ID
10944
Description
ECOG-E2108 Source Document Tracking Coversheet NCT01242800 Early Surgery or Standard Palliative Therapy in Treating Patients With Stage IV Breast Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=91E2AAB8-28DA-A87B-E040-BB89AD43631D
Link
Keywords
Versions (3)
- 8/26/12 8/26/12 -
- 1/9/15 1/9/15 - Martin Dugas
- 6/16/15 6/16/15 -
Uploaded on
June 16, 2015
DOI
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License
Creative Commons BY-NC 3.0 Legacy
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ECOG-E2108 Source Document Tracking Coversheet NCT01242800
INSTRUCTIONS (Single-step studies): Complete this form either after patient has completed protocol treatment for this study or when patient is stopping early or never started protocol treatment. Complete this form and submit original
- StudyEvent: ECOG-E2108 Source Document Tracking Coversheet
Description
Patient demographics
Description
Patient Initials
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS CUI-1
- C2986440
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25536
Description
Study Number Participating Group
Data type
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
Description
Protocol Number ECOG
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C3274381
- NCI Thesaurus ObjectClass
- C25320
- UMLS CUI-2
- C1512162
- NCI Thesaurus Property
- C25364
- NCI Thesaurus Property-2
- C25491
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
Description
Patient ID ECOG
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C2348585
- NCI Thesaurus ObjectClass
- C16960
- UMLS CUI-2
- C1512162
- NCI Thesaurus Property
- C25364
- NCI Thesaurus Property-2
- C25491
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
Description
Footer module
Description
Document type, required
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS CUI-1
- C1547673
- NCI Thesaurus ObjectClass
- C42651
- UMLS CUI-2
- C1514873
- NCI Thesaurus ObjectClass-2
- C19498
- NCI Thesaurus Property
- C25695
Description
ReportCreatedDate
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C25375
- UMLS 2011AA ObjectClass
- C0684224
- NCI Thesaurus Property
- C42620
- UMLS 2011AA Property
- C1706214
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INSTRUCTIONS (Single-step studies): Complete this form either after patient has completed protocol treatment for this study or when patient is stopping early or never started protocol treatment. Complete this form and submit original
- StudyEvent: ECOG-E2108 Source Document Tracking Coversheet
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
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C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
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C3274381 (UMLS CUI-1)
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C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
C1547673 (UMLS CUI-1)
C42651 (NCI Thesaurus ObjectClass)
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