ID

10575

Beschrijving

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

Link

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

Trefwoorden

Versies (3)
  1. 19-09-12 19-09-12 -
  2. 28-05-15 28-05-15 -
  3. 03-06-15 03-06-15 -
Geüploaded op

3 juni 2015

DOI

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Licentie

Creative Commons BY-NC 3.0 Legacy
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NOTICE OF DEATH NCT00020709

Engels

No Instruction available.

1 Formulieren  
  1. StudyEvent: NOTICE OF DEATH
    1. No Instruction available.
SWOG clinical trial administrative data
Beschrijving

SWOG clinical trial administrative data

SWOG Patient ID
Beschrijving

SWOGPatientID

Datatype

text

Most Recent SWOG Study No.
Beschrijving

MostRecentSWOGStudyNo.

Datatype

text

Registration Step
Beschrijving

RegistrationStep

Datatype

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)
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

float

Pt. ID (Groups other than SWOG )
Beschrijving

Pt.ID

Datatype

text

Death documentation
Beschrijving

Death documentation

Date of Death (month / day / year)
Beschrijving

DeathDocumentedDate

Datatype

date

Any cancer (select one)
Beschrijving

Anycancer

Datatype

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
Beschrijving

PersonCancerAssociatedDeathType

Datatype

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
Beschrijving

SouthwestOncologyGroupMalignantNeoplasmMostRecentProtocolSpecify

Datatype

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
Beschrijving

CancerofotherSWOGstudy,specifycancer

Datatype

text

Other cancer, specify
Beschrijving

Othercancer,specify

Datatype

text

Toxicity from disease related treatment (select one)
Beschrijving

Toxicityfromdiseaserelatedtreatment

Datatype

text

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

IfPrimaryCause,ContributoryorPossible,specifytreatmentandtoxicity

Datatype

text

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

Non-cancerandnon-treatmentrelatedcauses

Datatype

text

If Primary Cause, Contributory or Possible, specify
Beschrijving

IfPrimaryCause,ContributoryorPossible,specify

Datatype

text

Autopsy done?
Beschrijving

Autopsydone?

Datatype

text

Death information obtained from (select all that apply)
Beschrijving

Deathinformationobtainedfrom

Datatype

text

Other, specify
Beschrijving

CytogeneticAnalysis,OtherReason,NoSuccess

Datatype

text

Notes
Beschrijving

Notes

Notes
Beschrijving

Notes

Datatype

text

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Similar models

No Instruction available.

1 Formulieren
  1. StudyEvent: NOTICE OF DEATH
    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
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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