ID

10617

Description

SOUTHWEST ONCOLOGY GROUP FOLLOW-UP TUMOR ASSESSMENT FORM (S0226) NCT00075764 S0226 Anastrozole With or Without Fulvestrant as First-Line Therapy in Postmenopausal Women With Metastatic Breast Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=C3223C5F-32FD-268C-E034-0003BA12F5E7

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=C3223C5F-32FD-268C-E034-0003BA12F5E7

Keywords

Versions (3)
  1. 8/26/12 8/26/12 -
  2. 5/22/15 5/22/15 -
  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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SOUTHWEST ONCOLOGY GROUP FOLLOW-UP TUMOR ASSESSMENT FORM (S0226) NCT00075764

English

No Instruction available.

1 forms  
  1. StudyEvent: SOUTHWEST ONCOLOGY GROUP FOLLOW-UP TUMOR ASSESSMENT FORM (S0226)
    1. No Instruction available.
SWOG clinical trial data
Description

SWOG clinical trial data

Institution/Affiliate
Description

CombinedInstitutionName

Data type

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
SWOG Patient ID
Description

SWOGPatientID

Data type

text

SWOG Study No.
Description

SWOGStudyNo.

Data type

text

Registration Step
Description

RegistrationStep

Data type

text

Patient Initials
Description

PatientInitials

Data type

text

Date form completed
Description

Dateformcompleted

Data type

text

Physician
Description

Physician

Data type

text

Group Name
Description

GroupName

Data type

text

Study No.
Description

StudyNo.

Data type

text

Pt. ID
Description

Pt.ID

Data type

text

Target Lesions
Description

Target Lesions

Target Lesions
Description

LesionTargetSite

Data type

text

Alias
NCI Thesaurus ValueDomain
C13717
UMLS 2011AA ValueDomain
C1515974
NCI Thesaurus ObjectClass
C3824
UMLS 2011AA ObjectClass
C0221198
NCI Thesaurus Property
C25341
UMLS 2011AA Property
C0450429
NCI Thesaurus Property
C25702
UMLS 2011AA Property
C1521840
Longest Diameter (cm)
Description

LongestDiameter

Data type

text

Assessment Type
Description

AssessmentType

Data type

text

Assessment Date
Description

AssessmentDate

Data type

date

Lesion number
Description

Lesion number

Data type

text

Non-target Disease
Description

Non-target Disease

Lesion Number
Description

Lesion,ReferenceNumber

Data type

double

Assessment Type
Description

AssessmentType

Data type

text

Assessment Date
Description

AssessmentDate

Data type

date

Lesion site
Description

Lesion site

Data type

text

Extent
Description

Extent

Data type

text

New Lesions
Description

New Lesions

Target Lesions
Description

LesionTargetSite

Data type

text

Alias
NCI Thesaurus ValueDomain
C13717
UMLS 2011AA ValueDomain
C1515974
NCI Thesaurus ObjectClass
C3824
UMLS 2011AA ObjectClass
C0221198
NCI Thesaurus Property
C25341
UMLS 2011AA Property
C0450429
NCI Thesaurus Property
C25702
UMLS 2011AA Property
C1521840
Assessment Type
Description

AssessmentType

Data type

text

Assessment Date
Description

AssessmentDate

Data type

date

Assessment Date
Description

AssessmentDate

Data type

date

Symptomatic deterioration
Description

ResponseSymptomaticDeteriorationInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C25755
UMLS 2011AA ObjectClass
C0871261
NCI Thesaurus Property
C25269
UMLS 2011AA Property
C0231220
NCI Thesaurus Property
C25751
UMLS 2011AA Property
C0868945
Lesion number
Description

Lesion number

Data type

text

Comments
Description

Comments

Comments
Description

Comments

Data type

text

Ccrr Module For Southwest Oncology Group Follow-up Tumor Assessment Form (s0226)
Description

Ccrr Module For Southwest Oncology Group Follow-up Tumor Assessment Form (s0226)

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Similar models

No Instruction available.

1 forms
  1. StudyEvent: SOUTHWEST ONCOLOGY GROUP FOLLOW-UP TUMOR ASSESSMENT FORM (S0226)
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
SWOG clinical trial data
CombinedInstitutionName
Item
Institution/Affiliate
text
C25454 (NCI Thesaurus ObjectClass)
C0205195 (UMLS 2011AA ObjectClass)
C21541 (NCI Thesaurus ObjectClass)
C0018704 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C21541 (NCI Thesaurus ValueDomain)
C0018704 (UMLS 2011AA ValueDomain)
SWOGPatientID
Item
SWOG Patient ID
text
SWOGStudyNo.
Item
SWOG Study No.
text
RegistrationStep
Item
Registration Step
text
PatientInitials
Item
Patient Initials
text
Dateformcompleted
Item
Date form completed
text
Physician
Item
Physician
text
GroupName
Item
Group Name
text
StudyNo.
Item
Study No.
text
Pt.ID
Item
Pt. ID
text
Item Group
Target Lesions
LesionTargetSite
Item
Target Lesions
text
C13717 (NCI Thesaurus ValueDomain)
C1515974 (UMLS 2011AA ValueDomain)
C3824 (NCI Thesaurus ObjectClass)
C0221198 (UMLS 2011AA ObjectClass)
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
C25702 (NCI Thesaurus Property)
C1521840 (UMLS 2011AA Property)
LongestDiameter
Item
Longest Diameter (cm)
text
Item
Assessment Type
text
CL.4
Code List
Assessment Type
CL Item
Palpation (Palpation)
CL Item
Visualization (Visualization)
CL Item
Colposcopy (Colposcopy)
CL Item
Endoscopy (Endoscopy)
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
Spiral CT scan (Spiral CT scan)
CL Item
Cystoscopy (Cystoscopy)
CL Item
Histologic confirmation (Histologic confirmation)
CL Item
Cytologic confirmation (Cytologic confirmation)
CL Item
Other (Other)
AssessmentDate
Item
Assessment Date
date
Lesionnumber
Item
Lesion number
text
Item Group
Non-target Disease
Lesion,ReferenceNumber
Item
Lesion Number
double
Item
Assessment Type
text
CL.4
Code List
Assessment Type
CL Item
Palpation (Palpation)
CL Item
Visualization (Visualization)
CL Item
Colposcopy (Colposcopy)
CL Item
Endoscopy (Endoscopy)
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
Spiral CT scan (Spiral CT scan)
CL Item
Cystoscopy (Cystoscopy)
CL Item
Histologic confirmation (Histologic confirmation)
CL Item
Cytologic confirmation (Cytologic confirmation)
CL Item
Other (Other)
AssessmentDate
Item
Assessment Date
date
Lesionsite
Item
Lesion site
text
Item
Extent
text
CL.2
Code List
Extent
CL Item
Complete disappearance (Complete disappearance)
CL Item
Present (Present)
CL Item
Clear increase (Clear increase)
CL Item
Not assessed (Not assessed)
Item Group
New Lesions
LesionTargetSite
Item
Target Lesions
text
C13717 (NCI Thesaurus ValueDomain)
C1515974 (UMLS 2011AA ValueDomain)
C3824 (NCI Thesaurus ObjectClass)
C0221198 (UMLS 2011AA ObjectClass)
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
C25702 (NCI Thesaurus Property)
C1521840 (UMLS 2011AA Property)
Item
Assessment Type
text
CL.4
Code List
Assessment Type
CL Item
Palpation (Palpation)
CL Item
Visualization (Visualization)
CL Item
Colposcopy (Colposcopy)
CL Item
Endoscopy (Endoscopy)
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
Spiral CT scan (Spiral CT scan)
CL Item
Cystoscopy (Cystoscopy)
CL Item
Histologic confirmation (Histologic confirmation)
CL Item
Cytologic confirmation (Cytologic confirmation)
CL Item
Other (Other)
AssessmentDate
Item
Assessment Date
date
AssessmentDate
Item
Assessment Date
date
Item
Symptomatic deterioration
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25755 (NCI Thesaurus ObjectClass)
C0871261 (UMLS 2011AA ObjectClass)
C25269 (NCI Thesaurus Property)
C0231220 (UMLS 2011AA Property)
C25751 (NCI Thesaurus Property)
C0868945 (UMLS 2011AA Property)
CL.5
Code List
Symptomatic deterioration
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Lesionnumber
Item
Lesion number
text
Item Group
Comments
Comments
Item
Comments
text
Item Group
Ccrr Module For Southwest Oncology Group Follow-up Tumor Assessment Form (s0226)
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