ID
11056
Beskrivning
E2108 Optimal Systemic Therapy Summary Form 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=91E1D8B2-2FF5-DD0A-E040-BB89AD434391
Länk
Nyckelord
Versioner (3)
- 2014-12-18 2014-12-18 - Martin Dugas
- 2015-01-09 2015-01-09 - Martin Dugas
- 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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E2108 Optimal Systemic Therapy Summary Form NCT01242800
INSTRUCTIONS: After patient is off treatment, complete this form for each required follow-up report period (see forms submission schedule).
- StudyEvent: E2108 Optimal Systemic Therapy Summary Form
Beskrivning
Report Period
Beskrivning
Data amendment
Beskrivning
Data amended
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C0680532
- NCI Thesaurus ObjectClass
- C25474
- NCI Thesaurus Property
- C25416
Beskrivning
Data amended date
Datatyp
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
Beskrivning
Arm A And Arm B
Beskrivning
SystemicTherapyAdministeredBeginDate
Datatyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C15698
- UMLS 2011AA ObjectClass
- C1515119
- NCI Thesaurus ValueDomain-2
- C25431
- UMLS 2011AA ValueDomain-2
- C0439659
- NCI Thesaurus Property
- C25382
- UMLS 2011AA Property
- C1521801
Beskrivning
SystemicTherapyAdministeredEndDate
Datatyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C15698
- UMLS 2011AA ObjectClass
- C1515119
- NCI Thesaurus Property
- C25382
- UMLS 2011AA Property
- C1521801
- NCI Thesaurus ValueDomain-2
- C25496
- UMLS 2011AA ValueDomain-2
- C2746065
Beskrivning
Vital Status
Beskrivning
Patient Status
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS CUI-1
- C3846084
- NCI Thesaurus ValueDomain
- C18003
- NCI Thesaurus ValueDomain-2
- C25688
- NCI Thesaurus Property
- C25717
Beskrivning
Date last contact
Datatyp
date
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS CUI-1
- C0805839
- NCI Thesaurus Property
- C25461
- NCI Thesaurus Property-2
- C25551
- NCI Thesaurus ValueDomain
- C25164
- NCI Thesaurus ValueDomain-2
- C25367
Beskrivning
Primary Cause of Death
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25638
- UMLS CUI-1
- C0007465
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C28554
- NCI Thesaurus ValueDomain-2
- C25251
Beskrivning
Cause of Death, specify
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS CUI-1
- C0007465
- NCI Thesaurus ObjectClass
- C16960
- UMLS CUI-2
- C1521902
- NCI Thesaurus Property
- C28554
Beskrivning
Therapy Administered - Chemotherapy
Beskrivning
ChemotherapyAdministeredInd
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
- NCI Thesaurus ObjectClass
- C15632
- UMLS 2011AA ObjectClass
- C0392920
- NCI Thesaurus Property
- C25382
- UMLS 2011AA Property
- C1521801
Beskrivning
ChemotherapyFirstCycleAgentName
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C15632
- UMLS 2011AA ObjectClass
- C0392920
- NCI Thesaurus Property
- C25472
- UMLS 2011AA Property
- C1511572
- NCI Thesaurus Property-2
- C25509
- UMLS 2011AA Property-2
- C1279901
- NCI Thesaurus Property-3
- C1708
- UMLS 2011AA Property-3
- C0450442
- NCI Thesaurus ValueDomain
- C42614
- UMLS 2011AA ValueDomain
- C0027365
Beskrivning
ChemotherapySecondCycleAgentName
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C15632
- UMLS 2011AA ObjectClass
- C0392920
- NCI Thesaurus Property
- C25472
- UMLS 2011AA Property
- C1511572
- NCI Thesaurus Property-2
- C25666
- UMLS 2011AA Property-2
- C0205436
- NCI Thesaurus Property-3
- C1708
- UMLS 2011AA Property-3
- C0450442
- NCI Thesaurus ValueDomain
- C42614
- UMLS 2011AA ValueDomain
- C0027365
Beskrivning
ChemotherapyThirdCycleAgentName
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C15632
- UMLS 2011AA ObjectClass
- C0392920
- NCI Thesaurus Property
- C25472
- UMLS 2011AA Property
- C1511572
- NCI Thesaurus Property-2
- C1708
- UMLS 2011AA Property-2
- C0450442
- NCI Thesaurus Property-3
- C25260
- UMLS 2011AA Property-3
- C0205437
- NCI Thesaurus ValueDomain
- C42614
- UMLS 2011AA ValueDomain
- C0027365
Beskrivning
ChemotherapyAgentSpecify
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
- NCI Thesaurus ObjectClass
- C15632
- UMLS 2011AA ObjectClass
- C0392920
- NCI Thesaurus ValueDomain-2
- C15368
- NCI Thesaurus Property
- C1708
- UMLS 2011AA Property
- C0450442
Beskrivning
Therapy Administered - Hormone Therapy
Beskrivning
HormoneTherapyReportPeriodAdministeredInd-3
Datatyp
boolean
Alias
- NCI Thesaurus ObjectClass
- C15445
- UMLS 2011AA ObjectClass
- C0279025
- NCI Thesaurus Property
- C25616
- UMLS 2011AA Property
- C1948053
- NCI Thesaurus Property-2
- C25375
- UMLS 2011AA Property-2
- C0684224
- NCI Thesaurus Property-3
- C25382
- UMLS 2011AA Property-3
- C1521801
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
Beskrivning
EndocrineTherapyFirstCycleAgentName
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C15445
- UMLS 2011AA ObjectClass
- C0279025
- NCI Thesaurus Property
- C25472
- UMLS 2011AA Property
- C1511572
- NCI Thesaurus Property-2
- C25509
- UMLS 2011AA Property-2
- C1279901
- NCI Thesaurus Property-3
- C1708
- UMLS 2011AA Property-3
- C0450442
- NCI Thesaurus ValueDomain
- C42614
- UMLS 2011AA ValueDomain
- C0027365
Beskrivning
EndocrineTherapySecondCycleAgentName
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C15445
- UMLS 2011AA ObjectClass
- C0279025
- NCI Thesaurus Property
- C25472
- UMLS 2011AA Property
- C1511572
- NCI Thesaurus Property-2
- C25666
- UMLS 2011AA Property-2
- C0205436
- NCI Thesaurus Property-3
- C1708
- UMLS 2011AA Property-3
- C0450442
- NCI Thesaurus ValueDomain
- C42614
- UMLS 2011AA ValueDomain
- C0027365
Beskrivning
EndocrineTherapyThirdCycleAgentName
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C15445
- UMLS 2011AA ObjectClass
- C0279025
- NCI Thesaurus Property
- C25472
- UMLS 2011AA Property
- C1511572
- NCI Thesaurus Property-2
- C1708
- UMLS 2011AA Property-2
- C0450442
- NCI Thesaurus Property-3
- C25260
- UMLS 2011AA Property-3
- C0205437
- NCI Thesaurus ValueDomain
- C42614
- UMLS 2011AA ValueDomain
- C0027365
Beskrivning
EndocrineTherapyAgentSpecify
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
- NCI Thesaurus ObjectClass
- C15445
- UMLS 2011AA ObjectClass
- C0279025
- NCI Thesaurus ValueDomain-2
- C15368
- NCI Thesaurus Property
- C1708
- UMLS 2011AA Property
- C0450442
Beskrivning
Therapy Administered - New Progression
Beskrivning
DiseaseNewProgressionInd-2
Datatyp
boolean
Alias
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
- NCI Thesaurus Property
- C25586
- UMLS 2011AA Property
- C0205314
- NCI Thesaurus Property-2
- C25331
- NCI Thesaurus ObjectClass
- C2991
- UMLS 2011AA ObjectClass
- C0012634
Beskrivning
DiseaseorDisorderNewDiseaseProgressionDiagnosisType
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C2991
- UMLS 2011AA ObjectClass
- C0012634
- NCI Thesaurus Property
- C25586
- UMLS 2011AA Property
- C0205314
- NCI Thesaurus Property-2
- C17747
- UMLS 2011AA Property-2
- C0242656
- NCI Thesaurus Property-3
- C15220
- UMLS 2011AA Property-3
- C0011900
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
Beskrivning
DiseaseProgressionDate
Datatyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ValueDomain-2
- C25367
- NCI Thesaurus Property
- C25331
- NCI Thesaurus ObjectClass
- C2991
- UMLS 2011AA ObjectClass
- C0012634
Beskrivning
Comments
Beskrivning
Investigator Signature
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C2346576
- NCI Thesaurus Property
- C25678
- NCI Thesaurus ObjectClass
- C17089
Beskrivning
Investigator Signature Date
Datatyp
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
Similar models
INSTRUCTIONS: After patient is off treatment, complete this form for each required follow-up report period (see forms submission schedule).
- StudyEvent: E2108 Optimal Systemic Therapy Summary Form
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1512162 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25491 (NCI Thesaurus Property-2)
C3242750 (UMLS CUI-1)
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C25452 (NCI Thesaurus ObjectClass-2)
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C0237753 (UMLS CUI-2)
C16154 (NCI Thesaurus Property)
C16154 (NCI Thesaurus ValueDomain-2)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C25191 (NCI Thesaurus ValueDomain)
C21541 (NCI Thesaurus ValueDomain-2)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
C2347804 (UMLS CUI-1)
C25214 (NCI Thesaurus ObjectClass)
C25616 (NCI Thesaurus Property)
C25651 (NCI Thesaurus ObjectClass-2)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
C0680532 (UMLS CUI-1)
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C0011008 (UMLS CUI-2)
C25416 (NCI Thesaurus Property)
C25367 (NCI Thesaurus ValueDomain-2)
C0011008 (UMLS 2011AA ValueDomain)
C15698 (NCI Thesaurus ObjectClass)
C1515119 (UMLS 2011AA ObjectClass)
C25431 (NCI Thesaurus ValueDomain-2)
C0439659 (UMLS 2011AA ValueDomain-2)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
C0011008 (UMLS 2011AA ValueDomain)
C15698 (NCI Thesaurus ObjectClass)
C1515119 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
C25496 (NCI Thesaurus ValueDomain-2)
C2746065 (UMLS 2011AA ValueDomain-2)
C3846084 (UMLS CUI-1)
C18003 (NCI Thesaurus ValueDomain)
C25688 (NCI Thesaurus ValueDomain-2)
C25717 (NCI Thesaurus Property)
C0805839 (UMLS CUI-1)
C25461 (NCI Thesaurus Property)
C25551 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
C0007465 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C28554 (NCI Thesaurus Property)
C25251 (NCI Thesaurus ValueDomain-2)
C0439673 (UMLS 2011AA)
C0007465 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1521902 (UMLS CUI-2)
C28554 (NCI Thesaurus Property)
C1522602 (UMLS 2011AA ValueDomain)
C15632 (NCI Thesaurus ObjectClass)
C0392920 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
C1298908 (UMLS 2011AA)
C1272460 (UMLS 2011AA)
C0392920 (UMLS 2011AA ObjectClass)
C25472 (NCI Thesaurus Property)
C1511572 (UMLS 2011AA Property)
C25509 (NCI Thesaurus Property-2)
C1279901 (UMLS 2011AA Property-2)
C1708 (NCI Thesaurus Property-3)
C0450442 (UMLS 2011AA Property-3)
C42614 (NCI Thesaurus ValueDomain)
C0027365 (UMLS 2011AA ValueDomain)
C0796392 (UMLS 2011AA)
C0671970 (UMLS 2011AA)
C0079083 (UMLS 2011AA)
C0008838 (UMLS 2011AA)
C0010583 (UMLS 2011AA)
C0246415 (UMLS 2011AA)
C0013089 (UMLS 2011AA)
C0014582 (UMLS 2011AA)
C0016360 (UMLS 2011AA)
C0045093 (UMLS 2011AA)
C0879430 (UMLS 2011AA)
C1173538 (UMLS 2011AA)
C0025677 (UMLS 2011AA)
C0205394 (UMLS 2011AA)
C0144576 (UMLS 2011AA)
C0338204 (UMLS 2011AA)
C0078257 (UMLS 2011AA)
C0392920 (UMLS 2011AA ObjectClass)
C25472 (NCI Thesaurus Property)
C1511572 (UMLS 2011AA Property)
C25666 (NCI Thesaurus Property-2)
C0205436 (UMLS 2011AA Property-2)
C1708 (NCI Thesaurus Property-3)
C0450442 (UMLS 2011AA Property-3)
C42614 (NCI Thesaurus ValueDomain)
C0027365 (UMLS 2011AA ValueDomain)
C0796392 (UMLS 2011AA)
C0671970 (UMLS 2011AA)
C0079083 (UMLS 2011AA)
C0008838 (UMLS 2011AA)
C0010583 (UMLS 2011AA)
C0246415 (UMLS 2011AA)
C0013089 (UMLS 2011AA)
C0014582 (UMLS 2011AA)
C0016360 (UMLS 2011AA)
C0045093 (UMLS 2011AA)
C0879430 (UMLS 2011AA)
C1173538 (UMLS 2011AA)
C0025677 (UMLS 2011AA)
C0205394 (UMLS 2011AA)
C0144576 (UMLS 2011AA)
C0338204 (UMLS 2011AA)
C0078257 (UMLS 2011AA)
C0392920 (UMLS 2011AA ObjectClass)
C25472 (NCI Thesaurus Property)
C1511572 (UMLS 2011AA Property)
C1708 (NCI Thesaurus Property-2)
C0450442 (UMLS 2011AA Property-2)
C25260 (NCI Thesaurus Property-3)
C0205437 (UMLS 2011AA Property-3)
C42614 (NCI Thesaurus ValueDomain)
C0027365 (UMLS 2011AA ValueDomain)
C0796392 (UMLS 2011AA)
C0671970 (UMLS 2011AA)
C0079083 (UMLS 2011AA)
C0008838 (UMLS 2011AA)
C0010583 (UMLS 2011AA)
C0246415 (UMLS 2011AA)
C0013089 (UMLS 2011AA)
C0014582 (UMLS 2011AA)
C0016360 (UMLS 2011AA)
C0045093 (UMLS 2011AA)
C0879430 (UMLS 2011AA)
C1173538 (UMLS 2011AA)
C0025677 (UMLS 2011AA)
C0205394 (UMLS 2011AA)
C0144576 (UMLS 2011AA)
C0338204 (UMLS 2011AA)
C0078257 (UMLS 2011AA)
C1521902 (UMLS 2011AA ValueDomain)
C15632 (NCI Thesaurus ObjectClass)
C0392920 (UMLS 2011AA ObjectClass)
C15368 (NCI Thesaurus ValueDomain-2)
C1708 (NCI Thesaurus Property)
C0450442 (UMLS 2011AA Property)
C0279025 (UMLS 2011AA ObjectClass)
C25616 (NCI Thesaurus Property)
C1948053 (UMLS 2011AA Property)
C25375 (NCI Thesaurus Property-2)
C0684224 (UMLS 2011AA Property-2)
C25382 (NCI Thesaurus Property-3)
C1521801 (UMLS 2011AA Property-3)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C0279025 (UMLS 2011AA ObjectClass)
C25472 (NCI Thesaurus Property)
C1511572 (UMLS 2011AA Property)
C25509 (NCI Thesaurus Property-2)
C1279901 (UMLS 2011AA Property-2)
C1708 (NCI Thesaurus Property-3)
C0450442 (UMLS 2011AA Property-3)
C42614 (NCI Thesaurus ValueDomain)
C0027365 (UMLS 2011AA ValueDomain)
C0290882 (UMLS 2011AA)
C0015011 (UMLS 2011AA)
C0060116 (UMLS 2011AA)
C0016366 (UMLS 2011AA)
C0701491 (UMLS 2011AA)
C0246421 (UMLS 2011AA)
C0065879 (UMLS 2011AA)
C0039286 (UMLS 2011AA)
C0076836 (UMLS 2011AA)
C0279025 (UMLS 2011AA ObjectClass)
C25472 (NCI Thesaurus Property)
C1511572 (UMLS 2011AA Property)
C25666 (NCI Thesaurus Property-2)
C0205436 (UMLS 2011AA Property-2)
C1708 (NCI Thesaurus Property-3)
C0450442 (UMLS 2011AA Property-3)
C42614 (NCI Thesaurus ValueDomain)
C0027365 (UMLS 2011AA ValueDomain)
C0290882 (UMLS 2011AA)
C0015011 (UMLS 2011AA)
C0060116 (UMLS 2011AA)
C0016366 (UMLS 2011AA)
C0701491 (UMLS 2011AA)
C0246421 (UMLS 2011AA)
C0065879 (UMLS 2011AA)
C0039286 (UMLS 2011AA)
C0076836 (UMLS 2011AA)
C0279025 (UMLS 2011AA ObjectClass)
C25472 (NCI Thesaurus Property)
C1511572 (UMLS 2011AA Property)
C1708 (NCI Thesaurus Property-2)
C0450442 (UMLS 2011AA Property-2)
C25260 (NCI Thesaurus Property-3)
C0205437 (UMLS 2011AA Property-3)
C42614 (NCI Thesaurus ValueDomain)
C0027365 (UMLS 2011AA ValueDomain)
C0290882 (UMLS 2011AA)
C0015011 (UMLS 2011AA)
C0060116 (UMLS 2011AA)
C0016366 (UMLS 2011AA)
C0701491 (UMLS 2011AA)
C0246421 (UMLS 2011AA)
C0065879 (UMLS 2011AA)
C0039286 (UMLS 2011AA)
C0076836 (UMLS 2011AA)
C1521902 (UMLS 2011AA ValueDomain)
C15445 (NCI Thesaurus ObjectClass)
C0279025 (UMLS 2011AA ObjectClass)
C15368 (NCI Thesaurus ValueDomain-2)
C1708 (NCI Thesaurus Property)
C0450442 (UMLS 2011AA Property)
C1512698 (UMLS 2011AA ValueDomain)
C25586 (NCI Thesaurus Property)
C0205314 (UMLS 2011AA Property)
C25331 (NCI Thesaurus Property-2)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C25586 (NCI Thesaurus Property)
C0205314 (UMLS 2011AA Property)
C17747 (NCI Thesaurus Property-2)
C0242656 (UMLS 2011AA Property-2)
C15220 (NCI Thesaurus Property-3)
C0011900 (UMLS 2011AA Property-3)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
C25331 (NCI Thesaurus Property)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C2346576 (UMLS CUI-1)
C25678 (NCI Thesaurus Property)
C17089 (NCI Thesaurus ObjectClass)
C2346576 (UMLS CUI-1)
C25678 (NCI Thesaurus Property)
C0011008 (UMLS CUI-2)
C25367 (NCI Thesaurus ValueDomain-2)
C17089 (NCI Thesaurus ObjectClass)