INSTRUCTIONS: These questions ask about your sexual feelings and responses during the past 4 weeks. Please answer the following questions as honestly and clearly as possible. Your responses will be kept completely confidential.

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Header Module
Item
Visit
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C25616 (NCI Thesaurus Property)
C1948053 (UMLS 2011AA Property)
C19712 (NCI Thesaurus ObjectClass)
C1515944 (UMLS 2011AA ObjectClass)
C25716 (NCI Thesaurus ObjectClass-2)
C0545082 (UMLS 2011AA ObjectClass-2)
CL.1
Code List
Visit
CL Item
Pre-operative (Pre-Op)
CL Item
4-6 Weeks Post-surgery (4-6 weeks post-surgery)
CL Item
Month 3 (Month 3)
CL Item
Month 12 (Month 12)
Patient Study ID
Item
Patient ID (Pt. ID issued during registration unless pt. previously registered to an ACOSOG study.)
text
C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25462 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
Patient Initials
Item
Patient Initials
text
C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
Institution Name
Item
Institution Name
text
C25191 (NCI Thesaurus ValueDomain)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C21541 (NCI Thesaurus ValueDomain-2)
C25364 (NCI Thesaurus Property)
Institution Number
Item
Institution No.
text
C25337 (NCI Thesaurus ValueDomain)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C0805701 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
Assessment Date
Item
Date
date
C25164 (NCI Thesaurus ValueDomain)
C2985720 (UMLS CUI-1)
C25367 (NCI Thesaurus ObjectClass)
C25367 (NCI Thesaurus ValueDomain-2)
C38000 (NCI Thesaurus Property)
Item Group
Female Sexual Function Assessment
Item
Over the past 4 weeks, how often did you feel sexual desire or interest
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C17127 (NCI Thesaurus ObjectClass-2)
C0036864 (UMLS 2011AA ObjectClass-2)
C25367 (NCI Thesaurus Property)
C37986 (NCI Thesaurus Property-2)
C0023618 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.2
Code List
Over the past 4 weeks, how often did you feel sexual desire or interest
CL Item
A Few Times (A few times)
CL Item
Almost Always Or Always (Almost always or always)
CL Item
Almost Never Or Never (Almost never or never)
CL Item
Most Times (Most times)
CL Item
Sometimes (Sometimes)
Item
Over the past 4 weeks, how would you rate your level (degree) of sexual desire or interest
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C17127 (NCI Thesaurus ObjectClass-2)
C0036864 (UMLS 2011AA ObjectClass-2)
C25367 (NCI Thesaurus Property)
C25275 (NCI Thesaurus Property-2)
C2745955 (UMLS 2011AA Property)
C37986 (NCI Thesaurus Property-3)
C0023618 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.3
Code List
Over the past 4 weeks, how would you rate your level (degree) of sexual desire or interest
CL Item
High (High)
C25227 (NCI Thesaurus)
C0205250 (UMLS 2011AA)
CL Item
Low (Low)
C54722 (NCI Thesaurus)
C0205251 (UMLS 2011AA)
CL Item
Moderation (Moderate)
C61376 (NCI Thesaurus)
C1881878 (UMLS 2011AA)
CL Item
Very High (Very high)
CL Item
Very Low Or None At All (Very low or none at all)
Item
Over the past 4 weeks, how often did you feel sexually aroused ('turned on') during sexual activity or intercourse?
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C17127 (NCI Thesaurus ObjectClass-2)
C0036864 (UMLS 2011AA ObjectClass-2)
C25367 (NCI Thesaurus Property)
C25554 (NCI Thesaurus Property-2)
C0441889 (UMLS 2011AA Property)
C37986 (NCI Thesaurus Property-3)
C0023618 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.4
Code List
Over the past 4 weeks, how often did you feel sexually aroused ('turned on') during sexual activity or intercourse?
CL Item
A Few Times (A few times)
CL Item
Almost Always Or Always (Almost always or always)
CL Item
Almost Never Or Never (Almost never or never)
CL Item
Most Times (Most times)
CL Item
No Sexual Activity (No sexual activity)
CL Item
Sometimes (Sometimes)
Item
Over the past 4 weeks, how would you rate your level of sexual arousal ('turn on') during sexual activity or intercourse?
text
C17047 (NCI Thesaurus ObjectClass)
C0023618 (UMLS CUI-1)
C17127 (NCI Thesaurus ObjectClass-2)
C25367 (NCI Thesaurus Property)
C25275 (NCI Thesaurus Property-2)
C73522 (NCI Thesaurus Property-3)
C25664 (NCI Thesaurus ValueDomain)
CL.5
Code List
Over the past 4 weeks, how would you rate your level of sexual arousal ('turn on') during sexual activity or intercourse?
CL Item
High (High)
C25227 (NCI Thesaurus)
C0205250 (UMLS 2011AA)
CL Item
Low (Low)
C54722 (NCI Thesaurus)
C0205251 (UMLS 2011AA)
CL Item
Moderation (Moderate)
C61376 (NCI Thesaurus)
C1881878 (UMLS 2011AA)
CL Item
No Sexual Activity (No sexual activity)
CL Item
Very High (Very high)
CL Item
Very Low Or None At All (Very low or none at all)
Item
Over the past 4 weeks, how confident were you about becoming sexually aroused during sexual activity or intercourse?
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C17127 (NCI Thesaurus ObjectClass-2)
C0036864 (UMLS 2011AA ObjectClass-2)
C25367 (NCI Thesaurus Property)
C43367 (NCI Thesaurus Property-2)
C1704726 (UMLS 2011AA Property)
C73522 (NCI Thesaurus Property-3)
C0233972 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.6
Code List
Over the past 4 weeks, how confident were you about becoming sexually aroused during sexual activity or intercourse?
CL Item
High Confidence (High confidence)
CL Item
Low Confidence (Low confidence)
CL Item
Moderate Confidence (Moderate confidence)
CL Item
No Sexual Activity (No sexual activity)
CL Item
Very High Confidence (Very high confidence)
CL Item
Very Low Or No Confidence (Very low or no confidence)
Item
Over the past 4 weeks, how often have you been satisfied with your arousal (excitement) during sexual activity or intercourse
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C17127 (NCI Thesaurus ObjectClass-2)
C0036864 (UMLS 2011AA ObjectClass-2)
C25367 (NCI Thesaurus Property)
C62185 (NCI Thesaurus Property-2)
C0242428 (UMLS 2011AA Property)
C25275 (NCI Thesaurus Property-3)
C2745955 (UMLS 2011AA Property-2)
C73522 (NCI Thesaurus Property-4)
C0233972 (UMLS 2011AA Property-3)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.7
Code List
Over the past 4 weeks, how often have you been satisfied with your arousal (excitement) during sexual activity or intercourse
CL Item
A Few Times (A few times)
CL Item
Almost Always Or Always (Almost always or always)
CL Item
Almost Never Or Never (Almost never or never)
CL Item
Most Times (Most times)
CL Item
No Sexual Activity (No sexual activity)
CL Item
Sometimes (Sometimes)
Item
Over the past 4 weeks, how often did you become lubricated ('wet') during sexual activity or intercourse
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C17127 (NCI Thesaurus ObjectClass-2)
C0036864 (UMLS 2011AA ObjectClass-2)
C25367 (NCI Thesaurus Property)
C12407 (NCI Thesaurus Property-2)
C0042232 (UMLS 2011AA Property)
C25275 (NCI Thesaurus Property-3)
C2745955 (UMLS 2011AA Property-2)
C17119 (NCI Thesaurus Property-4)
C1327616 (UMLS 2011AA Property-3)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.8
Code List
Over the past 4 weeks, how often did you become lubricated ('wet') during sexual activity or intercourse
CL Item
A Few Times (A few times)
CL Item
Almost Always Or Always (Almost always or always)
CL Item
Almost Never Or Never (Almost never or never)
CL Item
Most Times (Most times)
CL Item
No Sexual Activity (No sexual activity)
CL Item
Sometimes (Sometimes)
Item
Over the past 4 weeks, how difficult was it to become lubricated ('wet') during sexual activity or intercourse
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C17127 (NCI Thesaurus ObjectClass-2)
C0036864 (UMLS 2011AA ObjectClass-2)
C25367 (NCI Thesaurus Property)
C12407 (NCI Thesaurus Property-2)
C0042232 (UMLS 2011AA Property)
C62189 (NCI Thesaurus Property-3)
C1299586 (UMLS 2011AA Property-2)
C17119 (NCI Thesaurus Property-4)
C1327616 (UMLS 2011AA Property-3)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.9
Code List
Over the past 4 weeks, how difficult was it to become lubricated ('wet') during sexual activity or intercourse
CL Item
Difficult (Difficult)
CL Item
Extremely Difficult Or Impossible (Extremely difficult or impossible)
CL Item
No Sexual Activity (No sexual activity)
CL Item
Not Difficult (Not difficult)
CL Item
Slightly Difficult (Slightly difficult)
CL Item
Very Difficult (Very difficult)
Item
Over the past 4 weeks, how often did you maintain your lubrication ('wetness') until completion of sexual activity or intercourse
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C17127 (NCI Thesaurus ObjectClass-2)
C0036864 (UMLS 2011AA ObjectClass-2)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C25367 (NCI Thesaurus Property-2)
C12407 (NCI Thesaurus Property-3)
C0042232 (UMLS 2011AA Property-2)
C25275 (NCI Thesaurus Property-4)
C2745955 (UMLS 2011AA Property-3)
C17119 (NCI Thesaurus Property-5)
C1327616 (UMLS 2011AA Property-4)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.10
Code List
Over the past 4 weeks, how often did you maintain your lubrication ('wetness') until completion of sexual activity or intercourse
CL Item
A Few Times (A few times)
CL Item
Almost Always Or Always (Almost always or always)
CL Item
Almost Never Or Never (Almost never or never)
CL Item
Most Times (Most times)
CL Item
No Sexual Activity (No sexual activity)
CL Item
Sometimes (Sometimes)
Item
Over the past 4 weeks, how difficult was it to maintain your lubrication ('wetness') until completion of sexual activity or intercourse
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C17127 (NCI Thesaurus ObjectClass-2)
C0036864 (UMLS 2011AA ObjectClass-2)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C25367 (NCI Thesaurus Property-2)
C12407 (NCI Thesaurus Property-3)
C0042232 (UMLS 2011AA Property-2)
C62189 (NCI Thesaurus Property-4)
C1299586 (UMLS 2011AA Property-3)
C17119 (NCI Thesaurus Property-5)
C1327616 (UMLS 2011AA Property-4)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.11
Code List
Over the past 4 weeks, how difficult was it to maintain your lubrication ('wetness') until completion of sexual activity or intercourse
CL Item
Difficult (Difficult)
CL Item
Extremely Difficult Or Impossible (Extremely difficult or impossible)
CL Item
No Sexual Activity (No sexual activity)
CL Item
Not Difficult (Not difficult)
CL Item
Slightly Difficult (Slightly difficult)
CL Item
Very Difficult (Very difficult)
Item
Over the past 4 weeks, when you had sexual stimulation or intercourse, how often did you reach orgasm (climax)
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C17127 (NCI Thesaurus ObjectClass-2)
C0036864 (UMLS 2011AA ObjectClass-2)
C25367 (NCI Thesaurus Property)
C25275 (NCI Thesaurus Property-2)
C2745955 (UMLS 2011AA Property)
C73521 (NCI Thesaurus Property-3)
C0029260 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.12
Code List
Over the past 4 weeks, when you had sexual stimulation or intercourse, how often did you reach orgasm (climax)
CL Item
A Few Times (A few times)
CL Item
Almost Never Or Never (Almost never or never)
CL Item
Most Times (Most times)
CL Item
Sometimes (Sometimes)
Item
Over the past 4 weeks, when you had sexual stimulation or intercourse, how difficult was it for you to reach orgasm (climax)
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C17127 (NCI Thesaurus ObjectClass-2)
C0036864 (UMLS 2011AA ObjectClass-2)
C25367 (NCI Thesaurus Property)
C62189 (NCI Thesaurus Property-2)
C1299586 (UMLS 2011AA Property)
C73521 (NCI Thesaurus Property-3)
C0029260 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.13
Code List
Over the past 4 weeks, when you had sexual stimulation or intercourse, how difficult was it for you to reach orgasm (climax)
CL Item
Difficult (Difficult)
CL Item
Extremely Difficult Or Impossible (Extremely difficult or impossible)
CL Item
No Sexual Activity (No sexual activity)
CL Item
Not Difficult (Not difficult)
CL Item
Slightly Difficult (Slightly difficult)
CL Item
Very Difficult (Very difficult)
Item
Over the past 4 weeks, how satisfied were you with your ability to reach orgasm (climax) during sexual activity or intercourse
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C17127 (NCI Thesaurus ObjectClass-2)
C0036864 (UMLS 2011AA ObjectClass-2)
C25367 (NCI Thesaurus Property)
C62185 (NCI Thesaurus Property-2)
C0242428 (UMLS 2011AA Property)
C73521 (NCI Thesaurus Property-3)
C0029260 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.14
Code List
Over the past 4 weeks, how satisfied were you with your ability to reach orgasm (climax) during sexual activity or intercourse
CL Item
About Equally Satisfied And Dissatisfied (About equally satisfied and dissatisfied)
CL Item
Moderately Dissatisfied (Moderately dissatisfied)
CL Item
Moderately Satisfied (Moderately satisfied)
CL Item
No Sexual Activity (No sexual activity)
CL Item
Very Dissatisfied (Very dissatisfied)
CL Item
Very Satisfied (Very satisfied)
Item
Over the past 4 weeks, how satisfied have you been with the amount of emotional closeness during sexual activity between you and your partner
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C17127 (NCI Thesaurus ObjectClass-2)
C0036864 (UMLS 2011AA ObjectClass-2)
C25367 (NCI Thesaurus Property)
C62185 (NCI Thesaurus Property-2)
C0242428 (UMLS 2011AA Property)
C25648 (NCI Thesaurus Property-3)
C0439849 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.15
Code List
Over the past 4 weeks, how satisfied have you been with the amount of emotional closeness during sexual activity between you and your partner
CL Item
About Equally Satisfied And Dissatisfied (About equally satisfied and dissatisfied)
CL Item
Moderately Dissatisfied (Moderately dissatisfied)
CL Item
Moderately Satisfied (Moderately satisfied)
CL Item
Very Dissatisfied (Very dissatisfied)
CL Item
Very Satisfied (Very satisfied)
Item
Over the past 4 weeks, how satisfied have you been with your sexual relationship with your partner
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C17127 (NCI Thesaurus ObjectClass-2)
C0036864 (UMLS 2011AA ObjectClass-2)
C25367 (NCI Thesaurus Property)
C62185 (NCI Thesaurus Property-2)
C0242428 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.16
Code List
Over the past 4 weeks, how satisfied have you been with your sexual relationship with your partner
CL Item
About Equally Satisfied And Dissatisfied (About equally satisfied and dissatisfied)
CL Item
Moderately Dissatisfied (Moderately dissatisfied)
CL Item
Moderately Satisfied (Moderately satisfied)
CL Item
Very Dissatisfied (Very dissatisfied)
CL Item
Very Satisfied (Very satisfied)
Item
Over the past 4 weeks, how satisfied have you been with your overall sexual life
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C17127 (NCI Thesaurus ObjectClass-2)
C0036864 (UMLS 2011AA ObjectClass-2)
C25605 (NCI Thesaurus Property)
C1561607 (UMLS 2011AA Property)
C25367 (NCI Thesaurus Property-2)
C62185 (NCI Thesaurus Property-3)
C0242428 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.17
Code List
Over the past 4 weeks, how satisfied have you been with your overall sexual life
CL Item
About Equally Satisfied And Dissatisfied (About equally satisfied and dissatisfied)
CL Item
Moderately Dissatisfied (Moderately dissatisfied)
CL Item
Moderately Satisfied (Moderately satisfied)
CL Item
Very Dissatisfied (Very dissatisfied)
CL Item
Very Satisfied (Very satisfied)
Item
Over the past 4 weeks, how often did you experience discomfort or pain during vaginal penetration
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C17127 (NCI Thesaurus ObjectClass-2)
C0036864 (UMLS 2011AA ObjectClass-2)
C25367 (NCI Thesaurus Property)
C3303 (NCI Thesaurus Property-2)
C0030193 (UMLS 2011AA Property)
C25275 (NCI Thesaurus Property-3)
C2745955 (UMLS 2011AA Property-2)
C25490 (NCI Thesaurus Property-4)
C0347984 (UMLS 2011AA Property-3)
C72881 (NCI Thesaurus Property-5)
C0009253 (UMLS 2011AA Property-4)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.18
Code List
Over the past 4 weeks, how often did you experience discomfort or pain during vaginal penetration
CL Item
Did Not Attempt Intercourse (Did not attempt intercourse)
CL Item
A Few Times (A few times)
CL Item
Almost Always Or Always (Almost always or always)
CL Item
Almost Never Or Never (Almost never or never)
CL Item
Most Times (Most times)
CL Item
Sometimes (Sometimes)
Item
Over the past 4 weeks, how often did you experience discomfort or pain following vaginal penetration
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C17127 (NCI Thesaurus ObjectClass-2)
C0036864 (UMLS 2011AA ObjectClass-2)
C25367 (NCI Thesaurus Property)
C3303 (NCI Thesaurus Property-2)
C0030193 (UMLS 2011AA Property)
C38008 (NCI Thesaurus Property-3)
C0687676 (UMLS 2011AA Property-2)
C25275 (NCI Thesaurus Property-4)
C2745955 (UMLS 2011AA Property-3)
C72881 (NCI Thesaurus Property-5)
C0009253 (UMLS 2011AA Property-4)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.19
Code List
Over the past 4 weeks, how often did you experience discomfort or pain following vaginal penetration
CL Item
Did Not Attempt Intercourse (Did not attempt intercourse)
CL Item
A Few Times (A few times)
CL Item
Almost Always Or Always (Almost always or always)
CL Item
Almost Never Or Never (Almost never or never)
CL Item
Most Times (Most times)
CL Item
Sometimes (Sometimes)
Item
Over the past 4 weeks, how would you rate your level (degree) of discomfort or pain during or following vaginal penetration
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C17127 (NCI Thesaurus ObjectClass-2)
C0036864 (UMLS 2011AA ObjectClass-2)
C25367 (NCI Thesaurus Property)
C3303 (NCI Thesaurus Property-2)
C0030193 (UMLS 2011AA Property)
C25554 (NCI Thesaurus Property-3)
C0441889 (UMLS 2011AA Property-2)
C72881 (NCI Thesaurus Property-4)
C0009253 (UMLS 2011AA Property-3)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.20
Code List
Over the past 4 weeks, how would you rate your level (degree) of discomfort or pain during or following vaginal penetration
CL Item
Did Not Attempt Intercourse (Did not attempt intercourse)
CL Item
High (High)
C25227 (NCI Thesaurus)
C0205250 (UMLS 2011AA)
CL Item
Low (Low)
C54722 (NCI Thesaurus)
C0205251 (UMLS 2011AA)
CL Item
Moderation (Moderate)
C61376 (NCI Thesaurus)
C1881878 (UMLS 2011AA)
CL Item
Very High (Very high)
CL Item
Very Low Or None At All (Very low or none at all)
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