ID
11056
Beschrijving
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
Link
Trefwoorden
Versies (3)
- 18-12-14 18-12-14 - Martin Dugas
- 09-01-15 09-01-15 - Martin Dugas
- 16-06-15 16-06-15 -
Geüploaded op
16 juni 2015
DOI
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Licentie
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
Beschrijving
Report Period
Beschrijving
Data amendment
Beschrijving
Data amended
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C0680532
- NCI Thesaurus ObjectClass
- C25474
- NCI Thesaurus Property
- C25416
Beschrijving
Data amended date
Datatype
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
Beschrijving
Arm A And Arm B
Beschrijving
SystemicTherapyAdministeredBeginDate
Datatype
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
Beschrijving
SystemicTherapyAdministeredEndDate
Datatype
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
Beschrijving
Vital Status
Beschrijving
Patient Status
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS CUI-1
- C3846084
- NCI Thesaurus ValueDomain
- C18003
- NCI Thesaurus ValueDomain-2
- C25688
- NCI Thesaurus Property
- C25717
Beschrijving
Date last contact
Datatype
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
Beschrijving
Primary Cause of Death
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25638
- UMLS CUI-1
- C0007465
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C28554
- NCI Thesaurus ValueDomain-2
- C25251
Beschrijving
Cause of Death, specify
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS CUI-1
- C0007465
- NCI Thesaurus ObjectClass
- C16960
- UMLS CUI-2
- C1521902
- NCI Thesaurus Property
- C28554
Beschrijving
Therapy Administered - Chemotherapy
Beschrijving
ChemotherapyAdministeredInd
Datatype
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
Beschrijving
ChemotherapyFirstCycleAgentName
Datatype
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
Beschrijving
ChemotherapySecondCycleAgentName
Datatype
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
Beschrijving
ChemotherapyThirdCycleAgentName
Datatype
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
Beschrijving
ChemotherapyAgentSpecify
Datatype
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
Beschrijving
Therapy Administered - Hormone Therapy
Beschrijving
HormoneTherapyReportPeriodAdministeredInd-3
Datatype
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
Beschrijving
EndocrineTherapyFirstCycleAgentName
Datatype
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
Beschrijving
EndocrineTherapySecondCycleAgentName
Datatype
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
Beschrijving
EndocrineTherapyThirdCycleAgentName
Datatype
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
Beschrijving
EndocrineTherapyAgentSpecify
Datatype
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
Beschrijving
Therapy Administered - New Progression
Beschrijving
DiseaseNewProgressionInd-2
Datatype
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
Beschrijving
DiseaseorDisorderNewDiseaseProgressionDiagnosisType
Datatype
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
Beschrijving
DiseaseProgressionDate
Datatype
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
Beschrijving
Comments
Beschrijving
Investigator Signature
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C2346576
- NCI Thesaurus Property
- C25678
- NCI Thesaurus ObjectClass
- C17089
Beschrijving
Investigator Signature Date
Datatype
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: 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)
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C25164 (NCI Thesaurus ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
C0007465 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
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C1173538 (UMLS 2011AA)
C0025677 (UMLS 2011AA)
C0205394 (UMLS 2011AA)
C0144576 (UMLS 2011AA)
C0338204 (UMLS 2011AA)
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C0025677 (UMLS 2011AA)
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C0796392 (UMLS 2011AA)
C0671970 (UMLS 2011AA)
C0079083 (UMLS 2011AA)
C0008838 (UMLS 2011AA)
C0010583 (UMLS 2011AA)
C0246415 (UMLS 2011AA)
C0013089 (UMLS 2011AA)
C0014582 (UMLS 2011AA)
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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)
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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)
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