ID

10575

Description

NOTICE OF DEATH 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=9CA62D43-492B-361C-E034-080020C9C0E0

Lien

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=9CA62D43-492B-361C-E034-080020C9C0E0

Mots-clés

Versions (3)
  1. 19/09/2012 19/09/2012 -
  2. 28/05/2015 28/05/2015 -
  3. 03/06/2015 03/06/2015 -
Téléchargé le

3 juin 2015

DOI

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Licence

Creative Commons BY-NC 3.0 Legacy
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NOTICE OF DEATH NCT00020709

Anglais

No Instruction available.

1 Formulaires  
  1. StudyEvent: NOTICE OF DEATH
    1. No Instruction available.
SWOG clinical trial administrative data
Description

SWOG clinical trial administrative data

SWOG Patient ID
Description

SWOGPatientID

Type de données

text

Most Recent SWOG Study No.
Description

MostRecentSWOGStudyNo.

Type de données

text

Registration Step
Description

RegistrationStep

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ValueDomain-2
C16154
UMLS 2011AA ValueDomain-2
C1704379
Patient Initials (L, F,M)
Description

PatientInitials

Type de données

text

Institution / Affiliate
Description

Institution/Affiliate

Type de données

text

Physician
Description

Physician

Type de données

text

Group Name (Groups other than SWOG )
Description

GroupName

Type de données

text

Study No. (Groups other than SWOG )
Description

StudyNo.

Type de données

float

Pt. ID (Groups other than SWOG )
Description

Pt.ID

Type de données

text

Death documentation
Description

Death documentation

Date of Death (month / day / year)
Description

DeathDocumentedDate

Type de données

date

Any cancer (select one)
Description

Anycancer

Type de données

text

If cancer was the primary cause or if cancer possibly or definitely contributed to death, and the patient had had multiple tumor types, specify those which were causes of death
Description

PersonCancerAssociatedDeathType

Type de données

text

Alias
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C28554
UMLS 2011AA Property
C0011065
NCI Thesaurus Property-2
C9305
UMLS 2011AA Property-2
C0006826
NCI Thesaurus Property-3
C25281
UMLS 2011AA Property-3
C0332281
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Cancer of most recent SWOG study, specify cancer
Description

SouthwestOncologyGroupMalignantNeoplasmMostRecentProtocolSpecify

Type de données

text

Alias
NCI Thesaurus ObjectClass
C25699
UMLS 2011AA ObjectClass
C1519429
NCI Thesaurus ObjectClass-2
C9305
UMLS 2011AA ObjectClass-2
C0006826
NCI Thesaurus Property
C25320
UMLS 2011AA Property
C1507394
NCI Thesaurus Property-2
C25577
UMLS 2011AA Property-2
C1513491
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
Cancer of other SWOG study, specify cancer
Description

CancerofotherSWOGstudy,specifycancer

Type de données

text

Other cancer, specify
Description

Othercancer,specify

Type de données

text

Toxicity from disease related treatment (select one)
Description

Toxicityfromdiseaserelatedtreatment

Type de données

text

If Primary Cause, Contributory or Possible, specify treatment and toxicity
Description

IfPrimaryCause,ContributoryorPossible,specifytreatmentandtoxicity

Type de données

text

Non-cancer and non-treatment related causes (select one)
Description

Non-cancerandnon-treatmentrelatedcauses

Type de données

text

If Primary Cause, Contributory or Possible, specify
Description

IfPrimaryCause,ContributoryorPossible,specify

Type de données

text

Autopsy done?
Description

Autopsydone?

Type de données

text

Death information obtained from (select all that apply)
Description

Deathinformationobtainedfrom

Type de données

text

Other, specify
Description

CytogeneticAnalysis,OtherReason,NoSuccess

Type de données

text

Notes
Description

Notes

Notes
Description

Notes

Type de données

text

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Similar models

No Instruction available.

1 Formulaires
  1. StudyEvent: NOTICE OF DEATH
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Type de données
Alias
Item Group
SWOG clinical trial administrative data
SWOGPatientID
Item
SWOG Patient ID
text
MostRecentSWOGStudyNo.
Item
Most Recent SWOG Study No.
text
RegistrationStep
Item
Registration Step
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C16154 (NCI Thesaurus ValueDomain-2)
C1704379 (UMLS 2011AA ValueDomain-2)
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 )
float
Pt.ID
Item
Pt. ID (Groups other than SWOG )
text
Item Group
Death documentation
DeathDocumentedDate
Item
Date of Death (month / day / year)
date
Item
Any cancer (select one)
text
CL.1
Code List
Any cancer (select one)
CL Item
No (No)
CL Item
Primary Cause (Primary Cause)
CL Item
Contributory (Contributory)
CL Item
Possible (Possible)
CL Item
Unknown (Unknown)
Item
If cancer was the primary cause or if cancer possibly or definitely contributed to death, and the patient had had multiple tumor types, specify those which were causes of death
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C28554 (NCI Thesaurus Property)
C0011065 (UMLS 2011AA Property)
C9305 (NCI Thesaurus Property-2)
C0006826 (UMLS 2011AA Property-2)
C25281 (NCI Thesaurus Property-3)
C0332281 (UMLS 2011AA Property-3)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.2
Code List
If cancer was the primary cause or if cancer possibly or definitely contributed to death, and the patient had had multiple tumor types, specify those which were causes of death
CL Item
Cancer of most recent SWOG study, specify cancer (Cancer of most recent SWOG study, specify cancer)
CL Item
Cancer of other SWOG study, specify cancer (Cancer of other SWOG study, specify cancer)
CL Item
Other cancer, specify (Other cancer, specify)
SouthwestOncologyGroupMalignantNeoplasmMostRecentProtocolSpecify
Item
Cancer of most recent SWOG study, specify cancer
text
C25699 (NCI Thesaurus ObjectClass)
C1519429 (UMLS 2011AA ObjectClass)
C9305 (NCI Thesaurus ObjectClass-2)
C0006826 (UMLS 2011AA ObjectClass-2)
C25320 (NCI Thesaurus Property)
C1507394 (UMLS 2011AA Property)
C25577 (NCI Thesaurus Property-2)
C1513491 (UMLS 2011AA Property-2)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
CancerofotherSWOGstudy,specifycancer
Item
Cancer of other SWOG study, specify cancer
text
Othercancer,specify
Item
Other cancer, specify
text
Item
Toxicity from disease related treatment (select one)
text
CL.3
Code List
Toxicity from disease related treatment (select one)
CL Item
No (No)
CL Item
Primary Cause (Primary Cause)
CL Item
Contributory (Contributory)
CL Item
Possible (Possible)
CL Item
Unknown (Unknown)
IfPrimaryCause,ContributoryorPossible,specifytreatmentandtoxicity
Item
If Primary Cause, Contributory or Possible, specify treatment and toxicity
text
Item
Non-cancer and non-treatment related causes (select one)
text
CL.4
Code List
Non-cancer and non-treatment related causes (select one)
CL Item
No (No)
CL Item
Primary Cause (Primary Cause)
CL Item
Contributory (Contributory)
CL Item
Possible (Possible)
CL Item
Unknown (Unknown)
IfPrimaryCause,ContributoryorPossible,specify
Item
If Primary Cause, Contributory or Possible, specify
text
Item
Autopsy done?
text
CL.5
Code List
Autopsy done?
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Unknown (Unknown)
Item
Death information obtained from (select all that apply)
text
CL.6
Code List
Death information obtained from (select all that apply)
CL Item
Autopsy report (Autopsy report)
CL Item
Medical record / Death certificate (Medical record / Death certificate)
CL Item
Physician (Physician)
CL Item
Relative or friend (Relative or friend)
CL Item
Other, specify (Other, specify)
CytogeneticAnalysis,OtherReason,NoSuccess
Item
Other, specify
text
Item Group
Notes
Notes
Item
Notes
text
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