0 Ratings

ID

10861

Description

Southwest Oncology Group S0819 Baseline Tumor Assessment Form NCT00946712 Carboplatin and Paclitaxel With or Without Bevacizumab and/or Cetuximab in Treating Patients With Stage IV or Recurrent Non-Small Cell Lung Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=684CF883-62F5-1929-E040-BB89AD4373A3

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=684CF883-62F5-1929-E040-BB89AD4373A3

Keywords

  1. 9/19/12 9/19/12 -
  2. 1/9/15 1/9/15 - Martin Dugas
  3. 6/9/15 6/9/15 -
Uploaded on

June 9, 2015

DOI

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Creative Commons BY-NC 3.0 Legacy

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    Southwest Oncology Group S0819 Baseline Tumor Assessment Form NCT00946712

    No Instruction available.

    1. StudyEvent: Southwest Oncology Group S0819 Baseline Tumor Assessment Form
      1. No Instruction available.
    Header
    Description

    Header

    SWOG Patient ID
    Description

    Trial subject ID SWOG

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C2348585
    NCI Thesaurus ObjectClass
    C16960
    UMLS CUI-2
    C1519429
    NCI Thesaurus Property
    C25364
    NCI Thesaurus Property-2
    C25699
    SWOG Study No.
    Description

    Protocol ID SWOG

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C3274381
    NCI Thesaurus ObjectClass
    C25320
    UMLS CUI-2
    C1519429
    NCI Thesaurus Property
    C25364
    NCI Thesaurus Property-2
    C25699
    Registration Step
    Description

    Registration Number

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C1514821
    NCI Thesaurus ObjectClass
    C25646
    UMLS CUI-2
    C0237753
    NCI Thesaurus Property
    C16154
    NCI Thesaurus ValueDomain-2
    C16154
    Patient Initials (L, F M)
    Description

    Patient Initials

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS CUI-1
    C2986440
    NCI Thesaurus ObjectClass
    C16960
    NCI Thesaurus Property
    C25536
    Institution/Affiliate
    Description

    Institution Name

    Data type

    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
    Physician (Participating Group)
    Description

    Investigator Name

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS CUI-1
    C2826892
    NCI Thesaurus Property
    C25364
    NCI Thesaurus ObjectClass
    C17089
    NCI Thesaurus ObjectClass-2
    C25644
    Participating Group Name
    Description

    Participating Group

    Data type

    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.
    Description

    StudyNo.

    Data type

    text

    Participating Group Patient ID
    Description

    Trial subject ID Participating Group

    Data type

    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
    Evaluation of lesions
    Description

    Evaluation of 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-2
    C25702
    UMLS 2011AA Property-2
    C1521840
    Longest Diameter (cm)
    Description

    BaselineMalignantNeoplasmLongestDiameterMeasurement

    Data type

    float

    Measurement units
    • cm
    Alias
    NCI Thesaurus ObjectClass
    C25213
    UMLS 2011AA ObjectClass
    C1442488
    NCI Thesaurus ObjectClass-2
    C9305
    UMLS 2011AA ObjectClass-2
    C0006826
    NCI Thesaurus Property
    C25285
    UMLS 2011AA Property
    C1301886
    NCI Thesaurus Property-2
    C25558
    UMLS 2011AA Property-2
    C1522425
    NCI Thesaurus ValueDomain
    C25209
    UMLS 2011AA ValueDomain
    C0242485
    NCI Thesaurus ValueDomain-2
    C25285
    UMLS 2011AA ValueDomain-2
    C1301886
    cm
    Assessment Type (*)
    Description

    Evaluation method

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25284
    UMLS CUI-1
    C2911685
    NCI Thesaurus ObjectClass
    C20989
    NCI Thesaurus Property
    C16847
    Assessment Date
    Description

    LesionAssessmentDate

    Data type

    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
    Assessment Type (*)
    Description

    Evaluation method

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25284
    UMLS CUI-1
    C2911685
    NCI Thesaurus ObjectClass
    C20989
    NCI Thesaurus Property
    C16847
    Assessment Date
    Description

    LesionAssessmentDate

    Data type

    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
    Non-target disease
    Description

    LesionNontargetSite

    Data type

    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
    Extent
    Description

    DiseaseExtentStatus

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C2991
    UMLS 2011AA ObjectClass
    C0012634
    NCI Thesaurus ValueDomain
    C25688
    UMLS 2011AA ValueDomain
    C0449438
    NCI Thesaurus Property
    C25332
    UMLS 2011AA Property
    C0439792
    Lesions assessment and/or measurements provided by
    Description

    LesionPersonPerformedDiagnosticImagingType

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C3824
    UMLS 2011AA ObjectClass
    C0221198
    NCI Thesaurus Property
    C25190
    UMLS 2011AA Property
    C0027361
    NCI Thesaurus Property-2
    C16502
    UMLS 2011AA Property-2
    C0011923
    NCI Thesaurus Property-3
    C38000
    UMLS 2011AA Property-3
    C0884358
    NCI Thesaurus ValueDomain
    C25284
    UMLS 2011AA ValueDomain
    C0332307
    Diagnostic test
    Description

    Diagnostic test

    Tests/studies
    Description

    TestDiagnosticSpecify

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25685
    UMLS 2011AA ValueDomain
    C1521902
    NCI Thesaurus ObjectClass
    C25294
    UMLS 2011AA ObjectClass
    C0022885
    NCI Thesaurus Property
    C25482
    UMLS 2011AA Property
    C0348026
    Assessment Date
    Description

    LesionAssessmentDate

    Data type

    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
    Comments
    Description

    Comments

    Comments
    Description

    Research Comments

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704
    UMLS CUI-1
    C0947611
    NCI Thesaurus ObjectClass
    C15319
    NCI Thesaurus Property
    C25393

    Similar models

    No Instruction available.

    1. StudyEvent: Southwest Oncology Group S0819 Baseline Tumor Assessment Form
      1. No Instruction available.
    Name
    Type
    Description | Question | Decode (Coded Value)
    Data type
    Alias
    Item Group
    Header
    Trial subject ID SWOG
    Item
    SWOG Patient ID
    text
    C25337 (NCI Thesaurus ValueDomain)
    C2348585 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C1519429 (UMLS CUI-2)
    C25364 (NCI Thesaurus Property)
    C25699 (NCI Thesaurus Property-2)
    Protocol ID SWOG
    Item
    SWOG Study No.
    text
    C25337 (NCI Thesaurus ValueDomain)
    C3274381 (UMLS CUI-1)
    C25320 (NCI Thesaurus ObjectClass)
    C1519429 (UMLS CUI-2)
    C25364 (NCI Thesaurus Property)
    C25699 (NCI Thesaurus Property-2)
    Registration Number
    Item
    Registration Step
    text
    C25337 (NCI Thesaurus ValueDomain)
    C1514821 (UMLS CUI-1)
    C25646 (NCI Thesaurus ObjectClass)
    C0237753 (UMLS CUI-2)
    C16154 (NCI Thesaurus Property)
    C16154 (NCI Thesaurus ValueDomain-2)
    Patient Initials
    Item
    Patient Initials (L, F M)
    text
    C25191 (NCI Thesaurus ValueDomain)
    C2986440 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C25536 (NCI Thesaurus Property)
    Institution Name
    Item
    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)
    Investigator Name
    Item
    Physician (Participating Group)
    text
    C25191 (NCI Thesaurus ValueDomain)
    C2826892 (UMLS CUI-1)
    C25364 (NCI Thesaurus Property)
    C17089 (NCI Thesaurus ObjectClass)
    C25644 (NCI Thesaurus ObjectClass-2)
    Participating Group
    Item
    Participating Group Name
    text
    C25191 (NCI Thesaurus ValueDomain)
    C2347449 (UMLS CUI-1)
    C25608 (NCI Thesaurus ObjectClass)
    C17005 (NCI Thesaurus ObjectClass-2)
    C25364 (NCI Thesaurus Property)
    StudyNo.
    Item
    Participating Group Study No.
    text
    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
    Evaluation of 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-2)
    C1521840 (UMLS 2011AA Property-2)
    BaselineMalignantNeoplasmLongestDiameterMeasurement
    Item
    Longest Diameter (cm)
    float
    C25213 (NCI Thesaurus ObjectClass)
    C1442488 (UMLS 2011AA ObjectClass)
    C9305 (NCI Thesaurus ObjectClass-2)
    C0006826 (UMLS 2011AA ObjectClass-2)
    C25285 (NCI Thesaurus Property)
    C1301886 (UMLS 2011AA Property)
    C25558 (NCI Thesaurus Property-2)
    C1522425 (UMLS 2011AA Property-2)
    C25209 (NCI Thesaurus ValueDomain)
    C0242485 (UMLS 2011AA ValueDomain)
    C25285 (NCI Thesaurus ValueDomain-2)
    C1301886 (UMLS 2011AA ValueDomain-2)
    Item
    Assessment Type (*)
    text
    C25284 (NCI Thesaurus ValueDomain)
    C2911685 (UMLS CUI-1)
    C20989 (NCI Thesaurus ObjectClass)
    C16847 (NCI Thesaurus Property)
    Code List
    Assessment Type (*)
    CL Item
    Palpation (Palpation)
    CL Item
    Visualization (Visualization)
    CL Item
    Colposcopy (Colposcopy)
    CL Item
    Endoscopy (Endoscopy)
    C16546 (NCI Thesaurus)
    C0014245 (UMLS 2011AA)
    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)
    C64384 (NCI Thesaurus)
    C1456803 (UMLS 2011AA)
    CL Item
    Pet Scan (PET scan)
    CL Item
    Spiral Ct Scan (Spiral CT scan)
    CL Item
    Cystoscopy (Cystoscopy)
    C16482 (NCI Thesaurus)
    C0010702 (UMLS 2011AA)
    CL Item
    Histologic (Histologic confirmation)
    CL Item
    Cytologic Confirmation (Cytologic confirmation)
    CL Item
    Spiral Ct Positron Emission Tomography (PET/Spiral CT)
    C17007 (NCI Thesaurus)
    C0032743 (UMLS 2011AA)
    C20645 (NCI Thesaurus-3)
    C0860888 (UMLS 2011AA-4)
    CL Item
    Computed Tomography Positron Emission Tomography (PET/Conventional CT)
    C17007 (NCI Thesaurus)
    C0032743 (UMLS 2011AA)
    C17204 (NCI Thesaurus-3)
    C0040405 (UMLS 2011AA-4)
    CL Item
    Other (Other)
    C17649 (NCI Thesaurus)
    C0205394 (UMLS 2011AA)
    LesionAssessmentDate
    Item
    Assessment Date
    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
    Assessment Type (*)
    text
    C25284 (NCI Thesaurus ValueDomain)
    C2911685 (UMLS CUI-1)
    C20989 (NCI Thesaurus ObjectClass)
    C16847 (NCI Thesaurus Property)
    Code List
    Assessment Type (*)
    CL Item
    Palpation (Palpation)
    CL Item
    Visualization (Visualization)
    CL Item
    Colposcopy (Colposcopy)
    CL Item
    Endoscopy (Endoscopy)
    C16546 (NCI Thesaurus)
    C0014245 (UMLS 2011AA)
    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)
    C64384 (NCI Thesaurus)
    C1456803 (UMLS 2011AA)
    CL Item
    Pet Scan (PET scan)
    CL Item
    Spiral Ct Scan (Spiral CT scan)
    CL Item
    Cystoscopy (Cystoscopy)
    C16482 (NCI Thesaurus)
    C0010702 (UMLS 2011AA)
    CL Item
    Histologic (Histologic confirmation)
    CL Item
    Cytologic Confirmation (Cytologic confirmation)
    CL Item
    Spiral Ct Positron Emission Tomography (PET/Spiral CT)
    C17007 (NCI Thesaurus)
    C0032743 (UMLS 2011AA)
    C20645 (NCI Thesaurus-3)
    C0860888 (UMLS 2011AA-4)
    CL Item
    Computed Tomography Positron Emission Tomography (PET/Conventional CT)
    C17007 (NCI Thesaurus)
    C0032743 (UMLS 2011AA)
    C17204 (NCI Thesaurus-3)
    C0040405 (UMLS 2011AA-4)
    CL Item
    Other (Other)
    C17649 (NCI Thesaurus)
    C0205394 (UMLS 2011AA)
    LesionAssessmentDate
    Item
    Assessment Date
    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)
    LesionNontargetSite
    Item
    Non-target disease
    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)
    DiseaseExtentStatus
    Item
    Extent
    text
    C2991 (NCI Thesaurus ObjectClass)
    C0012634 (UMLS 2011AA ObjectClass)
    C25688 (NCI Thesaurus ValueDomain)
    C0449438 (UMLS 2011AA ValueDomain)
    C25332 (NCI Thesaurus Property)
    C0439792 (UMLS 2011AA Property)
    Item
    Lesions assessment and/or measurements provided by
    text
    C3824 (NCI Thesaurus ObjectClass)
    C0221198 (UMLS 2011AA ObjectClass)
    C25190 (NCI Thesaurus Property)
    C0027361 (UMLS 2011AA Property)
    C16502 (NCI Thesaurus Property-2)
    C0011923 (UMLS 2011AA Property-2)
    C38000 (NCI Thesaurus Property-3)
    C0884358 (UMLS 2011AA Property-3)
    C25284 (NCI Thesaurus ValueDomain)
    C0332307 (UMLS 2011AA ValueDomain)
    Code List
    Lesions assessment and/or measurements provided by
    CL Item
    Radiologist (Radiologist)
    C17824 (NCI Thesaurus)
    C0260194 (UMLS 2011AA)
    CL Item
    Treating Physician (Treating Physician)
    C51883 (NCI Thesaurus)
    C1710470 (UMLS 2011AA)
    Item Group
    Diagnostic test
    TestDiagnosticSpecify
    Item
    Tests/studies
    text
    C25685 (NCI Thesaurus ValueDomain)
    C1521902 (UMLS 2011AA ValueDomain)
    C25294 (NCI Thesaurus ObjectClass)
    C0022885 (UMLS 2011AA ObjectClass)
    C25482 (NCI Thesaurus Property)
    C0348026 (UMLS 2011AA Property)
    LesionAssessmentDate
    Item
    Assessment Date
    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 Group
    Comments
    Research Comments
    Item
    Comments
    text
    C25704 (NCI Thesaurus ValueDomain)
    C0947611 (UMLS CUI-1)
    C15319 (NCI Thesaurus ObjectClass)
    C25393 (NCI Thesaurus Property)

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