ID
2743
Description
Melanoma-Treatment Summary Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=99CD59C5-A9A0-3FA4-E034-080020C9C0E0
Link
Keywords
Versions (2)
- 9/19/12 9/19/12 -
- 1/8/15 1/8/15 - Martin Dugas
Uploaded on
September 19, 2012
DOI
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License
Creative Commons BY-NC 3.0 Legacy
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Treatment - Melanoma-Treatment Summary Form - 2020200v2.31
No Instruction available.
- StudyEvent: Melanoma-Treatment Summary Form
Description
Melanoma: Treatment Schedule-surgery
Description
ProtocolSurgeryInd
Data type
text
Description
ProtocolSurgeryDate
Data type
date
Description
ProtocolSurgeryType
Data type
text
Description
SurgicalTreatmentCompleted
Data type
text
Description
SurgicalTreatmentCompleted,Specify
Data type
text
Description
RadialMarginDistance
Data type
double
Alias
- NCI Thesaurus ValueDomain
- C25209
- UMLS 2011AA ValueDomain
- C0242485
Description
Melanoma: Treatment Schedule-systemic Therapy
Description
TreatmentBeginDate
Data type
date
Description
AgentCountCoursesAdministered
Data type
double
Description
TreatmentEndDate
Data type
date
Description
AgentTotalDose
Data type
double
Description
AgentDoseUnits
Data type
text
Description
AgentName
Data type
text
Description
Melanoma: Treatment Schedule-vaccine Therapy
Description
VaccineDate,First
Data type
date
Description
VaccineDate,Last
Data type
date
Description
VaccineSite
Data type
text
Description
VaccineSite,Other
Data type
text
Description
AgentTotalDose
Data type
double
Description
AgentDoseUnits
Data type
text
Description
AgentName
Data type
text
Description
Melanoma: Treatment Schedule Summary-radiation Therapy
Description
RTBeginDate
Data type
date
Description
RTEndDate
Data type
date
Description
RTSite
Data type
text
Description
RTSite,Other
Data type
text
Description
RTTotalDose
Data type
double
Description
RTInterruptionsInd
Data type
text
Description
RTInterruptionsReason
Data type
text
Description
Melanoma: Treatment Modifications
Description
Melanoma: Off-treatment
Description
OffTreatmentReason
Data type
text
Description
OffTreatmentReason,Toxicity
Data type
text
Description
OffTreatmentReason,Other
Data type
text
Description
Melanoma: Treatment Schedule-non-protocol Therapy
Description
Allows Documentation Of Any Additional Cooments
Similar models
No Instruction available.
- StudyEvent: Melanoma-Treatment Summary Form
C0805701 (UMLS 2011AA ValueDomain)
C1507394 (UMLS 2011AA ObjectClass)
C42774 (NCI Thesaurus Property)
C1705823 (UMLS 2011AA Property)
C0805701 (UMLS 2011AA ValueDomain)
C1298908 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0242485 (UMLS 2011AA ValueDomain)
C0439148 (UMLS 2011AA)
C1272460 (UMLS 2011AA)
C0439473 (UMLS 2011AA)
C0475210 (UMLS 2011AA)
C0439209 (UMLS 2011AA)
C0439242 (UMLS 2011AA)
C0439210 (UMLS 2011AA)
C0439200 (UMLS 2011AA)
C0460005 (UMLS 2011AA)
C0439148 (UMLS 2011AA)
C1272460 (UMLS 2011AA)
C0439473 (UMLS 2011AA)
C0475210 (UMLS 2011AA)
C0439209 (UMLS 2011AA)
C0439242 (UMLS 2011AA)
C0439210 (UMLS 2011AA)
C0439200 (UMLS 2011AA)
C0262950 (UMLS 2011AA)
C0006104 (UMLS 2011AA)
C0460004 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C0205394 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C1298908 (UMLS 2011AA)