ID
10982
Descrizione
E2603 Baseline Data Form (6/05) NCT00110019 Carboplatin and Paclitaxel With or Without Sorafenib in Treating Patients With Unresectable Stage III or Stage IV Melanoma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=FA0DB0C8-3665-5AA6-E034-0003BA3F9857
collegamento
Keywords
versioni (4)
- 19.09.12 19.09.12 -
- 08.01.15 08.01.15 - Martin Dugas
- 09.01.15 09.01.15 - Martin Dugas
- 16.06.15 16.06.15 -
Caricato su
16. Juni 2015
DOI
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Licenza
Creative Commons BY-NC 3.0 Legacy
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E2603 Baseline Data Form (6/05) NCT00110019
INSTRUCTIONS: Complete this form and submit original to the ECOG Coordinating Center within one week of registration. Keep a copy for your files
- StudyEvent: E2603 Baseline Data Form (6/05)
Descrizione
Patient demographics
Descrizione
Patient Initials
Tipo di dati
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS CUI-1
- C2986440
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25536
Descrizione
Protocol Number ECOG
Tipo di dati
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
Descrizione
Study Number Participating Group
Tipo di dati
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
Descrizione
Institution Name
Tipo di dati
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
Descrizione
Patient ID ECOG
Tipo di dati
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
Descrizione
Trial subject ID Participating Group
Tipo di dati
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
Descrizione
Data amendment
Descrizione
Data amended
Tipo di dati
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C0680532
- NCI Thesaurus ObjectClass
- C25474
- NCI Thesaurus Property
- C25416
Descrizione
Data amended date
Tipo di dati
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C0680532
- NCI Thesaurus ObjectClass
- C25474
- UMLS CUI-2
- C0011008
- NCI Thesaurus Property
- C25416
- NCI Thesaurus ValueDomain-2
- C25367
Descrizione
Pre-registration Hematology/chemistry
Descrizione
HematologyLabIdentifierName
Tipo di dati
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS 2011AA ValueDomain
- C1547383
- NCI Thesaurus Property
- C25364
- UMLS 2011AA Property
- C0600091
- NCI Thesaurus ObjectClass
- C16673
- UMLS 2011AA ObjectClass
- C0018943
- NCI Thesaurus Property-2
- C37984
- UMLS 2011AA Property-2
- C0022877
Descrizione
Laboratory Procedure Not Performed
Tipo di dati
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C0022885
- NCI Thesaurus Property
- C25594
- UMLS CUI-2
- C0445106
- NCI Thesaurus Property-2
- C38000
- NCI Thesaurus ObjectClass
- C25294
Descrizione
Platelets
Tipo di dati
float
Unità di misura
- 1000/uL
Alias
- NCI Thesaurus Property
- C20200
- UMLS CUI-1
- C0005821
- NCI Thesaurus Property-2
- C12520
- NCI Thesaurus ObjectClass
- C25294
- NCI Thesaurus ValueDomain
- C25712
Descrizione
Platelets LLN
Tipo di dati
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS CUI-1
- C0005821
- NCI Thesaurus Property
- C20200
- UMLS CUI-2
- C1518030
- NCI Thesaurus Property-2
- C12520
- NCI Thesaurus ValueDomain
- C25712
- NCI Thesaurus ValueDomain-2
- C25555
Descrizione
HepaticAlkalinePhosphataseLabValue
Tipo di dati
float
Alias
- NCI Thesaurus ObjectClass
- C13308
- UMLS 2011AA ObjectClass
- C0205054
- NCI Thesaurus Property
- C37984
- UMLS 2011AA Property
- C0022877
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
- NCI Thesaurus Property-2
- C16276
- UMLS 2011AA Property-2
- C0002059
Descrizione
Alkaline Phosphatase ULN
Tipo di dati
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS CUI-1
- C0151420
- NCI Thesaurus Property
- C20200
- NCI Thesaurus Property-2
- C16276
- NCI Thesaurus ValueDomain
- C25712
- NCI Thesaurus ValueDomain-2
- C25706
Descrizione
LDH
Tipo di dati
float
Unità di misura
- U/L
Alias
- NCI Thesaurus Property
- C20200
- UMLS CUI-1
- C0202113
- NCI Thesaurus ObjectClass
- C25294
- NCI Thesaurus ValueDomain
- C25712
- NCI Thesaurus Property-2
- C25184
Descrizione
LDH ULN
Tipo di dati
float
Unità di misura
- U/L
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS CUI-1
- C0202113
- NCI Thesaurus Property
- C20200
- UMLS CUI-2
- C1519815
- NCI Thesaurus Property-2
- C25184
- NCI Thesaurus ValueDomain
- C25712
- NCI Thesaurus ValueDomain-2
- C38024
- NCI Thesaurus ValueDomain-3
- C25706
Descrizione
HematologySpecimenCollectedDate
Tipo di dati
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C16673
- UMLS 2011AA ObjectClass
- C0018943
- NCI Thesaurus ObjectClass-2
- C19157
- UMLS 2011AA ObjectClass-2
- C0370003
- NCI Thesaurus Property
- C25452
Descrizione
Prior Treatment For This Disease
Descrizione
PriorChemotherapyAdministeredInd-3
Tipo di dati
boolean
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
- NCI Thesaurus ObjectClass
- C15632
- UMLS 2011AA ObjectClass
- C0392920
- NCI Thesaurus ObjectClass-2
- C25629
- UMLS 2011AA ObjectClass-2
- C0332152
- NCI Thesaurus Property
- C25382
- UMLS 2011AA Property
- C1521801
Descrizione
PriorImmunotherapyAdministeredInd-3
Tipo di dati
boolean
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
- NCI Thesaurus ObjectClass
- C15262
- UMLS 2011AA ObjectClass
- C0021083
- NCI Thesaurus ObjectClass-2
- C25629
- UMLS 2011AA ObjectClass-2
- C0332152
- NCI Thesaurus Property
- C25382
- UMLS 2011AA Property
- C1521801
Descrizione
PriorInvestigationalTherapiesAdministeredInd-2
Tipo di dati
boolean
Alias
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
- NCI Thesaurus ObjectClass
- C25629
- UMLS 2011AA ObjectClass
- C0332152
- NCI Metathesaurus ObjectClass
- C0949266
- NCI Thesaurus Property
- C25382
- UMLS 2011AA Property
- C1521801
Descrizione
PriorImmunotherapyOtherAgent
Tipo di dati
text
Descrizione
PriorTreatmentRegimenBeginDate
Tipo di dati
date
Alias
- NCI Thesaurus ObjectClass
- C25629
- UMLS 2011AA ObjectClass
- C0332152
- NCI Thesaurus ObjectClass-2
- C15368
- NCI Thesaurus Property
- C15697
- UMLS 2011AA Property
- C0040808
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ValueDomain-2
- C25431
- UMLS 2011AA ValueDomain-2
- C0439659
Descrizione
PriorTreatmentProgressionMostRecentDate
Tipo di dati
date
Alias
- NCI Thesaurus ObjectClass
- C25629
- UMLS 2011AA ObjectClass
- C0332152
- NCI Thesaurus ObjectClass-2
- C15368
- NCI Thesaurus Property
- C25331
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ValueDomain-2
- C25577
- UMLS 2011AA ValueDomain-2
- C1513491
Descrizione
PriorTreatmentRegimenEndDate
Tipo di dati
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C25629
- UMLS 2011AA ObjectClass
- C0332152
- NCI Thesaurus ObjectClass-2
- C15368
- NCI Thesaurus Property
- C15697
- UMLS 2011AA Property
- C0040808
Descrizione
Prior Surgery
Tipo di dati
boolean
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS CUI-1
- C0744961
- NCI Thesaurus Property
- C38000
- NCI Thesaurus ObjectClass
- C15329
- NCI Thesaurus ObjectClass-2
- C25629
Descrizione
PriorSurgeryPerformedText
Tipo di dati
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus Property
- C38000
- UMLS 2011AA Property
- C0884358
- NCI Thesaurus ObjectClass
- C15329
- UMLS 2011AA ObjectClass
- C0543467
- NCI Thesaurus ObjectClass-2
- C25629
- UMLS 2011AA ObjectClass-2
- C0332152
Descrizione
Prior Radiation Therapy
Tipo di dati
boolean
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS CUI-1
- C1522449
- NCI Thesaurus ObjectClass
- C15313
- UMLS CUI-2
- C0332152
- NCI Thesaurus ObjectClass-2
- C25629
- NCI Thesaurus Property
- C25382
Descrizione
PriorRTEndDate
Tipo di dati
date
Alias
- NCI Thesaurus ObjectClass
- C15313
- UMLS 2011AA ObjectClass
- C1522449
- NCI Thesaurus ObjectClass-2
- C25629
- UMLS 2011AA ObjectClass-2
- C0332152
- NCI Thesaurus Property
- C25275
- UMLS 2011AA Property
- C2745955
- NCI Thesaurus Property-2
- C25496
- UMLS 2011AA Property-2
- C2746065
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
Descrizione
PriorRTSiteSpecify
Tipo di dati
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
- NCI Thesaurus Property
- C25341
- UMLS 2011AA Property
- C0450429
- NCI Thesaurus ObjectClass
- C15313
- UMLS 2011AA ObjectClass
- C1522449
- NCI Thesaurus ObjectClass-2
- C25629
- UMLS 2011AA ObjectClass-2
- C0332152
Descrizione
Radiation Therapy Total Dose
Tipo di dati
float
Alias
- NCI Thesaurus ValueDomain
- C25304
- UMLS CUI-1
- C2169193
- NCI Thesaurus ObjectClass
- C15313
- NCI Thesaurus ValueDomain-2
- C25488
- NCI Thesaurus Property
- C25382
Descrizione
Listmostrecentfirst
Tipo di dati
text
Descrizione
Comments
Descrizione
Research Comments
Tipo di dati
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C0947611
- NCI Thesaurus ObjectClass
- C15319
- NCI Thesaurus Property
- C25393
Descrizione
Investigator Signature
Tipo di dati
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C2346576
- NCI Thesaurus Property
- C25678
- NCI Thesaurus ObjectClass
- C17089
Descrizione
Investigator Signature Date
Tipo di dati
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C2346576
- NCI Thesaurus Property
- C25678
- UMLS CUI-2
- C0011008
- NCI Thesaurus ValueDomain-2
- C25367
- NCI Thesaurus ObjectClass
- C17089
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INSTRUCTIONS: Complete this form and submit original to the ECOG Coordinating Center within one week of registration. Keep a copy for your files
- StudyEvent: E2603 Baseline Data Form (6/05)
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C0018943 (UMLS 2011AA ObjectClass)
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C0022877 (UMLS 2011AA Property-2)
C0022885 (UMLS CUI-1)
C25594 (NCI Thesaurus Property)
C0445106 (UMLS CUI-2)
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C0005821 (UMLS CUI-1)
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C25184 (NCI Thesaurus Property-2)
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C20200 (NCI Thesaurus Property)
C1519815 (UMLS CUI-2)
C25184 (NCI Thesaurus Property-2)
C25712 (NCI Thesaurus ValueDomain)
C38024 (NCI Thesaurus ValueDomain-2)
C25706 (NCI Thesaurus ValueDomain-3)
C0011008 (UMLS 2011AA ValueDomain)
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C0018943 (UMLS 2011AA ObjectClass)
C19157 (NCI Thesaurus ObjectClass-2)
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C15368 (NCI Thesaurus ObjectClass-2)
C25331 (NCI Thesaurus Property)
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