ID
1059
Beschrijving
CALGB HER2/neu Testing Form Paclitaxel and Trastuzumab With or Without Lapatinib in Treating Patients With Stage II or Stage III Breast Cancer That Can Be Removed by Surgery Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=3CB1A910-D444-4DE4-E044-0003BA3F9857
Link
Trefwoorden
Versies (3)
- 26-08-12 26-08-12 -
- 09-01-15 09-01-15 - Martin Dugas
- 18-06-15 18-06-15 -
Geüploaded op
26 augustus 2012
DOI
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Licentie
Creative Commons BY-NC 3.0 Legacy
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Breast Cancer NCT00770809 On-Study - CALGB HER2/neu Testing Form - 2690009v1.0
INSTRUCTIONS: Complete all information on this form. Submit within one week of registration along with the On-Study Form.
- StudyEvent: CALGB HER2/neu Testing Form
Beschrijving
Unnamed2
Beschrijving
PatientInitialsName
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS 2011AA ValueDomain
- C1547383
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25536
- UMLS 2011AA Property
- C1555582
Beschrijving
PatientMedicalRecordNumber
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS 2011AA ValueDomain
- C0237753
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25261
- UMLS 2011AA Property
- C0205476
- NCI Thesaurus Property
- C25198
- UMLS 2011AA Property
- C0034869
Beschrijving
CombinedInstitutionName
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C25454
- UMLS 2011AA ObjectClass
- C0205195
- NCI Thesaurus ObjectClass
- C21541
- UMLS 2011AA ObjectClass
- C0018704
- NCI Thesaurus Property
- C25364
- UMLS 2011AA Property
- C0600091
- NCI Thesaurus ValueDomain
- C25191
- UMLS 2011AA ValueDomain
- C1547383
- NCI Thesaurus ValueDomain
- C21541
- UMLS 2011AA ValueDomain
- C0018704
Beschrijving
ParticipatingGroupName
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS 2011AA ValueDomain
- C1547383
- NCI Thesaurus ObjectClass
- C25608
- UMLS 2011AA ObjectClass
- C0679823
- NCI Thesaurus ObjectClass
- C17005
- UMLS 2011AA ObjectClass
- C1257890
- NCI Thesaurus Property
- C25364
- UMLS 2011AA Property
- C0600091
Beschrijving
ProtocolParticipatingIdentifierNumber
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS 2011AA ValueDomain
- C0237753
- NCI Thesaurus ObjectClass
- C25320
- UMLS 2011AA ObjectClass
- C1507394
- NCI Thesaurus Property
- C25608
- UMLS 2011AA Property
- C0679823
- NCI Thesaurus Property
- C25364
- UMLS 2011AA Property
- C0600091
Beschrijving
PatientParticipatingIdentifierNumber
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS 2011AA ValueDomain
- C0237753
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25608
- UMLS 2011AA Property
- C0679823
- NCI Thesaurus Property
- C25364
- UMLS 2011AA Property
- C0600091
Beschrijving
Testing Data
Beschrijving
PathologyTissueSpecimenAntibodyStainingMethodType
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C12801
- UMLS 2011AA ObjectClass
- C0040300
- NCI Thesaurus ObjectClass
- C19157
- UMLS 2011AA ObjectClass
- C0370003
- NCI Thesaurus ObjectClass
- C18189
- UMLS 2011AA ObjectClass
- C0030664
- NCI Thesaurus Property
- C16295
- UMLS 2011AA Property
- C0003241
- NCI Thesaurus Property
- C23010
- UMLS 2011AA Property
- C0487602
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
Beschrijving
PathologyTissueSpecimenAntibodyStainingMethodText
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C12801
- UMLS 2011AA ObjectClass
- C0040300
- NCI Thesaurus ObjectClass
- C19157
- UMLS 2011AA ObjectClass
- C0370003
- NCI Thesaurus ObjectClass
- C18189
- UMLS 2011AA ObjectClass
- C0030664
- NCI Thesaurus Property
- C16295
- UMLS 2011AA Property
- C0003241
- NCI Thesaurus Property
- C23010
- UMLS 2011AA Property
- C0487602
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
Beschrijving
BreastCytogeneticsHER2/neuPolyclonalAntibodyTestScore
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C12971
- UMLS 2011AA ObjectClass
- C0006141
- NCI Thesaurus ObjectClass
- C16487
- UMLS 2011AA ObjectClass
- C0010802
- NCI Thesaurus Property
- C25294
- UMLS 2011AA Property
- C0022885
- NCI Thesaurus Property
- C17756
- UMLS 2011AA Property
- C0242957
- NCI Thesaurus Property
- C61381
- UMLS 2011AA Property
- C0312586
- NCI Thesaurus ValueDomain
- C25338
- UMLS 2011AA ValueDomain
- C0449820
Beschrijving
LaboratoryProcedureHER2/neuImmunohistochemistryResultMonoclonalAntibodyCB11Score
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C16722
- NCI Thesaurus Property
- C20200
- UMLS 2011AA Property
- C1274040
- NCI Thesaurus Property
- C17756
- UMLS 2011AA Property
- C0242957
- NCI Thesaurus ValueDomain
- C20401
- UMLS 2011AA ValueDomain
- C0003250
- NCI Thesaurus ValueDomain
- C25338
- UMLS 2011AA ValueDomain
- C0449820
Beschrijving
LaboratoryProcedureHER2/neuImmunohistochemistryResultText
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C16722
- NCI Thesaurus Property
- C20200
- UMLS 2011AA Property
- C1274040
- NCI Thesaurus Property
- C17756
- UMLS 2011AA Property
- C0242957
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus ValueDomain
- C20200
- UMLS 2011AA ValueDomain
- C1274040
Beschrijving
FISHAssessmentTestType
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus ObjectClass
- C20989
- UMLS 2011AA ObjectClass
- C0031809
- NCI Thesaurus ObjectClass
- C17563
- UMLS 2011AA ObjectClass
- C0162789
- NCI Thesaurus Property
- C25294
- UMLS 2011AA Property
- C0022885
Beschrijving
FISHAssessmentChromosome17ResultHER2NeuNumber
Datatype
double
Alias
- NCI Thesaurus ObjectClass
- C20989
- UMLS 2011AA ObjectClass
- C0031809
- NCI Thesaurus ObjectClass
- C17563
- UMLS 2011AA ObjectClass
- C0162789
- NCI Thesaurus Property
- C20200
- UMLS 2011AA Property
- C1274040
- NCI Thesaurus Property
- C13212
- UMLS 2011AA Property
- C0008659
- NCI Thesaurus ValueDomain
- C25337
- UMLS 2011AA ValueDomain
- C0237753
- NCI Thesaurus ValueDomain
- C17756
- UMLS 2011AA ValueDomain
- C0242957
Beschrijving
BreastCytogeneticsHER2/neuMonoclonalAntibodyTestScore
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C12971
- UMLS 2011AA ObjectClass
- C0006141
- NCI Thesaurus ObjectClass
- C16487
- UMLS 2011AA ObjectClass
- C0010802
- NCI Thesaurus Property
- C20401
- UMLS 2011AA Property
- C0003250
- NCI Thesaurus Property
- C25294
- UMLS 2011AA Property
- C0022885
- NCI Thesaurus Property
- C17756
- UMLS 2011AA Property
- C0242957
- NCI Thesaurus ValueDomain
- C25338
- UMLS 2011AA ValueDomain
- C0449820
Beschrijving
BreastCytogeneticsHER2/neuMonoclonalAntibodyTestScore
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C12971
- UMLS 2011AA ObjectClass
- C0006141
- NCI Thesaurus ObjectClass
- C16487
- UMLS 2011AA ObjectClass
- C0010802
- NCI Thesaurus Property
- C20401
- UMLS 2011AA Property
- C0003250
- NCI Thesaurus Property
- C25294
- UMLS 2011AA Property
- C0022885
- NCI Thesaurus Property
- C17756
- UMLS 2011AA Property
- C0242957
- NCI Thesaurus ValueDomain
- C25338
- UMLS 2011AA ValueDomain
- C0449820
Beschrijving
FISHAssessmentTestSpecify
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
- NCI Thesaurus ObjectClass
- C20989
- UMLS 2011AA ObjectClass
- C0031809
- NCI Thesaurus ObjectClass
- C17563
- UMLS 2011AA ObjectClass
- C0162789
- NCI Thesaurus Property
- C25294
- UMLS 2011AA Property
- C0022885
Beschrijving
FISHAssessmentTestResultText
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C20989
- UMLS 2011AA ObjectClass
- C0031809
- NCI Thesaurus ObjectClass
- C17563
- UMLS 2011AA ObjectClass
- C0162789
- NCI Thesaurus Property
- C25294
- UMLS 2011AA Property
- C0022885
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus ValueDomain
- C20200
- UMLS 2011AA ValueDomain
- C1274040
Beschrijving
Testing Results
Beschrijving
Required Laboratory Values
Beschrijving
Footer Module
Beschrijving
ResponsiblePersonName
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS 2011AA ValueDomain
- C1547383
- NCI Thesaurus ObjectClass
- C25657
- UMLS 2011AA ObjectClass
- C1273518
- NCI Thesaurus Property
- C25364
- UMLS 2011AA Property
- C0600091
Beschrijving
FormCompleteDate
Datatype
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C40988
- UMLS 2011AA ObjectClass
- C1516308
- NCI Thesaurus Property
- C25250
- UMLS 2011AA Property
- C0205197
- NCI Thesaurus ValueDomain
- C25367
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INSTRUCTIONS: Complete all information on this form. Submit within one week of registration along with the On-Study Form.
- StudyEvent: CALGB HER2/neu Testing Form
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C16722 (NCI Thesaurus Property)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
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C20401 (NCI Thesaurus ValueDomain)
C0003250 (UMLS 2011AA ValueDomain)
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C0449820 (UMLS 2011AA ValueDomain)
C0022885 (UMLS 2011AA ObjectClass)
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