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11043

Beskrivning

ECOG Baseline Disease Evaluation Form (RECIST) NCT00309985 Androgen Ablation Therapy With or Without Chemotherapy in Treating Patients With Metastatic Prostate Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=F97FF9CE-5363-2533-E034-0003BA3F9857

Länk

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=F97FF9CE-5363-2533-E034-0003BA3F9857

Nyckelord

  1. 2012-09-19 2012-09-19 -
  2. 2015-01-09 2015-01-09 - Martin Dugas
  3. 2015-06-16 2015-06-16 -
Uppladdad den

16 juni 2015

DOI

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Licens

Creative Commons BY-NC 3.0 Legacy

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    ECOG Baseline Disease Evaluation Form (RECIST) NCT00309985

    INSTRUCTIONS: Complete this form and submit original to the ECOG Coordinating Center within one week of registration. Keep a copy for your files.

    Header
    Beskrivning

    Header

    ECOG Protocol Number
    Beskrivning

    Protocol Number ECOG

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337 (undefined)
    UMLS CUI-1
    C3274381 (Clinical Trial Registry Identifier)
    NCI Thesaurus ObjectClass
    C25320 (undefined)
    UMLS CUI-2
    C1512162 (Eastern Cooperative Oncology Group)
    LOINC
    LP76239-0
    NCI Thesaurus Property
    C25364 (undefined)
    NCI Thesaurus Property-2
    C25491 (undefined)
    ECOG Patient ID
    Beskrivning

    Patient ID ECOG

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337 (undefined)
    UMLS CUI-1
    C2348585 (Clinical Trial Subject Unique Identifier)
    NCI Thesaurus ObjectClass
    C16960 (undefined)
    UMLS CUI-2
    C1512162 (Eastern Cooperative Oncology Group)
    LOINC
    LP76239-0
    NCI Thesaurus Property
    C25364 (undefined)
    NCI Thesaurus Property-2
    C25491 (undefined)
    DCI Name
    Beskrivning

    Generic drug form

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191 (undefined)
    UMLS CUI-1
    C3242750 (generic drug form)
    NCI Thesaurus Property
    C19464 (undefined)
    NCI Thesaurus ObjectClass
    C25474 (undefined)
    NCI Thesaurus ObjectClass-2
    C25452 (undefined)
    Registration Step
    Beskrivning

    Registration Number

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337 (undefined)
    UMLS CUI-1
    C1514821 (Registration)
    NCI Thesaurus ObjectClass
    C25646 (undefined)
    UMLS CUI-2
    C0237753 (Numbers)
    SNOMED
    260299005
    LOINC
    LP6841-3
    NCI Thesaurus Property
    C16154 (undefined)
    NCI Thesaurus ValueDomain-2
    C16154 (undefined)
    Reporting Period
    Beskrivning

    Clinical Trial Period

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25284 (undefined)
    UMLS CUI-1
    C2347804 (Clinical Trial Period)
    NCI Thesaurus ObjectClass
    C25214 (undefined)
    NCI Thesaurus Property
    C25616 (undefined)
    NCI Thesaurus ObjectClass-2
    C25651 (undefined)
    Data amendment
    Beskrivning

    Data amendment

    Please mark an 'X' if data have been amended.
    Beskrivning

    Data amended

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704 (undefined)
    UMLS CUI-1
    C0680532 (Amendment)
    NCI Thesaurus ObjectClass
    C25474 (undefined)
    NCI Thesaurus Property
    C25416 (undefined)
    Date data amended
    Beskrivning

    Data amended date

    Datatyp

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164 (undefined)
    UMLS CUI-1
    C0680532 (Amendment)
    NCI Thesaurus ObjectClass
    C25474 (undefined)
    UMLS CUI-2
    C0011008 (Date in time)
    SNOMED
    410671006
    NCI Thesaurus Property
    C25416 (undefined)
    NCI Thesaurus ValueDomain-2
    C25367 (undefined)
    Patient demographics
    Beskrivning

    Patient demographics

    ECOG Protocol Number
    Beskrivning

    Protocol Number ECOG

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337 (undefined)
    UMLS CUI-1
    C3274381 (Clinical Trial Registry Identifier)
    NCI Thesaurus ObjectClass
    C25320 (undefined)
    UMLS CUI-2
    C1512162 (Eastern Cooperative Oncology Group)
    LOINC
    LP76239-0
    NCI Thesaurus Property
    C25364 (undefined)
    NCI Thesaurus Property-2
    C25491 (undefined)
    ECOG Patient ID
    Beskrivning

    Patient ID ECOG

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337 (undefined)
    UMLS CUI-1
    C2348585 (Clinical Trial Subject Unique Identifier)
    NCI Thesaurus ObjectClass
    C16960 (undefined)
    UMLS CUI-2
    C1512162 (Eastern Cooperative Oncology Group)
    LOINC
    LP76239-0
    NCI Thesaurus Property
    C25364 (undefined)
    NCI Thesaurus Property-2
    C25491 (undefined)
    Patient Initials
    Beskrivning

    Patient Initials

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191 (undefined)
    UMLS CUI-1
    C2986440 (Person Initials)
    NCI Thesaurus ObjectClass
    C16960 (undefined)
    NCI Thesaurus Property
    C25536 (undefined)
    Participating Group Protocol Number
    Beskrivning

    Study Number Participating Group

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337 (undefined)
    UMLS CUI-1
    C3274381 (Clinical Trial Registry Identifier)
    NCI Thesaurus ObjectClass
    C25320 (undefined)
    UMLS CUI-2
    C2347449 (Participating Clinical Study Organization)
    NCI Thesaurus Property
    C25608 (undefined)
    NCI Thesaurus Property-2
    C25364 (undefined)
    Institution/Affiliate
    Beskrivning

    Institution Name

    Datatyp

    text

    Alias
    NCI Thesaurus ObjectClass
    C25454 (undefined)
    UMLS CUI-1
    C1301943 (Institution name)
    SNOMED
    398321007
    NCI Thesaurus ObjectClass-2
    C21541 (undefined)
    NCI Thesaurus Property
    C25364 (undefined)
    NCI Thesaurus ValueDomain
    C25191 (undefined)
    NCI Thesaurus ValueDomain-2
    C21541 (undefined)
    Participating Group Patient ID
    Beskrivning

    Trial subject ID Participating Group

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337 (undefined)
    UMLS CUI-1
    C2348585 (Clinical Trial Subject Unique Identifier)
    NCI Thesaurus ObjectClass
    C16960 (undefined)
    UMLS CUI-2
    C2347449 (Participating Clinical Study Organization)
    NCI Thesaurus Property
    C25608 (undefined)
    NCI Thesaurus Property-2
    C25364 (undefined)
    TARGET LESIONS
    Beskrivning

    TARGET LESIONS

    Are there any target lesions
    Beskrivning

    TargetLesionPresentInd-2

    Datatyp

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38147 (undefined)
    UMLS 2011AA ValueDomain
    C1512698 (Yes or No Response)
    NCI Thesaurus ObjectClass
    C3824 (undefined)
    UMLS 2011AA ObjectClass
    C0221198 (Lesion)
    SNOMED
    52988006
    NCI Thesaurus Property
    C25626 (undefined)
    UMLS 2011AA Property
    C0150312 (Present)
    SNOMED
    52101004
    LOINC
    LA9633-4
    NCI Thesaurus ObjectClass-2
    C25702 (undefined)
    UMLS 2011AA ObjectClass-2
    C1521840 (Target)
    Lesion Number
    Beskrivning

    LesionSiteNumber

    Datatyp

    float

    Alias
    NCI Thesaurus ValueDomain
    C25337 (undefined)
    UMLS 2011AA ValueDomain
    C0237753 (Numbers)
    SNOMED
    260299005
    LOINC
    LP6841-3
    NCI Thesaurus ObjectClass
    C3824 (undefined)
    UMLS 2011AA ObjectClass
    C0221198 (Lesion)
    SNOMED
    52988006
    NCI Thesaurus Property
    C25341 (undefined)
    UMLS 2011AA Property
    C0450429 (Location)
    SNOMED
    246267002
    LOINC
    LP149876-7
    Site of Lesion (Comments - Multiple nontarget lesions within an organ may be combined as a single site; report in a consistent manner on subsequent forms.)
    Beskrivning

    Lesion Site, Primary

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C13717 (undefined)
    UMLS CUI-1
    C0449695 (Site of primary lesion)
    SNOMED
    246312001
    LOINC
    MTHU010322
    NCI Thesaurus ObjectClass
    C3824 (undefined)
    NCI Thesaurus Property
    C25341 (undefined)
    Site Code
    Beskrivning

    LesionMeasurableEvaluationAnatomicSite

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C13717 (undefined)
    UMLS 2011AA ValueDomain
    C1515974 (Anatomic Site)
    NCI Thesaurus ObjectClass
    C3824 (undefined)
    UMLS 2011AA ObjectClass
    C0221198 (Lesion)
    SNOMED
    52988006
    NCI Thesaurus Property
    C25214 (undefined)
    UMLS 2011AA Property
    C0220825 (Evaluation)
    LOINC
    LP36377-7
    NCI Thesaurus Property-2
    C37894 (undefined)
    UMLS 2011AA Property-2
    C1513040 (Measurable)
    Method of Evaluation
    Beskrivning

    Evaluation method

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25284 (undefined)
    UMLS CUI-1
    C2911685 (Evaluation Method)
    NCI Thesaurus ObjectClass
    C20989 (undefined)
    NCI Thesaurus Property
    C16847 (undefined)
    Date of Evaluation
    Beskrivning

    LesionAssessmentDate

    Datatyp

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164 (undefined)
    UMLS 2011AA ValueDomain
    C0011008 (Date in time)
    SNOMED
    410671006
    NCI Thesaurus ObjectClass
    C3824 (undefined)
    UMLS 2011AA ObjectClass
    C0221198 (Lesion)
    SNOMED
    52988006
    NCI Thesaurus Property
    C20989 (undefined)
    UMLS 2011AA Property
    C0031809 (Physical Examination)
    SNOMED
    5880005
    LOINC
    MTHU028014
    NCI Thesaurus ValueDomain-2
    C25367 (undefined)
    Longest Diameter of Lesion
    Beskrivning

    Longest Diameter of Lesion

    Datatyp

    float

    Måttenheter
    • cm
    Alias
    NCI Thesaurus ObjectClass
    C3824 (undefined)
    UMLS CUI-1
    C0221198 (Lesion)
    SNOMED
    52988006
    NCI Thesaurus Property
    C25285 (undefined)
    UMLS CUI-2
    C1301886 (Diameter (qualifier value))
    SNOMED
    81827009
    LOINC
    LP66948-8
    NCI Thesaurus Property-2
    C25558 (undefined)
    UMLS CUI-3
    C1522425 (Longest)
    NCI Thesaurus ValueDomain
    C25209 (undefined)
    NCI Thesaurus ValueDomain-2
    C25285 (undefined)
    cm
    Sum of longest diameters of all target lesions
    Beskrivning

    LongestLesionSumDiameterMeasurement

    Datatyp

    float

    Alias
    NCI Thesaurus ObjectClass
    C25558 (undefined)
    UMLS 2011AA ObjectClass
    C1522425 (Longest)
    NCI Thesaurus ObjectClass-2
    C3824 (undefined)
    UMLS 2011AA ObjectClass-2
    C0221198 (Lesion)
    SNOMED
    52988006
    NCI Thesaurus Property
    C25285 (undefined)
    UMLS 2011AA Property
    C1301886 (Diameter (qualifier value))
    SNOMED
    81827009
    LOINC
    LP66948-8
    NCI Thesaurus Property-2
    C25697 (undefined)
    UMLS 2011AA Property-2
    C1515051 (Sum)
    NCI Thesaurus ValueDomain
    C25209 (undefined)
    UMLS 2011AA ValueDomain
    C0242485 (Measurement)
    SNOMED
    272391002
    LOINC
    LP7412-2
    Nontarget Lesions
    Beskrivning

    Nontarget Lesions

    Lesion Number
    Beskrivning

    LesionSiteNumber

    Datatyp

    float

    Alias
    NCI Thesaurus ValueDomain
    C25337 (undefined)
    UMLS 2011AA ValueDomain
    C0237753 (Numbers)
    SNOMED
    260299005
    LOINC
    LP6841-3
    NCI Thesaurus ObjectClass
    C3824 (undefined)
    UMLS 2011AA ObjectClass
    C0221198 (Lesion)
    SNOMED
    52988006
    NCI Thesaurus Property
    C25341 (undefined)
    UMLS 2011AA Property
    C0450429 (Location)
    SNOMED
    246267002
    LOINC
    LP149876-7
    Site of Lesion (Comments - Multiple nontarget lesions within an organ may be combined as a single site; report in a consistent manner on subsequent forms.)
    Beskrivning

    Lesion Site, Primary

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C13717 (undefined)
    UMLS CUI-1
    C0449695 (Site of primary lesion)
    SNOMED
    246312001
    LOINC
    MTHU010322
    NCI Thesaurus ObjectClass
    C3824 (undefined)
    NCI Thesaurus Property
    C25341 (undefined)
    Site Code
    Beskrivning

    LesionMeasurableEvaluationAnatomicSite

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C13717 (undefined)
    UMLS 2011AA ValueDomain
    C1515974 (Anatomic Site)
    NCI Thesaurus ObjectClass
    C3824 (undefined)
    UMLS 2011AA ObjectClass
    C0221198 (Lesion)
    SNOMED
    52988006
    NCI Thesaurus Property
    C25214 (undefined)
    UMLS 2011AA Property
    C0220825 (Evaluation)
    LOINC
    LP36377-7
    NCI Thesaurus Property-2
    C37894 (undefined)
    UMLS 2011AA Property-2
    C1513040 (Measurable)
    Method of Evaluation
    Beskrivning

    Evaluation method

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25284 (undefined)
    UMLS CUI-1
    C2911685 (Evaluation Method)
    NCI Thesaurus ObjectClass
    C20989 (undefined)
    NCI Thesaurus Property
    C16847 (undefined)
    Date of Evaluation
    Beskrivning

    LesionAssessmentDate

    Datatyp

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164 (undefined)
    UMLS 2011AA ValueDomain
    C0011008 (Date in time)
    SNOMED
    410671006
    NCI Thesaurus ObjectClass
    C3824 (undefined)
    UMLS 2011AA ObjectClass
    C0221198 (Lesion)
    SNOMED
    52988006
    NCI Thesaurus Property
    C20989 (undefined)
    UMLS 2011AA Property
    C0031809 (Physical Examination)
    SNOMED
    5880005
    LOINC
    MTHU028014
    NCI Thesaurus ValueDomain-2
    C25367 (undefined)
    Cytology Result
    Beskrivning

    CytologyResultType

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25284 (undefined)
    UMLS 2011AA ValueDomain
    C0332307 (Type - attribute)
    SNOMED
    261664005
    NCI Thesaurus ObjectClass
    C16491 (undefined)
    UMLS 2011AA ObjectClass
    C0010819 (Cytology)
    NCI Thesaurus Property
    C20200 (undefined)
    UMLS 2011AA Property
    C1274040 (Result)
    SNOMED
    394617004
    Comments
    Beskrivning

    Comments

    Comments
    Beskrivning

    Research Comments

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704 (undefined)
    UMLS CUI-1
    C0947611 (Comment)
    LOINC
    LP72293-1
    NCI Thesaurus ObjectClass
    C15319 (undefined)
    NCI Thesaurus Property
    C25393 (undefined)
    Investigator Signature
    Beskrivning

    Investigator Signature

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704 (undefined)
    UMLS CUI-1
    C2346576 (Investigator Signature)
    NCI Thesaurus Property
    C25678 (undefined)
    NCI Thesaurus ObjectClass
    C17089 (undefined)
    Investigator Signature Date
    Beskrivning

    Investigator Signature Date

    Datatyp

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164 (undefined)
    UMLS CUI-1
    C2346576 (Investigator Signature)
    NCI Thesaurus Property
    C25678 (undefined)
    UMLS CUI-2
    C0011008 (Date in time)
    SNOMED
    410671006
    NCI Thesaurus ValueDomain-2
    C25367 (undefined)
    NCI Thesaurus ObjectClass
    C17089 (undefined)

    Similar models

    INSTRUCTIONS: Complete this form and submit original to the ECOG Coordinating Center within one week of registration. Keep a copy for your files.

    Name
    Typ
    Description | Question | Decode (Coded Value)
    Datatyp
    Alias
    Item Group
    Header
    Protocol Number ECOG
    Item
    ECOG Protocol Number
    text
    C25337 (NCI Thesaurus ValueDomain)
    C3274381 (UMLS CUI-1)
    C25320 (NCI Thesaurus ObjectClass)
    C1512162 (UMLS CUI-2)
    C25364 (NCI Thesaurus Property)
    C25491 (NCI Thesaurus Property-2)
    Patient ID ECOG
    Item
    ECOG Patient ID
    text
    C25337 (NCI Thesaurus ValueDomain)
    C2348585 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C1512162 (UMLS CUI-2)
    C25364 (NCI Thesaurus Property)
    C25491 (NCI Thesaurus Property-2)
    Generic drug form
    Item
    DCI Name
    text
    C25191 (NCI Thesaurus ValueDomain)
    C3242750 (UMLS CUI-1)
    C19464 (NCI Thesaurus Property)
    C25474 (NCI Thesaurus ObjectClass)
    C25452 (NCI Thesaurus ObjectClass-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)
    Item
    Reporting Period
    text
    C25284 (NCI Thesaurus ValueDomain)
    C2347804 (UMLS CUI-1)
    C25214 (NCI Thesaurus ObjectClass)
    C25616 (NCI Thesaurus Property)
    C25651 (NCI Thesaurus ObjectClass-2)
    Code List
    Reporting Period
    CL Item
    Baseline (Baseline)
    C25213 (NCI Thesaurus)
    C1442488 (UMLS 2011AA)
    Item Group
    Data amendment
    Data amended
    Item
    Please mark an 'X' if data have been amended.
    text
    C25704 (NCI Thesaurus ValueDomain)
    C0680532 (UMLS CUI-1)
    C25474 (NCI Thesaurus ObjectClass)
    C25416 (NCI Thesaurus Property)
    Data amended date
    Item
    Date data amended
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0680532 (UMLS CUI-1)
    C25474 (NCI Thesaurus ObjectClass)
    C0011008 (UMLS CUI-2)
    C25416 (NCI Thesaurus Property)
    C25367 (NCI Thesaurus ValueDomain-2)
    Item Group
    Patient demographics
    Protocol Number ECOG
    Item
    ECOG Protocol Number
    text
    C25337 (NCI Thesaurus ValueDomain)
    C3274381 (UMLS CUI-1)
    C25320 (NCI Thesaurus ObjectClass)
    C1512162 (UMLS CUI-2)
    C25364 (NCI Thesaurus Property)
    C25491 (NCI Thesaurus Property-2)
    Patient ID ECOG
    Item
    ECOG Patient ID
    text
    C25337 (NCI Thesaurus ValueDomain)
    C2348585 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C1512162 (UMLS CUI-2)
    C25364 (NCI Thesaurus Property)
    C25491 (NCI Thesaurus Property-2)
    Patient Initials
    Item
    Patient Initials
    text
    C25191 (NCI Thesaurus ValueDomain)
    C2986440 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C25536 (NCI Thesaurus Property)
    Study Number Participating Group
    Item
    Participating Group Protocol Number
    text
    C25337 (NCI Thesaurus ValueDomain)
    C3274381 (UMLS CUI-1)
    C25320 (NCI Thesaurus ObjectClass)
    C2347449 (UMLS CUI-2)
    C25608 (NCI Thesaurus Property)
    C25364 (NCI Thesaurus Property-2)
    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)
    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
    TARGET LESIONS
    TargetLesionPresentInd-2
    Item
    Are there any target lesions
    boolean
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    C3824 (NCI Thesaurus ObjectClass)
    C0221198 (UMLS 2011AA ObjectClass)
    C25626 (NCI Thesaurus Property)
    C0150312 (UMLS 2011AA Property)
    C25702 (NCI Thesaurus ObjectClass-2)
    C1521840 (UMLS 2011AA ObjectClass-2)
    LesionSiteNumber
    Item
    Lesion Number
    float
    C25337 (NCI Thesaurus ValueDomain)
    C0237753 (UMLS 2011AA ValueDomain)
    C3824 (NCI Thesaurus ObjectClass)
    C0221198 (UMLS 2011AA ObjectClass)
    C25341 (NCI Thesaurus Property)
    C0450429 (UMLS 2011AA Property)
    Lesion Site, Primary
    Item
    Site of Lesion (Comments - Multiple nontarget lesions within an organ may be combined as a single site; report in a consistent manner on subsequent forms.)
    text
    C13717 (NCI Thesaurus ValueDomain)
    C0449695 (UMLS CUI-1)
    C3824 (NCI Thesaurus ObjectClass)
    C25341 (NCI Thesaurus Property)
    Item
    Site Code
    text
    C13717 (NCI Thesaurus ValueDomain)
    C1515974 (UMLS 2011AA ValueDomain)
    C3824 (NCI Thesaurus ObjectClass)
    C0221198 (UMLS 2011AA ObjectClass)
    C25214 (NCI Thesaurus Property)
    C0220825 (UMLS 2011AA Property)
    C37894 (NCI Thesaurus Property-2)
    C1513040 (UMLS 2011AA Property-2)
    Code List
    Site Code
    CL Item
    Bone (bone)
    C12366 (NCI Thesaurus)
    C0262950 (UMLS 2011AA)
    CL Item
    Brain (Brain)
    C12439 (NCI Thesaurus)
    C0006104 (UMLS 2011AA)
    CL Item
    Breast (Breast)
    C12971 (NCI Thesaurus)
    C0006141 (UMLS 2011AA)
    CL Item
    Effusion/ascites (Effusion/Ascites)
    CL Item
    Gi (GI)
    CL Item
    Gu (GU)
    CL Item
    Head & Neck (Head & Neck)
    CL Item
    Liver (Liver)
    C12392 (NCI Thesaurus)
    C0023884 (UMLS 2011AA)
    CL Item
    Lung (Lung)
    C12468 (NCI Thesaurus)
    C0024109 (UMLS 2011AA)
    CL Item
    Nodes (Nodes)
    CL Item
    Skin (Skin)
    C12470 (NCI Thesaurus)
    C1123023 (UMLS 2011AA)
    CL Item
    Other (other)
    C17649 (NCI Thesaurus)
    C0205394 (UMLS 2011AA)
    Item
    Method of Evaluation
    text
    C25284 (NCI Thesaurus ValueDomain)
    C2911685 (UMLS CUI-1)
    C20989 (NCI Thesaurus ObjectClass)
    C16847 (NCI Thesaurus Property)
    Code List
    Method of Evaluation
    CL Item
    Clinical (Clinical Examination)
    C25398 (NCI Thesaurus)
    C0205210 (UMLS 2011AA)
    CL Item
    Chest X-ray (Chest X-Ray)
    CL Item
    Ct Scan (CT Scan)
    CL Item
    Spiral Ct Scan (Spiral CT scan)
    CL Item
    Mri (MRI)
    CL Item
    Ultrasound (Ultrasound)
    C64384 (NCI Thesaurus)
    C1456803 (UMLS 2011AA)
    CL Item
    Bone Scan (Bone scan)
    C17646 (NCI Thesaurus)
    C0203668 (UMLS 2011AA)
    CL Item
    Other (other)
    C17649 (NCI Thesaurus)
    C0205394 (UMLS 2011AA)
    LesionAssessmentDate
    Item
    Date of Evaluation
    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)
    Longest Diameter of Lesion
    Item
    Longest Diameter of Lesion
    float
    C3824 (NCI Thesaurus ObjectClass)
    C0221198 (UMLS CUI-1)
    C25285 (NCI Thesaurus Property)
    C1301886 (UMLS CUI-2)
    C25558 (NCI Thesaurus Property-2)
    C1522425 (UMLS CUI-3)
    C25209 (NCI Thesaurus ValueDomain)
    C25285 (NCI Thesaurus ValueDomain-2)
    LongestLesionSumDiameterMeasurement
    Item
    Sum of longest diameters of all target lesions
    float
    C25558 (NCI Thesaurus ObjectClass)
    C1522425 (UMLS 2011AA ObjectClass)
    C3824 (NCI Thesaurus ObjectClass-2)
    C0221198 (UMLS 2011AA ObjectClass-2)
    C25285 (NCI Thesaurus Property)
    C1301886 (UMLS 2011AA Property)
    C25697 (NCI Thesaurus Property-2)
    C1515051 (UMLS 2011AA Property-2)
    C25209 (NCI Thesaurus ValueDomain)
    C0242485 (UMLS 2011AA ValueDomain)
    Item Group
    Nontarget Lesions
    LesionSiteNumber
    Item
    Lesion Number
    float
    C25337 (NCI Thesaurus ValueDomain)
    C0237753 (UMLS 2011AA ValueDomain)
    C3824 (NCI Thesaurus ObjectClass)
    C0221198 (UMLS 2011AA ObjectClass)
    C25341 (NCI Thesaurus Property)
    C0450429 (UMLS 2011AA Property)
    Lesion Site, Primary
    Item
    Site of Lesion (Comments - Multiple nontarget lesions within an organ may be combined as a single site; report in a consistent manner on subsequent forms.)
    text
    C13717 (NCI Thesaurus ValueDomain)
    C0449695 (UMLS CUI-1)
    C3824 (NCI Thesaurus ObjectClass)
    C25341 (NCI Thesaurus Property)
    Item
    Site Code
    text
    C13717 (NCI Thesaurus ValueDomain)
    C1515974 (UMLS 2011AA ValueDomain)
    C3824 (NCI Thesaurus ObjectClass)
    C0221198 (UMLS 2011AA ObjectClass)
    C25214 (NCI Thesaurus Property)
    C0220825 (UMLS 2011AA Property)
    C37894 (NCI Thesaurus Property-2)
    C1513040 (UMLS 2011AA Property-2)
    Code List
    Site Code
    CL Item
    Bone (bone)
    C12366 (NCI Thesaurus)
    C0262950 (UMLS 2011AA)
    CL Item
    Brain (Brain)
    C12439 (NCI Thesaurus)
    C0006104 (UMLS 2011AA)
    CL Item
    Breast (Breast)
    C12971 (NCI Thesaurus)
    C0006141 (UMLS 2011AA)
    CL Item
    Effusion/ascites (Effusion/Ascites)
    CL Item
    Gi (GI)
    CL Item
    Gu (GU)
    CL Item
    Head & Neck (Head & Neck)
    CL Item
    Liver (Liver)
    C12392 (NCI Thesaurus)
    C0023884 (UMLS 2011AA)
    CL Item
    Lung (Lung)
    C12468 (NCI Thesaurus)
    C0024109 (UMLS 2011AA)
    CL Item
    Nodes (Nodes)
    CL Item
    Skin (Skin)
    C12470 (NCI Thesaurus)
    C1123023 (UMLS 2011AA)
    CL Item
    Other (other)
    C17649 (NCI Thesaurus)
    C0205394 (UMLS 2011AA)
    Item
    Method of Evaluation
    text
    C25284 (NCI Thesaurus ValueDomain)
    C2911685 (UMLS CUI-1)
    C20989 (NCI Thesaurus ObjectClass)
    C16847 (NCI Thesaurus Property)
    Code List
    Method of Evaluation
    CL Item
    Clinical (Clinical Examination)
    C25398 (NCI Thesaurus)
    C0205210 (UMLS 2011AA)
    CL Item
    Chest X-ray (Chest X-Ray)
    CL Item
    Ct Scan (CT Scan)
    CL Item
    Spiral Ct Scan (Spiral CT scan)
    CL Item
    Mri (MRI)
    CL Item
    Ultrasound (Ultrasound)
    C64384 (NCI Thesaurus)
    C1456803 (UMLS 2011AA)
    CL Item
    Bone Scan (Bone scan)
    C17646 (NCI Thesaurus)
    C0203668 (UMLS 2011AA)
    CL Item
    Other (other)
    C17649 (NCI Thesaurus)
    C0205394 (UMLS 2011AA)
    LesionAssessmentDate
    Item
    Date of Evaluation
    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
    Cytology Result
    text
    C25284 (NCI Thesaurus ValueDomain)
    C0332307 (UMLS 2011AA ValueDomain)
    C16491 (NCI Thesaurus ObjectClass)
    C0010819 (UMLS 2011AA ObjectClass)
    C20200 (NCI Thesaurus Property)
    C1274040 (UMLS 2011AA Property)
    Code List
    Cytology Result
    CL Item
    Negative (Negative)
    C25247 (NCI Thesaurus)
    C0205160 (UMLS 2011AA)
    CL Item
    Positive (Positive)
    C25246 (NCI Thesaurus)
    C1446409 (UMLS 2011AA)
    CL Item
    Not Done (Not done)
    CL281691 (NCI Metathesaurus)
    Item Group
    Comments
    Research Comments
    Item
    Comments
    text
    C25704 (NCI Thesaurus ValueDomain)
    C0947611 (UMLS CUI-1)
    C15319 (NCI Thesaurus ObjectClass)
    C25393 (NCI Thesaurus Property)
    Investigator Signature
    Item
    Investigator Signature
    text
    C25704 (NCI Thesaurus ValueDomain)
    C2346576 (UMLS CUI-1)
    C25678 (NCI Thesaurus Property)
    C17089 (NCI Thesaurus ObjectClass)
    Investigator Signature Date
    Item
    Investigator Signature Date
    date
    C25164 (NCI Thesaurus ValueDomain)
    C2346576 (UMLS CUI-1)
    C25678 (NCI Thesaurus Property)
    C0011008 (UMLS CUI-2)
    C25367 (NCI Thesaurus ValueDomain-2)
    C17089 (NCI Thesaurus ObjectClass)

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