ID
6175
Beschreibung
Quality of Life Module for Trial 24-02 (Form 24-QLM) Brain Function in Premenopausal Women Receiving Tamoxifen With or Without Ovarian Function Suppression for Early-Stage Breast Cancer on Clinical Trial IBCSG-2402 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=B0EA5B57-DF0D-6356-E034-0003BA12F5E7
Link
Stichworte
Versionen (1)
- 15.12.14 15.12.14 - Martin Dugas
Hochgeladen am
15. Dezember 2014
DOI
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Lizenz
Creative Commons BY-NC 3.0 Legacy
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Breast Cancer NCT00659373 Quality of Life - Quality of Life Module for Trial 24-02 (Form 24-QLM) - 2073726v3.0
QUALITY OF LIFE MODULE FOR TRIAL 24-02 (Form 24-QLM) Patient Instructions: We would like to know how strongly you are affected by your illness and treatment. Please answer the following questions by placing a vertical mark on the line depending on how you assess yourself. (See the example on the Quality of Life Core Questionnaire.) Your information will be treated as strictly confidential. Thank you for replying!
- StudyEvent: Quality of Life Module for Trial 24-02 (Form 24-QLM)
Beschreibung
Ccrr Module For Quality Of Life Module For Trial 24-02 (form 24-qlm)
Beschreibung
Patient ID Number (Study No.)
Datentyp
text
Alias
- UMLS CUI-1
- C1549740
Beschreibung
Patient Initials
Datentyp
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25536
- UMLS CUI-1
- C2986440
Beschreibung
Patient's Date of Birth (day)
Datentyp
date
Alias
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25275
- UMLS CUI-1
- C0421451
Beschreibung
Participating Center/Affiliate
Datentyp
text
Beschreibung
Center Code
Datentyp
text
Alias
- NCI Thesaurus ValueDomain
- C25162
- UMLS CUI-1
- C0565990
Ähnliche Modelle
QUALITY OF LIFE MODULE FOR TRIAL 24-02 (Form 24-QLM) Patient Instructions: We would like to know how strongly you are affected by your illness and treatment. Please answer the following questions by placing a vertical mark on the line depending on how you assess yourself. (See the example on the Quality of Life Core Questionnaire.) Your information will be treated as strictly confidential. Thank you for replying!
- StudyEvent: Quality of Life Module for Trial 24-02 (Form 24-QLM)
C0022107 (UMLS CUI-1)
C0038990 (UMLS CUI-1)
C0227791 (UMLS CUI-1)
C34661 (NCI Thesaurus ObjectClass)
C25688 (NCI Thesaurus ValueDomain)
C0018681 (UMLS CUI-1)
C0151825 (UMLS CUI-1)
C0003862 (UMLS CUI-2)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C2986440 (UMLS CUI-1)
C25275 (NCI Thesaurus Property)
C0421451 (UMLS CUI-1)
C0565990 (UMLS CUI-1)