ID
10815
Beschrijving
PACCT-1 TAILORx FACT - Fatique Scale Form NCT00310180 Hormone Therapy With or Without Combination Chemotherapy in Treating Women Who Have Undergone Surgery for Node-Negative Breast Cancer (The TAILORx Trial) Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=84B81FA9-D91A-473F-E040-BB89AD4317EF
Link
Trefwoorden
Versies (3)
- 26-08-12 26-08-12 -
- 08-01-15 08-01-15 - Martin Dugas
- 08-06-15 08-06-15 -
Geüploaded op
8 juni 2015
DOI
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Licentie
Creative Commons BY-NC 3.0 Legacy
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PACCT-1 TAILORx FACT - Fatique Scale Form NCT00310180
INSTRUCTIONS: Please complete this form according to the forms submission schedule. Submit original to the ECOG Coordinating Center. Keep a copy for your files
- StudyEvent: PACCT-1 TAILORx FACT - Fatique Scale Form
Beschrijving
Report Period on Treatment
Beschrijving
Data amendment
Beschrijving
Data amended
Datatype
boolean
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS CUI-1
- C0680532
- NCI Thesaurus ObjectClass
- C25474
- NCI Thesaurus Property
- C25416
Beschrijving
Data amended date
Datatype
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C0680532
- NCI Thesaurus ObjectClass
- C25474
- UMLS CUI-2
- C0011008
- NCI Thesaurus Property
- C25416
- NCI Thesaurus ValueDomain-2
- C25367
Beschrijving
Data amended date
Datatype
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C0680532
- NCI Thesaurus ObjectClass
- C25474
- UMLS CUI-2
- C0011008
- NCI Thesaurus Property
- C25416
- NCI Thesaurus ValueDomain-2
- C25367
Beschrijving
Assessment Date
Beschrijving
Additional Concerns
Beschrijving
Quality-of-LifeAssessmentPatientFatigueScale
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C15584
- UMLS 2011AA ObjectClass
- C0281588
- NCI Thesaurus Property
- C16960
- UMLS 2011AA Property
- C0030705
- NCI Thesaurus Property-2
- C3036
- UMLS 2011AA Property-2
- C0015672
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus ValueDomain-2
- C17047
- UMLS 2011AA ValueDomain-2
- C0518214
Beschrijving
NeurotoxicityPatientMuscleWeaknessAssessmentQualityofLifeScale
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus ObjectClass-2
- C27961
- UMLS 2011AA ObjectClass-2
- C0235032
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Metathesaurus Property
- C0151786
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus ValueDomain-2
- C17047
- UMLS 2011AA ValueDomain-2
- C0518214
Beschrijving
Quality-of-LifeAssessmentPatientLethargicScale
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C15584
- UMLS 2011AA ObjectClass
- C0281588
- NCI Thesaurus Property
- C16960
- UMLS 2011AA Property
- C0030705
- NCI Thesaurus Property-2
- C50412
- UMLS 2011AA Property-2
- C0023380
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus ValueDomain-2
- C17047
- UMLS 2011AA ValueDomain-2
- C0518214
Beschrijving
Quality-of-LifeAssessmentPatientSmallFatigueScale
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C15584
- UMLS 2011AA ObjectClass
- C0281588
- NCI Thesaurus Property
- C16960
- UMLS 2011AA Property
- C0030705
- NCI Thesaurus Property-2
- C3036
- UMLS 2011AA Property-2
- C0015672
- NCI Thesaurus Property-3
- C25376
- UMLS 2011AA Property-3
- C0700321
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus ValueDomain-2
- C17047
- UMLS 2011AA ValueDomain-2
- C0518214
Beschrijving
Quality-of-LifeAssessmentPatientBeginFatigueScale
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C15584
- UMLS 2011AA ObjectClass
- C0281588
- NCI Thesaurus Property
- C16960
- UMLS 2011AA Property
- C0030705
- NCI Thesaurus Property-2
- C3036
- UMLS 2011AA Property-2
- C0015672
- NCI Thesaurus Property-3
- C25431
- UMLS 2011AA Property-3
- C0439659
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus ValueDomain-2
- C17047
- UMLS 2011AA ValueDomain-2
- C0518214
Beschrijving
Quality-of-LifeAssessmentPatientEndFatigueScale
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C15584
- UMLS 2011AA ObjectClass
- C0281588
- NCI Thesaurus Property
- C16960
- UMLS 2011AA Property
- C0030705
- NCI Thesaurus Property-2
- C3036
- UMLS 2011AA Property-2
- C0015672
- NCI Thesaurus Property-3
- C25496
- UMLS 2011AA Property-3
- C2746065
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus ValueDomain-2
- C17047
- UMLS 2011AA ValueDomain-2
- C0518214
Beschrijving
Quality-of-LifeAssessmentPatientEnergyScale
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C15584
- UMLS 2011AA ObjectClass
- C0281588
- NCI Thesaurus Property
- C16960
- UMLS 2011AA Property
- C0030705
- NCI Thesaurus Property-2
- C48058
- UMLS 2011AA Property-2
- C0542479
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus ValueDomain-2
- C17047
- UMLS 2011AA ValueDomain-2
- C0518214
Beschrijving
Quality-of-LifeAssessmentPatientActivityType
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus Property
- C16960
- UMLS 2011AA Property
- C0030705
- NCI Thesaurus Property-2
- C43431
- UMLS 2011AA Property-2
- C0441655
- NCI Thesaurus ObjectClass
- C15584
- UMLS 2011AA ObjectClass
- C0281588
Beschrijving
Quality-of-LifeAssessmentPatientDayRestingScale
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C15584
- UMLS 2011AA ObjectClass
- C0281588
- NCI Thesaurus Property
- C16960
- UMLS 2011AA Property
- C0030705
- NCI Thesaurus Property-2
- C25301
- UMLS 2011AA Property-2
- C0439228
- NCI Thesaurus Property-3
- C28185
- UMLS 2011AA Property-3
- C0035253
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus ValueDomain-2
- C17047
- UMLS 2011AA ValueDomain-2
- C0518214
Beschrijving
Quality-of-LifeAssessmentPatientIngestionFatigueScale
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C15584
- UMLS 2011AA ObjectClass
- C0281588
- NCI Thesaurus Property
- C16960
- UMLS 2011AA Property
- C0030705
- NCI Thesaurus Property-2
- C3036
- UMLS 2011AA Property-2
- C0015672
- NCI Thesaurus Property-3
- C28229
- UMLS 2011AA Property-3
- C0232478
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus ValueDomain-2
- C17047
- UMLS 2011AA ValueDomain-2
- C0518214
Beschrijving
Quality-of-LifeAssessmentPatientSupportActivityScale
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C15584
- UMLS 2011AA ObjectClass
- C0281588
- NCI Thesaurus Property
- C16960
- UMLS 2011AA Property
- C0030705
- NCI Thesaurus Property-2
- C43431
- UMLS 2011AA Property-2
- C0441655
- NCI Thesaurus Property-3
- C37902
- UMLS 2011AA Property-3
- C1521721
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus ValueDomain-2
- C17047
- UMLS 2011AA ValueDomain-2
- C0518214
Beschrijving
Quality-of-LifeAssessmentPatientFrustrationScale
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C15584
- UMLS 2011AA ObjectClass
- C0281588
- NCI Thesaurus Property
- C16960
- UMLS 2011AA Property
- C0030705
- NCI Thesaurus Property-2
- C61483
- UMLS 2011AA Property-2
- C0016770
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus ValueDomain-2
- C17047
- UMLS 2011AA ValueDomain-2
- C0518214
Beschrijving
Quality-of-LifeAssessmentPatientFatigueActivityScale
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C15584
- UMLS 2011AA ObjectClass
- C0281588
- NCI Thesaurus Property
- C16960
- UMLS 2011AA Property
- C0030705
- NCI Thesaurus Property-2
- C43431
- UMLS 2011AA Property-2
- C0441655
- NCI Thesaurus Property-3
- C3036
- UMLS 2011AA Property-3
- C0015672
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus ValueDomain-2
- C17047
- UMLS 2011AA ValueDomain-2
- C0518214
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INSTRUCTIONS: Please complete this form according to the forms submission schedule. Submit original to the ECOG Coordinating Center. Keep a copy for your files
- StudyEvent: PACCT-1 TAILORx FACT - Fatique Scale Form
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C25367 (NCI Thesaurus ValueDomain-2)
C0680532 (UMLS CUI-1)
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C0011008 (UMLS CUI-2)
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C25367 (NCI Thesaurus ValueDomain-2)
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C91213 (NCI Thesaurus-2)
C70543 (NCI Thesaurus-3)
C2003901 (UMLS 2011AA)
C91216 (NCI Thesaurus-2)
C91217 (NCI Thesaurus-2)
C0030705 (UMLS 2011AA ObjectClass)
C27961 (NCI Thesaurus ObjectClass-2)
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C0031809 (UMLS 2011AA Property)
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C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)
C91213 (NCI Thesaurus-2)
C70543 (NCI Thesaurus-3)
C2003901 (UMLS 2011AA)
C91216 (NCI Thesaurus-2)
C91217 (NCI Thesaurus-2)
C0281588 (UMLS 2011AA ObjectClass)
C16960 (NCI Thesaurus Property)
C0030705 (UMLS 2011AA Property)
C50412 (NCI Thesaurus Property-2)
C0023380 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
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C0518214 (UMLS 2011AA ValueDomain-2)
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C70543 (NCI Thesaurus-3)
C2003901 (UMLS 2011AA)
C91216 (NCI Thesaurus-2)
C91217 (NCI Thesaurus-2)
C0281588 (UMLS 2011AA ObjectClass)
C16960 (NCI Thesaurus Property)
C0030705 (UMLS 2011AA Property)
C3036 (NCI Thesaurus Property-2)
C0015672 (UMLS 2011AA Property-2)
C25431 (NCI Thesaurus Property-3)
C0439659 (UMLS 2011AA Property-3)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)
C91213 (NCI Thesaurus-2)
C70543 (NCI Thesaurus-3)
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C2003901 (UMLS 2011AA)
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C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)
C91213 (NCI Thesaurus-2)
C70543 (NCI Thesaurus-3)
C2003901 (UMLS 2011AA)
C91216 (NCI Thesaurus-2)
C91217 (NCI Thesaurus-2)
C0332307 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus Property)
C0030705 (UMLS 2011AA Property)
C43431 (NCI Thesaurus Property-2)
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C0281588 (UMLS 2011AA ObjectClass)
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C0439228 (UMLS 2011AA Property-2)
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C70543 (NCI Thesaurus-3)
C2003901 (UMLS 2011AA)
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C70543 (NCI Thesaurus-3)
C2003901 (UMLS 2011AA)
C91216 (NCI Thesaurus-2)
C91217 (NCI Thesaurus-2)
C0281588 (UMLS 2011AA ObjectClass)
C16960 (NCI Thesaurus Property)
C0030705 (UMLS 2011AA Property)
C61483 (NCI Thesaurus Property-2)
C0016770 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
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C0518214 (UMLS 2011AA ValueDomain-2)
C91213 (NCI Thesaurus-2)
C70543 (NCI Thesaurus-3)
C2003901 (UMLS 2011AA)
C91216 (NCI Thesaurus-2)
C91217 (NCI Thesaurus-2)
C0281588 (UMLS 2011AA ObjectClass)
C16960 (NCI Thesaurus Property)
C0030705 (UMLS 2011AA Property)
C43431 (NCI Thesaurus Property-2)
C0441655 (UMLS 2011AA Property-2)
C3036 (NCI Thesaurus Property-3)
C0015672 (UMLS 2011AA Property-3)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ValueDomain-2)
C91213 (NCI Thesaurus-2)
C70543 (NCI Thesaurus-3)
C2003901 (UMLS 2011AA)
C91216 (NCI Thesaurus-2)
C91217 (NCI Thesaurus-2)