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Protocol - Chronic Medical Conditions - Self Reported

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Description

A self-report questionnaire which assesses 13 common medical conditions and the impact of comorbidities on functional status.

Specific Instructions

The comorbidity questionnaire is most useful for adults and would not be beneficial for research on pediatric, adolescent and adult patients younger than age 50

Protocol

The following is a list of common problems. Please indicate if you currently have the problem in the first column. If you do not have the problem, skip to next problem.

If you do have the problem, please indicate in the second column if you receive medications or some other type of treatment for the problem.

In the third column indicate if the problem limits any of your activities.

Finally, indicate all medical conditions that are not listed under “other medical problems” at the end of the page.

Do you have the problem?

Do you receive treatment for it?

Does it limit your activities?

PROBLEM

No
(0)

Yes→
(1)

No
(0)

Yes
(1)

No
(0)

Yes
(1)

Heart disease

 [ ] N

 [ ] Y

 [ ] N

 [ ] Y

 [ ] N

 [ ] Y

High blood pressure

 [ ] N

 [ ] Y

 [ ] N

 [ ] Y

 [ ] N

 [ ] Y

Lung disease

 [ ] N

 [ ] Y

 [ ] N

 [ ] Y

 [ ] N

 [ ] Y

Diabetes

 [ ] N

 [ ] Y

 [ ] N

 [ ] Y

 [ ] N

 [ ] Y

Ulcer or stomach disease

 [ ] N

 [ ] Y

 [ ] N

 [ ] Y

 [ ] N

 [ ] Y

Kidney disease

 [ ] N

 [ ] Y

 [ ] N

 [ ] Y

 [ ] N

 [ ] Y

Liver disease

 [ ] N

 [ ] Y

 [ ] N

 [ ] Y

 [ ] N

 [ ] Y

Anemia or other blood disease

 [ ] N

 [ ] Y

 [ ] N

 [ ] Y

 [ ] N

 [ ] Y

Cancer

 [ ] N

 [ ] Y

 [ ] N

 [ ] Y

 [ ] N

 [ ] Y

Depression

 [ ] N

 [ ] Y

 [ ] N

 [ ] Y

 [ ] N

 [ ] Y

Osteoarthritis, degenerative arthritis

 [ ] N

 [ ] Y

 [ ] N

 [ ] Y

 [ ] N

 [ ] Y

Back pain

 [ ] N

 [ ] Y

 [ ] N

 [ ] Y

 [ ] N

 [ ] Y

Rheumatoid arthritis

 [ ] N

 [ ] Y

 [ ] N

 [ ] Y

 [ ] N

 [ ] Y

Other medical problems (please write in)

 [ ] N

 [ ] Y

 [ ] N

 [ ] Y

 [ ] N

 [ ] Y

 [ ] N

 [ ] Y

 [ ] N

 [ ] Y

 [ ] N

 [ ] Y

Scoring. An individual can receive a maximum of 3 points for each medical condition: 1 point for the presence of the problem, another point if he/she receives treatment for it, and an additional point if the problem causes a limitation in functioning. Because there are 12 defined medical problems and 3 optional conditions, the maximum score totals 45 points if the open‐ended items are used and 36 points if only the close‐ended items are used.

Availability

Available

Personnel and Training Required

None

Equipment Needs

None

Requirements
Requirement CategoryRequired
Major equipment No
Specialized training No
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual No
Mode of Administration

Self-administered questionnaire

Lifestage

Adult, Senior

Participants

Females ages 50 years and older inpatients from medical and surgical care units. Patients also had to be able to complete the questionnaire in English.

Selection Rationale

This represents an efficient method to assess comorbid conditions in clinical and health services research. It will be particularly useful in settings where medical records are unavailable.

Language

English

Standards
StandardNameIDSource
caDSR Common Data Elements (CDE) Cancer Outcome Self-Administered Comorbidity Questionnaire (SCQ) Assessment Text   7533645 CDE Browser
Derived Variables

None

Process and Review

Not Applicable

Protocol Name from Source

Self-Administered Comorbidity Questionnaire (SCQ)

Source

Erdem D, Gezer H, Acer Kasman S, Duruoz M. Reliability and Validity of the Self-Administered Comorbidity Questionnaire in Psoriatic Arthritis [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10).

General References

Kates, JM. Treatment-related decisional conflict, quality of life, and comorbidity in older adults with cancer. Asia Pac J Oncol Nurs. 2018 Oct-Dec;5(4):421-429.

Mols F, Oerlemans S, Denollet J, et al. Type D personality is associated with increased comorbidity burden and health care utilization among 3080 cancer survivors. Gen Hosp Psychiatry. 2012 Jul-Aug;34(4):352-9.

Morgans AK, van Bommel ACM, Stowell C, et al. Development of a standardized set of patient-centered outcomes for advanced prostate cancer: an international effort for a unified approach. European Urology. 2015 Nov;68(5):891-8.

Sangha O, Stucki G, Liang MH, Fossel AH, Katz JN. The Self-Administered Comorbidity Questionnaire: a new method to assess comorbidity for clinical and health services research. Arthritis Rheum. 2003; 49(2):156-63.

Iezzoni LI, Foley SM, Daley J, Hughes J, Fisher ES, Heeren T. Comorbidities, complications, and coding bias: does the number of diagnosis codes matter in predicting in-hospital mortality. JAMA 1992; 267: 2197–203.

Jencks SF, Williams DK, Kay TL. Assessing hospital-associated deaths from discharge data: the role of length of stay and comorbidities. JAMA 1988; 260: 2240–6

Protocol ID

320201

Variables
Export Variables
Variable Name Variable IDVariable DescriptiondbGaP Mapping
PX320201_Chronic_Medical_Conditions_Self_Reported_Anemia_Other_Blood_Disease_Limit_Activities
PX320201370000 Does it limit your activities? Anemia or more
other blood disease show less
N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Anemia_Other_Blood_Disease_Problem
PX320201080000 Do you have the problem? Anemia or other more
blood disease show less
N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Anemia_Other_Blood_Disease_Treatment
PX320201230000 Do you receive treatment for it? Anemia or more
other blood disease show less
N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Back_Pain_Limit_Activities
PX320201410000 Does it limit your activities? Back pain N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Back_Pain_Problem
PX320201120000 Do you have the problem? Back pain N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Back_Pain_Treatment
PX320201270000 Do you receive treatment for it? Back pain N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Cancer_Limit_Activities
PX320201380000 Does it limit your activities? Cancer N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Cancer_Problem
PX320201090000 Do you have the problem? Cancer N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Cancer_Treatment
PX320201240000 Do you receive treatment for it? Cancer N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Depression_Limit_Activities
PX320201390000 Does it limit your activities? Depression N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Depression_Problem
PX320201100000 Do you have the problem? Depression N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Depression_Treatment
PX320201250000 Do you receive treatment for it? Depression N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Diabetes_Limit_Activities
PX320201330000 Does it limit your activities? Diabetes N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Diabetes_Problem
PX320201040000 Do you have the problem? Diabetes N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Diabetes_Treatment
PX320201190000 Do you receive treatment for it? Diabetes N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Heart_Disease_Limit_Activities
PX320201300000 Does it limit your activities? Heart disease N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Heart_Disease_Problem
PX320201010000 Do you have the problem? Heart disease N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Heart_Disease_Treatment
PX320201160000 Do you receive treatment for it? Heart disease N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_High_Blood_Pressure_Limit_Activities
PX320201310000 Does it limit your activities? High blood pressure N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_High_Blood_Pressure_Problem
PX320201020000 Do you have the problem? High blood pressure N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_High_Blood_Pressure_Treatment
PX320201170000 Do you receive treatment for it? High blood more
pressure show less
N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Kidney_Disease_Limit_Activities
PX320201350000 Does it limit your activities? Kidney disease N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Kidney_Disease_Problem
PX320201060000 Do you have the problem? Kidney disease N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Kidney_Disease_Treatment
PX320201210000 Do you receive treatment for it? Kidney disease N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Liver_Disease_Limit_Activities
PX320201360000 Does it limit your activities? Liver disease N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Liver_Disease_Problem
PX320201070000 Do you have the problem? Liver disease N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Liver_Disease_Treatment
PX320201220000 Do you receive treatment for it? Liver disease N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Lung_Disease_Limit_Activities
PX320201320000 Does it limit your activities? Lung disease N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Lung_Disease_Problem
PX320201030000 Do you have the problem? Lung disease N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Lung_Disease_Treatment
PX320201180000 Do you receive treatment for it? Lung disease N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Osteoarthritis_Degenerative_Arthritis_Limit_Activities
PX320201400000 Does it limit your activities? more
Osteoarthritis, degenerative arthritis show less
N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Osteoarthritis_Degenerative_Arthritis_Problem
PX320201110000 Do you have the problem? Osteoarthritis, more
degenerative arthritis show less
N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Osteoarthritis_Degenerative_Arthritis_Treatment
PX320201260000 Do you receive treatment for it? more
Osteoarthritis, degenerative arthritis show less
N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Other_Medical_Problem
PX320201140000 Do you have the problem? Other medical problems N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Other_Medical_Problems_Describe
PX320201150000 Please write in: N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Other_Medical_Problems_Limit_Activities
PX320201430000 Does it limit your activities? Other medical more
problems show less
N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Other_Medical_Problems_Treatment
PX320201290000 Do you receive treatment for it? Other more
medical problems show less
N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Rheumatoid_Arthritis_Limit_Activities
PX320201420000 Does it limit your activities? Rheumatoid more
arthritis show less
N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Rheumatoid_Arthritis_Problem
PX320201130000 Do you have the problem? Rheumatoid arthritis N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Rheumatoid_Arthritis_Treatment
PX320201280000 Do you receive treatment for it? Rheumatoid more
arthritis show less
N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Ulcer_Stomach_Disease_Limit_Activities
PX320201340000 Does it limit your activities? Ulcer or more
stomach disease show less
N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Ulcer_Stomach_Disease_Problem
PX320201050000 Do you have the problem? Ulcer or stomach disease N/A
PX320201_Chronic_Medical_Conditions_Self_Reported_Ulcer_Stomach_Disease_Treatment
PX320201200000 Do you receive treatment for it? Ulcer or more
stomach disease show less
N/A
Cancer Outcomes and Survivorship
Measure Name

Chronic Medical Conditions - Self Reported

Release Date

December 17, 2020

Definition

The Self-Administered Comorbidity Questionnaire (SCQ) is a self-report which assesses the presence of medical problems, their severity, and whether or not the condition limits activities.

Purpose

A new method to assess comorbidity for clinical and health services research

Keywords

Cancer Outcomes and Survivorship, comorbidity, chronic medical conditions, cancer patient, conditions, questionnaire, self-administered comorbidity questionnaire (SCQ)

Measure Protocols
Protocol ID Protocol Name
320201 Chronic Medical Conditions - Self Reported
Publications

There are no publications listed for this protocol.