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ID

10569

Description

BASELINE TUMOR ASSESSMENT FORM NCT00020709 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=9CA62D43-4831-361C-E034-080020C9C0E0

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=9CA62D43-4831-361C-E034-080020C9C0E0

Keywords

  1. 9/19/12 9/19/12 -
  2. 5/28/15 5/28/15 -
  3. 6/3/15 6/3/15 -
Uploaded on

June 3, 2015

DOI

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License

Creative Commons BY-NC 3.0 Legacy

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    BASELINE TUMOR ASSESSMENT FORM NCT00020709

    No Instruction available.

    1. StudyEvent: BASELINE TUMOR ASSESSMENT FORM
      1. No Instruction available.
    SWOG clinical trial administrative data
    Description

    SWOG clinical trial administrative data

    SWOG Patient ID
    Description

    SWOGPatientID

    Data type

    text

    SWOG Study No.
    Description

    SWOGStudyNo.

    Data type

    text

    Registration Step
    Description

    RegistrationStep

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337 (undefined)
    UMLS 2011AA ValueDomain
    C0237753 (Numbers)
    SNOMED
    260299005
    LOINC
    LP6841-3
    NCI Thesaurus ValueDomain
    C16154 (undefined)
    UMLS 2011AA ValueDomain
    C1704379 (Treatment Step)
    Patient Initials (L, F,M)
    Description

    PatientInitials

    Data type

    text

    Institution / Affiliate
    Description

    Institution/Affiliate

    Data type

    text

    Physician
    Description

    Physician

    Data type

    text

    Group Name (Groups other than SWOG )
    Description

    GroupName

    Data type

    text

    Study No. (Groups other than SWOG )
    Description

    StudyNo.

    Data type

    double

    Pt. ID (Groups other than SWOG )
    Description

    Pt.ID

    Data type

    text

    Target lesion status
    Description

    Target lesion status

    Target Lesion Site Number
    Description

    TargetLesionSiteNumber

    Data type

    text

    Target Lesion Site
    Description

    TargetLesionSite

    Data type

    text

    RT No Prog.
    Description

    RTNoProg.

    Data type

    text

    Longest Diameter (cm )
    Description

    LongestDiameter

    Data type

    text

    Target Lesion Assessment Type
    Description

    TargetLesionAssessmentType

    Data type

    text

    Target Lesion Assessment Date
    Description

    TargetLesionAssessmentDate

    Data type

    text

    Non-Target Lesion Site Number
    Description

    Non-TargetLesionSiteNumber

    Data type

    text

    Non-Target Lesion Site
    Description

    Non-TargetLesionSite

    Data type

    text

    Extent
    Description

    Extent

    Data type

    text

    Non-Target Lesion Assessment Type
    Description

    Non-TargetLesionAssessmentType

    Data type

    text

    Non-Target Lesion Assessment Date
    Description

    Non-TargetLesionAssessmentDate

    Data type

    text

    Tests
    Description

    Tests

    Tests/studies
    Description

    Tests/studies

    Data type

    text

    Assessment Date
    Description

    AssessmentDate

    Data type

    date

    Notes
    Description

    Notes

    Notes
    Description

    Notes

    Data type

    text

    Similar models

    No Instruction available.

    1. StudyEvent: BASELINE TUMOR ASSESSMENT FORM
      1. No Instruction available.
    Name
    Type
    Description | Question | Decode (Coded Value)
    Data type
    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
    Target lesion status
    Item
    Target Lesion Site Number
    text
    Code List
    Target Lesion Site Number
    CL Item
    L1 (L1)
    CL Item
    L2 (L2)
    CL Item
    L3 (L3)
    CL Item
    L4 (L4)
    CL Item
    L5 (L5)
    CL Item
    L6 (L6)
    CL Item
    L7 (L7)
    CL Item
    L8 (L8)
    CL Item
    L9 (L9)
    CL Item
    L10 (L10)
    TargetLesionSite
    Item
    Target Lesion Site
    text
    RTNoProg.
    Item
    RT No Prog.
    text
    LongestDiameter
    Item
    Longest Diameter (cm )
    text
    Item
    Target Lesion Assessment Type
    text
    Code List
    Target Lesion Assessment Type
    CL Item
    Palpation (Palpation)
    CL Item
    Visualization (Visualization)
    CL Item
    Colposcopy (Colposcopy)
    CL Item
    CA-125 assay (CA-125 assay)
    CL Item
    Endoscopy (Endoscopy)
    CL Item
    PSA (PSA)
    CL Item
    Plain film/X-ray without contrast (Plain film/X-ray without contrast)
    CL Item
    Plain film/X-ray with contrast (Plain film/X-ray with contrast)
    CL Item
    CT scan (CT scan)
    CL Item
    MRI scan (MRI scan)
    CL Item
    Radioisotope scan (Radioisotope scan)
    CL Item
    Ultrasound (Ultrasound)
    CL Item
    PET scan (PET scan)
    CL Item
    Histologic confirmation (Histologic confirmation)
    CL Item
    Cytologic confirmation (Cytologic confirmation)
    CL Item
    Other (Other)
    TargetLesionAssessmentDate
    Item
    Target Lesion Assessment Date
    text
    Item
    Non-Target Lesion Site Number
    text
    Code List
    Non-Target Lesion Site Number
    CL Item
    S1 (S1)
    CL Item
    S2 (S2)
    CL Item
    S3 (S3)
    CL Item
    S4 (S4)
    CL Item
    S5 (S5)
    Non-TargetLesionSite
    Item
    Non-Target Lesion Site
    text
    Extent
    Item
    Extent
    text
    Item
    Non-Target Lesion Assessment Type
    text
    Code List
    Non-Target Lesion Assessment Type
    CL Item
    Palpation (Palpation)
    CL Item
    Visualization (Visualization)
    CL Item
    Colposcopy (Colposcopy)
    CL Item
    CA-125 assay (CA-125 assay)
    CL Item
    Endoscopy (Endoscopy)
    CL Item
    PSA (PSA)
    CL Item
    Plain film/X-ray without contrast (Plain film/X-ray without contrast)
    CL Item
    Plain film/X-ray with contrast (Plain film/X-ray with contrast)
    CL Item
    CT scan (CT scan)
    CL Item
    MRI scan (MRI scan)
    CL Item
    Radioisotope scan (Radioisotope scan)
    CL Item
    Ultrasound (Ultrasound)
    CL Item
    PET scan (PET scan)
    CL Item
    Histologic confirmation (Histologic confirmation)
    CL Item
    Cytologic confirmation (Cytologic confirmation)
    CL Item
    Other (Other)
    Non-TargetLesionAssessmentDate
    Item
    Non-Target Lesion Assessment Date
    text
    Item Group
    Tests
    Tests/studies
    Item
    Tests/studies
    text
    AssessmentDate
    Item
    Assessment Date
    date
    Item Group
    Notes
    Notes
    Item
    Notes
    text

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