ID

10360

Beschrijving

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

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=9CA62D43-4AA8-361C-E034-080020C9C0E0

Trefwoorden

  1. 19-09-12 19-09-12 -
  2. 28-05-15 28-05-15 -
  3. 03-06-15 03-06-15 -
  4. 31-07-15 31-07-15 - Martin Dugas
  5. 20-09-21 20-09-21 -
Geüploaded op

28 mei 2015

DOI

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Licentie

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.

  1. StudyEvent: STAGE I - III BREAST CANCER PRESTUDY FORM (With SI Units for use by NCIC institutions only)
    1. No Instruction available.
SWOG clinical trial administrative data
Beschrijving

SWOG clinical trial administrative data

SWOG Patient ID
Beschrijving

SWOGPatientID

Datatype

text

SWOG Study No.
Beschrijving

SWOGStudyNo.

Datatype

text

Registration Step
Beschrijving

RegistrationStep

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ValueDomain
C16154
UMLS 2011AA ValueDomain
C1704379
Patient Initials (L, F M)
Beschrijving

PatientInitials

Datatype

text

Institution / Affiliate
Beschrijving

Institution/Affiliate

Datatype

text

Physician
Beschrijving

Physician

Datatype

text

Group Name (Groups other than SWOG )
Beschrijving

GroupName

Datatype

text

Study No. (Groups other than SWOG )
Beschrijving

StudyNo.

Datatype

double

Pt. ID (Groups other than SWOG )
Beschrijving

Pt.ID

Datatype

text

Patient And Disease Description
Beschrijving

Patient And Disease Description

Height (cm)
Beschrijving

Height

Datatype

text

Weight (kg)
Beschrijving

Weight

Datatype

text

BSA (m 2)
Beschrijving

BSA

Datatype

text

Performance Status
Beschrijving

PerformanceStatus

Datatype

text

Weight Loss in Previous Six Months
Beschrijving

WeightLossPriorSixMonths

Datatype

text

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C3445
UMLS 2011AA Property
C0043096
FEV1 (L)
Beschrijving

FEV1

Datatype

text

DLCO (%)
Beschrijving

DLCO

Datatype

text

Date of Initial Diagnosis of Primary Tumor
Beschrijving

FirstPositiveBiopsyDate

Datatype

date

Histologic Type
Beschrijving

HistologicType

Datatype

text

Other, Specify
Beschrijving

Other,Specify

Datatype

text

Tumor Stage T-status (select one)
Beschrijving

TumorStageT-status

Datatype

text

Node Stage N-status (select one)
Beschrijving

NodeStageN-status

Datatype

text

Current Laboratory Values (si Units)
Beschrijving

Current Laboratory Values (si Units)

Albumin (g%)
Beschrijving

Albumin

Datatype

text

LDH (U/I)
Beschrijving

LDH

Datatype

text

LDH ULN
Beschrijving

LDHULN

Datatype

text

Notes
Beschrijving

Notes

Notes
Beschrijving

Notes

Datatype

text

Similar models

No Instruction available.

  1. StudyEvent: STAGE I - III BREAST CANCER PRESTUDY FORM (With SI Units for use by NCIC institutions only)
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
SWOG clinical trial administrative data
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)
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
Item Group
Patient And Disease Description
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)
Code List
Weight Loss in Previous Six Months
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
Item
Histologic Type
text
Code List
Histologic Type
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
Item
Tumor Stage T-status (select one)
text
Code List
Tumor Stage T-status (select one)
CL Item
T1 (T1)
CL Item
T2 (T2)
CL Item
T3 (T3)
CL Item
T4 (T4)
Item
Node Stage N-status (select one)
text
Code List
Node Stage N-status (select one)
CL Item
N0 (N0)
CL Item
N1 (N1)
CL Item
N2 (N2)
CL Item
N3 (N3)
Item Group
Current Laboratory Values (si Units)
Albumin
Item
Albumin (g%)
text
LDH
Item
LDH (U/I)
text
LDHULN
Item
LDH ULN
text
Item Group
Notes
Notes
Item
Notes
text

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