ID

10431

Description

UNANTICIPATED LAB DATA Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A5EB171F-7888-2E5C-E034-0003BA0B1A09

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A5EB171F-7888-2E5C-E034-0003BA0B1A09

Keywords

Versions (2)
  1. 9/19/12 9/19/12 -
  2. 6/1/15 6/1/15 -
Uploaded on

June 1, 2015

DOI

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License

Creative Commons BY-NC 3.0 Legacy
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UNANTICIPATED LAB DATA

English

NCI/DCTD/CTMS CASE REPORT FORM

1 forms  
  1. StudyEvent: UNANTICIPATED LAB DATA
    1. NCI/DCTD/CTMS CASE REPORT FORM
UNANTICIPATED LAB DATA
Description

UNANTICIPATED LAB DATA

Date Completed (dy/mth/yr)
Description

CompletionDate

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
Protocol #
Description

Protocol#

Data type

text

Alias
NCI Thesaurus Property
C25337
UMLS 2011AA Property
C0237753
NCI Thesaurus ObjectClass
C25320
UMLS 2011AA ObjectClass
C1507394
Institution
Description

NationalCancerInstituteInstituteCode

Data type

text

Alias
NCI Thesaurus ValueDomain
C25162
UMLS 2011AA ValueDomain
C0805701
NCI Thesaurus ObjectClass
C21541
UMLS 2011AA ObjectClass
C0018704
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Sheet #
Description

PageNumber

Data type

double

Alias
NCI Thesaurus Property
C25337
UMLS 2011AA Property
C0237753
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Metathesaurus ObjectClass
C0439643
Patient ID
Description

PatientIdentifier

Data type

text

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus ValueDomain
C25364
UMLS 2011AA ValueDomain
C0600091
Date (dy/mth/yr)
Description

LabDate

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
Time (hr:min)
Description

LabCollectionTime

Data type

time

Alias
NCI Thesaurus Property
C25453
UMLS 2011AA Property
C1516698
NCI Thesaurus Property
C25207
UMLS 2011AA Property
C0040223
NCI Thesaurus ValueDomain
C25207
UMLS 2011AA ValueDomain
C0040223
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
Lab Test
Description

LabTest

Data type

text

Body Site
Description

BodySiteName

Data type

text

Alias
NCI Thesaurus ObjectClass
C13717
UMLS 2011AA ObjectClass
C1515974
NCI Thesaurus Property
C25367
Normal/Abnormal
Description

Normal/Abnormal

Data type

text

Result Type
Description

ResultType

Data type

text

Result
Description

Result

Data type

text

Alias
NCI Thesaurus ObjectClass
C25218
UMLS 2011AA ObjectClass
C1948041
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
Ccrr Module For Unanticipated Lab Data
Description

Ccrr Module For Unanticipated Lab Data

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Similar models

NCI/DCTD/CTMS CASE REPORT FORM

1 forms
  1. StudyEvent: UNANTICIPATED LAB DATA
    1. NCI/DCTD/CTMS CASE REPORT FORM
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
UNANTICIPATED LAB DATA
CompletionDate
Item
Date Completed (dy/mth/yr)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
Protocol#
Item
Protocol #
text
C25337 (NCI Thesaurus Property)
C0237753 (UMLS 2011AA Property)
C25320 (NCI Thesaurus ObjectClass)
C1507394 (UMLS 2011AA ObjectClass)
NationalCancerInstituteInstituteCode
Item
Institution
text
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
C21541 (NCI Thesaurus ObjectClass)
C0018704 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
PageNumber
Item
Sheet #
double
C25337 (NCI Thesaurus Property)
C0237753 (UMLS 2011AA Property)
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C0439643 (NCI Metathesaurus ObjectClass)
PatientIdentifier
Item
Patient ID
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C25364 (NCI Thesaurus ValueDomain)
C0600091 (UMLS 2011AA ValueDomain)
LabDate
Item
Date (dy/mth/yr)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
LabCollectionTime
Item
Time (hr:min)
time
C25453 (NCI Thesaurus Property)
C1516698 (UMLS 2011AA Property)
C25207 (NCI Thesaurus Property)
C0040223 (UMLS 2011AA Property)
C25207 (NCI Thesaurus ValueDomain)
C0040223 (UMLS 2011AA ValueDomain)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
LabTest
Item
Lab Test
text
BodySiteName
Item
Body Site
text
C13717 (NCI Thesaurus ObjectClass)
C1515974 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
Item
Normal/Abnormal
text
CL.1
Code List
Normal/Abnormal
CL Item
Normal (N)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
CL Item
Abnormal (A)
C25401 (NCI Thesaurus)
C0205161 (UMLS 2011AA)
Item
Result Type
text
CL.2
Code List
Result Type
CL Item
Numeric (N)
CL Item
Literal (L)
C0679210 (NCI Metathesaurus)
Result
Item
Result
text
C25218 (NCI Thesaurus ObjectClass)
C1948041 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
Item Group
Ccrr Module For Unanticipated Lab Data
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