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

- 06.08.20 - 1 Formular, 8 Itemgruppen, 76 Datenelemente, 1 Sprache
Itemgruppen: 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

Patient reported outcome measures in ATTR amyloidosis (short version) - PROMs ATTR short

- 06.08.20 - 1 Formular, 3 Itemgruppen, 31 Datenelemente, 1 Sprache
Itemgruppen: Demographic Factors, Patient reported outcomes: Quality of life, Patient reported outcomes: Disability
Patient reported outcome measures (PROMS) in patients with ATTR amyloidosis (short version) 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)

- 17.09.21 - 1 Formular, 7 Itemgruppen, 36 Datenelemente, 1 Sprache
Itemgruppen: 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.

WHO-5 - WHO (Five) Well-Being Index

- 13.12.24 - 1 Formular, 1 Itemgruppe, 5 Datenelemente, 30 Sprachen
Itemgruppe: 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]

Aging Male Symptoms (AMS) Scale

- 28.11.17 - 1 Formular, 5 Itemgruppen, 23 Datenelemente, 1 Sprache
Itemgruppen: Personal data, Physical well-being, Mental well-being, Sexual well-being, AMS Scoring
The AMS scale was designed to measure the severity of aging-symptoms and their impact on the health-related quality of life (HRQoL) in a standardized manner and might serve as a screening instrument for androgen deficiency. It was developed by the The Berlin Center for Epidemiology and Health Research (ZEG Berlin: acronym for the German name: Zentrum für Epidemiologie & Gesundheitsforschung). http://www.aging-males-symptoms-scale.info/about.htm Heinemann LAJ, Zimmermann T, Vermeulen A, Thiel C. A New 'Aging Male's Symptoms' (AMS) Rating Scale. The Aging Male 1999; 2:105-114. Heinemann et al. The Aging Males' Symptoms rating scale. Cultural and linguistic validation into English. The Aging Male 2001; 4(1):14-22.

Tooth Sensitivity Questionnaire (PO1) NCT00867997

- 03.06.15 - 1 Formular, 2 Itemgruppen, 7 Datenelemente, 1 Sprache
Itemgruppen: Tooth Sensitivity Assessment, Date Form Completed
Tooth Sensitivity Questionnaire (PO1) NCT00867997 Noncarious Cervical Lesion Treatment Outcomes Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=23E09830-4E68-45B0-E044-0003BA3F9857

S0205 LASA QUALITY OF LIFE QUESTIONNAIRE NCT00075686

- 03.07.15 - 1 Formular, 4 Itemgruppen, 16 Datenelemente, 1 Sprache
Itemgruppen: SWOG clinical trial administrative data, Quality of life assessment, CCRR MODULE, CCRR MODULE
S0205 LASA QUALITY OF LIFE QUESTIONNAIRE NCT00075686 S0205 Gemcitabine With or Without Cetuximab as First-Line Therapy in Treating Patients With Locally Advanced Unresectable or Metastatic Adenocarcinoma of the Pancreas Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A66316F3-7D6E-48C9-E034-0003BA0B1A09

Z6051 Mayo Bowel Function Questionnaire (MBFQ) NCT00726622

- 26.06.15 - 1 Formular, 2 Itemgruppen, 25 Datenelemente, 1 Sprache
Itemgruppen: Header Module, Patient Bowel Function
Z6051 Mayo Bowel Function Questionnaire (MBFQ) NCT00726622 Laparoscopic-Assisted Resection or Open Resection in Treating Patients With Stage IIA, Stage IIIA, or Stage IIIB Rectal Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=4AEB4B3D-5518-0337-E044-0003BA3F9857

E3201 Patient Bowel Function/Uniscale Questionnaire NCT00068692

- 16.06.15 - 1 Formular, 3 Itemgruppen, 28 Datenelemente, 1 Sprache
Itemgruppen: Header, Patient Bowel Function, CCRR MODULE
E3201 Patient Bowel Function/Uniscale Questionnaire NCT00068692 Comparison of Adjuvant Chemotherapy Regimens in Treating Patients With Stage II or Stage III Rectal Cancer Who Are Receiving Radiation Therapy and Fluorouracil Before or After Surgery Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=B552120F-3E84-6D21-E034-0003BA12F5E7

E3201 Patient Bowel Function/Uniscale Questionnaire NCT00068692

- 16.06.15 - 1 Formular, 3 Itemgruppen, 28 Datenelemente, 1 Sprache
Itemgruppen: Header, Patient Bowel Function, CCRR MODULE
E3201 Patient Bowel Function/Uniscale Questionnaire NCT00068692 Comparison of Adjuvant Chemotherapy Regimens in Treating Patients With Stage II or Stage III Rectal Cancer Who Are Receiving Radiation Therapy and Fluorouracil Before or After Surgery Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=08ED038D-7845-6501-E044-0003BA3F9857

E5204 Patient Bowel Function/Uniscale Questionnaire NCT00303628

- 16.06.15 - 1 Formular, 2 Itemgruppen, 27 Datenelemente, 1 Sprache
Itemgruppen: Header, Patient Bowel Function
E5204 Patient Bowel Function/Uniscale Questionnaire NCT00303628 Combination Chemotherapy With or Without Bevacizumab in Treating Patients Who Have Had Surgery for Stage II or Stage III Rectal Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=08ED057C-100B-64FF-E044-0003BA3F9857

USMCI 8214/Z6091: SF-36 Patient Self Assessment Questionnaire NCT01167725

- 21.11.16 - 1 Formular, 2 Itemgruppen, 6 Datenelemente, 2 Sprachen
Itemgruppen: Header Module, SF36v2
USMCI 8214/Z6091: SF-36 Patient Self Assessment Questionnaire NCT01167725 Standard Therapy With or Without Surgery and Mitomycin C in Treating Patients With Advanced Limited Peritoneal Dissemination of Colon Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=665C50CD-E1EF-DFF5-E040-BB89AD43117E

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