ID

3187

Description

Lung Cancer - Pathology Form - Bronchoscopy Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=152C7A2C-614F-698F-E044-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=152C7A2C-614F-698F-E044-0003BA3F9857

Keywords

Versions (3)
  1. 9/19/12 9/19/12 -
  2. 1/9/15 1/9/15 - Martin Dugas
  3. 1/9/15 1/9/15 - Martin Dugas
Uploaded on

September 19, 2012

DOI

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License

Creative Commons BY-NC 3.0 Legacy
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Pathology - Lung Cancer - Pathology Form - Bronchoscopy - 2019346v3.0

English

No Instruction available.

1 forms  
  1. StudyEvent: Lung Cancer - Pathology Form - Bronchoscopy
    1. No Instruction available.
Crf Header
Description

Crf Header

Coordinating Group Protocol No.
Description

ProtocolCoordinatingIdentifierNumber

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C25320
UMLS 2011AA ObjectClass
C1507394
NCI Thesaurus Property
C25462
UMLS 2011AA Property
C0700114
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Coordinating Group Code
Description

CoordinatingGroupIdentifierCode

Data type

text

Alias
NCI Thesaurus ValueDomain
C25162
UMLS 2011AA ValueDomain
C0805701
NCI Thesaurus ObjectClass
C17005
UMLS 2011AA ObjectClass
C1257890
NCI Thesaurus ObjectClass
C25462
UMLS 2011AA ObjectClass
C0700114
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Protocol Title
Description

ProtocolTitleName

Data type

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ObjectClass
C25320
UMLS 2011AA ObjectClass
C1507394
NCI Thesaurus Property
C42774
UMLS 2011AA Property
C1705823
Patient Study ID
Description

PatientCoordinatingIdentifierNumber

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25462
UMLS 2011AA Property
C0700114
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Institution/Affiliate
Description

CombinedInstitutionName

Data type

text

Alias
NCI Thesaurus ObjectClass
C25454
UMLS 2011AA ObjectClass
C0205195
NCI Thesaurus ObjectClass
C21541
UMLS 2011AA ObjectClass
C0018704
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ValueDomain
C21541
UMLS 2011AA ValueDomain
C0018704
Other Patient ID
Description

PatientParticipatingIdentifierNumber

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25608
UMLS 2011AA Property
C0679823
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Participating Group Code
Description

ParticipatingGroupIdentifierCode

Data type

text

Alias
NCI Thesaurus ValueDomain
C25162
UMLS 2011AA ValueDomain
C0805701
NCI Thesaurus ObjectClass
C25608
UMLS 2011AA ObjectClass
C0679823
NCI Thesaurus ObjectClass
C17005
UMLS 2011AA ObjectClass
C1257890
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Patient Name (initials acceptable)
Description

PatientName

Data type

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Lung Pathology: Form Administration
Description

Lung Pathology: Form Administration

Person Completing Form
Description

ResponsiblePersonName

Data type

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ObjectClass
C25657
UMLS 2011AA ObjectClass
C1273518
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Are data amended (If data are amended, please circle in red when using paper form)
Description

DataAmendedInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C25474
UMLS 2011AA ObjectClass
C1511726
NCI Thesaurus Property
C25416
UMLS 2011AA Property
C1691222
Pathology: Bronchoscopy Tissues Samples
Description

Pathology: Bronchoscopy Tissues Samples

Date Specimen Collected (s - surgical procedure)
Description

SpecimenCollectedDate

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C19157
UMLS 2011AA ObjectClass
C0370003
NCI Thesaurus Property
C25452
NCI Thesaurus Property
C25275
UMLS 2011AA Property
C2745955
Bronchoscopy Reason (Note: Only list values needed for protocol)
Description

BronchoscopyProcedureReason

Data type

text

Alias
NCI Thesaurus ValueDomain
C25638
UMLS 2011AA ValueDomain
C0392360
NCI Thesaurus ObjectClass
C16366
UMLS 2011AA ObjectClass
C0006290
NCI Thesaurus Property
C38000
UMLS 2011AA Property
C0884358
NCI Thesaurus ObjectClass
C15368
Specimen ID
Description

SpecimenIdentifierNumber

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus ObjectClass
C19157
UMLS 2011AA ObjectClass
C0370003
Specimen Cell Source
Description

LungSpecimenCellSourceType

Data type

text

Alias
NCI Thesaurus ObjectClass
C12468
UMLS 2011AA ObjectClass
C0024109
NCI Thesaurus ObjectClass
C19157
UMLS 2011AA ObjectClass
C0370003
NCI Thesaurus Property
C12508
UMLS 2011AA Property
C0007634
NCI Thesaurus Property
C25683
UMLS 2011AA Property
C0449416
NCI Metathesaurus ValueDomain
C0332307
Other specify
Description

SpecimenCellSourceSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus Property
C12508
UMLS 2011AA Property
C0007634
NCI Thesaurus Property
C25683
UMLS 2011AA Property
C0449416
NCI Thesaurus ObjectClass
C19157
UMLS 2011AA ObjectClass
C0370003
Type of Bronchoscopy (check all that apply)
Description

BronchoscopyProcedureType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C16366
UMLS 2011AA ObjectClass
C0006290
NCI Thesaurus Property
C38000
UMLS 2011AA Property
C0884358
NCI Thesaurus ObjectClass
C15368
Other, specify
Description

BronchoscopyTherapyPerformedSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ObjectClass
C16366
UMLS 2011AA ObjectClass
C0006290
NCI Thesaurus Property
C38000
UMLS 2011AA Property
C0884358
NCI Thesaurus ObjectClass
C15368
Bronchoscopic Findings
Description

BronchoscopyFindingProcedure

Data type

text

Alias
NCI Thesaurus ObjectClass
C16366
UMLS 2011AA ObjectClass
C0006290
NCI Thesaurus ValueDomain
C25218
UMLS 2011AA ValueDomain
C1948041
NCI Thesaurus Property
C3367
UMLS 2011AA Property
C0037088
Other, specify
Description

BronchoscopyOtherFindingProcedure

Data type

text

Alias
NCI Thesaurus Property
C17649
UMLS 2011AA Property
C0205394
NCI Thesaurus ObjectClass
C16366
UMLS 2011AA ObjectClass
C0006290
NCI Thesaurus ValueDomain
C25218
UMLS 2011AA ValueDomain
C1948041
NCI Thesaurus Property
C3367
UMLS 2011AA Property
C0037088
By what type of bronchoscopy was the abnormality detected (If abnormality was observed, - for Chemoprevention trials - check all that apply)
Description

BronchoscopyAbnormalityType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C16366
UMLS 2011AA ObjectClass
C0006290
NCI Thesaurus Property
C9440
UMLS 2011AA Property
C1704258
Other specify
Description

BronchoscopyAbnormalityOtherSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ValueDomain
C17649
UMLS 2011AA ValueDomain
C0205394
NCI Thesaurus ObjectClass
C16366
UMLS 2011AA ObjectClass
C0006290
NCI Thesaurus Property
C9440
UMLS 2011AA Property
C1704258
Bronchial Site (check all that apply - Note: Only list values needed for protocol)
Description

BronchialSpecimenSamplingSite

Data type

text

Alias
NCI Thesaurus ValueDomain
C13717
UMLS 2011AA ValueDomain
C1515974
NCI Thesaurus ObjectClass
C25222
UMLS 2011AA ObjectClass
C0205039
NCI Thesaurus ObjectClass
C19157
UMLS 2011AA ObjectClass
C0370003
NCI Thesaurus Property
C25662
UMLS 2011AA Property
C0441621
Other, specify
Description

BronchialSpecimenSamplingOtherSite

Data type

text

Alias
NCI Thesaurus ValueDomain
C13717
UMLS 2011AA ValueDomain
C1515974
NCI Thesaurus ObjectClass
C25222
UMLS 2011AA ObjectClass
C0205039
NCI Thesaurus ObjectClass
C19157
UMLS 2011AA ObjectClass
C0370003
NCI Thesaurus Property
C25662
UMLS 2011AA Property
C0441621
Histologic Type (WHO - check all that apply)
Description

LungTumorHistologicClassificationLungTumorHistologicCategory

Data type

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass
C12468
UMLS 2011AA ObjectClass
C0024109
NCI Thesaurus Property
C25526
UMLS 2011AA Property
C0205462
NCI Thesaurus Property
C25161
UMLS 2011AA Property
C0008902
NCI Thesaurus ValueDomain
C25372
UMLS 2011AA ValueDomain
C0683312
NCI Thesaurus ValueDomain
C25526
UMLS 2011AA ValueDomain
C0205462
Specify subcategories
Description

TumorHistologicSubcategorySpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus Property
C25526
UMLS 2011AA Property
C0205462
NCI Thesaurus Property
C25692
UMLS 2011AA Property
C1515010
Other specify
Description

TumorHistologicCategorySpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus Property
C25526
UMLS 2011AA Property
C0205462
NCI Thesaurus Property
C25161
UMLS 2011AA Property
C0008902
Associated Pre-Malignant Histologic Changes (If Pre-Malignant Changes Observed, - check all that apply)
Description

AssociatedSpecimenPremalignantHistologicChangeName

Data type

text

Alias
NCI Thesaurus ObjectClass
C19157
UMLS 2011AA ObjectClass
C0370003
NCI Thesaurus ObjectClass
C25281
UMLS 2011AA ObjectClass
C0332281
NCI Thesaurus Property
C25446
UMLS 2011AA Property
C0392747
NCI Thesaurus Property
C25526
UMLS 2011AA Property
C0205462
NCI Thesaurus Property
C25624
UMLS 2011AA Property
C1514391
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
Other, specify
Description

AssociatedSpecimenPremalignantHistologicChangeSpecify

Data type

text

Alias
NCI Thesaurus ObjectClass
C19157
UMLS 2011AA ObjectClass
C0370003
NCI Thesaurus ObjectClass
C25281
UMLS 2011AA ObjectClass
C0332281
NCI Thesaurus Property
C25446
UMLS 2011AA Property
C0392747
NCI Thesaurus Property
C25526
UMLS 2011AA Property
C0205462
NCI Thesaurus Property
C25624
UMLS 2011AA Property
C1514391
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
Specimen Condition
Description

LabConditionSpecimenType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C37984
UMLS 2011AA ObjectClass
C0022877
NCI Thesaurus Property
C19157
UMLS 2011AA Property
C0370003
NCI Thesaurus Property
C25457
UMLS 2011AA Property
C0348080
Inflammatory Change
Description

SpecimenInflammationChangeType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus Property
C25446
UMLS 2011AA Property
C0392747
NCI Thesaurus Property
C3137
UMLS 2011AA Property
C0021368
NCI Thesaurus ObjectClass
C19157
UMLS 2011AA ObjectClass
C0370003
Additional Diagnoses Specify
Description

PathologyAdditionalDiagnosisText

Data type

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus Property
C15220
UMLS 2011AA Property
C0011900
NCI Thesaurus Property
C25406
UMLS 2011AA Property
C1524062
NCI Thesaurus ObjectClass
C18189
UMLS 2011AA ObjectClass
C0030664
Reviewing Pathologist
Description

ReviewingPathologistName

Data type

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus ObjectClass
C17723
UMLS 2011AA ObjectClass
C0334866
NCI Thesaurus ObjectClass
C25661
UMLS 2011AA ObjectClass
C1704362
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1 forms
  1. StudyEvent: Lung Cancer - Pathology Form - Bronchoscopy
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Crf Header
ProtocolCoordinatingIdentifierNumber
Item
Coordinating Group Protocol No.
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C25320 (NCI Thesaurus ObjectClass)
C1507394 (UMLS 2011AA ObjectClass)
C25462 (NCI Thesaurus Property)
C0700114 (UMLS 2011AA Property)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
CoordinatingGroupIdentifierCode
Item
Coordinating Group Code
text
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
C17005 (NCI Thesaurus ObjectClass)
C1257890 (UMLS 2011AA ObjectClass)
C25462 (NCI Thesaurus ObjectClass)
C0700114 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
ProtocolTitleName
Item
Protocol Title
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C25320 (NCI Thesaurus ObjectClass)
C1507394 (UMLS 2011AA ObjectClass)
C42774 (NCI Thesaurus Property)
C1705823 (UMLS 2011AA Property)
PatientCoordinatingIdentifierNumber
Item
Patient Study ID
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25462 (NCI Thesaurus Property)
C0700114 (UMLS 2011AA Property)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
CombinedInstitutionName
Item
Institution/Affiliate
text
C25454 (NCI Thesaurus ObjectClass)
C0205195 (UMLS 2011AA ObjectClass)
C21541 (NCI Thesaurus ObjectClass)
C0018704 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C21541 (NCI Thesaurus ValueDomain)
C0018704 (UMLS 2011AA ValueDomain)
PatientParticipatingIdentifierNumber
Item
Other Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25608 (NCI Thesaurus Property)
C0679823 (UMLS 2011AA Property)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
ParticipatingGroupIdentifierCode
Item
Participating Group Code
text
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
C25608 (NCI Thesaurus ObjectClass)
C0679823 (UMLS 2011AA ObjectClass)
C17005 (NCI Thesaurus ObjectClass)
C1257890 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
PatientName
Item
Patient Name (initials acceptable)
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
Item Group
Lung Pathology: Form Administration
ResponsiblePersonName
Item
Person Completing Form
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C25657 (NCI Thesaurus ObjectClass)
C1273518 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
Item
Are data amended (If data are amended, please circle in red when using paper form)
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25474 (NCI Thesaurus ObjectClass)
C1511726 (UMLS 2011AA ObjectClass)
C25416 (NCI Thesaurus Property)
C1691222 (UMLS 2011AA Property)
CL.1
Code List
Are data amended (If data are amended, please circle in red when using paper form)
CL Item
Yes (yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (no)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Item Group
Pathology: Bronchoscopy Tissues Samples
SpecimenCollectedDate
Item
Date Specimen Collected (s - surgical procedure)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C25452 (NCI Thesaurus Property)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
Item
Bronchoscopy Reason (Note: Only list values needed for protocol)
text
C25638 (NCI Thesaurus ValueDomain)
C0392360 (UMLS 2011AA ValueDomain)
C16366 (NCI Thesaurus ObjectClass)
C0006290 (UMLS 2011AA ObjectClass)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C15368 (NCI Thesaurus ObjectClass)
CL.2
Code List
Bronchoscopy Reason (Note: Only list values needed for protocol)
CL Item
Chemoprevention (Chemoprevention)
C15604 (NCI Thesaurus)
C0278925 (UMLS 2011AA)
CL Item
Early Detection (Early detection)
C16209 (NCI Thesaurus)
C0596473 (UMLS 2011AA)
CL Item
Surveillance (Surveillance)
C15719 (NCI Thesaurus)
C0733511 (UMLS 2011AA)
CL Item
Diagnosis (Diagnosis)
C15220 (NCI Thesaurus)
C0011900 (UMLS 2011AA)
CL Item
Staging (Staging)
C15608 (NCI Thesaurus)
C0332305 (UMLS 2011AA)
SpecimenIdentifierNumber
Item
Specimen ID
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
Item
Specimen Cell Source
text
C12468 (NCI Thesaurus ObjectClass)
C0024109 (UMLS 2011AA ObjectClass)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C12508 (NCI Thesaurus Property)
C0007634 (UMLS 2011AA Property)
C25683 (NCI Thesaurus Property)
C0449416 (UMLS 2011AA Property)
C0332307 (NCI Metathesaurus ValueDomain)
CL.3
Code List
Specimen Cell Source
CL Item
Primary Tumor (Primary tumor)
CL Item
Dysplastic Site (Dysplastic site)
CL Item
Normal Tissue (Normal tissue)
C33177 (NCI Thesaurus)
CL Item
Bronchial Tissue, Suspicious For Abnormality (Bronchial tissue, suspicious for abnormality)
CL Item
Other, Specify (Other, specify)
SpecimenCellSourceSpecify
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C12508 (NCI Thesaurus Property)
C0007634 (UMLS 2011AA Property)
C25683 (NCI Thesaurus Property)
C0449416 (UMLS 2011AA Property)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
Item
Type of Bronchoscopy (check all that apply)
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C16366 (NCI Thesaurus ObjectClass)
C0006290 (UMLS 2011AA ObjectClass)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C15368 (NCI Thesaurus ObjectClass)
CL.4
Code List
Type of Bronchoscopy (check all that apply)
CL Item
Fluorescence (Fluorescence)
C16586 (NCI Thesaurus)
C0016315 (UMLS 2011AA)
CL Item
White Light (White light)
CL Item
Rigid (Rigid)
CL Item
Other, Specify (Other, specify)
BronchoscopyTherapyPerformedSpecify
Item
Other, specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C16366 (NCI Thesaurus ObjectClass)
C0006290 (UMLS 2011AA ObjectClass)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C15368 (NCI Thesaurus ObjectClass)
Item
Bronchoscopic Findings
text
C16366 (NCI Thesaurus ObjectClass)
C0006290 (UMLS 2011AA ObjectClass)
C25218 (NCI Thesaurus ValueDomain)
C1948041 (UMLS 2011AA ValueDomain)
C3367 (NCI Thesaurus Property)
C0037088 (UMLS 2011AA Property)
CL.5
Code List
Bronchoscopic Findings
CL Item
Abnormal/malignant (Abnormal/malignant)
CL Item
Inflammatory (Inflammatory)
C25535 (NCI Thesaurus)
C0333348 (UMLS 2011AA)
CL Item
Normal Bronchial Epithelium (Normal bronchial epithelium)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
CL Item
Other, Specify (Other, specify)
BronchoscopyOtherFindingProcedure
Item
Other, specify
text
C17649 (NCI Thesaurus Property)
C0205394 (UMLS 2011AA Property)
C16366 (NCI Thesaurus ObjectClass)
C0006290 (UMLS 2011AA ObjectClass)
C25218 (NCI Thesaurus ValueDomain)
C1948041 (UMLS 2011AA ValueDomain)
C3367 (NCI Thesaurus Property)
C0037088 (UMLS 2011AA Property)
Item
By what type of bronchoscopy was the abnormality detected (If abnormality was observed, - for Chemoprevention trials - check all that apply)
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C16366 (NCI Thesaurus ObjectClass)
C0006290 (UMLS 2011AA ObjectClass)
C9440 (NCI Thesaurus Property)
C1704258 (UMLS 2011AA Property)
CL.6
Code List
By what type of bronchoscopy was the abnormality detected (If abnormality was observed, - for Chemoprevention trials - check all that apply)
CL Item
Fluorescence (Fluorescence)
C16586 (NCI Thesaurus)
C0016315 (UMLS 2011AA)
CL Item
White Light (White light)
CL Item
Rigid (Rigid)
CL Item
Other, Specify (Other, specify)
BronchoscopyAbnormalityOtherSpecify
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C17649 (NCI Thesaurus ValueDomain)
C0205394 (UMLS 2011AA ValueDomain)
C16366 (NCI Thesaurus ObjectClass)
C0006290 (UMLS 2011AA ObjectClass)
C9440 (NCI Thesaurus Property)
C1704258 (UMLS 2011AA Property)
Item
Bronchial Site (check all that apply - Note: Only list values needed for protocol)
text
C13717 (NCI Thesaurus ValueDomain)
C1515974 (UMLS 2011AA ValueDomain)
C25222 (NCI Thesaurus ObjectClass)
C0205039 (UMLS 2011AA ObjectClass)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C25662 (NCI Thesaurus Property)
C0441621 (UMLS 2011AA Property)
CL.7
Code List
Bronchial Site (check all that apply - Note: Only list values needed for protocol)
CL Item
Carina, Not Otherwise Specified (Carina, NOS)
CL Item
Carina Between Right Bronchus 1 And Right Bronchus 2, Right Bronchus 1/2 (Carina between RB1 and RB2, RB1/2)
CL Item
Carina Between Right Bronchus 1 A And B, Right Bronchus 1a/b (Carina between RB1 A and B, RB1A/B)
CL Item
Carina Between Right Bronchus 1 And Right Bronchus 3, Right Bronchus 1/3 (Carina between RB1 and RB3, RB1/3)
CL Item
Carina Between Right Bronchus 2 A And B, Right Bronchus 2a/b (Carina between RB2 A and B, RB2A/B)
CL Item
Carina Between Right Bronchus 2 And Right Bronchus 3, Right Bronchus 2/3 (Carina between RB2 and RB3, RB2/3)
CL Item
Carina Between Right Bronchus 3 A And B, Right Bronchus 3a/b (Carina between RB3 A and B, RB3A/B)
CL Item
Carina Between Right Bronchus 4 And Right Bronchus 5, Right Bronchus 4/5 (Carina between RB4 and RB5, RB4/5)
CL Item
Carina Between Right Bronchus 4 A And B, Right Bronchus 4a/b (Carina between RB4 A and B, RB4A/B)
CL Item
Carina Between Right Bronchus 5 A And B, Right Bronchus 5a/b (Carina between RB5 A and B, RB5A/B)
CL Item
Carina Between Right Bronchus 6 A And B, Right Bronchus 6a/b (Carina between RB6 A and B, RB6A/B)
CL Item
Carina Between Right Bronchus 6 A And C, Right Bronchus 6a/c (Carina between RB6 A and C, RB6A/C)
CL Item
Carina Between Right Bronchus 6 B And C, Right Bronchus 6b/c (Carina between RB6 B and C, RB6B/C)
CL Item
Carina Between Right Bronchus 7 A And B, Right Bronchus 7a/b (Carina between RB7 A and B, RB7A/B)
CL Item
Carina Between Right Bronchus 8 And Right Bronchus 9, Right Bronchus 8/9 (Carina between RB8 and RB9, RB8/9)
CL Item
Carina Between Right Bronchus 8 A And B, Right Bronchus 8a/b (Carina between RB8 A and B, RB8A/B)
CL Item
Carina Between Right Bronchus 9 And Right Bronchus 10, Right Bronchus 9/10 (Carina between RB9 and RB10, RB9/10)
CL Item
Carina Between Right Bronchus 9 A And B, Right Bronchus 9a/b (Carina between RB 9 A and B, RB9A/B)
CL Item
Carina Between Right Bronchus 10 A And B, Right Bronchus 10a/b (Carina between RB10 A and B, RB10A/B)
CL Item
Carina Between Right Bronchus 10 A And C, Right Bronchus 10a/c (Carina between RB10 A and C, RB10A/C)
CL Item
Carina Between Right Bronchus 10 B And C, Right Bronchus 10b/c (Carina between RB10 B and C, RB10B/C)
CL Item
Carina Between Left Bronchus 1 And Left Bronchus 2, Left Bronchus 1/2 (Carina between LB1 and LB2, LB1/2)
CL Item
Carina Between Left Bronchus 1 A And B, Left Bronchus 1a/b (Carina between LB1 A and B, LB1A/B)
CL Item
Carina Between Left Bronchus 1 A And C, Left Bronchus 1a/c (Carina between LB1 A and C, LB1A/C)
CL Item
Carina Between Left Bronchus 1 B And C, Left Bronchus 1b/c (Carina between LB1 B and C, LB1B/C)
CL Item
Carina Between Left Bronchus 2 A And B, Left Bronchus 2a/b (Carina between LB2 A and B, LB2A/B)
CL Item
Carina Between Left Bronchus 2 A And C, Left Bronchus 2a/c (Carina between LB2 A and C, LB2A/C)
CL Item
Carina Between Left Bronchus 2 B And C, Left Bronchus 2b/c (Carina between LB2 B and C, LB2B/C)
CL Item
Carina Between Left Bronchus 1+2 And Left Bronchus 3, Left Bronchus 1+2/3 (Carina between LB1+2 and LB3, LB1+2/3)
CL Item
Carina Between Left Bronchus 3 A And B, Left Bronchus 3a/b (Carina between LB3 A and B, LB3A/B)
CL Item
Carina Between Left Bronchus 4 And Left Bronchus 5, Left Bronchus 4/5 (Carina between LB4 and LB5, LB4/5)
CL Item
Carina Between Left Bronchus 4 A And B, Left Bronchus 4a/b (Carina between LB4 A and B, LB4A/B)
CL Item
Carina Between Left Bronchus 5 A And B, Left Bronchus 5a/b (Carina between LB5 A and B, LB5A/B)
CL Item
Carina Between Left Bronchus 6 A And B, Left Bronchus 6a/b (Carina between LB6 A and B, LB6A/B)
CL Item
Carina Between Left Bronchus 6 A And C, Left Bronchus 6a/c (Carina between LB6 A and C, LB6A/C)
CL Item
Carina Between Left Bronchus 6 B And C, Left Bronchus 6b/c (Carina between LB6 B and C, LB6B/C)
CL Item
Carina Between Left Bronchus 8 And Left Bronchus 9, Left Bronchus 8/9 (Carina between LB8 and LB9, LB8/9)
CL Item
Carina Between Left Bronchus 8 A And B, Left Bronchus 8a/b (Carina between LB8 A and B, LB8A/B)
CL Item
Carina Between Left Bronchus 9 And Left Bronchus 10, Left Bronchus 9/10 (Carina between LB9 and LB10, LB9/10)
CL Item
Carina Between Left Bronchus 9 A And B, Left Bronchus 9a/b (Carina between LB9 A and B, LB9A/B)
CL Item
Carina Between Left Bronchus 10 A And B, Left Bronchus 10a/b (Carina between LB10 A and B, LB10A/B)
CL Item
Carina Between Left Bronchus 10 A And C, Left Bronchus 10a/c (Carina between LB10 A and C, LB10A/C)
CL Item
Carina Between Left Bronchus 10 B And C, Left Bronchus 10b/c (Carina between LB10 B and C, LB10B/C)
CL Item
Other, Specify (OTHER, SPECIFY)
BronchialSpecimenSamplingOtherSite
Item
Other, specify
text
C13717 (NCI Thesaurus ValueDomain)
C1515974 (UMLS 2011AA ValueDomain)
C25222 (NCI Thesaurus ObjectClass)
C0205039 (UMLS 2011AA ObjectClass)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C25662 (NCI Thesaurus Property)
C0441621 (UMLS 2011AA Property)
Item
Histologic Type (WHO - check all that apply)
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12468 (NCI Thesaurus ObjectClass)
C0024109 (UMLS 2011AA ObjectClass)
C25526 (NCI Thesaurus Property)
C0205462 (UMLS 2011AA Property)
C25161 (NCI Thesaurus Property)
C0008902 (UMLS 2011AA Property)
C25372 (NCI Thesaurus ValueDomain)
C0683312 (UMLS 2011AA ValueDomain)
C25526 (NCI Thesaurus ValueDomain)
C0205462 (UMLS 2011AA ValueDomain)
CL.8
Code List
Histologic Type (WHO - check all that apply)
CL Item
Adenocarcinoma (Adenocarcinoma)
C2852 (NCI Thesaurus)
C0001418 (UMLS 2011AA)
CL Item
Squamous Cell Carcinoma (Squamous cell carcinoma)
C2929 (NCI Thesaurus)
C0007137 (UMLS 2011AA)
CL Item
Large Cell Carcinoma (Large cell carcinoma)
C3780 (NCI Thesaurus)
C0206704 (UMLS 2011AA)
CL Item
Small Cell Carcinoma (oat Cell) (Small cell carcinoma (oat cell))
CL Item
Non-small Cell Lung Cancer (nsclc), Nos (Non-small cell lung cancer NOS)
CL Item
Bronchoalveolar (bac) (Bronchoalveolar carcinoma (BAC))
CL Item
Carcinoid (Carcinoid)
CL Item
Combined/mixed, Specify Subcategories (Combined/mixed)
CL Item
Pre-malignant Changes Observed (Pre-malignant changes observed)
CL Item
No Malignancy Observed (No malignancy observed)
CL Item
Other (Other specify)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
TumorHistologicSubcategorySpecify
Item
Specify subcategories
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C25526 (NCI Thesaurus Property)
C0205462 (UMLS 2011AA Property)
C25692 (NCI Thesaurus Property)
C1515010 (UMLS 2011AA Property)
TumorHistologicCategorySpecify
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C25526 (NCI Thesaurus Property)
C0205462 (UMLS 2011AA Property)
C25161 (NCI Thesaurus Property)
C0008902 (UMLS 2011AA Property)
Item
Associated Pre-Malignant Histologic Changes (If Pre-Malignant Changes Observed, - check all that apply)
text
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C25281 (NCI Thesaurus ObjectClass)
C0332281 (UMLS 2011AA ObjectClass)
C25446 (NCI Thesaurus Property)
C0392747 (UMLS 2011AA Property)
C25526 (NCI Thesaurus Property)
C0205462 (UMLS 2011AA Property)
C25624 (NCI Thesaurus Property)
C1514391 (UMLS 2011AA Property)
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
CL.9
Code List
Associated Pre-Malignant Histologic Changes (If Pre-Malignant Changes Observed, - check all that apply)
CL Item
Basal Cell Hyperplasia (Basal cell hyperplasia)
C35845 (NCI Thesaurus)
C0333990 (UMLS 2011AA)
CL Item
Basal Cell Hyperplasia With Angiogenic Squamous Dysplasia Changes (Basal cell hyperplasia with ASD changes)
CL Item
Squamous Metaplasia (Squamous Metaplasia)
C3237 (NCI Thesaurus)
C0025570 (UMLS 2011AA)
CL Item
Squamous Metaplasia With Angiogenic Squamous Dysplasia Changes (Squamous metaplasia with ASD changes)
CL Item
Carcinoma In Situ (Carcinoma in situ)
C2917 (NCI Thesaurus)
C0007099 (UMLS 2011AA)
CL Item
Atypical Adenomatous Hyperplasia (Atypical adenomatous hyperplasia)
CL Item
Mild Dysplasia (Mild dysplasia)
C8362 (NCI Thesaurus)
C0334046 (UMLS 2011AA)
CL Item
Mild Dyplasia With Angiogenic Squamous Dysplasia Changes (Mild dysplasia with ASD changes)
CL Item
Moderate Dysplasia (Moderate dysplasia)
C8363 (NCI Thesaurus)
C0334047 (UMLS 2011AA)
CL Item
Moderate Dysplasia With Angiogenic Squamous Dysplasia Changes (Moderate dysplasia with ASD changes)
CL Item
Severe Dysplasia (Severe dysplasia)
C8364 (NCI Thesaurus)
C0334048 (UMLS 2011AA)
CL Item
Severe Dysplasia With Angiogenic Squamous Dysplasia Changes (Severe dysplasia with ASD changes)
CL Item
Other, Specify (Other, specify)
AssociatedSpecimenPremalignantHistologicChangeSpecify
Item
Other, specify
text
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C25281 (NCI Thesaurus ObjectClass)
C0332281 (UMLS 2011AA ObjectClass)
C25446 (NCI Thesaurus Property)
C0392747 (UMLS 2011AA Property)
C25526 (NCI Thesaurus Property)
C0205462 (UMLS 2011AA Property)
C25624 (NCI Thesaurus Property)
C1514391 (UMLS 2011AA Property)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
Item
Specimen Condition
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C37984 (NCI Thesaurus ObjectClass)
C0022877 (UMLS 2011AA ObjectClass)
C19157 (NCI Thesaurus Property)
C0370003 (UMLS 2011AA Property)
C25457 (NCI Thesaurus Property)
C0348080 (UMLS 2011AA Property)
CL.10
Code List
Specimen Condition
CL Item
Satisfactory (Satisfactory)
CL Item
Suboptimal (Suboptimal)
CL Item
Inadequate (Inadequate)
Item
Inflammatory Change
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C25446 (NCI Thesaurus Property)
C0392747 (UMLS 2011AA Property)
C3137 (NCI Thesaurus Property)
C0021368 (UMLS 2011AA Property)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
CL.11
Code List
Inflammatory Change
CL Item
Specimen Or Sample Is Comprised Of Less Than 10% Inflammatory Cells (<10% inflammatory cells)
CL Item
Specimen Or Sample Is Comprised Of 10% To 75% (inclusive) Inflammatory Cells (10-75% inflammatory cells)
CL Item
Specimen Or Sample Is Comprised Of More Than 75% Inflammatory Cells (>75% inflammatory cells)
PathologyAdditionalDiagnosisText
Item
Additional Diagnoses Specify
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)
C25406 (NCI Thesaurus Property)
C1524062 (UMLS 2011AA Property)
C18189 (NCI Thesaurus ObjectClass)
C0030664 (UMLS 2011AA ObjectClass)
ReviewingPathologistName
Item
Reviewing Pathologist
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C17723 (NCI Thesaurus ObjectClass)
C0334866 (UMLS 2011AA ObjectClass)
C25661 (NCI Thesaurus ObjectClass)
C1704362 (UMLS 2011AA ObjectClass)
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