Questionnaire | Question set | Research topic | Number of pages | Questionnaire pack |
---|---|---|---|---|
Data capture form | Diagnosis and treatment | Based on the UK National Head and neck Cancer Audit [8] | 1 | Baseline, 4-month, 12-month |
 | Co-morbidity | Adult co-morbidity assessment 27 (ACE-27) [11] | 1 |  |
Health and Lifestyle | About You | Demographic data, Education, occupation [12], Income [13], EQ5D initially then EQ-5D-5Â L [14], Smoking [15, 16], Alcohol [15, 16] | 4 | Baseline, 4-month, 12-month |
Quality of life | Your Outlook | Revised Life Orientation Test (LOT-R) [17] | 1 | Baseline, 4-month, 12-month |
 | Your General Health | EORTC QLQ-C30 [18] | 2.5 | Baseline, 4-month, 12-month |
 | Specific Aspects of Your Health | EORTC QLQ-H&N35 [19] | 2 | Baseline, 4-month, 12-month |
 | Your Feelings | Hospital Anxiety and Depression Scale (HADS) [20] | 2 | Baseline, 4-month, 12-month |
 | Your Diet | Three items (fruit, vegetables and deep fried food) modified from the semi-quantitative Food, Frequency Questionnaire [21] | 1 | Baseline, 4-month, 12-month |
 | You and Cancer | Fears of Recurrence [22] | ½ | 4-month, 12-month |
 | Your Personal costs | Designed by the study team | 2 | 4-month , 12-month |
Sexual history | Sexual History | Sexual History [23] | 1 | Baseline |
Quality of life | Your symptoms | Head and neck radiotherapy questionnaire (late toxicity) [24] | 5 | 12-months (only people who receive radiotherapy) |
Withdrawal form | Withdrawal from study | Questions designed by the study team completed by research nurse | 1 | As appropriate |
Mortality form | Place and mode of death | Questions designed by the study team completed by research nurse | 2 | As appropriate |
Quality of life additional questions used in Bristol participants | Your Quality of Life | The revised University of Washington (UW) QOL questionnaire [25, 26] | 2 | Baseline, 4-month, 12-month |
 | Difficulties in Your Life | The Social Difficulties Inventory (SDI) [27] | 2 | Baseline, 4-month, 12-month |
 | Your Appearance | The Derriford Appearance Scale (DAS 24) [28] | 6 | Baseline, 4-month, 12-month |