentifierNumber

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus Property
C25521
UMLS 2011AA Property
C1512288
Person Completing Form, Last Name
Descripción

ResponsiblePersonLastName

Tipo de datos

text

Alias
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus ObjectClass
C25657
UMLS 2011AA ObjectClass
C1273518
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus Property
C25551
UMLS 2011AA Property
C1517741
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
Smoking History Questionnaire
Descripción

Smoking History Questionnaire

Have you ever smoked tobacco products?
Descripción

TobaccoSmokingHistoryIndicator

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
NCI Thesaurus ObjectClass
C17934
UMLS 2011AA ObjectClass
C0453996
NCI Thesaurus Property
C18772
UMLS 2011AA Property
C0262926
Personal Smoking Section
Descripción

Personal Smoking Section

Have you smoked at least 100 cigarette during your lifetime
Descripción

Smoking history

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C1519384
NCI Thesaurus Property
C20989
NCI Thesaurus ObjectClass
C29719
Are you currently using nicotine skin patches or gum
Descripción

SmokingCessationNicotinePatchNicotineGumUseInd-2

Tipo de datos

text

Alias
NCI Thesaurus ObjectClass
C17427
UMLS 2011AA ObjectClass
C0085134
NCI Thesaurus Property
C25340
UMLS 2011AA Property
C0457083
NCI Thesaurus Property
C17955
UMLS 2011AA Property
C0358855
NCI Thesaurus Property
C15663
UMLS 2011AA Property
C0068722
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
How old were you when you smoked your first cigarette
Descripción

PatientInitialCigaretteSmokingAgeYearCount

Tipo de datos

double

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25536
UMLS 2011AA Property
C1555582
NCI Thesaurus Property
C18270
UMLS 2011AA Property
C0700219
NCI Thesaurus ValueDomain
C29848
UMLS 2011AA ValueDomain
C0439234
NCI Thesaurus ValueDomain
C25463
UMLS 2011AA ValueDomain
C0750480
On average, how many cigarettes do/did you smoke per day
Descripción

CigaretteAverageDailyUseCount

Tipo de datos

double

Alias
NCI Thesaurus ObjectClass
C1802
UMLS 2011AA ObjectClass
C0677453
NCI Thesaurus Property
C25473
UMLS 2011AA Property
C0332173
NCI Thesaurus Property
C37917
UMLS 2011AA Property
C1510992
NCI Thesaurus Property
C25340
UMLS 2011AA Property
C0457083
NCI Thesaurus ValueDomain
C25463
UMLS 2011AA ValueDomain
C0750480
Are you still smoking at least one cigarette per week
Descripción

PersonCigaretteWeekCurrentUseSmokingHistoryInd-2

Tipo de datos

text

Alias
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C25471
UMLS 2011AA Property
C0521116
NCI Thesaurus Property
C1802
UMLS 2011AA Property
C0677453
NCI Thesaurus Property
C29844
UMLS 2011AA Property
C0439230
NCI Thesaurus Property
C29719
UMLS 2011AA Property
C1519384
NCI Thesaurus Property
C25340
UMLS 2011AA Property
C0457083
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
If you are no longer smoking, how old were you when you stopped smoking (years old)
Descripción

PersonCigaretteSmokingCessationAgeYearCount

Tipo de datos

double

Alias
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C1802
UMLS 2011AA Property
C0677453
NCI Thesaurus Property
C17427
UMLS 2011AA Property
C0085134
NCI Thesaurus Property
C25150
UMLS 2011AA Property
C0001779
NCI Thesaurus ValueDomain
C29848
UMLS 2011AA ValueDomain
C0439234
NCI Thesaurus ValueDomain
C25463
UMLS 2011AA ValueDomain
C0750480
Household Smoking Section
Descripción

Household Smoking Section

Have you ever lived for at least a year in the same household with someone who smoked cigarettes regularly
Descripción

PersonHouseholdYearPassiveSmokeExposureInd-2

Tipo de datos

text

Alias
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C29848
UMLS 2011AA Property
C0439234
NCI Thesaurus Property
C41194
UMLS 2011AA Property
C0020052
NCI Thesaurus Property
C17140
UMLS 2011AA Property
C0037370
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
For about how many years, in total, have you lived with someone who smoked cigarettes regularly at the time (years)
Descripción

PersonHouseholdYearPassiveSmokeExposureYearCount

Tipo de datos

double

Alias
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C29848
UMLS 2011AA Property
C0439234
NCI Thesaurus Property
C41194
UMLS 2011AA Property
C0020052
NCI Thesaurus Property
C17140
UMLS 2011AA Property
C0037370
NCI Thesaurus ValueDomain
C29848
UMLS 2011AA ValueDomain
C0439234
NCI Thesaurus ValueDomain
C25463
UMLS 2011AA ValueDomain
C0750480
Do you now live in the same household with someone who smokes cigarettes regularly
Descripción

PersonCurrentHouseholdCigarettePassiveSmokeExposureInd-2

Tipo de datos

text

Alias
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C25471
UMLS 2011AA Property
C0521116
NCI Thesaurus Property
C1802
UMLS 2011AA Property
C0677453
NCI Thesaurus Property
C41194
UMLS 2011AA Property
C0020052
NCI Thesaurus Property
C17140
UMLS 2011AA Property
C0037370
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
On average, how many cigarettes per day are smoked by other people while you are at home (cigarettes/day)
Descripción

PersonCurrentHouseholdCigarettePassiveSmokeExposureDayCount

Tipo de datos

double

Alias
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C25471
UMLS 2011AA Property
C0521116
NCI Thesaurus Property
C1802
UMLS 2011AA Property
C0677453
NCI Thesaurus Property
C41194
UMLS 2011AA Property
C0020052
NCI Thesaurus Property
C17140
UMLS 2011AA Property
C0037370
NCI Thesaurus ValueDomain
C25301
UMLS 2011AA ValueDomain
C0439228
NCI Thesaurus ValueDomain
C25463
UMLS 2011AA ValueDomain
C0750480
Second Hand Smoking Section
Descripción

Second Hand Smoking Section

Are you exposed to smoke from another person's cigarettes at least once per week when you are outside of your household
Descripción

PersonCurrentExternalHouseholdCigarettePassiveSmokeExposureInd-2

Tipo de datos

text

Alias
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C25471
UMLS 2011AA Property
C0521116
NCI Thesaurus Property
C1802
UMLS 2011AA Property
C0677453
NCI Thesaurus Property
C44280
UMLS 2011AA Property
C0205101
NCI Thesaurus Property
C41194
UMLS 2011AA Property
C0020052
NCI Thesaurus Property
C17140
UMLS 2011AA Property
C0037370
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
On average, how many hours per week are you exposed to smoke from other person's cigarettes outside of your household (hours/week)
Descripción

PersonCurrentExternalHouseholdCigaretteHourWeekPassiveSmokeExposureCount

Tipo de datos

double

Alias
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C25471
UMLS 2011AA Property
C0521116
NCI Thesaurus Property
C1802
UMLS 2011AA Property
C0677453
NCI Thesaurus Property
C44280
UMLS 2011AA Property
C0205101
NCI Thesaurus Property
C25529
UMLS 2011AA Property
C0439227
NCI Thesaurus Property
C29844
UMLS 2011AA Property
C0439230
NCI Thesaurus Property
C41194
UMLS 2011AA Property
C0020052
NCI Thesaurus Property
C17140
UMLS 2011AA Property
C0037370
NCI Thesaurus ValueDomain
C25463
UMLS 2011AA ValueDomain
C0750480
Comments
Descripción

Comments

COMMENTS
Descripción

ResearchCommentsText

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus ObjectClass
C15319
NCI Thesaurus Property
C25393
UMLS 2011AA Property
C0282411
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Similar models

No Instruction available.

1 formularios
  1. StudyEvent: Gynecologic Oncology Group Smoking History Questionnaire (Form SHQ)
    1. No Instruction available.
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
Header Module
FormOriginalCompleteDate
Item
Date form originally completed (m d y)
date
C19464 (NCI Thesaurus ObjectClass)
C0376315 (UMLS 2011AA ObjectClass)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C25604 (NCI Thesaurus Property)
C0205313 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain)
FormAmendedCompleteDate
Item
Date form amended (m d y)
date
C19464 (NCI Thesaurus ObjectClass)
C0376315 (UMLS 2011AA ObjectClass)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C25416 (NCI Thesaurus Property)
C1691222 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain)
ResponsiblePersonReportingChangeLastName
Item
Person amending form, last name
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
PatientLastName
Item
Patient Name, Last
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C25551 (NCI Thesaurus Property)
C1517741 (UMLS 2011AA Property)
PatientFirstName
Item
Patient Name, First
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C25509 (NCI Thesaurus Property)
C1279901 (UMLS 2011AA Property)
PatientGynecologicOncologyGroupIdentifierNumber
Item
Patient Study ID
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C25521 (NCI Thesaurus Property)
C1512288 (UMLS 2011AA Property)
ResponsiblePersonLastName
Item
Person Completing Form, Last Name
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25657 (NCI Thesaurus ObjectClass)
C1273518 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C25551 (NCI Thesaurus Property)
C1517741 (UMLS 2011AA Property)
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
Item Group
Smoking History Questionnaire
Item
Have you ever smoked tobacco products?
text
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C17934 (NCI Thesaurus ObjectClass)
C0453996 (UMLS 2011AA ObjectClass)
C18772 (NCI Thesaurus Property)
C0262926 (UMLS 2011AA Property)
CL.1
Code List
Have you ever smoked tobacco products?
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item Group
Personal Smoking Section
Item
Have you smoked at least 100 cigarette during your lifetime
text
C25180 (NCI Thesaurus ValueDomain)
C1519384 (UMLS CUI-1)
C20989 (NCI Thesaurus Property)
C29719 (NCI Thesaurus ObjectClass)
CL.2
Code List
Have you smoked at least 100 cigarette during your lifetime
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes, But Quit (Yes, but quit)
CL Item
Yes, Currently Smoke (Yes, currently smoke)
Item
Are you currently using nicotine skin patches or gum
text
C17427 (NCI Thesaurus ObjectClass)
C0085134 (UMLS 2011AA ObjectClass)
C25340 (NCI Thesaurus Property)
C0457083 (UMLS 2011AA Property)
C17955 (NCI Thesaurus Property)
C0358855 (UMLS 2011AA Property)
C15663 (NCI Thesaurus Property)
C0068722 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
CL.3
Code List
Are you currently using nicotine skin patches or gum
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
PatientInitialCigaretteSmokingAgeYearCount
Item
How old were you when you smoked your first cigarette
double
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25536 (NCI Thesaurus Property)
C1555582 (UMLS 2011AA Property)
C18270 (NCI Thesaurus Property)
C0700219 (UMLS 2011AA Property)
C29848 (NCI Thesaurus ValueDomain)
C0439234 (UMLS 2011AA ValueDomain)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
CigaretteAverageDailyUseCount
Item
On average, how many cigarettes do/did you smoke per day
double
C1802 (NCI Thesaurus ObjectClass)
C0677453 (UMLS 2011AA ObjectClass)
C25473 (NCI Thesaurus Property)
C0332173 (UMLS 2011AA Property)
C37917 (NCI Thesaurus Property)
C1510992 (UMLS 2011AA Property)
C25340 (NCI Thesaurus Property)
C0457083 (UMLS 2011AA Property)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
Item
Are you still smoking at least one cigarette per week
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25471 (NCI Thesaurus Property)
C0521116 (UMLS 2011AA Property)
C1802 (NCI Thesaurus Property)
C0677453 (UMLS 2011AA Property)
C29844 (NCI Thesaurus Property)
C0439230 (UMLS 2011AA Property)
C29719 (NCI Thesaurus Property)
C1519384 (UMLS 2011AA Property)
C25340 (NCI Thesaurus Property)
C0457083 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
CL.4
Code List
Are you still smoking at least one cigarette per week
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
PersonCigaretteSmokingCessationAgeYearCount
Item
If you are no longer smoking, how old were you when you stopped smoking (years old)
double
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C1802 (NCI Thesaurus Property)
C0677453 (UMLS 2011AA Property)
C17427 (NCI Thesaurus Property)
C0085134 (UMLS 2011AA Property)
C25150 (NCI Thesaurus Property)
C0001779 (UMLS 2011AA Property)
C29848 (NCI Thesaurus ValueDomain)
C0439234 (UMLS 2011AA ValueDomain)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
Item Group
Household Smoking Section
Item
Have you ever lived for at least a year in the same household with someone who smoked cigarettes regularly
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C29848 (NCI Thesaurus Property)
C0439234 (UMLS 2011AA Property)
C41194 (NCI Thesaurus Property)
C0020052 (UMLS 2011AA Property)
C17140 (NCI Thesaurus Property)
C0037370 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
CL.5
Code List
Have you ever lived for at least a year in the same household with someone who smoked cigarettes regularly
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
PersonHouseholdYearPassiveSmokeExposureYearCount
Item
For about how many years, in total, have you lived with someone who smoked cigarettes regularly at the time (years)
double
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C29848 (NCI Thesaurus Property)
C0439234 (UMLS 2011AA Property)
C41194 (NCI Thesaurus Property)
C0020052 (UMLS 2011AA Property)
C17140 (NCI Thesaurus Property)
C0037370 (UMLS 2011AA Property)
C29848 (NCI Thesaurus ValueDomain)
C0439234 (UMLS 2011AA ValueDomain)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
Item
Do you now live in the same household with someone who smokes cigarettes regularly
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25471 (NCI Thesaurus Property)
C0521116 (UMLS 2011AA Property)
C1802 (NCI Thesaurus Property)
C0677453 (UMLS 2011AA Property)
C41194 (NCI Thesaurus Property)
C0020052 (UMLS 2011AA Property)
C17140 (NCI Thesaurus Property)
C0037370 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
CL.6
Code List
Do you now live in the same household with someone who smokes cigarettes regularly
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
PersonCurrentHouseholdCigarettePassiveSmokeExposureDayCount
Item
On average, how many cigarettes per day are smoked by other people while you are at home (cigarettes/day)
double
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25471 (NCI Thesaurus Property)
C0521116 (UMLS 2011AA Property)
C1802 (NCI Thesaurus Property)
C0677453 (UMLS 2011AA Property)
C41194 (NCI Thesaurus Property)
C0020052 (UMLS 2011AA Property)
C17140 (NCI Thesaurus Property)
C0037370 (UMLS 2011AA Property)
C25301 (NCI Thesaurus ValueDomain)
C0439228 (UMLS 2011AA ValueDomain)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
Item Group
Second Hand Smoking Section
Item
Are you exposed to smoke from another person's cigarettes at least once per week when you are outside of your household
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25471 (NCI Thesaurus Property)
C0521116 (UMLS 2011AA Property)
C1802 (NCI Thesaurus Property)
C0677453 (UMLS 2011AA Property)
C44280 (NCI Thesaurus Property)
C0205101 (UMLS 2011AA Property)
C41194 (NCI Thesaurus Property)
C0020052 (UMLS 2011AA Property)
C17140 (NCI Thesaurus Property)
C0037370 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
CL.7
Code List
Are you exposed to smoke from another person's cigarettes at least once per week when you are outside of your household
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
PersonCurrentExternalHouseholdCigaretteHourWeekPassiveSmokeExposureCount
Item
On average, how many hours per week are you exposed to smoke from other person's cigarettes outside of your household (hours/week)
double
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25471 (NCI Thesaurus Property)
C0521116 (UMLS 2011AA Property)
C1802 (NCI Thesaurus Property)
C0677453 (UMLS 2011AA Property)
C44280 (NCI Thesaurus Property)
C0205101 (UMLS 2011AA Property)
C25529 (NCI Thesaurus Property)
C0439227 (UMLS 2011AA Property)
C29844 (NCI Thesaurus Property)
C0439230 (UMLS 2011AA Property)
C41194 (NCI Thesaurus Property)
C0020052 (UMLS 2011AA Property)
C17140 (NCI Thesaurus Property)
C0037370 (UMLS 2011AA Property)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
Item Group
Comments
ResearchCommentsText
Item
COMMENTS
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C0282411 (UMLS 2011AA Property)
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