Form ID CALGB
Item
CALGB Form
text
C25337 (NCI Thesaurus ValueDomain)
C3262252 (UMLS CUI-1)
C19464 (NCI Thesaurus ObjectClass)
C1516238 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25442 (NCI Thesaurus ObjectClass-2)
Protocol ID CALGB
Item
CALGB Study No
text
C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1516238 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25442 (NCI Thesaurus Property-2)
Trial subject ID CALGB
Item
CALGB Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1516238 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25442 (NCI Thesaurus Property-2)
Data amended
Item
Are data amended
boolean
C38148 (NCI Thesaurus ValueDomain)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
Patient Initials
Item
Patient Initials (Last, First Middle)
text
C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
Medical Record Number
Item
Patient Hospital No.
text
C25337 (NCI Thesaurus ValueDomain)
C1301894 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25261 (NCI Thesaurus Property)
C25198 (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)
Participating Group
Item
Participating Group
text
C25191 (NCI Thesaurus ValueDomain)
C2347449 (UMLS CUI-1)
C25608 (NCI Thesaurus ObjectClass)
C17005 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
Study Number Participating Group
Item
Participating Group Study No
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)
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)
Visit number
Item
Visit number
float
C25337 (NCI Thesaurus ValueDomain)
C1549755 (UMLS CUI-1)
C16696 (NCI Thesaurus ObjectClass)
C25385 (NCI Thesaurus Property)
Item
Any reminder brought back feelings about it
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C54266 (NCI Thesaurus ObjectClass-2)
C0013987 (UMLS 2011AA ObjectClass-2)
C54270 (NCI Thesaurus ObjectClass-3)
C1709896 (UMLS 2011AA ObjectClass-3)
C25367 (NCI Thesaurus Property)
C37987 (NCI Thesaurus Property-2)
C0376558 (UMLS 2011AA Property)
C37942 (NCI Thesaurus Property-3)
C0231303 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
Code List
Any reminder brought back feelings about it
CL Item
A Little Bit (A little bit)
CL Item
Extremely (Extremely)
CL Item
Moderately (Moderately)
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
CL Item
Quite A Bit (Quite a bit)
C91216 (NCI Thesaurus)
Item
I had trouble staying asleep
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C73425 (NCI Thesaurus Property-2)
C0037313 (UMLS 2011AA Property)
C62189 (NCI Thesaurus Property-3)
C1299586 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
Code List
I had trouble staying asleep
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
C91213 (NCI Thesaurus-2)
CL Item
A Little Bit (A little bit)
CL Item
Moderately (Moderately)
CL Item
Quite A Bit (Quite a bit)
C91216 (NCI Thesaurus)
C91216 (NCI Thesaurus-2)
CL Item
Extremely (Extremely)
Item
Other things kept making me think about it
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C54270 (NCI Thesaurus ObjectClass-2)
C1709896 (UMLS 2011AA ObjectClass-2)
C54226 (NCI Thesaurus ObjectClass-3)
C0039869 (UMLS 2011AA ObjectClass-3)
C25367 (NCI Thesaurus Property)
C37987 (NCI Thesaurus Property-2)
C0376558 (UMLS 2011AA Property)
C37942 (NCI Thesaurus Property-3)
C0231303 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
Code List
Other things kept making me think about it
CL Item
A Little Bit (A little bit)
CL Item
Extremely (Extremely)
CL Item
Moderately (Moderately)
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
CL Item
Quite A Bit (Quite a bit)
C91216 (NCI Thesaurus)
Item
I thought about it when I didn't mean to
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C34340 (NCI Thesaurus ObjectClass-2)
C0000924 (UMLS 2011AA ObjectClass-2)
C54270 (NCI Thesaurus ObjectClass-3)
C1709896 (UMLS 2011AA ObjectClass-3)
C54226 (NCI Thesaurus ObjectClass-4)
C0039869 (UMLS 2011AA ObjectClass-4)
C25367 (NCI Thesaurus Property)
C37987 (NCI Thesaurus Property-2)
C0376558 (UMLS 2011AA Property)
C37942 (NCI Thesaurus Property-3)
C0231303 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
Code List
I thought about it when I didn't mean to
CL Item
A Little Bit (A little bit)
CL Item
Extremely (Extremely)
CL Item
Moderately (Moderately)
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
CL Item
Quite A Bit (Quite a bit)
C91216 (NCI Thesaurus)
Item
Pictures about it popped into my mind
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C54270 (NCI Thesaurus ObjectClass-2)
C1709896 (UMLS 2011AA ObjectClass-2)
C54226 (NCI Thesaurus ObjectClass-3)
C0039869 (UMLS 2011AA ObjectClass-3)
C54273 (NCI Thesaurus ObjectClass-4)
C0441469 (UMLS 2011AA ObjectClass-4)
C25367 (NCI Thesaurus Property)
C37987 (NCI Thesaurus Property-2)
C0376558 (UMLS 2011AA Property)
C37942 (NCI Thesaurus Property-3)
C0231303 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
Code List
Pictures about it popped into my mind
CL Item
A Little Bit (A little bit)
CL Item
Extremely (Extremely)
CL Item
Moderately (Moderately)
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
CL Item
Quite A Bit (Quite a bit)
C91216 (NCI Thesaurus)
Item
I had waves of strong feelings about it
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C54266 (NCI Thesaurus ObjectClass-2)
C0013987 (UMLS 2011AA ObjectClass-2)
C62223 (NCI Thesaurus ObjectClass-3)
C0442821 (UMLS 2011AA ObjectClass-3)
C25367 (NCI Thesaurus Property)
C37987 (NCI Thesaurus Property-2)
C0376558 (UMLS 2011AA Property)
C37942 (NCI Thesaurus Property-3)
C0231303 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
Code List
I had waves of strong feelings about it
CL Item
A Little Bit (A little bit)
CL Item
Extremely (Extremely)
CL Item
Moderately (Moderately)
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
CL Item
Quite A Bit (Quite a bit)
C91216 (NCI Thesaurus)
Item
I had dreams about it
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C54268 (NCI Thesaurus ObjectClass-2)
C0013117 (UMLS 2011AA ObjectClass-2)
C25367 (NCI Thesaurus Property)
C37987 (NCI Thesaurus Property-2)
C0376558 (UMLS 2011AA Property)
C37942 (NCI Thesaurus Property-3)
C0231303 (UMLS 2011AA Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
Code List
I had dreams about it
CL Item
A Little Bit (A little bit)
CL Item
Extremely (Extremely)
CL Item
Moderately (Moderately)
CL Item
Not At All (Not at all)
C91213 (NCI Thesaurus)
CL Item
Quite A Bit (Quite a bit)
C91216 (NCI Thesaurus)
Person Completing Form
Item
Completed by (print or type name)
text
C25191 (NCI Thesaurus ValueDomain)
C1550483 (UMLS CUI-1)
C25657 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)
Date Form Completed
Item
Date Form Completed (MM DD YYYY)
date
C25164 (NCI Thesaurus ValueDomain)
C1115437 (UMLS CUI-1)
C40988 (NCI Thesaurus ObjectClass)
C25250 (NCI Thesaurus Property)
C25367 (NCI Thesaurus ValueDomain-2)