ID

10102

Description

SOUTHWEST ONCOLOGY GROUP BASELINE TUMOR ASSESSMENT FORM S0227 Comparison of Cisplatin Combined With Either Paclitaxel or Gemcitabine in Treating Patients With Recurrent, Persistent, or Metastatic Cervical Cancer NCT00057928 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A9C374FF-72CD-367D-E034-0003BA12F5E7

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A9C374FF-72CD-367D-E034-0003BA12F5E7

Keywords

Versions (3)
  1. 8/27/12 8/27/12 -
  2. 1/9/15 1/9/15 - Martin Dugas
  3. 3/28/15 3/28/15 - Martin Dugas
Uploaded on

March 28, 2015

DOI

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License

Creative Commons BY-NC 3.0 Legacy
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Cervical Cancer Baseline assessment NCT00057928

English

No Instruction available.

1 forms  
  1. StudyEvent: SOUTHWEST ONCOLOGY GROUP BASELINE TUMOR ASSESSMENT FORM
    1. No Instruction available.
Header
Description

Header

SWOG Patient ID
Description

SWOG Patient ID

Data type

text

Alias
UMLS CUI-1
C2348585
UMLS CUI-2
C1519429
SWOG Study No.
Description

SWOGStudyNo.

Data type

text

Registration Step
Description

RegistrationStep

Data type

text

Patient Initials (L, F M)
Description

Patient Initials

Data type

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C2986440
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25536
Institution / Affiliate
Description

InstitutionName

Data type

text

Physician (Groups Other than SWOG)
Description

Physician (Groups Other than SWOG)

Data type

text

Alias
UMLS CUI-1
C2826892
Group Name
Description

ParticipatingGroupName

Data type

text

Study No.
Description

Particip.GroupProtocolNumber

Data type

float

Pt. ID
Description

Pt. ID (Instructions: Record the requested information for all target lesions and all sites of other disease. Please refer to section 10.0 of the protocol for definitions. Choose all measurable lesions up to a maximum of 5 lesions per organ and 10 lesions in total to follow as target lesions. Record any remaining measurable lesions and all non-measurable lesions as non-terget lesions.)

Data type

text

Alias
UMLS CUI-1
C2348585
Comments
Description

Comments

Data type

text

Target Lesions
Description

Target Lesions

Alias
UMLS CUI-1
C2986546
Lesion number
Description

Lesion, Reference Number

Data type

integer

Alias
UMLS CUI-1
C0449791
Lesion site
Description

Lesion,AnatomicSite

Data type

text

Alias
UMLS CUI-1
C0449695
Longest Diameter
Description

Longest Diameter (cm)

Data type

float

Measurement units
  • cm
Alias
NCI Thesaurus ValueDomain
C25209
UMLS CUI-1
C0475440
cm
Assessment Type
Description

Assessment Type

Data type

text

Alias
UMLS CUI-1
C2911685
Assessment Date
Description

Assessment Date

Data type

date

Alias
UMLS CUI-1
C2985720
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No Instruction available.

1 forms
  1. StudyEvent: SOUTHWEST ONCOLOGY GROUP BASELINE TUMOR ASSESSMENT FORM
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Header
SWOGPatientID
Item
SWOG Patient ID
text
C2348585 (UMLS CUI-1)
C1519429 (UMLS CUI-2)
SWOGStudyNo.
Item
SWOG Study No.
text
RegistrationStep
Item
Registration Step
text
Patient Initials
Item
Patient Initials (L, F M)
text
C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
InstitutionName
Item
Institution / Affiliate
text
RegisteredInvestigator
Item
Physician (Groups Other than SWOG)
text
C2826892 (UMLS CUI-1)
ParticipatingGroupName
Item
Group Name
text
Particip.GroupProtocolNumber
Item
Study No.
float
PatientStudyID
Item
Pt. ID
text
C2348585 (UMLS CUI-1)
Comments
Item
Comments
text
Item Group
Target Lesions
C2986546 (UMLS CUI-1)
Lesion, Reference Number
Item
Lesion number
integer
C0449791 (UMLS CUI-1)
Lesion,AnatomicSite
Item
Lesion site
text
C0449695 (UMLS CUI-1)
Lesion, Tumor Diameter
Item
Longest Diameter
float
C25209 (NCI Thesaurus ValueDomain)
C0475440 (UMLS CUI-1)
Item
Assessment Type
text
C2911685 (UMLS CUI-1)
CL.2
Code List
Assessment Type
CL Item
Clinical Examination (Palpation)
C1456356 (UMLS CUI-1)
CL Item
Visualization (Visualization)
C15266 (NCI Thesaurus)
C0178707 (UMLS CUI-1)
CL Item
Colposcopy (Colposcopy)
C16969 (NCI Thesaurus)
C0009417 (UMLS CUI-1)
CL Item
Endoscopy (Endoscopy)
C16969 (NCI Thesaurus)
C0014245 (UMLS CUI-1)
CL Item
Plain film/X-ray without contrast (Plain film/X-ray without contrast)
C1306645 (UMLS CUI-1)
CL Item
Plain film/X-ray with contrast (Plain film/X-ray with contrast)
C3267101 (UMLS CUI-1)
CL Item
CT Scan (CT scan)
C0040405 (UMLS CUI-1)
CL Item
MRI (MRI scan)
C0024485 (UMLS CUI-1)
CL Item
Radioisotope scan (Radioisotope scan)
C0034606 (UMLS CUI-1)
CL Item
Ultrasound (Ultrasound)
C64384 (NCI Thesaurus)
C1456803 (UMLS CUI-1)
CL Item
PET scan (PET scan)
C0032743 (UMLS CUI-1)
CL Item
Spiral CT Scan (Spiral CT scan)
C0860888 (UMLS CUI-1)
CL Item
Histology (Histologic confirmation)
C16681 (NCI Thesaurus)
C0019638 (UMLS CUI-1)
CL Item
Cytology (Cytologic confirmation)
C16491 (NCI Thesaurus)
C0010819 (UMLS CUI-1)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS CUI-1)
AssessmentDate
Item
Assessment Date
date
C2985720 (UMLS CUI-1)
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