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ID

10702

Beschrijving

CALGB 40302 FOLLOW-UP SOLID TUMOR EVALUATION FORM NCT00390455 Fulvestrant With or Without Lapatinib in Treating Postmenopausal Women With Stage III or Stage IV Breast Cancer That is Hormone Receptor-Positive Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=F593450E-79E6-42E1-E034-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=F593450E-79E6-42E1-E034-0003BA3F9857

Trefwoorden

Versies (3)
  1. 26-08-12 26-08-12 -
  2. 08-01-15 08-01-15 - Martin Dugas
  3. 08-06-15 08-06-15 -
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8 juni 2015

DOI

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Creative Commons BY-NC 3.0 Legacy
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    CALGB_40302_FU_SOL_TUM_EVAL_FRM NCT00390455

    Engels

    INSTRUCTIONS: Complete and submit this form as required by the protocol. Information in the upper right box must be completed for this form to be accepted. For optimal accuracy use black ink.

    1 Formulieren  
    Header
    Beschrijving

    Header

    CALGB Form
    Beschrijving

    CALGB Form

    Datatype

    text

    Alias
    UMLS CUI-1
    C3262252
    UMLS CUI-2
    C1516238
    CALGB Study No
    Beschrijving

    Protocol ID CALGB

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C3274381
    NCI Thesaurus ObjectClass
    C25320
    UMLS CUI-2
    C1516238
    NCI Thesaurus Property
    C25364
    NCI Thesaurus Property-2
    C25442
    CALGB Patient ID
    Beschrijving

    Trial subject ID CALGB

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C2348585
    NCI Thesaurus ObjectClass
    C16960
    UMLS CUI-2
    C1516238
    NCI Thesaurus Property
    C25364
    NCI Thesaurus Property-2
    C25442
    Are data amended
    Beschrijving

    Data amended

    Datatype

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38148
    UMLS CUI-1
    C0680532
    NCI Thesaurus ObjectClass
    C25474
    NCI Thesaurus Property
    C25416
    Patient demographics
    Beschrijving

    Patient demographics

    Patient Initials
    Beschrijving

    Patient Initials

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS CUI-1
    C2986440
    NCI Thesaurus ObjectClass
    C16960
    NCI Thesaurus Property
    C25536
    Patient Hospital Number
    Beschrijving

    Patient Hospital No

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C0421459
    NCI Thesaurus Property
    C16960
    NCI Thesaurus Property-2
    C25364
    NCI Thesaurus ObjectClass
    C16696
    Main Member Institution/Affiliate
    Beschrijving

    Institution Name

    Datatype

    text

    Alias
    NCI Thesaurus ObjectClass
    C25454
    UMLS CUI-1
    C1301943
    NCI Thesaurus ObjectClass-2
    C21541
    NCI Thesaurus Property
    C25364
    NCI Thesaurus ValueDomain
    C25191
    NCI Thesaurus ValueDomain-2
    C21541
    Participating Group
    Beschrijving

    Participating Group

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS CUI-1
    C2347449
    NCI Thesaurus ObjectClass
    C25608
    NCI Thesaurus ObjectClass-2
    C17005
    NCI Thesaurus Property
    C25364
    Participating Group Study No
    Beschrijving

    Study Number Participating Group

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C3274381
    NCI Thesaurus ObjectClass
    C25320
    UMLS CUI-2
    C2347449
    NCI Thesaurus Property
    C25608
    NCI Thesaurus Property-2
    C25364
    Participating Group Patient ID
    Beschrijving

    Trial subject ID Participating Group

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C2348585
    NCI Thesaurus ObjectClass
    C16960
    UMLS CUI-2
    C2347449
    NCI Thesaurus Property
    C25608
    NCI Thesaurus Property-2
    C25364
    Reporting Period
    Beschrijving

    Reporting Period

    Start Date (MM DD YYYY)
    Beschrijving

    Reporting Period Start Date

    Datatype

    date

    Alias
    NCI Thesaurus ObjectClass
    C15368
    NCI Thesaurus Property
    C25616
    UMLS CUI-1
    C2361257
    NCI Thesaurus Property-2
    C25651
    NCI Thesaurus ValueDomain
    C25164
    NCI Thesaurus ValueDomain-2
    C25431
    End Date (MM DD YYYY)
    Beschrijving

    Reporting Period End Date

    Datatype

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS CUI-1
    C2361259
    NCI Thesaurus Property
    C25616
    NCI Thesaurus ObjectClass
    C15368
    NCI Thesaurus Property-2
    C25651
    Date of evaluation (MM DD YYYY)
    Beschrijving

    LesionAssessmentDate

    Datatype

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ObjectClass
    C3824
    UMLS 2011AA ObjectClass
    C0221198
    NCI Thesaurus Property
    C20989
    UMLS 2011AA Property
    C0031809
    NCI Thesaurus ValueDomain-2
    C25367
    Lesion, Anatomic Site, Target
    Beschrijving

    LesionTargetSite

    Datatype

    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-2
    C25702
    UMLS 2011AA Property-2
    C1521840
    Method of Evaluation (**)
    Beschrijving

    Evaluation method

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C25284
    UMLS CUI-1
    C2911685
    NCI Thesaurus ObjectClass
    C20989
    NCI Thesaurus Property
    C16847
    If Other, specify
    Beschrijving

    EvaluationMethodSpecify

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C25685
    UMLS 2011AA ValueDomain
    C1521902
    NCI Thesaurus ObjectClass
    C25214
    UMLS 2011AA ObjectClass
    C0220825
    NCI Thesaurus Property
    C16847
    UMLS 2011AA Property
    C0449851
    Longest Diameter of Lesion (s)
    Beschrijving

    Longest Diameter of Lesion

    Datatype

    float

    Maateenheden
    • cm
    Alias
    NCI Thesaurus ObjectClass
    C3824
    UMLS CUI-1
    C0221198
    NCI Thesaurus Property
    C25285
    UMLS CUI-2
    C1301886
    NCI Thesaurus Property-2
    C25558
    UMLS CUI-3
    C1522425
    NCI Thesaurus ValueDomain
    C25209
    NCI Thesaurus ValueDomain-2
    C25285
    cm
    Sum of Longest Diameters of All Target Lesions
    Beschrijving

    LongestLesionSumDiameterMeasurement

    Datatype

    float

    Alias
    NCI Thesaurus ObjectClass
    C25558
    UMLS 2011AA ObjectClass
    C1522425
    NCI Thesaurus ObjectClass-2
    C3824
    UMLS 2011AA ObjectClass-2
    C0221198
    NCI Thesaurus Property
    C25285
    UMLS 2011AA Property
    C1301886
    NCI Thesaurus Property-2
    C25697
    UMLS 2011AA Property-2
    C1515051
    NCI Thesaurus ValueDomain
    C25209
    UMLS 2011AA ValueDomain
    C0242485
    Response Status at This Assessment, Target Lesion (s)
    Beschrijving

    TargetLesionResponseStatus

    Datatype

    text

    Alias
    NCI Thesaurus ObjectClass
    C3824
    UMLS 2011AA ObjectClass
    C0221198
    NCI Thesaurus Property
    C25755
    UMLS 2011AA Property
    C0871261
    NCI Thesaurus ObjectClass-2
    C25702
    UMLS 2011AA ObjectClass-2
    C1521840
    NCI Thesaurus ValueDomain
    C25688
    UMLS 2011AA ValueDomain
    C0449438
    Non-target Lesion(s) Follow-up Evaluation
    Beschrijving

    Non-target Lesion(s) Follow-up Evaluation

    Are there any non-target lesions
    Beschrijving

    NontargetLesionPresentInd-2

    Datatype

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    NCI Thesaurus ObjectClass
    C3824
    UMLS 2011AA ObjectClass
    C0221198
    NCI Thesaurus ObjectClass-2
    C25592
    UMLS 2011AA ObjectClass-2
    C1518389
    NCI Thesaurus Property
    C25626
    UMLS 2011AA Property
    C0150312
    Lesion, Anatomic Site, Non-Target
    Beschrijving

    LesionNontargetSite

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C13717
    UMLS 2011AA ValueDomain
    C1515974
    NCI Thesaurus ObjectClass
    C3824
    UMLS 2011AA ObjectClass
    C0221198
    NCI Thesaurus Property
    C25592
    UMLS 2011AA Property
    C1518389
    NCI Thesaurus Property-2
    C25341
    UMLS 2011AA Property-2
    C0450429
    Date of evaluation (MM DD YYYY)
    Beschrijving

    LesionAssessmentDate

    Datatype

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ObjectClass
    C3824
    UMLS 2011AA ObjectClass
    C0221198
    NCI Thesaurus Property
    C20989
    UMLS 2011AA Property
    C0031809
    NCI Thesaurus ValueDomain-2
    C25367
    Method of Evaluation (**)
    Beschrijving

    Evaluation method

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C25284
    UMLS CUI-1
    C2911685
    NCI Thesaurus ObjectClass
    C20989
    NCI Thesaurus Property
    C16847
    If Other, specify
    Beschrijving

    EvaluationMethodSpecify

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C25685
    UMLS 2011AA ValueDomain
    C1521902
    NCI Thesaurus ObjectClass
    C25214
    UMLS 2011AA ObjectClass
    C0220825
    NCI Thesaurus Property
    C16847
    UMLS 2011AA Property
    C0449851
    F/U Response Status (Use response status codes below.)
    Beschrijving

    Follow-upLesionResponseStatus

    Datatype

    text

    Alias
    NCI Thesaurus ObjectClass
    C3824
    UMLS 2011AA ObjectClass
    C0221198
    NCI Thesaurus Property
    C25755
    UMLS 2011AA Property
    C0871261
    NCI Thesaurus ObjectClass-2
    C16033
    UMLS 2011AA ObjectClass-2
    C1522577
    NCI Thesaurus ValueDomain
    C25688
    UMLS 2011AA ValueDomain
    C0449438
    Response Status at This Assessment, Non-Target Lesion (s)
    Beschrijving

    Non-TargetLesionResponseStatus

    Datatype

    text

    Alias
    NCI Thesaurus ObjectClass
    C3824
    UMLS 2011AA ObjectClass
    C0221198
    NCI Thesaurus ObjectClass-2
    C25592
    UMLS 2011AA ObjectClass-2
    C1518389
    NCI Thesaurus Property
    C25755
    UMLS 2011AA Property
    C0871261
    NCI Thesaurus ValueDomain
    C25688
    UMLS 2011AA ValueDomain
    C0449438
    New Lesion(s) At Follow-up Evaluation
    Beschrijving

    New Lesion(s) At Follow-up Evaluation

    Was the appearance of any new lesions documented since the baseline evaluation
    Beschrijving

    NewLesionAppearanceInd-2

    Datatype

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    NCI Thesaurus ObjectClass
    C3824
    UMLS 2011AA ObjectClass
    C0221198
    NCI Thesaurus ObjectClass-2
    C25586
    UMLS 2011AA ObjectClass-2
    C0205314
    NCI Thesaurus Property
    C25377
    UMLS 2011AA Property
    C0700364
    Lesion, Anatomic Site, New
    Beschrijving

    LesionNewSite

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C13717
    UMLS 2011AA ValueDomain
    C1515974
    NCI Thesaurus ObjectClass
    C3824
    UMLS 2011AA ObjectClass
    C0221198
    NCI Thesaurus Property
    C25586
    UMLS 2011AA Property
    C0205314
    NCI Thesaurus Property-2
    C25341
    UMLS 2011AA Property-2
    C0450429
    Date of evaluation (MM DD YYYY)
    Beschrijving

    LesionAssessmentDate

    Datatype

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ObjectClass
    C3824
    UMLS 2011AA ObjectClass
    C0221198
    NCI Thesaurus Property
    C20989
    UMLS 2011AA Property
    C0031809
    NCI Thesaurus ValueDomain-2
    C25367
    Method of Evaluation (**)
    Beschrijving

    Evaluation method

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C25284
    UMLS CUI-1
    C2911685
    NCI Thesaurus ObjectClass
    C20989
    NCI Thesaurus Property
    C16847
    If Other, specify
    Beschrijving

    EvaluationMethodSpecify

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C25685
    UMLS 2011AA ValueDomain
    C1521902
    NCI Thesaurus ObjectClass
    C25214
    UMLS 2011AA ObjectClass
    C0220825
    NCI Thesaurus Property
    C16847
    UMLS 2011AA Property
    C0449851
    Overall Response
    Beschrijving

    Overall Response

    Overall response (Combine Target, Non-Target, and New Lesions.)
    Beschrijving

    OverallLesionResponseStatus

    Datatype

    text

    Alias
    NCI Thesaurus ObjectClass
    C3824
    UMLS 2011AA ObjectClass
    C0221198
    NCI Thesaurus ObjectClass-2
    C25605
    UMLS 2011AA ObjectClass-2
    C1561607
    NCI Thesaurus Property
    C25755
    UMLS 2011AA Property
    C0871261
    NCI Thesaurus ValueDomain
    C25688
    UMLS 2011AA ValueDomain
    C0449438
    Completed by (print or type name)
    Beschrijving

    Person Completing Form

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS CUI-1
    C1550483
    NCI Thesaurus ObjectClass
    C25657
    NCI Thesaurus Property
    C25364
    Date Form Completed (MM DD YYYY)
    Beschrijving

    Date Form Completed

    Datatype

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS CUI-1
    C1115437
    NCI Thesaurus ObjectClass
    C40988
    NCI Thesaurus Property
    C25250
    NCI Thesaurus ValueDomain-2
    C25367
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    Similar models

    INSTRUCTIONS: Complete and submit this form as required by the protocol. Information in the upper right box must be completed for this form to be accepted. For optimal accuracy use black ink.

    1 Formulieren
    Name
    Type
    Description | Question | Decode (Coded Value)
    Datatype
    Alias
    Item Group
    Header
    CALGB Form
    Item
    CALGB Form
    text
    C3262252 (UMLS CUI-1)
    C1516238 (UMLS CUI-2)
    Protocol ID CALGB
    Item
    CALGB Study No
    text
    C25337 (NCI Thesaurus ValueDomain)
    C3274381 (UMLS CUI-1)
    C25320 (NCI Thesaurus ObjectClass)
    C1516238 (UMLS CUI-2)
    C25364 (NCI Thesaurus Property)
    C25442 (NCI Thesaurus Property-2)
    Trial subject ID CALGB
    Item
    CALGB Patient ID
    text
    C25337 (NCI Thesaurus ValueDomain)
    C2348585 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C1516238 (UMLS CUI-2)
    C25364 (NCI Thesaurus Property)
    C25442 (NCI Thesaurus Property-2)
    Data amended
    Item
    Are data amended
    boolean
    C38148 (NCI Thesaurus ValueDomain)
    C0680532 (UMLS CUI-1)
    C25474 (NCI Thesaurus ObjectClass)
    C25416 (NCI Thesaurus Property)
    Item Group
    Patient demographics
    Patient Initials
    Item
    Patient Initials
    text
    C25191 (NCI Thesaurus ValueDomain)
    C2986440 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C25536 (NCI Thesaurus Property)
    Patient Hospital No
    Item
    Patient Hospital Number
    text
    C25337 (NCI Thesaurus ValueDomain)
    C0421459 (UMLS CUI-1)
    C16960 (NCI Thesaurus Property)
    C25364 (NCI Thesaurus Property-2)
    C16696 (NCI Thesaurus ObjectClass)
    Institution Name
    Item
    Main Member Institution/Affiliate
    text
    C25454 (NCI Thesaurus ObjectClass)
    C1301943 (UMLS CUI-1)
    C21541 (NCI Thesaurus ObjectClass-2)
    C25364 (NCI Thesaurus Property)
    C25191 (NCI Thesaurus ValueDomain)
    C21541 (NCI Thesaurus ValueDomain-2)
    Participating Group
    Item
    Participating Group
    text
    C25191 (NCI Thesaurus ValueDomain)
    C2347449 (UMLS CUI-1)
    C25608 (NCI Thesaurus ObjectClass)
    C17005 (NCI Thesaurus ObjectClass-2)
    C25364 (NCI Thesaurus Property)
    Study Number Participating Group
    Item
    Participating Group Study No
    text
    C25337 (NCI Thesaurus ValueDomain)
    C3274381 (UMLS CUI-1)
    C25320 (NCI Thesaurus ObjectClass)
    C2347449 (UMLS CUI-2)
    C25608 (NCI Thesaurus Property)
    C25364 (NCI Thesaurus Property-2)
    Trial subject ID Participating Group
    Item
    Participating Group Patient ID
    text
    C25337 (NCI Thesaurus ValueDomain)
    C2348585 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C2347449 (UMLS CUI-2)
    C25608 (NCI Thesaurus Property)
    C25364 (NCI Thesaurus Property-2)
    Item Group
    Reporting Period
    Reporting Period Start Date
    Item
    Start Date (MM DD YYYY)
    date
    C15368 (NCI Thesaurus ObjectClass)
    C25616 (NCI Thesaurus Property)
    C2361257 (UMLS CUI-1)
    C25651 (NCI Thesaurus Property-2)
    C25164 (NCI Thesaurus ValueDomain)
    C25431 (NCI Thesaurus ValueDomain-2)
    Reporting Period End Date
    Item
    End Date (MM DD YYYY)
    date
    C25164 (NCI Thesaurus ValueDomain)
    C2361259 (UMLS CUI-1)
    C25616 (NCI Thesaurus Property)
    C15368 (NCI Thesaurus ObjectClass)
    C25651 (NCI Thesaurus Property-2)
    LesionAssessmentDate
    Item
    Date of evaluation (MM DD YYYY)
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C3824 (NCI Thesaurus ObjectClass)
    C0221198 (UMLS 2011AA ObjectClass)
    C20989 (NCI Thesaurus Property)
    C0031809 (UMLS 2011AA Property)
    C25367 (NCI Thesaurus ValueDomain-2)
    LesionTargetSite
    Item
    Lesion, Anatomic Site, Target
    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-2)
    C1521840 (UMLS 2011AA Property-2)
    Item
    Method of Evaluation (**)
    text
    C25284 (NCI Thesaurus ValueDomain)
    C2911685 (UMLS CUI-1)
    C20989 (NCI Thesaurus ObjectClass)
    C16847 (NCI Thesaurus Property)
    CL.9
    Code List
    Method of Evaluation (**)
    CL Item
    Clinical (Clinical Examination)
    C25398 (NCI Thesaurus)
    C0205210 (UMLS 2011AA)
    CL Item
    Chest X-ray (Chest X-ray)
    CL Item
    Ct Scan (CT Scan)
    CL Item
    Spiral Ct Scan (Spiral CT Scan)
    CL Item
    Mri (MRI)
    CL Item
    Ultrasound (Ultrasound)
    C64384 (NCI Thesaurus)
    C1456803 (UMLS 2011AA)
    CL Item
    Bone Scan (Bone Scan)
    C17646 (NCI Thesaurus)
    C0203668 (UMLS 2011AA)
    CL Item
    Other (Other)
    C17649 (NCI Thesaurus)
    C0205394 (UMLS 2011AA)
    EvaluationMethodSpecify
    Item
    If Other, specify
    text
    C25685 (NCI Thesaurus ValueDomain)
    C1521902 (UMLS 2011AA ValueDomain)
    C25214 (NCI Thesaurus ObjectClass)
    C0220825 (UMLS 2011AA ObjectClass)
    C16847 (NCI Thesaurus Property)
    C0449851 (UMLS 2011AA Property)
    Longest Diameter of Lesion
    Item
    Longest Diameter of Lesion (s)
    float
    C3824 (NCI Thesaurus ObjectClass)
    C0221198 (UMLS CUI-1)
    C25285 (NCI Thesaurus Property)
    C1301886 (UMLS CUI-2)
    C25558 (NCI Thesaurus Property-2)
    C1522425 (UMLS CUI-3)
    C25209 (NCI Thesaurus ValueDomain)
    C25285 (NCI Thesaurus ValueDomain-2)
    LongestLesionSumDiameterMeasurement
    Item
    Sum of Longest Diameters of All Target Lesions
    float
    C25558 (NCI Thesaurus ObjectClass)
    C1522425 (UMLS 2011AA ObjectClass)
    C3824 (NCI Thesaurus ObjectClass-2)
    C0221198 (UMLS 2011AA ObjectClass-2)
    C25285 (NCI Thesaurus Property)
    C1301886 (UMLS 2011AA Property)
    C25697 (NCI Thesaurus Property-2)
    C1515051 (UMLS 2011AA Property-2)
    C25209 (NCI Thesaurus ValueDomain)
    C0242485 (UMLS 2011AA ValueDomain)
    Item
    Response Status at This Assessment, Target Lesion (s)
    text
    C3824 (NCI Thesaurus ObjectClass)
    C0221198 (UMLS 2011AA ObjectClass)
    C25755 (NCI Thesaurus Property)
    C0871261 (UMLS 2011AA Property)
    C25702 (NCI Thesaurus ObjectClass-2)
    C1521840 (UMLS 2011AA ObjectClass-2)
    C25688 (NCI Thesaurus ValueDomain)
    C0449438 (UMLS 2011AA ValueDomain)
    CL.3
    Code List
    Response Status at This Assessment, Target Lesion (s)
    CL Item
    Complete Response (Complete Response)
    CL Item
    Partial Response (Partial Response)
    CL Item
    Stable Disease (Stable Disease)
    C18213 (NCI Thesaurus)
    C0677946 (UMLS 2011AA)
    CL Item
    Progressive Disease (Progressive Disease)
    C35571 (NCI Thesaurus)
    C1335499 (UMLS 2011AA)
    CL Item
    Insufficient Evaluation To Determine Response Status (Insufficient evaluation to determine response status)
    Item Group
    Non-target Lesion(s) Follow-up Evaluation
    NontargetLesionPresentInd-2
    Item
    Are there any non-target lesions
    boolean
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    C3824 (NCI Thesaurus ObjectClass)
    C0221198 (UMLS 2011AA ObjectClass)
    C25592 (NCI Thesaurus ObjectClass-2)
    C1518389 (UMLS 2011AA ObjectClass-2)
    C25626 (NCI Thesaurus Property)
    C0150312 (UMLS 2011AA Property)
    LesionNontargetSite
    Item
    Lesion, Anatomic Site, Non-Target
    text
    C13717 (NCI Thesaurus ValueDomain)
    C1515974 (UMLS 2011AA ValueDomain)
    C3824 (NCI Thesaurus ObjectClass)
    C0221198 (UMLS 2011AA ObjectClass)
    C25592 (NCI Thesaurus Property)
    C1518389 (UMLS 2011AA Property)
    C25341 (NCI Thesaurus Property-2)
    C0450429 (UMLS 2011AA Property-2)
    LesionAssessmentDate
    Item
    Date of evaluation (MM DD YYYY)
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C3824 (NCI Thesaurus ObjectClass)
    C0221198 (UMLS 2011AA ObjectClass)
    C20989 (NCI Thesaurus Property)
    C0031809 (UMLS 2011AA Property)
    C25367 (NCI Thesaurus ValueDomain-2)
    Item
    Method of Evaluation (**)
    text
    C25284 (NCI Thesaurus ValueDomain)
    C2911685 (UMLS CUI-1)
    C20989 (NCI Thesaurus ObjectClass)
    C16847 (NCI Thesaurus Property)
    CL.9
    Code List
    Method of Evaluation (**)
    CL Item
    Clinical (Clinical Examination)
    C25398 (NCI Thesaurus)
    C0205210 (UMLS 2011AA)
    CL Item
    Chest X-ray (Chest X-ray)
    CL Item
    Ct Scan (CT Scan)
    CL Item
    Spiral Ct Scan (Spiral CT Scan)
    CL Item
    Mri (MRI)
    CL Item
    Ultrasound (Ultrasound)
    C64384 (NCI Thesaurus)
    C1456803 (UMLS 2011AA)
    CL Item
    Bone Scan (Bone Scan)
    C17646 (NCI Thesaurus)
    C0203668 (UMLS 2011AA)
    CL Item
    Other (Other)
    C17649 (NCI Thesaurus)
    C0205394 (UMLS 2011AA)
    EvaluationMethodSpecify
    Item
    If Other, specify
    text
    C25685 (NCI Thesaurus ValueDomain)
    C1521902 (UMLS 2011AA ValueDomain)
    C25214 (NCI Thesaurus ObjectClass)
    C0220825 (UMLS 2011AA ObjectClass)
    C16847 (NCI Thesaurus Property)
    C0449851 (UMLS 2011AA Property)
    Item
    F/U Response Status (Use response status codes below.)
    text
    C3824 (NCI Thesaurus ObjectClass)
    C0221198 (UMLS 2011AA ObjectClass)
    C25755 (NCI Thesaurus Property)
    C0871261 (UMLS 2011AA Property)
    C16033 (NCI Thesaurus ObjectClass-2)
    C1522577 (UMLS 2011AA ObjectClass-2)
    C25688 (NCI Thesaurus ValueDomain)
    C0449438 (UMLS 2011AA ValueDomain)
    CL.6
    Code List
    F/U Response Status (Use response status codes below.)
    CL Item
    Complete Response (Complete Response)
    CL Item
    Incomplete Response/sd (Incomplete Response/SD)
    CL Item
    Progressive Disease (Progressive Disease)
    C35571 (NCI Thesaurus)
    C1335499 (UMLS 2011AA)
    CL Item
    Insufficient Evaluation To Determine Response Status (Insufficient evaluation to determine response status)
    Item
    Response Status at This Assessment, Non-Target Lesion (s)
    text
    C3824 (NCI Thesaurus ObjectClass)
    C0221198 (UMLS 2011AA ObjectClass)
    C25592 (NCI Thesaurus ObjectClass-2)
    C1518389 (UMLS 2011AA ObjectClass-2)
    C25755 (NCI Thesaurus Property)
    C0871261 (UMLS 2011AA Property)
    C25688 (NCI Thesaurus ValueDomain)
    C0449438 (UMLS 2011AA ValueDomain)
    CL.7
    Code List
    Response Status at This Assessment, Non-Target Lesion (s)
    CL Item
    Complete Response (Complete Response)
    CL Item
    Incomplete Response/sd (Incomplete Response/SD)
    CL Item
    Progressive Disease (Progressive Disease)
    C35571 (NCI Thesaurus)
    C1335499 (UMLS 2011AA)
    CL Item
    Insufficient Evaluation To Determine Response Status (Insufficient evaluation to determine response status)
    Item Group
    New Lesion(s) At Follow-up Evaluation
    NewLesionAppearanceInd-2
    Item
    Was the appearance of any new lesions documented since the baseline evaluation
    boolean
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    C3824 (NCI Thesaurus ObjectClass)
    C0221198 (UMLS 2011AA ObjectClass)
    C25586 (NCI Thesaurus ObjectClass-2)
    C0205314 (UMLS 2011AA ObjectClass-2)
    C25377 (NCI Thesaurus Property)
    C0700364 (UMLS 2011AA Property)
    LesionNewSite
    Item
    Lesion, Anatomic Site, New
    text
    C13717 (NCI Thesaurus ValueDomain)
    C1515974 (UMLS 2011AA ValueDomain)
    C3824 (NCI Thesaurus ObjectClass)
    C0221198 (UMLS 2011AA ObjectClass)
    C25586 (NCI Thesaurus Property)
    C0205314 (UMLS 2011AA Property)
    C25341 (NCI Thesaurus Property-2)
    C0450429 (UMLS 2011AA Property-2)
    LesionAssessmentDate
    Item
    Date of evaluation (MM DD YYYY)
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C3824 (NCI Thesaurus ObjectClass)
    C0221198 (UMLS 2011AA ObjectClass)
    C20989 (NCI Thesaurus Property)
    C0031809 (UMLS 2011AA Property)
    C25367 (NCI Thesaurus ValueDomain-2)
    Item
    Method of Evaluation (**)
    text
    C25284 (NCI Thesaurus ValueDomain)
    C2911685 (UMLS CUI-1)
    C20989 (NCI Thesaurus ObjectClass)
    C16847 (NCI Thesaurus Property)
    CL.9
    Code List
    Method of Evaluation (**)
    CL Item
    Clinical (Clinical Examination)
    C25398 (NCI Thesaurus)
    C0205210 (UMLS 2011AA)
    CL Item
    Chest X-ray (Chest X-ray)
    CL Item
    Ct Scan (CT Scan)
    CL Item
    Spiral Ct Scan (Spiral CT Scan)
    CL Item
    Mri (MRI)
    CL Item
    Ultrasound (Ultrasound)
    C64384 (NCI Thesaurus)
    C1456803 (UMLS 2011AA)
    CL Item
    Bone Scan (Bone Scan)
    C17646 (NCI Thesaurus)
    C0203668 (UMLS 2011AA)
    CL Item
    Other (Other)
    C17649 (NCI Thesaurus)
    C0205394 (UMLS 2011AA)
    EvaluationMethodSpecify
    Item
    If Other, specify
    text
    C25685 (NCI Thesaurus ValueDomain)
    C1521902 (UMLS 2011AA ValueDomain)
    C25214 (NCI Thesaurus ObjectClass)
    C0220825 (UMLS 2011AA ObjectClass)
    C16847 (NCI Thesaurus Property)
    C0449851 (UMLS 2011AA Property)
    Item Group
    Overall Response
    Item
    Overall response (Combine Target, Non-Target, and New Lesions.)
    text
    C3824 (NCI Thesaurus ObjectClass)
    C0221198 (UMLS 2011AA ObjectClass)
    C25605 (NCI Thesaurus ObjectClass-2)
    C1561607 (UMLS 2011AA ObjectClass-2)
    C25755 (NCI Thesaurus Property)
    C0871261 (UMLS 2011AA Property)
    C25688 (NCI Thesaurus ValueDomain)
    C0449438 (UMLS 2011AA ValueDomain)
    CL.10
    Code List
    Overall response (Combine Target, Non-Target, and New Lesions.)
    CL Item
    Complete Response (Complete Response)
    CL Item
    Partial Response (Partial Response)
    CL Item
    Incomplete Response (Incomplete Response)
    CL Item
    Progressive Disease (Progressive Disease)
    C35571 (NCI Thesaurus)
    C1335499 (UMLS 2011AA)
    CL Item
    Insufficient Evaluation To Determine Response Status (Insufficient evaluation to determine response status)
    Person Completing Form
    Item
    Completed by (print or type name)
    text
    C25191 (NCI Thesaurus ValueDomain)
    C1550483 (UMLS CUI-1)
    C25657 (NCI Thesaurus ObjectClass)
    C25364 (NCI Thesaurus Property)
    Date Form Completed
    Item
    Date Form Completed (MM DD YYYY)
    date
    C25164 (NCI Thesaurus ValueDomain)
    C1115437 (UMLS CUI-1)
    C40988 (NCI Thesaurus ObjectClass)
    C25250 (NCI Thesaurus Property)
    C25367 (NCI Thesaurus ValueDomain-2)
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