ID
1089
Beschreibung
NSABP-B-47 Treatment Discontinuation Form (Form OFF) A Randomized Phase III Trial of Adjuvant Therapy Comparing Chemotherapy Alone (Six Cycles of Docetaxel Plus Cyclophosphamide or Four Cycles of Doxorubicin Plus Cyclophosphamide Followed by Weekly Paclitaxel) to Chemotherapy Plus Trastuzumab in Women With Node- Positive or High-Risk Node-Negative HER2-Low Invasive Breast Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=955983BD-6DF9-0939-E040-BB89AD430554
Link
Stichworte
Versionen (2)
- 27.08.12 27.08.12 -
- 09.01.15 09.01.15 - Martin Dugas
Hochgeladen am
27. August 2012
DOI
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Lizenz
Creative Commons BY-NC 3.0 Legacy
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Breast Cancer NCT01275677 Off Treatment - NSABP-B-47 Treatment Discontinuation Form (Form OFF) - 3161872v1.0
This paper worksheet may be completed to facilitate the entry of the information in NSABP Coordinator Online. Partially completed online forms may be saved in Coordinator Online. DO NOT SUBMIT THIS WORKSHEET VIA FAX OR MAIL. Submit the Form OFF when any of the following conditions apply: When it is confirmed that the patient will NOT begin any study drugs. When the patient permanently discontinues or completes all of the study drugs during chemotherapy. Groups 2A and 2B only: When the patient permanently discontinues or completes trastuzumab
- StudyEvent: NSABP-B-47 Treatment Discontinuation Form (Form OFF)
Beschreibung
Time Point
Beschreibung
Header Module
Beschreibung
AnyClinicalStudyProtocolTherapyAdministeredInd-2
Datentyp
text
Alias
- NCI Thesaurus ObjectClass
- C25320
- UMLS 2011AA ObjectClass
- C1507394
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus ObjectClass
- C81168
- UMLS 2011AA ObjectClass
- C1552551
- NCI Thesaurus Property
- C25382
- UMLS 2011AA Property
- C1521801
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Beschreibung
LastCycleTherapyAdministeredCount
Datentyp
double
Alias
- NCI Thesaurus ObjectClass
- C25472
- UMLS 2011AA ObjectClass
- C1511572
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus ObjectClass
- C25551
- UMLS 2011AA ObjectClass
- C1517741
- NCI Thesaurus Property
- C25382
- UMLS 2011AA Property
- C1521801
- NCI Thesaurus ValueDomain
- C25463
- UMLS 2011AA ValueDomain
- C0750480
Beschreibung
AgentName
Datentyp
text
Alias
- NCI Thesaurus Property
- C25364
- UMLS 2011AA Property
- C0600091
- NCI Thesaurus ObjectClass
- C1708
- UMLS 2011AA ObjectClass
- C0450442
- NCI Thesaurus ValueDomain
- C1708
- UMLS 2011AA ValueDomain
- C0450442
- NCI Thesaurus ValueDomain
- C42614
- UMLS 2011AA ValueDomain
- C0027365
Beschreibung
AgentBeginAdministeredInd-2
Datentyp
text
Alias
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
- NCI Thesaurus Property
- C25431
- UMLS 2011AA Property
- C0439659
- NCI Thesaurus ObjectClass
- C1708
- UMLS 2011AA ObjectClass
- C0450442
- NCI Thesaurus Property
- C25382
- UMLS 2011AA Property
- C1521801
Beschreibung
NationalSurgicalAdjuvantBreastandBowelProjectTreatmentNotAdministeredReason
Datentyp
text
Alias
- NCI Thesaurus ObjectClass
- C15818
- UMLS 2011AA ObjectClass
- C1513905
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus Property
- C25594
- UMLS 2011AA Property
- C1518422
- NCI Thesaurus Property
- C25382
- UMLS 2011AA Property
- C1521801
- NCI Thesaurus ValueDomain
- C25638
- UMLS 2011AA ValueDomain
- C0392360
Beschreibung
Header Module
Beschreibung
ImmunotherapyTrastuzumabReceivedInd-2
Datentyp
text
Alias
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
- NCI Thesaurus Property
- C1647
- UMLS 2011AA Property
- C0338204
- NCI Thesaurus ObjectClass
- C15262
- UMLS 2011AA ObjectClass
- C0021083
- NCI Thesaurus Property
- C25639
- UMLS 2011AA Property
- C1514756
Beschreibung
LastCycleTherapyTrastuzumabAdministeredCount
Datentyp
double
Alias
- NCI Thesaurus ObjectClass
- C25472
- UMLS 2011AA ObjectClass
- C1511572
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus ObjectClass
- C25551
- UMLS 2011AA ObjectClass
- C1517741
- NCI Thesaurus Property
- C1647
- UMLS 2011AA Property
- C0338204
- NCI Thesaurus Property
- C25382
- UMLS 2011AA Property
- C1521801
- NCI Thesaurus ValueDomain
- C25463
- UMLS 2011AA ValueDomain
- C0750480
Beschreibung
NationalSurgicalAdjuvantBreastandBowelProjectTreatmentNotAdministeredReason
Datentyp
text
Alias
- NCI Thesaurus ObjectClass
- C15818
- UMLS 2011AA ObjectClass
- C1513905
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus Property
- C25594
- UMLS 2011AA Property
- C1518422
- NCI Thesaurus Property
- C25382
- UMLS 2011AA Property
- C1521801
- NCI Thesaurus ValueDomain
- C25638
- UMLS 2011AA ValueDomain
- C0392360
Beschreibung
Footer
Beschreibung
ResearchCommentsText
Datentyp
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus ObjectClass
- C15319
- NCI Thesaurus Property
- C25393
- UMLS 2011AA Property
- C0282411
Beschreibung
ResponsiblePersonName
Datentyp
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS 2011AA ValueDomain
- C1547383
- NCI Thesaurus ObjectClass
- C25657
- UMLS 2011AA ObjectClass
- C1273518
- NCI Thesaurus Property
- C25364
- UMLS 2011AA Property
- C0600091
Beschreibung
FormCompleteDate
Datentyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C40988
- UMLS 2011AA ObjectClass
- C1516308
- NCI Thesaurus Property
- C25250
- UMLS 2011AA Property
- C0205197
- NCI Thesaurus ValueDomain
- C25367
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This paper worksheet may be completed to facilitate the entry of the information in NSABP Coordinator Online. Partially completed online forms may be saved in Coordinator Online. DO NOT SUBMIT THIS WORKSHEET VIA FAX OR MAIL. Submit the Form OFF when any of the following conditions apply: When it is confirmed that the patient will NOT begin any study drugs. When the patient permanently discontinues or completes all of the study drugs during chemotherapy. Groups 2A and 2B only: When the patient permanently discontinues or completes trastuzumab
- StudyEvent: NSABP-B-47 Treatment Discontinuation Form (Form OFF)
C1547383 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25536 (NCI Thesaurus Property)
C1555582 (UMLS 2011AA Property)
C0237753 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C15818 (NCI Thesaurus Property)
C1513905 (UMLS 2011AA Property)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25616 (NCI Thesaurus Property)
C1948053 (UMLS 2011AA Property)
C0392920 (UMLS 2011AA)
C0338204 (UMLS 2011AA)
C1507394 (UMLS 2011AA ObjectClass)
C15368 (NCI Thesaurus ObjectClass)
C81168 (NCI Thesaurus ObjectClass)
C1552551 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C1705108 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
C1511572 (UMLS 2011AA ObjectClass)
C15368 (NCI Thesaurus ObjectClass)
C25551 (NCI Thesaurus ObjectClass)
C1517741 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
C0600091 (UMLS 2011AA Property)
C1708 (NCI Thesaurus ObjectClass)
C0450442 (UMLS 2011AA ObjectClass)
C1708 (NCI Thesaurus ValueDomain)
C0450442 (UMLS 2011AA ValueDomain)
C42614 (NCI Thesaurus ValueDomain)
C0027365 (UMLS 2011AA ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C25431 (NCI Thesaurus Property)
C0439659 (UMLS 2011AA Property)
C1708 (NCI Thesaurus ObjectClass)
C0450442 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
C1705108 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
C1513905 (UMLS 2011AA ObjectClass)
C15368 (NCI Thesaurus ObjectClass)
C25594 (NCI Thesaurus Property)
C1518422 (UMLS 2011AA Property)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
C25638 (NCI Thesaurus ValueDomain)
C0392360 (UMLS 2011AA ValueDomain)
C0011065 (UMLS 2011AA)
C0205394 (UMLS 2011AA)
C1512698 (UMLS 2011AA ValueDomain)
C1647 (NCI Thesaurus Property)
C0338204 (UMLS 2011AA Property)
C15262 (NCI Thesaurus ObjectClass)
C0021083 (UMLS 2011AA ObjectClass)
C25639 (NCI Thesaurus Property)
C1514756 (UMLS 2011AA Property)
C1705108 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
C1511572 (UMLS 2011AA ObjectClass)
C15368 (NCI Thesaurus ObjectClass)
C25551 (NCI Thesaurus ObjectClass)
C1517741 (UMLS 2011AA ObjectClass)
C1647 (NCI Thesaurus Property)
C0338204 (UMLS 2011AA Property)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
C1513905 (UMLS 2011AA ObjectClass)
C15368 (NCI Thesaurus ObjectClass)
C25594 (NCI Thesaurus Property)
C1518422 (UMLS 2011AA Property)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
C25638 (NCI Thesaurus ValueDomain)
C0392360 (UMLS 2011AA ValueDomain)
C0011065 (UMLS 2011AA)
C0205394 (UMLS 2011AA)
C1527021 (UMLS 2011AA ValueDomain)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C0282411 (UMLS 2011AA Property)
C1547383 (UMLS 2011AA ValueDomain)
C25657 (NCI Thesaurus ObjectClass)
C1273518 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C0011008 (UMLS 2011AA ValueDomain)
C40988 (NCI Thesaurus ObjectClass)
C1516308 (UMLS 2011AA ObjectClass)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C25367 (NCI Thesaurus ValueDomain)