ID
10492
Beskrivning
Radiation Therapy Oncology Group Demographic Data Form - Version 2 NCT00048997 Radiation Therapy in Preventing CNS Metastases in Patients With Non-Small Cell Lung Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=9EC372A6-6D13-05D5-E034-080020C9C0E0
Länk
Nyckelord
Versioner (4)
- 2012-09-19 2012-09-19 -
- 2014-08-11 2014-08-11 - Martin Dugas
- 2015-06-02 2015-06-02 -
- 2015-06-03 2015-06-03 -
Uppladdad den
3 juni 2015
DOI
För en begäran logga in.
Licens
Creative Commons BY-NC 3.0 Legacy
Modellkommentarer :
Här kan du kommentera modellen. Med hjälp av pratbubblor i Item-grupperna och Item kan du lägga in specifika kommentarer.
Itemgroup-kommentar för :
Item-kommentar för :
Du måste vara inloggad för att kunna ladda ner formulär. Var vänlig logga in eller registrera dig utan kostnad.
Radiation Therapy Oncology Group Demographic Data Form - Version 2 NCT00048997
No Instruction available.
- StudyEvent: Radiation Therapy Oncology Group Demographic Data Form - Version 2
Beskrivning
Patient administration
Beskrivning
Patient demographics
Beskrivning
Whocompletedthisform?
Datatyp
text
Beskrivning
PatientRace/Ethnicity
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C17049
- UMLS 2011AA Property
- C0034510
Beskrivning
RaceOther,specify
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
Beskrivning
AdditionalRace/Ethnicity
Datatyp
text
Beskrivning
Highestschoolgradecompleted
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus Property
- C16529
- UMLS 2011AA Property
- C0013622
- NCI Thesaurus Property-2
- C25525
- UMLS 2011AA Property-2
- C1522410
Beskrivning
HighestschoolgradecompletedOther,specify
Datatyp
text
Beskrivning
PersonPediatricReligionName
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus Property
- C39299
- UMLS 2011AA Property
- C0231335
- NCI Thesaurus ValueDomain
- C42614
- UMLS 2011AA ValueDomain
- C0027365
- NCI Thesaurus Property-2
- C17085
- UMLS 2011AA Property-2
- C0035039
Beskrivning
ReligionduringchildhoodOther,specify
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
Beskrivning
Maritalstatus
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
Beskrivning
Wherewereyouborn?
Datatyp
text
Beskrivning
USA,specifythe2letterStatecode,egNY
Datatyp
text
Beskrivning
PatientAddress,Country
Datatyp
text
Beskrivning
Wheredidyoulivethelongest
Datatyp
text
Beskrivning
USA,specifythe2letterStatecode,egNY
Datatyp
text
Beskrivning
Wheredidyoulivethelongest,othercountry,specify
Datatyp
text
Beskrivning
Smoking history
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS CUI-1
- C1519384
- NCI Thesaurus Property
- C20989
- NCI Thesaurus ObjectClass
- C29719
Beskrivning
PatientInitialCigaretteSmokingAgeYearCount
Datatyp
float
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25536
- UMLS 2011AA Property
- C1555582
- NCI Thesaurus Property-2
- C18270
- UMLS 2011AA Property-2
- C0700219
- NCI Thesaurus ValueDomain
- C29848
- UMLS 2011AA ValueDomain
- C0439234
- NCI Thesaurus ValueDomain-2
- C25463
- UMLS 2011AA ValueDomain-2
- C0750480
Beskrivning
Numberofyearssmokedcigarettes
Datatyp
text
Beskrivning
Averagenumberofcigarettessmokedperday
Datatyp
float
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS 2011AA ValueDomain
- C0237753
Beskrivning
PatientSmokingCessationAgeYear
Datatyp
float
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus ValueDomain
- C29848
- UMLS 2011AA ValueDomain
- C0439234
- NCI Thesaurus ValueDomain-2
- C25463
- UMLS 2011AA ValueDomain-2
- C0750480
- NCI Metathesaurus Property
- C0085134
Beskrivning
Ifyouhavehadanyoftheillnesslistedbelow,pleasecheckyesforthosethatapply.
Datatyp
text
Beskrivning
Illness,specifyother
Datatyp
text
Beskrivning
Howmanyofthefollowingfamilymembers(livinganddead)doyouhave?
Datatyp
text
Beskrivning
Brothers
Datatyp
text
Beskrivning
Sisters
Datatyp
text
Beskrivning
Sons
Datatyp
text
Beskrivning
Daughters
Datatyp
text
Beskrivning
Areyouadopted?
Datatyp
boolean
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25290
- UMLS 2011AA Property
- C0425382
Beskrivning
Bloodrelativewithcancer
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
Beskrivning
PersonFirstCancerDiagnosisAgeYearCount
Datatyp
float
Alias
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus Property
- C9305
- UMLS 2011AA Property
- C0006826
- NCI Thesaurus Property-2
- C25509
- UMLS 2011AA Property-2
- C1279901
- NCI Thesaurus Property-3
- C15220
- UMLS 2011AA Property-3
- C0011900
- NCI Thesaurus Property-4
- C25150
- UMLS 2011AA Property-4
- C0001779
- NCI Thesaurus ValueDomain
- C29848
- UMLS 2011AA ValueDomain
- C0439234
- NCI Thesaurus ValueDomain-2
- C25463
- UMLS 2011AA ValueDomain-2
- C0750480
Beskrivning
TypeofCancer
Datatyp
text
Beskrivning
CancerPreventionTrialKnowledgeDocumentedInd-2
Datatyp
boolean
Alias
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
- NCI Thesaurus ObjectClass
- C15790
- UMLS 2011AA ObjectClass
- C1516220
- NCI Thesaurus Property
- C25356
- UMLS 2011AA Property
- C1301725
- NCI Metathesaurus Property
- C0376554
Beskrivning
CancerPreventionTrialParticipationScale
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus Property
- C25608
- UMLS 2011AA Property
- C0679823
- NCI Thesaurus ObjectClass
- C15790
- UMLS 2011AA ObjectClass
- C1516220
Similar models
No Instruction available.
- StudyEvent: Radiation Therapy Oncology Group Demographic Data Form - Version 2
C1511726 (UMLS 2011AA ObjectClass)
C25416 (NCI Thesaurus Property)
C1691222 (UMLS 2011AA Property)
C0036588 (UMLS 2011AA)
C0030705 (UMLS 2011AA ObjectClass)
C17049 (NCI Thesaurus Property)
C0034510 (UMLS 2011AA Property)
C1521902 (UMLS 2011AA ValueDomain)
C0086409 (UMLS 2011AA)
C0027361 (UMLS 2011AA ObjectClass)
C16529 (NCI Thesaurus Property)
C0013622 (UMLS 2011AA Property)
C25525 (NCI Thesaurus Property-2)
C1522410 (UMLS 2011AA Property-2)
C1511035 (UMLS 2011AA)
C0027361 (UMLS 2011AA ObjectClass)
C39299 (NCI Thesaurus Property)
C0231335 (UMLS 2011AA Property)
C42614 (NCI Thesaurus ValueDomain)
C0027365 (UMLS 2011AA ValueDomain)
C17085 (NCI Thesaurus Property-2)
C0035039 (UMLS 2011AA Property-2)
C0549184 (UMLS 2011AA)
C1521902 (UMLS 2011AA ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C0206275 (UMLS 2011AA)
C1519384 (UMLS CUI-1)
C20989 (NCI Thesaurus Property)
C29719 (NCI Thesaurus ObjectClass)
C1298908 (UMLS 2011AA)
C0030705 (UMLS 2011AA ObjectClass)
C25536 (NCI Thesaurus Property)
C1555582 (UMLS 2011AA Property)
C18270 (NCI Thesaurus Property-2)
C0700219 (UMLS 2011AA Property-2)
C29848 (NCI Thesaurus ValueDomain)
C0439234 (UMLS 2011AA ValueDomain)
C25463 (NCI Thesaurus ValueDomain-2)
C0750480 (UMLS 2011AA ValueDomain-2)
C0237753 (UMLS 2011AA ValueDomain)
C0030705 (UMLS 2011AA ObjectClass)
C29848 (NCI Thesaurus ValueDomain)
C0439234 (UMLS 2011AA ValueDomain)
C25463 (NCI Thesaurus ValueDomain-2)
C0750480 (UMLS 2011AA ValueDomain-2)
C0085134 (NCI Metathesaurus Property)
C0036572 (UMLS 2011AA)
C0205394 (UMLS 2011AA)
C0030705 (UMLS 2011AA ObjectClass)
C25290 (NCI Thesaurus Property)
C0425382 (UMLS 2011AA Property)
C0332307 (UMLS 2011AA ValueDomain)
C0015671 (UMLS 2011AA)
C0026591 (UMLS 2011AA)
C0027361 (UMLS 2011AA ObjectClass)
C9305 (NCI Thesaurus Property)
C0006826 (UMLS 2011AA Property)
C25509 (NCI Thesaurus Property-2)
C1279901 (UMLS 2011AA Property-2)
C15220 (NCI Thesaurus Property-3)
C0011900 (UMLS 2011AA Property-3)
C25150 (NCI Thesaurus Property-4)
C0001779 (UMLS 2011AA Property-4)
C29848 (NCI Thesaurus ValueDomain)
C0439234 (UMLS 2011AA ValueDomain)
C25463 (NCI Thesaurus ValueDomain-2)
C0750480 (UMLS 2011AA ValueDomain-2)
C0024109 (UMLS 2011AA)
C0006141 (UMLS 2011AA)
C0009368 (UMLS 2011AA)
C0033572 (UMLS 2011AA)
C0205394 (UMLS 2011AA)
C1512698 (UMLS 2011AA ValueDomain)
C15790 (NCI Thesaurus ObjectClass)
C1516220 (UMLS 2011AA ObjectClass)
C25356 (NCI Thesaurus Property)
C1301725 (UMLS 2011AA Property)
C0376554 (NCI Metathesaurus Property)
C0349674 (UMLS 2011AA ValueDomain)
C25608 (NCI Thesaurus Property)
C0679823 (UMLS 2011AA Property)
C15790 (NCI Thesaurus ObjectClass)
C1516220 (UMLS 2011AA ObjectClass)
C0205448 (UMLS 2011AA)