ID
1083
Description
ACOSOG-Z1072 OPEN Registration Worksheet Cryoablation Therapy in Treating Patients With Invasive Ductal Breast Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=7FF941F7-5D5F-47CE-E040-BB89AD432465
Link
Keywords
Versions (4)
- 8/26/12 8/26/12 -
- 1/9/15 1/9/15 - Martin Dugas
- 6/21/15 6/21/15 -
- 9/20/21 9/20/21 -
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August 26, 2012
DOI
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Creative Commons BY-NC 3.0 Legacy
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Breast Cancer NCT00723294 Registration - ACOSOG-Z1072 OPEN Registration Worksheet - 3013196v1.0
No Instruction available.
- StudyEvent: ACOSOG-Z1072 OPEN Registration Worksheet
Description
General Information
Description
PatientIdentifier
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25364
- UMLS 2011AA Property
- C0600091
- NCI Thesaurus ValueDomain
- C25364
- UMLS 2011AA ValueDomain
- C0600091
Description
PatientLastInitialsName
Data type
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
- NCI Thesaurus Property
- C25551
- UMLS 2011AA Property
- C1517741
Description
PatientFirstInitialsName
Data type
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
- NCI Thesaurus Property
- C25509
- UMLS 2011AA Property
- C1279901
Description
PatientMiddleInitialsName
Data type
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
- NCI Thesaurus Property
- C25569
- UMLS 2011AA Property
- C0444598
Description
ResponsiblePersonE-mailAddressText
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus ObjectClass
- C25657
- UMLS 2011AA ObjectClass
- C1273518
- NCI Thesaurus Property
- C42775
- UMLS 2011AA Property
- C1705961
Description
PriorTherapyPatientAmericanCollegeofSurgeonsOncologyGroupStudyInd-2
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus ObjectClass
- C16124
- UMLS 2011AA ObjectClass
- C1514463
- NCI Thesaurus Property
- C19712
- UMLS 2011AA Property
- C1515944
- NCI Metathesaurus Property
- CL238692
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Description
PatientCoordinatingIdentifierNumber
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS 2011AA ValueDomain
- C0237753
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25462
- UMLS 2011AA Property
- C0700114
- NCI Thesaurus Property
- C25364
- UMLS 2011AA Property
- C0600091
Description
InformedConsentFormSignedDate
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ValueDomain
- C25367
- NCI Thesaurus ObjectClass
- C16468
- UMLS 2011AA ObjectClass
- C0009797
- NCI Thesaurus Property
- C25679
Description
HealthInsurancePortabilityandAccountabilityActAuthorizationIndicator
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
- NCI Thesaurus ObjectClass
- C62504
- UMLS 2011AA ObjectClass
- C0600593
- NCI Thesaurus Property
- C41192
- UMLS 2011AA Property
- C1524004
Description
PatientSignedDischargeMedicalRecordDate
Data type
date
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25679
- NCI Metathesaurus Property
- C0012621
- NCI Thesaurus Property
- C45258
- UMLS 2011AA Property
- C0025102
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
Description
Eligibility Criteria
Description
InvasiveBreastCarcinomaHistologicallyConfirmedIndicator
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C4872
- UMLS 2011AA ObjectClass
- C0678222
- NCI Thesaurus ObjectClass
- C14159
- UMLS 2011AA ObjectClass
- C0205281
- NCI Thesaurus Property
- C25458
- UMLS 2011AA Property
- C0750484
- NCI Thesaurus Property
- C25527
- UMLS 2011AA Property
- C0205462
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Description
BreastBiopsyIndicator
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
- NCI Thesaurus Property
- C15189
- UMLS 2011AA Property
- C0005558
- NCI Thesaurus ObjectClass
- C12971
- UMLS 2011AA ObjectClass
- C0006141
Description
BreastCarcinomaTwoCentimeterPresentIndicator
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C4872
- UMLS 2011AA ObjectClass
- C0678222
- NCI Thesaurus Property
- C25626
- UMLS 2011AA Property
- C0150312
- NCI Thesaurus Property
- C49668
- UMLS 2011AA Property
- C0475210
- NCI Thesaurus Property
- C66833
- UMLS 2011AA Property
- C0205448
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Description
MeasurableDiseaseEnhancingLesionPresentIndicator
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C2991
- UMLS 2011AA ObjectClass
- C0012634
- NCI Thesaurus ObjectClass
- C37894
- UMLS 2011AA ObjectClass
- C1513040
- NCI Thesaurus Property
- C25626
- UMLS 2011AA Property
- C0150312
- NCI Thesaurus Property
- C28746
- UMLS 2011AA Property
- C1333400
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Description
TumorHistologicVariationIndicator
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
- NCI Thesaurus ObjectClass
- C3262
- UMLS 2011AA ObjectClass
- C0027651
- NCI Thesaurus Property
- C25526
- UMLS 2011AA Property
- C0205462
- NCI Thesaurus Property
- C25713
- UMLS 2011AA Property
- C0205419
Description
PriorSystemicTherapyInvasiveBreastCarcinomaAdministeredIndicator
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C15698
- UMLS 2011AA ObjectClass
- C1515119
- NCI Thesaurus ObjectClass
- C25629
- UMLS 2011AA ObjectClass
- C0332152
- NCI Thesaurus Property
- C9245
- UMLS 2011AA Property
- C0853879
- NCI Thesaurus Property
- C25382
- UMLS 2011AA Property
- C1521801
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Description
PatientNegativePregnancyTestIndicator
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25247
- UMLS 2011AA Property
- C0205160
- NCI Metathesaurus Property
- C0032976
Description
PatientNegativePregnancyTestDate
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25247
- UMLS 2011AA Property
- C0205160
- NCI Metathesaurus Property
- C0032976
Description
BreastSizeDocumentedIndicator
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
- NCI Thesaurus ObjectClass
- C12971
- UMLS 2011AA ObjectClass
- C0006141
- NCI Thesaurus Property
- C25681
- UMLS 2011AA Property
- C0456389
- NCI Thesaurus Property
- C25356
- UMLS 2011AA Property
- C1301725
Description
RecurrentIpsilateralBreastNeoplasmDiagnosisInd-2
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C3262
- UMLS 2011AA ObjectClass
- C0027651
- NCI Thesaurus ObjectClass
- C12971
- UMLS 2011AA ObjectClass
- C0006141
- NCI Thesaurus ObjectClass
- C14173
- UMLS 2011AA ObjectClass
- C2945760
- NCI Thesaurus ObjectClass
- C25308
- UMLS 2011AA ObjectClass
- C0441989
- NCI Thesaurus Property
- C15220
- UMLS 2011AA Property
- C0011900
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
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No Instruction available.
- StudyEvent: ACOSOG-Z1072 OPEN Registration Worksheet
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