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  1. 1. Clinical Trial
  2. 2. Routine Documentation
  3. 3. Registry/Cohort Study
  4. 4. Quality Assurance
  5. 5. Data Standard
  6. 6. Patient-Reported Outcome
  7. 7. Medical Specialty
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WHO-5 - WHO (Five) Well-Being Index

- 12/13/24 - 1 form, 1 itemgroup, 5 items, 30 languages
Itemgroup: Over the last two weeks
WHO (Five) Well-Being Index (1998 version) Also called : WHO Five, WHO 5 [Topp CW, Østergaard SD, Søndergaard S, Bech P. The WHO-5 Well-Being Index: a systematic review of the literature. Psychother Psychosom. 2015;84(3):167-76. doi: 10.1159/000376585]

ECOG

- 8/7/23 - 1 form, 1 itemgroup, 1 item, 2 languages
Itemgroup: ECOG
ECOG - WHO - Zubrod Performance Status Scale

Patient reported outcome measures in ATTR amyloidosis - PROMs in ATTR amyloidosis

- 8/6/20 - 1 form, 8 itemgroups, 76 items, 1 language
Itemgroups: Demographic Factors, Comorbidities, Patient reported outcomes: ATTR Diagnosis, First organ system involved, Patient reported outcomes: Quality of life, Patient reported outcomes: Disability, Patient reported Outcomes: ATTR Management, ATTR Therapy
Patient reported outcome measures (PROMS) in patients with ATTR amyloidosis Dr. med. Fabian Johannes Bolte Klinik für Gastroenterologie und Hepatologie Universitätsklinikum Münster Conditions: ATTR Amyloidosis This form is used for patient reported outcome measures (PROMS) in patients with ATTR amyloidosis to understand patients challenges and needs. Use of the following Scores for this standard set: (1) Patient Reported Outcomes Measurement Information System Short Form version 1.1 Global Health (PROMIS-10) (2) World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0)- 12-item Instrument

SF-36 (RAND)

- 9/17/21 - 1 form, 7 itemgroups, 36 items, 1 language
Itemgroups: General Info, Current health limitations, Physical Health related problems during past 4 weeks, Emotional problems during past 4 weeks, Past 4 weeks, Emotions in past 4 weeks, General statements
This document contains the 36-Item Short Form Survey Instrument Version 1 (SF-36) form, developed at RAND as part of the Medical Outcomes Study. RAND owns the copyright. All of the surveys and tools from RAND Health are public documents, available without charge. For more information - e.g. on terms and conditions for use or scoring instructions: https://www.rand.org/health-care/surveys_tools/mos/36-item-short-form.html Changes made to the questionnaire should be made clearly identifiable.

Pancreatic Cancer NCT00058149 Quality of Life - Brief Pain Inventory - 2031356v3.0 - Brief Pain Inventory

- 1/9/15 - 1 form, 2 itemgroups, 23 items, 1 language
Itemgroups: Header, CCRR MODULE
Brief Pain Inventory A Phase III, Randomized Study of Gemcitabine (Fixed-Dose Rate Infusion) and Oxaliplatin (NSC 266046) Versus Gemcitabine (Fixed-Dose Rate Infusion) Versus Gemcitabine (30-Minute Infusion) in Pancreatic Carcinoma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=AE65F8E1-704E-30A0-E034-0003BA12F5E7

HADS - Hospital Anxiety and Depression Scale (HADS)

- 11/16/18 - 1 form, 1 itemgroup, 14 items, 1 language
Itemgroup: In the past week
Hospital Anxiety and Depression Scale (HADS) was originally developed by [Zigmond, AS; Snaith, RP (1983). "The hospital anxiety and depression scale". Acta Psychiatrica Scandinavica 67 (6): 361–370] and is commonly used by doctors to determine the levels of anxiety and depression that a patient is experiencing. Also used for routine documentation at the University Hospital Muenster (UKM) see http://en.wikipedia.org/wiki/Hospital_Anxiety_and_Depression_Scale

DLQI - Dermatology Life Quality Index (DLQI)

- 9/7/16 - 1 form, 1 itemgroup, 12 items, 17 languages
Itemgroup: Skin problems past week
Details and Conditions of Use see: Finlay A.Y., Khan G.K. Dermatology Life Quality Index (DLQI) - A simple practical measure for routine clinical use. Clinical and Experimental Derm 1994; 19:210-16 Used as routine documentation at the University Hospital in Muenster (UKM).

EORTC QLQ_C30 - EORTC QLQ_C30 MS University Hospital Muenster (UKM)

- 11/7/17 - 1 form, 1 itemgroup, 3 items, 1 language
Itemgroup: General information
Used as Hospital Routine Documentation Form at the University Hospital Muenster. Original Form name: EORTC QLQ-C30 MS. Copyright: 1995 EORTC Quality of Life Group. All rights reserved. Version 3.0 German description: EORTC QLQ-C30 (version 3.0) Wir sind an einigen Angaben interessiert, die Sie und Ihre Gesundheit betreffen. Bitte beantworten Sie die folgenden Fragen selbst, indem Sie die Zahl ankreuzen, die am besten auf Sie zutrifft. Es gibt keine "richtigen" oder "falschen" Antworten. Ihre Angaben werden streng vertraulich behandelt.

Study SHIP-TREND_TREND0_SAQ - t0.saq_eingabe_assi

- 10/26/24 - 11 forms, 1 itemgroup, 9 items, 2 languages
Itemgroup: t0.saq_eingabe_assi
SHIP Study https://doi.org/10.1093/ije/dyac034

t0.ble_phq

1 itemgroup 18 items

t0.ble_vertreibung

1 itemgroup 1 item

t0.saq_beschwer

1 itemgroup 41 items

t0.saq_health

1 itemgroup 13 items

t0.saq_qol

1 itemgroup 50 items

t0.ble_tas

1 itemgroup 20 items

German Myeloma Patient Outcome Scale (MyPOS) - MyPOS

- 3/15/22 - 1 form, 8 itemgroups, 40 items, 1 language
Itemgroups: Administratative Angaben, Symptome und Nebenwirkungen - Beeinträchtigung in der letzten Woche, Beeinträchtigung durch weitere Symptome, Verlauf der letzten Woche (Teil 1), Verlauf der letzten Woche (Teil 2), Probleme und Sorgen, Sorgen und Ängste, Ausfüllen des Fragebogens
Die Nutzung des MyPOS ist kostenfrei, es wird aber eine (kostenfreie) Registrierung auf der POS-Website (www.pos-pal.org) gewünscht. Um eine Information über Nutzung und/oder Änderung wird seitens des POS-Team explizit gebeten. Affiliation: Dr. med. Christina Gerlach M.Sc. Oberärztin | Klinik für Palliativmedizin Fachärztin für Innere Medizin, Hämatologie & Onkologie; Notfallmedizin, Palliativmedizin Universitätsklinikum Heidelberg | Im Neuenheimer Feld 305 | 69120 Heidelberg Tel. +49 6221 56-310683 | Fax. +49 6221 56-7203 | E-Mail: christina.gerlach@med.uni-heidelberg.de http://www.klinikum.uni-heidelberg.de Gerlach, C., Taylor, K., Ferner, M. et al. Challenges in the cultural adaptation of the German Myeloma Patient Outcome Scale (MyPOS): an outcome measure to support routine symptom assessment in myeloma care. BMC Cancer 20, 245 (2020). https://doi.org/10.1186/s12885-020-06730-7

Visit 24 (Week 240) BG00012 Monotherapy Safety and Efficacy Extension Study in Multiple Sclerosis (MS) (ENDORSE) NCT00835770

- 2/18/22 - 1 form, 10 itemgroups, 41 items, 1 language
Itemgroups: Subject Identification, Vital Signs, Physical examination, EDSS Evaluation, Functional System Scores, EDSS, Additional and Results, Visual Function Test, Contrast Sensitivity Evaluation Binocular, Study Drug Accountability, Additional Surveys
The primary objective of this study is to evaluate the long-term safety profile of BG00012 (dimethyl fumarate). Secondary objectives of this study are to evaluate the long-term efficacy of BG00012 using clinical endpoints and disability progression, to evaluate further the long-term effects of BG00012 on multiple sclerosis (MS) brain lesions on magnetic resonance imaging (MRI) scans in participants who had MRI scans as part of Studies 109MS301 (NCT00420212) and 109MS302 (NCT00451451) and to evaluate the long-term effects of BG00012 on health economics assessments and the visual function test. NCT00835770 Part: Visit 24 (Week 240)

Visit 20 (Week 192) BG00012 Monotherapy Safety and Efficacy Extension Study in Multiple Sclerosis (MS) (ENDORSE) NCT00835770

- 2/17/22 - 1 form, 10 itemgroups, 42 items, 1 language
Itemgroups: Subject Identification, Vital Signs, Physical examination, EDSS Evaluation, Functional System Scores, EDSS, Additional and Results, Visual Function Test, Contrast Sensitivity Evaluation Binocular, Study Drug Accountability, Additional Surveys
The primary objective of this study is to evaluate the long-term safety profile of BG00012 (dimethyl fumarate). Secondary objectives of this study are to evaluate the long-term efficacy of BG00012 using clinical endpoints and disability progression, to evaluate further the long-term effects of BG00012 on multiple sclerosis (MS) brain lesions on magnetic resonance imaging (MRI) scans in participants who had MRI scans as part of Studies 109MS301 (NCT00420212) and 109MS302 (NCT00451451) and to evaluate the long-term effects of BG00012 on health economics assessments and the visual function test. NCT00835770 Part: Visit 20 (Week 192)

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