ID

10508

Beskrivning

FACT-HEP (Version 4) NCT00057876 Gemcitabine With or Without Radiation Therapy in Treating Patients With Pancreatic Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A65F5E36-2E67-453E-E034-0003BA0B1A09

Länk

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A65F5E36-2E67-453E-E034-0003BA0B1A09

Nyckelord

C25

D016430

Quality of Life

Uppladdad den

3 juni 2015

DOI

För en begäran logga in.

Licens

Creative Commons BY-NC 3.0 Legacy

Modellkommentarer :

Här kan du kommentera modellen. Med hjälp av pratbubblor i Item-grupperna och Item kan du lägga in specifika kommentarer.

Tillbaka till modellkommentarer

Itemgroup-kommentar för :

Item-kommentar för :

Du måste vara inloggad för att kunna ladda ner formulär. Var vänlig logga in eller registrera dig utan kostnad.

FACT-HEP (Version 4) NCT00057876

model
Detaljer

No Instruction available.

1 Formulär

StudyEvent: FACT-HEP (Version 4)
1. No Instruction available.

Name

Typ

Description | Question | Decode (Coded Value)

Datatyp

Alias

ECOG clinical trial administrative data

Item Group

ECOG clinical trial administrative data

RegistrationStep

Item

Registration Step

text

Dateofassessment

Item

Date of assessment

text

Patient'sName

Item

Patient?s Name

text

ECOGProtocolNo.

Item

ECOG Protocol No.

text

ECOGProtocolNo.

Item

ECOG Protocol No.

text

ECOGPatientID

Item

ECOG Patient ID

text

ECOGPatientID

Item

ECOG Patient ID

text

ParticipatingGroupProtocolNo.

Item

Participating Group Protocol No.

text

ParticipatingGroupPatientID

Item

Participating Group Patient ID

text

MainMemberInstitution/Affiliate

Item

Institution/Affiliate (Physical Well-Being)

text

Assessment of Quality of Life

Item Group

Assessment of Quality of Life

Ihavealackofenergy

Item

I have a lack of energy

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.1

Code List

I have a lack of energy

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

PatientNauseaAssessmentQualityofLifeScale

Item

I have nausea

text

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

CL.2

Code List

I have nausea

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

PatientGeneralPhysicalConditionAssessmentQualityofLifeScale

Item

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

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)
C0518214 (UMLS 2011AA ValueDomain)

CL.3

Code List

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

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

PatientPainAssessmentQualityofLifeScale

Item

I have pain

text

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

CL.4

Code List

I have pain

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

PatientAdverseEventAssessmentQualityofLifeScale

Item

I am bothered by side effects of treatment

text

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

CL.5

Code List

I am bothered by side effects of treatment

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

PatientMalaiseAssessmentQualityofLifeScale

Item

I feel ill

text

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

CL.6

Code List

I feel ill

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

PatientBedRestAssessmentQualityofLifeScale

Item

I am forced to spend time in bed (Social/Family Well-Being)

text

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

CL.7

Code List

I am forced to spend time in bed (Social/Family Well-Being)

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

Ifeelclosetomyfriends

Item

I feel close to my friends

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.8

Code List

I feel close to my friends

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

Igetemotionalsupportfrommyfamily

Item

I get emotional support from my family

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.9

Code List

I get emotional support from my family

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

Igetsupportfrommyfriends

Item

I get support from my friends

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.10

Code List

I get support from my friends

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

Myfamilyhasacceptedmyillness

Item

My family has accepted my illness

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.11

Code List

My family has accepted my illness

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

Iamsatisfiedwithfamilycommunicationaboutmyillness

Item

I am satisfied with family communication about my illness

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.12

Code List

I am satisfied with family communication about my illness

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

Ifeelclosetomypartner(orthepersonwhoismymainsupport)

Item

I feel close to my partner (or the person who is my main support)

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.13

Code List

I feel close to my partner (or the person who is my main support)

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

Iamsatisfiedwithmysexlife

Item

I am satisfied with my sex life (Emotional Well-Being)

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.14

Code List

I am satisfied with my sex life (Emotional Well-Being)

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

Ifeelsad

Item

I feel sad

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.15

Code List

I feel sad

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

IamsatisfiedwithhowIamcopingwithmyillness

Item

I am satisfied with how I am coping with my illness

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.16

Code List

I am satisfied with how I am coping with my illness

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

Iamlosinghopeinthefightagainstmyillness

Item

I am losing hope in the fight against my illness

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.17

Code List

I am losing hope in the fight against my illness

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

Ifeelnervous

Item

I feel nervous

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.18

Code List

I feel nervous

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

Iworryaboutdying

Item

I worry about dying

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.19

Code List

I worry about dying

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

Iworrythatmyconditionwillgetworse

Item

I worry that my condition will get worse (Functional Well-Being)

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.20

Code List

I worry that my condition will get worse (Functional Well-Being)

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

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)
C0518214 (UMLS 2011AA ValueDomain)

CL.21

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)
C70543 (NCI Thesaurus)
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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

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)
C0242428 (UMLS 2011AA Property)
C0043227 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)

CL.22

Code List

My work (include work at home) is fulfilling

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

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)
C0518214 (UMLS 2011AA ValueDomain)

CL.23

Code List

I am able to enjoy life

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

Ihaveacceptedmyillness

Item

I have accepted my illness

text

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

CL.24

Code List

I have accepted my illness

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

Iamsleepingwell

Item

I am sleeping well

text

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

CL.25

Code List

I am sleeping well

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

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)
C0518214 (UMLS 2011AA ValueDomain)

CL.26

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)
C70543 (NCI Thesaurus)
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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

PatientQualityofLifeAssessmentQualityofLifeScale

Item

I am content with the quality of my life right now (Additional Concerns)

text

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

CL.27

Code List

I am content with the quality of my life right now (Additional Concerns)

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

QualityofLifeAbdominalMuscleCrampSwellingAssessmentType

Item

I have swelling or cramps in my stomach area

text

C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25217 (NCI Thesaurus Property)
C1516048 (UMLS 2011AA Property)
C25342 (NCI Thesaurus Property)
C0000726 (UMLS 2011AA Property)
C3399 (NCI Thesaurus Property)
C0038999 (UMLS 2011AA Property)
C34827 (NCI Thesaurus Property)
C0026821 (UMLS 2011AA Property)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.28

Code List

I have swelling or cramps in my stomach area

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

PatientWeightLossAssessmentQualityofLifeScale

Item

I am losing weight

text

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C3445 (NCI Thesaurus Property)
C0043096 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)

CL.29

Code List

I am losing weight

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

BowelPatientIncontinenceAssessmentQualityofLifeScale

Item

I have control of my bowels

text

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C12736 (NCI Thesaurus ObjectClass)
C0021853 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0021167 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)

CL.30

Code List

I have control of my bowels

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

QualityofLifeDigestionAbilityAssessmentType

Item

I can digest my food well

text

C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25217 (NCI Thesaurus Property)
C1516048 (UMLS 2011AA Property)
C78209 (NCI Thesaurus Property)
C0085732 (UMLS 2011AA Property)
C16503 (NCI Thesaurus Property)
C0012238 (UMLS 2011AA Property)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.31

Code List

I can digest my food well

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

QualityofLifeDiarrheaEvaluationScale

Item

I have diarrhea

text

C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25214 (NCI Thesaurus Property)
C0220825 (UMLS 2011AA Property)
C2987 (NCI Thesaurus Property)
C0011991 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)

CL.32

Code List

I have diarrhea

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

PatientAppetiteAssessmentQualityofLifeScale

Item

I have a good appetite

text

C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25152 (NCI Thesaurus Property)
C0003618 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)

CL.33

Code List

I have a good appetite

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

QualityofLifeAppearanceChangeDissatisfactionEvaluationScale

Item

I am unhappy about a change in my appearance

text

C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25214 (NCI Thesaurus Property)
C0220825 (UMLS 2011AA Property)
C25377 (NCI Thesaurus Property)
C0700364 (UMLS 2011AA Property)
C25446 (NCI Thesaurus Property)
C0392747 (UMLS 2011AA Property)
C62184 (NCI Thesaurus Property)
C0870433 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)

CL.34

Code List

I am unhappy about a change in my appearance

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

Ihavepaininmyback

Item

I have pain in my back

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.35

Code List

I have pain in my back

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

QualityofLifeConstipationDistressEvaluationScale

Item

I am bothered by constipation

text

C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25214 (NCI Thesaurus Property)
C0220825 (UMLS 2011AA Property)
C37930 (NCI Thesaurus Property)
C0009806 (UMLS 2011AA Property)
C37942 (NCI Thesaurus Property)
C0231303 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)

CL.36

Code List

I am bothered by constipation

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

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)
C0015672 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)

CL.37

Code List

I feel fatigued

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

Quality-of-LifeAssessmentPatientActivityType

Item

I am able to do my usual activities

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus Property)
C0030705 (UMLS 2011AA Property)
C43431 (NCI Thesaurus Property)
C0441655 (UMLS 2011AA Property)
C15584 (NCI Thesaurus ObjectClass)
C0281588 (UMLS 2011AA ObjectClass)

CL.38

Code List

I am able to do my usual activities

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

Iambotheredbyjaundiceoryellowcolortomyskin

Item

I am bothered by jaundice or yellow color to my skin

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.39

Code List

I am bothered by jaundice or yellow color to my skin

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

Ihavehadfevers

Item

I have had fevers

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.40

Code List

I have had fevers

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

Ihavehaditching

Item

I have had itching

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.41

Code List

I have had itching

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

Ihavehadachangeinthewayfoodtastes

Item

I have had a change in the way food tastes

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.42

Code List

I have had a change in the way food tastes

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

Ihavehadchills

Item

I have had chills

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.43

Code List

I have had chills

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

Mymouthisdry

Item

My mouth is dry

text

C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)

CL.44

Code List

My mouth is dry

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)

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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)

QualityofLifeStomachPainEvaluationScale

Item

I have discomfort or pain in my stomach area

text

C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25214 (NCI Thesaurus Property)
C0220825 (UMLS 2011AA Property)
C3303 (NCI Thesaurus Property)
C0030193 (UMLS 2011AA Property)
C12391 (NCI Thesaurus Property)
C0038351 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain)
C0518214 (UMLS 2011AA ValueDomain)

CL.45

Code List

I have discomfort or pain in my stomach area

CL Item

Not At All (Not at all)

C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus)
C70543 (NCI Thesaurus)
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)

CL Item

Very Much (Very much)

C91217 (NCI Thesaurus)
C91217 (NCI Thesaurus)

CCRR MODULE

Item Group

Ccrr Module For Fact-hep (version 4)

AssessmentDate

Item

Assessment Date

date

Tillbaka till toppen

ID

Beskrivning

Länk

Nyckelord

Versioner (4)

Uppladdad den

DOI

Licens

Modellkommentarer :

Itemgroup-kommentar för :

Item-kommentar för :

FACT-HEP (Version 4) NCT00057876

No Instruction available.

Beskrivning

Beskrivning

Datatyp

Beskrivning

Datatyp

Beskrivning

Datatyp

Beskrivning

Datatyp

Beskrivning

Datatyp

Beskrivning

Datatyp

Beskrivning

Datatyp

Beskrivning

Datatyp

Beskrivning

Datatyp

Beskrivning

Datatyp

Beskrivning

Beskrivning

Datatyp

Alias

Beskrivning

Datatyp

Alias

Beskrivning

Datatyp

Alias

Beskrivning

Datatyp

Alias

Beskrivning

Datatyp

Alias

Beskrivning

Datatyp

Alias

Beskrivning

Datatyp

Alias

Beskrivning

Datatyp

Alias

Beskrivning

Datatyp

Alias

Beskrivning

Datatyp

Alias

Beskrivning

Datatyp

Alias

Beskrivning

Datatyp

Alias

Beskrivning

Datatyp

Alias

Beskrivning

Datatyp

Alias

Beskrivning

Datatyp

Alias