Protocol Number ECOG
Item
ECOG Protocol Number
text
C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1512162 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25491 (NCI Thesaurus Property-2)
Patient ID ECOG
Item
ECOG Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1512162 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25491 (NCI Thesaurus Property-2)
Generic drug form
Item
DCI Name
text
C25191 (NCI Thesaurus ValueDomain)
C3242750 (UMLS CUI-1)
C19464 (NCI Thesaurus Property)
C25474 (NCI Thesaurus ObjectClass)
C25452 (NCI Thesaurus ObjectClass-2)
Registration Number
Item
Registration Step
text
C25337 (NCI Thesaurus ValueDomain)
C1514821 (UMLS CUI-1)
C25646 (NCI Thesaurus ObjectClass)
C0237753 (UMLS CUI-2)
C16154 (NCI Thesaurus Property)
C16154 (NCI Thesaurus ValueDomain-2)
Patient Initials
Item
Patient Initials (Last, First)
text
C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
Study Number Participating Group
Item
Participating Group Protocol Number
text
C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
Institution Name
Item
Institution/Affiliate
text
C25454 (NCI Thesaurus ObjectClass)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C25191 (NCI Thesaurus ValueDomain)
C21541 (NCI Thesaurus ValueDomain-2)
Trial subject ID Participating Group
Item
Participating Group Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
Data amended
Item
Please mark an 'X' if data have been amended (Please circle amended data in red.)
text
C25704 (NCI Thesaurus ValueDomain)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
Data amended date
Item
Date data amended (M D Y)
date
C25164 (NCI Thesaurus ValueDomain)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C0011008 (UMLS CUI-2)
C25416 (NCI Thesaurus Property)
C25367 (NCI Thesaurus ValueDomain-2)
Investigator Signature
Item
Investigator Signature
text
C25704 (NCI Thesaurus ValueDomain)
C2346576 (UMLS CUI-1)
C25678 (NCI Thesaurus Property)
C17089 (NCI Thesaurus ObjectClass)
Investigator Signature Date
Item
Investigator Signature Date
date
C25164 (NCI Thesaurus ValueDomain)
C2346576 (UMLS CUI-1)
C25678 (NCI Thesaurus Property)
C0011008 (UMLS CUI-2)
C25367 (NCI Thesaurus ValueDomain-2)
C17089 (NCI Thesaurus ObjectClass)
Item
Reporting Period (since registration Both Arms)
text
C25284 (NCI Thesaurus ValueDomain)
C2347804 (UMLS CUI-1)
C25214 (NCI Thesaurus ObjectClass)
C25616 (NCI Thesaurus Property)
C25651 (NCI Thesaurus ObjectClass-2)
Code List
Reporting Period (since registration Both Arms)
CL Item
3 Months Post Registration (3 Months Post Registration)
CL Item
6 Months Post Registration (6 Months Post Registration)
CL Item
9 Months Post Registration (9 Months Post Registration)
CL Item
12 Months Post Registration (12 Months Post Registration)
Collection Date
Item
Date data obtained
date
C25164 (NCI Thesaurus ValueDomain)
C25474 (NCI Thesaurus ObjectClass)
C52349 (NCI Thesaurus Property)
C1317250 (UMLS CUI-1)
Item
Does the patient currently smoke cigarettes
text
C25180 (NCI Thesaurus ValueDomain)
C25471 (NCI Thesaurus Property)
C17934 (NCI Thesaurus ObjectClass)
C0449865 (NCI Metathesaurus Property)
C3241966 (UMLS CUI-1)
Code List
Does the patient currently smoke cigarettes
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS CUI-1)
CL Item
Patient Refused To Answer (Patient Refused to Answer)
C1705116 (UMLS CUI-1)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS CUI-1)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS CUI-1)
Item
Which of the following applies to the patient's smoking habit after diagnosis of his/her lung cancer
text
C38008 (NCI Thesaurus Property)
C15220 (NCI Thesaurus Property-2)
C17934 (NCI Thesaurus ObjectClass)
C25688 (NCI Thesaurus ValueDomain)
C0687676 (UMLS CUI-1)
C0011900 (UMLS CUI-2)
C0453996 (UMLS CUI-3)
Code List
Which of the following applies to the patient's smoking habit after diagnosis of his/her lung cancer
CL Item
No Change In Smoking Habits. Patient Smokes The Same Amount Now In Comparison To Before Diagnosis (No change in smoking habits. Patient smokes the same amount now in comparison to before diagnosis)
CL Item
No Change In Smoking Habits. Patient Still Does Not Smoke (No change in smoking habits. Patient still does not smoke)
CL Item
Patient Smokes Fewer Cigarettes Now (Patient smokes fewer cigarettes now)
CL Item
Patient Smokes More Cigarettes Now (Patient smokes more cigarettes now)
CL Item
Patient Stopped Smoking (Patient stopped smoking)
Smoking cessation date
Item
Date Patient Stopped Smoking (If patient stopped smoking:)
date
C25164 (NCI Thesaurus ValueDomain)
C25484 (NCI Thesaurus Property)
C17934 (NCI Thesaurus ObjectClass)
C3650858 (UMLS CUI-1)
Item
On average how many cigarettes per day does the patient smoke
text
C17934 (NCI Thesaurus ObjectClass)
C1608325 (UMLS CUI-1)
C25471 (NCI Thesaurus Property)
C0449865 (NCI Metathesaurus Property)
C25473 (NCI Thesaurus ValueDomain)
C25515 (NCI Thesaurus ValueDomain-2)
Code List
On average how many cigarettes per day does the patient smoke
CL Item
No Cigarettes (No cigarettes)
CL Item
Fewer Than 10 Cigarettes (Fewer than 10 cigarettes)
CL Item
10 To 20 Cigarettes (10 to 20 cigarettes)
CL Item
More Than 20 Cigarettes (more than 20 cigarettes)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
NicAlert Test Performed
Item
NicAlert Test Performed
boolean
C38147 (NCI Thesaurus ValueDomain)
C20200 (NCI Thesaurus Property)
C25294 (NCI Thesaurus ObjectClass)
C70941 (NCI Thesaurus Property-2)
C0010194 (UMLS CUI-1)
Item
Cotinine Concentration Level
text
C20200 (NCI Thesaurus Property)
C25294 (NCI Thesaurus ObjectClass)
C25688 (NCI Thesaurus ValueDomain)
C70941 (NCI Thesaurus Property-2)
C0010194 (UMLS CUI-1)
Code List
Cotinine Concentration Level
CL Item
Level 0 (Level 0)
CL Item
Level 1 (Level 1)
CL Item
Level 2 (Level 2)
CL Item
Level 3 (Level 3)
CL Item
Level 4 (Level 4)
CL Item
Level 5 (Level 5)
CL Item
Level 6 (Level 6)
Date of Nic Alert Test
Item
Date of Nic Alert Test
date
C25164 (NCI Thesaurus ValueDomain)
C20200 (NCI Thesaurus Property)
C25294 (NCI Thesaurus ObjectClass)
C70941 (NCI Thesaurus Property-2)
C0010194 (UMLS CUI-1)
C0011008 (UMLS CUI-2)