ID
10074
Beskrivning
I1 Radiation Therapy Oncology Group Phase III Randomized Study of Adjuvant Therapy for High Risk pT3NO Prostate Cancer Initial Evaluation Form Adjuvant Radiation Therapy Plus Hormone Therapy Compared With Radiation Therapy Alone in Treating Patients With Stage II or Stage III Prostate Cancer NCT00023829 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A4E26ACF-75E7-25EA-E034-080020C9C0E0
Länk
Nyckelord
Versioner (2)
- 2012-09-19 2012-09-19 -
- 2015-03-23 2015-03-23 - Martin Dugas
Uppladdad den
23 mars 2015
DOI
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Licens
Creative Commons BY-NC 3.0 Legacy
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Prostate Cancer NCT00023829
INSTRUCTIONS: Submit this form at patient's entry on study. Use -1 for unknown or not applicable unless otherwise specified in the codetable. All dates to be reported mm-dd-yyyy unless otherwise indicated.
- StudyEvent: I1 Radiation Therapy Oncology Group Phase III Randomized Study of Adjuvant Therapy for High Risk pT3NO Prostate Cancer Initial Evaluation Form
Beskrivning
Patient data
Beskrivning
PatientBirthDate
Datatyp
date
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25275
- UMLS 2011AA Property
- C2745955
Beskrivning
PERFORMANCESTATUS
Datatyp
text
Beskrivning
HASPATIENTHADANOTHERMALIGNANCY
Datatyp
boolean
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Beskrivning
SpecifySite(malignancyotherthanstudysite)
Datatyp
text
Beskrivning
DATEERADICATED
Datatyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus Property
- C20985
- UMLS 2011AA Property
- C0547070
Beskrivning
FirstPositiveBiopsyDate
Datatyp
date
Beskrivning
HistologicType
Datatyp
text
Beskrivning
Other,specify(histologictype)
Datatyp
text
Beskrivning
GleasonScore,PrimaryPattern
Datatyp
float
Beskrivning
GleasonScore,SecondaryPattern
Datatyp
float
Beskrivning
GleasonScore,WorstPattern
Datatyp
float
Beskrivning
GleasonScore,Combined
Datatyp
float
Beskrivning
ALKALINEPHOSPHATASE
Datatyp
text
Beskrivning
AlkPhosValue
Datatyp
float
Beskrivning
SPECIFY(unitofmeasure)
Datatyp
text
Beskrivning
Labnormalrange(alkalinephosphatase)
Datatyp
text
Beskrivning
ALT(SGPT)
Datatyp
text
Beskrivning
ALTValue
Datatyp
float
Beskrivning
LaboratoryProcedureSerumGlutamicPyruvicTransaminaseResultNormalRangeText
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C25294
- NCI Thesaurus Property
- C20200
- NCI Thesaurus Property-2
- C25293
- NCI Thesaurus ValueDomain
- C25704
- NCI Thesaurus ValueDomain-2
- C14165
- NCI Thesaurus ValueDomain-3
- C38013
- UMLS CUI-1
- C0376147
- UMLS CUI-2
- C0086715
Beskrivning
TOTALBILIRUBIN
Datatyp
text
Beskrivning
Total Bilirubin Value
Datatyp
float
Alias
- NCI Thesaurus ValueDomain
- C25209
- UMLS CUI-1
- C1278039
Beskrivning
Labnormalrange(totalbilirubin)
Datatyp
text
Beskrivning
BaselinePSADate
Datatyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
Beskrivning
Baseline PSA Value
Datatyp
float
Alias
- UMLS CUI-1
- C0138741
Beskrivning
TIMEPOINT
Datatyp
text
Beskrivning
URINARYINCONTINENCE,SeverityGrade
Datatyp
text
Beskrivning
URINARYINCONTINENCE,Attribution
Datatyp
text
Beskrivning
Other(attribution,urinaryincontinence)
Datatyp
text
Beskrivning
URINARYFREQUENCY/URGENCY,SeverityGrade
Datatyp
text
Beskrivning
URINARYFREQUENCY/URGENCY,Attribution
Datatyp
text
Beskrivning
Other(attribution,urinaryfrequency/urgency)
Datatyp
text
Beskrivning
ERECTILEIMPOTENCE,SeverityGrade
Datatyp
text
Beskrivning
ERECTILEIMPOTENCE,Attribution
Datatyp
text
Beskrivning
Other(erectileimpotence)
Datatyp
text
Beskrivning
TStage,Pathologic
Datatyp
text
Beskrivning
NStage,Pathologic
Datatyp
text
Beskrivning
NStage,Clinical
Datatyp
text
Beskrivning
ROACHRISKCALCULATION
Datatyp
text
Beskrivning
MStage,Clinical
Datatyp
text
Beskrivning
Prostate: Prior Treatment
Alias
- UMLS CUI-1
- C1514463
Beskrivning
PriorProstatectomyInd
Datatyp
boolean
Beskrivning
PriorProstatectomyDate
Datatyp
date
Beskrivning
POSITIVESURGICALMARGINS
Datatyp
boolean
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Beskrivning
SEMINALVESICLEINVASION
Datatyp
boolean
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Beskrivning
PRIORRADIATIONTHERAPY
Datatyp
boolean
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Beskrivning
Specify(priorradiationtherapy)
Datatyp
text
Beskrivning
PRIOR CHEMOTHERAPY (for any reason)
Datatyp
boolean
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS CUI-1
- C1514457
Beskrivning
PriorChemotherapyEndDate
Datatyp
date
Beskrivning
PRIORHORMONALTHERAPY
Datatyp
boolean
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Beskrivning
PRIORHORMONALTHERAPYTYPEFINASTERIDE
Datatyp
boolean
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Beskrivning
PriorHormonalTherapyEndDate
Datatyp
date
Beskrivning
PRIORHORMONALTHERAPYTYPETESTOSTERONE
Datatyp
boolean
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Beskrivning
PRIOROTHERHORMONALTHERAPY
Datatyp
boolean
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Beskrivning
Specify(priorotherhormonaltherapy)
Datatyp
text
Beskrivning
PriorOtherHormonalTherapyBeginDate
Datatyp
date
Beskrivning
ORCHIECTOMY
Datatyp
boolean
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS CUI-1
- C0029189
Beskrivning
Orchiectomy date
Datatyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- NCI Thesaurus ObjectClass
- C15288
- NCI Thesaurus Property
- C25275
- UMLS CUI-1
- C0029189
- UMLS CUI-2
- C0011008
Beskrivning
PRIORORCURRENTCOMPLEMENTARYALTERNATIVEMEDICINE(CAM)THERAPY
Datatyp
boolean
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS CUI-1
- C0002346
Beskrivning
Specify(priororcurrentcomplementaryalternativemedicinetherapy)
Datatyp
text
Beskrivning
DatepriororcurrentCAMtherapystarted
Datatyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
Beskrivning
PriorCAMtherapyenddate
Datatyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
Similar models
INSTRUCTIONS: Submit this form at patient's entry on study. Use -1 for unknown or not applicable unless otherwise specified in the codetable. All dates to be reported mm-dd-yyyy unless otherwise indicated.
- StudyEvent: I1 Radiation Therapy Oncology Group Phase III Randomized Study of Adjuvant Therapy for High Risk pT3NO Prostate Cancer Initial Evaluation Form
C0237753 (UMLS 2011AA ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C0030705 (UMLS 2011AA ObjectClass)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
C0205448 (UMLS 2011AA)
C1522602 (UMLS 2011AA ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C20985 (NCI Thesaurus Property)
C0547070 (UMLS 2011AA Property)
C0205307 (UMLS 2011AA)
C0205307 (UMLS 2011AA)
C20200 (NCI Thesaurus Property)
C25293 (NCI Thesaurus Property-2)
C25704 (NCI Thesaurus ValueDomain)
C14165 (NCI Thesaurus ValueDomain-2)
C38013 (NCI Thesaurus ValueDomain-3)
C0376147 (UMLS CUI-1)
C0086715 (UMLS CUI-2)
C0205307 (UMLS 2011AA)
C1278039 (UMLS CUI-1)
C0011008 (UMLS 2011AA ValueDomain)
C0205448 (UMLS 2011AA)
C1272460 (UMLS 2011AA)
C0205394 (UMLS 2011AA)
C0205448 (UMLS 2011AA)
C1272460 (UMLS 2011AA)
C0205394 (UMLS 2011AA)
C0205448 (UMLS 2011AA)
C1272460 (UMLS 2011AA)
C0205394 (UMLS 2011AA)
C1269798 (UMLS 2011AA)
C1522602 (UMLS 2011AA ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C1514457 (UMLS CUI-1)
C1522602 (UMLS 2011AA ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C0029189 (UMLS CUI-1)
C15288 (NCI Thesaurus ObjectClass)
C25275 (NCI Thesaurus Property)
C0029189 (UMLS CUI-1)
C0011008 (UMLS CUI-2)
C0002346 (UMLS CUI-1)
C0011008 (UMLS 2011AA ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
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