INSTRUCTIONS: Complete this form and submit original to the ECOG Coordinating Center. Keep a copy for your files.

1 forms

StudyEvent: E4A08 Quality of Life Assessment Form
1. INSTRUCTIONS: Complete this form and submit original to the ECOG Coordinating Center. Keep a copy for your files.

Name

Type

Description | Question | Decode (Coded Value)

Data type

Alias

Header

Item Group

Header

Protocol Number ECOG

Item

ECOG Protocol Number

text

C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1512162 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25491 (NCI Thesaurus Property-2)

Patient ID ECOG

Item

ECOG Patient ID

text

C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1512162 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25491 (NCI Thesaurus Property-2)

Generic drug form

Item

DCI Name

text

C25191 (NCI Thesaurus ValueDomain)
C3242750 (UMLS CUI-1)
C19464 (NCI Thesaurus Property)
C25474 (NCI Thesaurus ObjectClass)
C25452 (NCI Thesaurus ObjectClass-2)

Registration Number

Item

Registration Step

text

C25337 (NCI Thesaurus ValueDomain)
C1514821 (UMLS CUI-1)
C25646 (NCI Thesaurus ObjectClass)
C0237753 (UMLS CUI-2)
C16154 (NCI Thesaurus Property)
C16154 (NCI Thesaurus ValueDomain-2)

Unnamed2

Item Group

Unnamed2

Protocol Number ECOG

Item

ECOG Protocol Number

text

C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1512162 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25491 (NCI Thesaurus Property-2)

Patient Initials

Item

Patient Initials (Last, First)

text

C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)

Patient ID ECOG

Item

ECOG Patient ID

text

C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1512162 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25491 (NCI Thesaurus Property-2)

Study Number Participating Group

Item

Participating Group Protocol Number

text

C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)

Institution Name

Item

Institution/Affiliate

text

C25454 (NCI Thesaurus ObjectClass)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C25191 (NCI Thesaurus ValueDomain)
C21541 (NCI Thesaurus ValueDomain-2)

Trial subject ID Participating Group

Item

Participating Group Patient ID

text

C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)

Unnamed3

Item Group

Unnamed4

Cycle number

Item

On Treatment Report Period

text

C25284 (NCI Thesaurus ValueDomain)
C2045829 (UMLS CUI-1)
C25214 (NCI Thesaurus Property)
C25616 (NCI Thesaurus Property-2)
C15368 (NCI Thesaurus ObjectClass)

CL.1

Code List

On Treatment Report Period

CL Item

Baseline (baseline)

C25213 (NCI Thesaurus)
C1442488 (UMLS 2011AA)
C25213 (NCI Thesaurus-3)
C1442488 (UMLS 2011AA-4)

CL Item

End Of Cycle 3 (End of Cycle 3)

CL Item

End Of Cycle 5 (End of Cycle 5)

CL Item

End Of Cycle 6 (End of Cycle 6)

CL Item

End Of Cycle 8 (End of Cycle 8)

CL Item

End Of Cycle 9 (End of Cycle 9)

CL Item

End Of Treatment (End of Treatment)

PersonOff-TreatmentTimePeriodType

Item

Off Treatment Report Period

text

C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25616 (NCI Thesaurus Property)
C1948053 (UMLS 2011AA Property)
C25601 (NCI Thesaurus Property-2)
C1518544 (UMLS 2011AA Property-2)
C25207 (NCI Thesaurus Property-3)
C0040223 (UMLS 2011AA Property-3)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.2

Code List

Off Treatment Report Period

CL Item

3 Months (3 months post registration)

CL Item

6 Months (6 months post registration)

CL Item

9 Months (9 months post registration)

CL Item

12 Months (12 months post registration)

CL Item

15 Months (15 months post registration)

CL Item

18 Months (18 months post registration)

Assessment Date

Item

Date of Assessment (If not completed, enter date scheduled per E4A08 protocol.)

date

C25164 (NCI Thesaurus ValueDomain)
C2985720 (UMLS CUI-1)
C25367 (NCI Thesaurus ObjectClass)
C25367 (NCI Thesaurus ValueDomain-2)
C38000 (NCI Thesaurus Property)

Section II - FACT-G

Item Group

Physical Well-being

PatientEnergyAssessmentQualityofLifeScale

Item

I have a lack of energy (GP2)

text

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C48058 (NCI Thesaurus Property-2)
C0542479 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)

CL.3

Code List

I have a lack of energy (GP2)

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)

PatientNauseaAssessmentQualityofLifeScale

Item

I have nausea (GP3)

text

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C3258 (NCI Thesaurus Property-2)
C0027497 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)

CL.4

Code List

I have nausea (GP3)

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)

PatientGeneralPhysicalConditionAssessmentQualityofLifeScale

Item

Because of my physical condition, I have trouble meeting the needs of my family (GP4)

text

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
CL104641 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)

CL.5

Code List

Because of my physical condition, I have trouble meeting the needs of my family (GP4)

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 (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)

PatientPainAssessmentQualityofLifeScale

Item

I have pain (GP5)

text

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C3303 (NCI Thesaurus Property-2)
C0030193 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)

CL.6

Code List

I have pain (GP5)

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)

PatientAdverseEventAssessmentQualityofLifeScale

Item

I am bothered by side effects of treatment (GP6)

text

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C41331 (NCI Thesaurus Property-2)
C0877248 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)

CL.7

Code List

I am bothered by side effects of treatment (GP6)

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)

PatientMalaiseAssessmentQualityofLifeScale

Item

I feel ill (GP7)

text

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C3832 (NCI Thesaurus Property-2)
C0231218 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)

CL.8

Code List

I feel ill (GP7)

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)

PatientBedRestAssessmentQualityofLifeScale

Item

I am forced to spend time in bed (GS1)

text

C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)

CL.9

Code List

I am forced to spend time in bed (GS1)

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)

Functional Well-Being

Item Group

Functional Well-being

AbilityPatientWorkAssessmentQualityofLifeScale

Item

I am able to work (include work at home)

text

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C0085732 (NCI Metathesaurus ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0043227 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)

CL.10

Code List

I am able to work (include work at home)

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)

SatisfactionPatientWorkAssessmentQualityofLifeScale

Item

My work (include work at home) is fulfilling

text

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C62185 (NCI Thesaurus Property-2)
C0242428 (UMLS 2011AA Property)
C0043227 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)

CL.11

Code List

My work (include work at home) is fulfilling

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)

PatientEnjoymentofLifeAssessmentQualityofLifeAssessment

Item

I am able to enjoy life

text

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
CL196329 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)

CL.12

Code List

I am able to enjoy life

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)

Ihaveacceptedmyillness

Item

I have accepted my illness

text

C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)

CL.13

Code List

I have accepted my illness

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)

Iamsleepingwell

Item

I am sleeping well

text

C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)

CL.14

Code List

I am sleeping well

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)

IamenjoyingthethingsIusuallydoforfun

Item

I am enjoying the things I usually do for fun

text

C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)

CL.15

Code List

I am enjoying the things I usually do for fun

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)

PatientQualityofLifeAssessmentQualityofLifeScale

Item

I am content with the quality of my life right now

text

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C17047 (NCI Thesaurus Property)
C0518214 (UMLS 2011AA Property)
C20989 (NCI Thesaurus Property-2)
C0031809 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)

CL.16

Code List

I am content with the quality of my life right now

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)

Section IV - Multiple Myeloma Subscale

Item Group

Additional Concerns - Mms

SignificantPatientLocalizedPainAssessmentQualityofLifeScale

Item

I have certain areas of my body where I experience significant pain

text

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C41130 (NCI Thesaurus ObjectClass-2)
C0750502 (UMLS 2011AA ObjectClass-2)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
CL232212 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)

CL.17

Code List

I have certain areas of my body where I experience significant pain

CL Item

A Little Bit (A little bit)

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
C70543 (NCI Thesaurus-3)
C2003901 (UMLS 2011AA)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus-2)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus-2)

NeurotoxicityPatientMuscleWeaknessAssessmentQualityofLifeScale

Item

I feel weak all over

text

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C27961 (NCI Thesaurus ObjectClass-2)
C0235032 (UMLS 2011AA ObjectClass-2)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0151786 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)

CL.18

Code List

I feel weak all over

CL Item

A Little Bit (A little bit)

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
C70543 (NCI Thesaurus-3)
C2003901 (UMLS 2011AA)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus-2)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus-2)

Quality-of-LifeAssessmentPatientFatigueScale

Item

I feel fatigued

text

C15584 (NCI Thesaurus ObjectClass)
C0281588 (UMLS 2011AA ObjectClass)
C16960 (NCI Thesaurus Property)
C0030705 (UMLS 2011AA Property)
C3036 (NCI Thesaurus Property-2)
C0015672 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)

CL.29

Code List

I feel fatigued

CL Item

A Little Bit (A little bit)

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
C70543 (NCI Thesaurus-3)
C2003901 (UMLS 2011AA)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus-2)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus-2)

Quality-of-LifeAssessmentPatientFatigueScale

Item

I feel fatigued

text

CL.29

Code List

I feel fatigued

CL Item

A Little Bit (A little bit)

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
C70543 (NCI Thesaurus-3)
C2003901 (UMLS 2011AA)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus-2)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus-2)

Quality-of-LifeAssessmentPatientDifficultyAttentionConcentrationScale

Item

I have trouble concentrating

text

C15584 (NCI Thesaurus ObjectClass)
C0281588 (UMLS 2011AA ObjectClass)
C16960 (NCI Thesaurus Property)
C0030705 (UMLS 2011AA Property)
C62189 (NCI Thesaurus Property-2)
C1299586 (UMLS 2011AA Property-2)
C41209 (NCI Thesaurus Property-3)
C0004268 (UMLS 2011AA Property-3)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)

CL.20

Code List

I have trouble concentrating

CL Item

A Little Bit (A little bit)

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
C70543 (NCI Thesaurus-3)
C2003901 (UMLS 2011AA)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus-2)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus-2)

Quality-of-LifeAssessmentPatientInfectiousDisorderAnxietyScale

Item

I worry about getting infections

text

C15584 (NCI Thesaurus ObjectClass)
C0281588 (UMLS 2011AA ObjectClass)
C16960 (NCI Thesaurus Property)
C0030705 (UMLS 2011AA Property)
C26696 (NCI Thesaurus Property-2)
C0003467 (UMLS 2011AA Property-2)
C26726 (NCI Thesaurus Property-3)
C0009450 (UMLS 2011AA Property-3)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)

CL.21

Code List

I worry about getting infections

CL Item

A Little Bit (A little bit)

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
C70543 (NCI Thesaurus-3)
C2003901 (UMLS 2011AA)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus-2)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus-2)

PatientDespondencyAssessmentQualityofLifeScale

Item

I feel discouraged about my illness

text

CL.22

Code List

I feel discouraged about my illness

CL Item

A Little Bit (A little bit)

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
C70543 (NCI Thesaurus-3)
C2003901 (UMLS 2011AA)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus-2)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus-2)

Quality-of-LifeAssessmentPatientDifficultyPlanFutureScale

Item

Because of my illness, I have difficulty planning for the future

text

C15584 (NCI Thesaurus ObjectClass)
C0281588 (UMLS 2011AA ObjectClass)
C16960 (NCI Thesaurus Property)
C0030705 (UMLS 2011AA Property)
C67527 (NCI Thesaurus Property-2)
C0016884 (UMLS 2011AA Property-2)
C25619 (NCI Thesaurus Property-3)
C1301732 (UMLS 2011AA Property-3)
C62189 (NCI Thesaurus Property-4)
C1299586 (UMLS 2011AA Property-4)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)

CL.23

Code List

Because of my illness, I have difficulty planning for the future

CL Item

A Little Bit (A little bit)

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
C70543 (NCI Thesaurus-3)
C2003901 (UMLS 2011AA)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus-2)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus-2)

Quality-of-LifeAssessmentPatientNewSymptomAnxietyScale

Item

I worry that I might get new symptoms of my illness

text

C15584 (NCI Thesaurus ObjectClass)
C0281588 (UMLS 2011AA ObjectClass)
C16960 (NCI Thesaurus Property)
C0030705 (UMLS 2011AA Property)
C25586 (NCI Thesaurus Property-2)
C0205314 (UMLS 2011AA Property-2)
C26696 (NCI Thesaurus Property-3)
C0003467 (UMLS 2011AA Property-3)
C4876 (NCI Thesaurus Property-4)
C1457887 (UMLS 2011AA Property-4)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)

CL.24

Code List

I worry that I might get new symptoms of my illness

CL Item

A Little Bit (A little bit)

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
C70543 (NCI Thesaurus-3)
C2003901 (UMLS 2011AA)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus-2)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus-2)

Quality-of-LifeAssessmentPatientFluctuateEmotionScale

Item

I have emotional ups and downs

text

C15584 (NCI Thesaurus ObjectClass)
C0281588 (UMLS 2011AA ObjectClass)
C16960 (NCI Thesaurus Property)
C0030705 (UMLS 2011AA Property)
C54266 (NCI Thesaurus Property-2)
C0013987 (UMLS 2011AA Property-2)
C67528 (NCI Thesaurus Property-3)
C0231241 (UMLS 2011AA Property-3)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)

CL.25

Code List

I have emotional ups and downs

CL Item

A Little Bit (A little bit)

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
C70543 (NCI Thesaurus-3)
C2003901 (UMLS 2011AA)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus-2)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus-2)

Quality-of-LifeAssessmentPatientBonePainScale

Item

I have bone pain

text

C15584 (NCI Thesaurus ObjectClass)
C0281588 (UMLS 2011AA ObjectClass)
C16960 (NCI Thesaurus Property)
C0030705 (UMLS 2011AA Property)
C3303 (NCI Thesaurus Property-2)
C0030193 (UMLS 2011AA Property-2)
C12366 (NCI Thesaurus Property-3)
C0262950 (UMLS 2011AA Property-3)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)

CL.26

Code List

I have bone pain

CL Item

A Little Bit (A little bit)

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
C70543 (NCI Thesaurus-3)
C2003901 (UMLS 2011AA)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus-2)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus-2)

Quality-of-LifeAssessmentPatientSupportActivityScale

Item

I need help doing my usual activities

text

C15584 (NCI Thesaurus ObjectClass)
C0281588 (UMLS 2011AA ObjectClass)
C16960 (NCI Thesaurus Property)
C0030705 (UMLS 2011AA Property)
C43431 (NCI Thesaurus Property-2)
C0441655 (UMLS 2011AA Property-2)
C37902 (NCI Thesaurus Property-3)
C1521721 (UMLS 2011AA Property-3)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)

CL.27

Code List

I need help doing my usual activities

CL Item

A Little Bit (A little bit)

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
C70543 (NCI Thesaurus-3)
C2003901 (UMLS 2011AA)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus-2)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus-2)

Quality-of-LifeAssessmentPatientDifficultyMobilePainScale

Item

I have trouble walking because of pain

text

C15584 (NCI Thesaurus ObjectClass)
C0281588 (UMLS 2011AA ObjectClass)
C16960 (NCI Thesaurus Property)
C0030705 (UMLS 2011AA Property)
C3303 (NCI Thesaurus Property-2)
C0030193 (UMLS 2011AA Property-2)
C25295 (NCI Thesaurus Property-3)
C0231435 (UMLS 2011AA Property-3)
C62189 (NCI Thesaurus Property-4)
C1299586 (UMLS 2011AA Property-4)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)

CL.28

Code List

I have trouble walking because of pain

CL Item

A Little Bit (A little bit)

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
C70543 (NCI Thesaurus-3)
C2003901 (UMLS 2011AA)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus-2)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus-2)

Quality-of-LifeAssessmentPatientWeightGainScale

Item

I have gained weight

text

C15584 (NCI Thesaurus ObjectClass)
C0281588 (UMLS 2011AA ObjectClass)
C16960 (NCI Thesaurus Property)
C0030705 (UMLS 2011AA Property)
C62754 (NCI Thesaurus Property-2)
C0043094 (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 gained weight

CL Item

A Little Bit (A little bit)

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
C70543 (NCI Thesaurus-3)
C2003901 (UMLS 2011AA)

CL Item

Quite A Bit (Quite a bit)

C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus-2)

CL Item

Somewhat (Somewhat)

C91215 (NCI Thesaurus)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus-2)

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