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Información:
Error:
ID
10360
Descripción
STAGE I - III LUNG CANCER PRESTUDY FORM (With SI Units for use by NCIC institutions only) S0023: Combination Chemo Plus RT With or Without Gefitinib in Treating Patients With Unresectable Stage III NSCLC Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=9CA62D43-4AA8-361C-E034-080020C9C0E0
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Versiones (5)
- 19/9/12 19/9/12 -
- 28/5/15 28/5/15 -
- 3/6/15 3/6/15 -
- 31/7/15 31/7/15 - Martin Dugas
- 20/9/21 20/9/21 -
Subido en
28 de mayo de 2015
DOI
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Licencia
Creative Commons BY-NC 3.0 Legacy
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STAGE I - III BREAST CANCER PRESTUDY FORM (With SI Units for use by NCIC institutions only)
No Instruction available.
- StudyEvent: STAGE I - III BREAST CANCER PRESTUDY FORM (With SI Units for use by NCIC institutions only)
Similar models
No Instruction available.
- StudyEvent: STAGE I - III BREAST CANCER PRESTUDY FORM (With SI Units for use by NCIC institutions only)
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
SWOGPatientID
Item
SWOG Patient ID
text
SWOGStudyNo.
Item
SWOG Study No.
text
RegistrationStep
Item
Registration Step
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C16154 (NCI Thesaurus ValueDomain)
C1704379 (UMLS 2011AA ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C16154 (NCI Thesaurus ValueDomain)
C1704379 (UMLS 2011AA ValueDomain)
PatientInitials
Item
Patient Initials (L, F M)
text
Institution/Affiliate
Item
Institution / Affiliate
text
Physician
Item
Physician
text
GroupName
Item
Group Name (Groups other than SWOG )
text
StudyNo.
Item
Study No. (Groups other than SWOG )
double
Pt.ID
Item
Pt. ID (Groups other than SWOG )
text
Height
Item
Height (cm)
text
Weight
Item
Weight (kg)
text
BSA
Item
BSA (m 2)
text
PerformanceStatus
Item
Performance Status
text
Item
Weight Loss in Previous Six Months
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C3445 (NCI Thesaurus Property)
C0043096 (UMLS 2011AA Property)
C0030705 (UMLS 2011AA ObjectClass)
C3445 (NCI Thesaurus Property)
C0043096 (UMLS 2011AA Property)
CL Item
<5% (<5%)
CL Item
5 - < 10% (5 - < 10%)
CL Item
10 - < 20% (10 - < 20%)
CL Item
>=20% (>=20%)
FEV1
Item
FEV1 (L)
text
DLCO
Item
DLCO (%)
text
FirstPositiveBiopsyDate
Item
Date of Initial Diagnosis of Primary Tumor
date
CL Item
Squamous (Squamous)
CL Item
Adenocarcinoma (Adenocarcinoma)
CL Item
Large Cell Undifferentiated (Large Cell Undifferentiated)
CL Item
Bronchioloalveolar (BAC) (Bronchioloalveolar (BAC))
CL Item
NSCLC, NOS (NSCLC, NOS)
CL Item
Other, Specify (Other, Specify)
Other,Specify
Item
Other, Specify
text
CL Item
T1 (T1)
CL Item
T2 (T2)
CL Item
T3 (T3)
CL Item
T4 (T4)
CL Item
N0 (N0)
CL Item
N1 (N1)
CL Item
N2 (N2)
CL Item
N3 (N3)
Albumin
Item
Albumin (g%)
text
LDH
Item
LDH (U/I)
text
LDHULN
Item
LDH ULN
text
Notes
Item
Notes
text