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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

Life Stage

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
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)