ID
10838
Beschrijving
CALGB 40601 ON-STUDY FORM NCT00770809 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=39F0C5FF-8DFB-6139-E044-0003BA3F9857
Link
Trefwoorden
Versies (3)
- 27-08-12 27-08-12 -
- 09-01-15 09-01-15 - Martin Dugas
- 09-06-15 09-06-15 -
Geüploaded op
9 juni 2015
DOI
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Licentie
Creative Commons BY-NC 3.0 Legacy
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CALGB 40601 ON-STUDY FORM NCT00770809
INSTRUCTIONS: Complete all information on this form. Submit within one week of registration along with the On-Study Form.
- StudyEvent: CALGB 40601 ON-STUDY FORM
Beschrijving
Patient demographics
Beschrijving
Patient Initials
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS CUI-1
- C2986440
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25536
Beschrijving
Medical Record Number
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C1301894
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25261
- NCI Thesaurus Property-2
- C25198
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
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
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
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
Beschrijving
Menopausal Status
Beschrijving
PatientMenopauseCategory
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25372
- UMLS 2011AA ValueDomain
- C0683312
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C3231
- UMLS 2011AA Property
- C0025320
- NCI Thesaurus ValueDomain-2
- C3231
- UMLS 2011AA ValueDomain-2
- C0025320
Beschrijving
Disease Description
Beschrijving
PrimaryTumorLateralityType
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus ObjectClass
- C3262
- UMLS 2011AA ObjectClass
- C0027651
- NCI Thesaurus ObjectClass-2
- C25251
- UMLS 2011AA ObjectClass-2
- C0205225
- NCI Thesaurus Property
- C25185
- UMLS 2011AA Property
- C0332304
Beschrijving
ERLevelTumorStatus
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C3262
- UMLS 2011AA ValueDomain
- C0027651
- NCI Thesaurus ObjectClass
- C17069
- UMLS 2011AA ObjectClass
- C0034804
- NCI Thesaurus ValueDomain-2
- C25688
- UMLS 2011AA ValueDomain-2
- C0449438
- NCI Thesaurus Property
- C25554
- UMLS 2011AA Property
- C0441889
Beschrijving
PgRStatusType
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus ObjectClass
- C17075
- UMLS 2011AA ObjectClass
- C0034833
- NCI Metathesaurus Property
- C0678257
Beschrijving
BreastCarcinomaCombinedHistologicGradeCategory
Datatype
text
Alias
- NCI Thesaurus Property
- C25454
- UMLS 2011AA Property
- C0205195
- NCI Thesaurus ValueDomain
- C25372
- UMLS 2011AA ValueDomain
- C0683312
- NCI Thesaurus ObjectClass
- C4872
- UMLS 2011AA ObjectClass
- C0678222
- NCI Thesaurus Property-2
- C18000
- UMLS 2011AA Property-2
- C0919553
Beschrijving
BreastTumorHistologicCategory
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C3262
- UMLS 2011AA ObjectClass
- C0027651
- NCI Thesaurus ObjectClass-2
- C12971
- UMLS 2011AA ObjectClass-2
- C0006141
- NCI Thesaurus Property
- C25526
- UMLS 2011AA Property
- C0205462
- NCI Thesaurus Property-2
- C25161
- UMLS 2011AA Property-2
- C0008902
- NCI Thesaurus ValueDomain
- C25372
- UMLS 2011AA ValueDomain
- C0683312
- NCI Thesaurus ValueDomain-2
- C25526
- UMLS 2011AA ValueDomain-2
- C0205462
Beschrijving
Histologic Type, other
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS CUI-1
- C1299220
- NCI Thesaurus ObjectClass
- C3262
- NCI Thesaurus Property
- C25526
- NCI Thesaurus Property-2
- C25161
Beschrijving
BiopsyProcedure
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C15189
- UMLS 2011AA ObjectClass
- C0005558
- NCI Thesaurus Property
- C15368
- NCI Thesaurus ValueDomain
- C25218
- UMLS 2011AA ValueDomain
- C1948041
Beschrijving
Clinical Disease Assessment
Beschrijving
Evaluation method
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS CUI-1
- C2911685
- NCI Thesaurus ObjectClass
- C20989
- NCI Thesaurus Property
- C16847
Beschrijving
PrimaryTumorSizeMeasurement
Datatype
float
Alias
- NCI Thesaurus ValueDomain
- C25209
- UMLS 2011AA ValueDomain
- C0242485
- NCI Thesaurus ObjectClass
- C3262
- UMLS 2011AA ObjectClass
- C0027651
- NCI Thesaurus ObjectClass-2
- C25251
- UMLS 2011AA ObjectClass-2
- C0205225
- NCI Thesaurus Property
- C25681
- UMLS 2011AA Property
- C0456389
Beschrijving
BreastTumorClinicalTStage
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C3262
- UMLS 2011AA ObjectClass
- C0027651
- NCI Thesaurus ObjectClass-2
- C12971
- UMLS 2011AA ObjectClass-2
- C0006141
- NCI Thesaurus Property
- C25398
- UMLS 2011AA Property
- C0205210
- NCI Thesaurus Property-2
- C25728
- UMLS 2011AA Property-2
- C0475455
- NCI Thesaurus ValueDomain
- C16899
- UMLS 2011AA ValueDomain
- C1300072
Beschrijving
BreastTumorClinicalNStage
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C3262
- UMLS 2011AA ObjectClass
- C0027651
- NCI Thesaurus ObjectClass-2
- C12971
- UMLS 2011AA ObjectClass-2
- C0006141
- NCI Thesaurus Property
- C25398
- UMLS 2011AA Property
- C0205210
- NCI Thesaurus Property-2
- C25580
- UMLS 2011AA Property-2
- C0456532
- NCI Thesaurus ValueDomain
- C16899
- UMLS 2011AA ValueDomain
- C1300072
Beschrijving
BreastTumorClinicalMStage
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C3262
- UMLS 2011AA ObjectClass
- C0027651
- NCI Thesaurus ObjectClass-2
- C12971
- UMLS 2011AA ObjectClass-2
- C0006141
- NCI Thesaurus Property
- C25398
- UMLS 2011AA Property
- C0205210
- NCI Thesaurus Property-2
- C25727
- UMLS 2011AA Property-2
- C0456533
- NCI Thesaurus ValueDomain
- C16899
- UMLS 2011AA ValueDomain
- C1300072
Beschrijving
Comments
Beschrijving
ANC
Datatype
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS CUI-1
- C0948762
- NCI Thesaurus Property
- C20200
- NCI Thesaurus Property-2
- C63321
- NCI Thesaurus ValueDomain
- C38046
- NCI Thesaurus ValueDomain-2
- C25712
Beschrijving
Platelets
Datatype
float
Maateenheden
- 1000/uL
Alias
- NCI Thesaurus Property
- C20200
- UMLS CUI-1
- C0005821
- NCI Thesaurus Property-2
- C12520
- NCI Thesaurus ObjectClass
- C25294
- NCI Thesaurus ValueDomain
- C25712
Beschrijving
HeartLVEFTestPercentageValue
Datatype
float
Maateenheden
- %
Alias
- NCI Thesaurus ObjectClass
- C12727
- UMLS 2011AA ObjectClass
- C0018787
- NCI Thesaurus Property
- C25294
- UMLS 2011AA Property
- C0022885
- NCI Thesaurus Property-2
- C37946
- UMLS 2011AA Property-2
- C2700377
- NCI Thesaurus ValueDomain
- C25613
- UMLS 2011AA ValueDomain
- C0439165
- NCI Thesaurus ValueDomain-2
- C25712
- UMLS 2011AA ValueDomain-2
- C1522609
Beschrijving
HepaticBilirubinLabValue
Datatype
float
Maateenheden
- mg/dL
Alias
- NCI Thesaurus Property
- C20200
- UMLS 2011AA Property
- C1274040
- NCI Thesaurus Property-2
- C305
- UMLS 2011AA Property-2
- C0005437
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
Beschrijving
HepaticBilirubinLabUpperLimitNormalValue
Datatype
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C20200
- UMLS 2011AA Property
- C1274040
- NCI Thesaurus Property-2
- C305
- UMLS 2011AA Property-2
- C0005437
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
- NCI Thesaurus ValueDomain-2
- C25706
- UMLS 2011AA ValueDomain-2
- C1519815
Beschrijving
HepaticSGPT(ALT)LabUnspecifiedValue
Datatype
float
Alias
- NCI Thesaurus ObjectClass
- C13308
- UMLS 2011AA ObjectClass
- C0205054
- NCI Thesaurus Property
- C37984
- UMLS 2011AA Property
- C0022877
- NCI Thesaurus Property-2
- C25293
- UMLS 2011AA Property-2
- C0376147
- NCI Thesaurus ValueDomain
- C38046
- UMLS 2011AA ValueDomain
- C0205370
- NCI Thesaurus ValueDomain-2
- C25712
- UMLS 2011AA ValueDomain-2
- C1522609
Beschrijving
LaboratoryProcedureSerumGlutamicPyruvicTransaminaseResultUpperLimitofNormalValue
Datatype
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C20200
- UMLS 2011AA Property
- C1274040
- NCI Thesaurus Property-2
- C25293
- UMLS 2011AA Property-2
- C0376147
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
- NCI Thesaurus ValueDomain-2
- C25706
- UMLS 2011AA ValueDomain-2
- C1519815
Beschrijving
HepaticSGOT(AST)LabUnspecifiedValue
Datatype
float
Alias
- NCI Thesaurus ObjectClass
- C13308
- UMLS 2011AA ObjectClass
- C0205054
- NCI Thesaurus Property
- C25202
- UMLS 2011AA Property
- C0242192
- NCI Thesaurus Property-2
- C37984
- UMLS 2011AA Property-2
- C0022877
- NCI Thesaurus ValueDomain
- C38046
- UMLS 2011AA ValueDomain
- C0205370
- NCI Thesaurus ValueDomain-2
- C25712
- UMLS 2011AA ValueDomain-2
- C1522609
Beschrijving
LaboratoryProcedureSerumGlutamicOxaloaceticTransferaseResultUnspecifiedUpperLimitofNormalValue
Datatype
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C25202
- UMLS 2011AA Property
- C0242192
- NCI Thesaurus Property-2
- C20200
- UMLS 2011AA Property-2
- C1274040
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
- NCI Thesaurus ValueDomain-2
- C25706
- UMLS 2011AA ValueDomain-2
- C1519815
Beschrijving
Required Laboratory Values
Beschrijving
Footer Module
Beschrijving
Person Completing Form
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS CUI-1
- C1550483
- NCI Thesaurus ObjectClass
- C25657
- NCI Thesaurus Property
- C25364
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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INSTRUCTIONS: Complete all information on this form. Submit within one week of registration along with the On-Study Form.
- StudyEvent: CALGB 40601 ON-STUDY FORM
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C3231 (NCI Thesaurus ValueDomain-2)
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C0205160 (UMLS 2011AA)
C1446409 (UMLS 2011AA)
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C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C1550483 (UMLS CUI-1)
C25657 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)
C1115437 (UMLS CUI-1)
C40988 (NCI Thesaurus ObjectClass)
C25250 (NCI Thesaurus Property)
C25367 (NCI Thesaurus ValueDomain-2)