ID
11120
Descripción
CALGB-10501 Concerns About Cancer Progression Form NCT00513747 Early or Delayed Fludarabine and Rituximab in Treating Patients With Previously Untreated Chronic Lymphocytic Leukemia Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=340EDF8E-59EA-1F88-E044-0003BA3F9857
Link
Palabras clave
Versiones (3)
- 19/9/12 19/9/12 -
- 9/1/15 9/1/15 - Martin Dugas
- 18/6/15 18/6/15 -
Subido en
18 de junio de 2015
DOI
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Licencia
Creative Commons BY-NC 3.0 Legacy
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CALGB-10501 Concerns About Cancer Progression Form NCT00513747
INSTRUCTIONS: Complete and submit this form as required by the protocol. Information in the upper right box must be completed for this form to be accepted. For optimal accuracy use black ink. Mark an X in the appropriate box for fields with a choice
- StudyEvent: CALGB-10501 Concerns About Cancer Progression Form
Descripción
Patient demographics
Descripción
Patient Initials
Tipo de datos
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS CUI-1
- C2986440
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25536
Descripción
Medical Record Number
Tipo de datos
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C1301894
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25261
- NCI Thesaurus Property-2
- C25198
Descripción
Institution Name
Tipo de datos
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
Descripción
Participating Group
Tipo de datos
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS CUI-1
- C2347449
- NCI Thesaurus ObjectClass
- C25608
- NCI Thesaurus ObjectClass-2
- C17005
- NCI Thesaurus Property
- C25364
Descripción
Study Number Participating Group
Tipo de datos
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
Descripción
Trial subject ID Participating Group
Tipo de datos
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
Descripción
Visit number
Tipo de datos
float
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C1549755
- NCI Thesaurus ObjectClass
- C16696
- NCI Thesaurus Property
- C25385
Descripción
Concerns About Cancer Assessment
Descripción
AnxietyDurationDiseaseProgressionQualityofLifeAssessmentScale
Tipo de datos
text
Alias
- NCI Thesaurus ObjectClass
- C26696
- UMLS 2011AA ObjectClass
- C0003467
- NCI Thesaurus ObjectClass-2
- C17747
- UMLS 2011AA ObjectClass-2
- C0242656
- NCI Thesaurus ObjectClass-3
- C25330
- UMLS 2011AA ObjectClass-3
- C0449238
- NCI Thesaurus Property
- C17047
- UMLS 2011AA Property
- C0518214
- NCI Thesaurus Property-2
- C25367
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
Descripción
AnxietyAmountDiseaseProgressionQualityofLifeAssessmentScale
Tipo de datos
text
Alias
- NCI Thesaurus ObjectClass
- C26696
- UMLS 2011AA ObjectClass
- C0003467
- NCI Thesaurus ObjectClass-2
- C17747
- UMLS 2011AA ObjectClass-2
- C0242656
- NCI Thesaurus ObjectClass-3
- C25417
- NCI Thesaurus Property
- C17047
- UMLS 2011AA Property
- C0518214
- NCI Thesaurus Property-2
- C25367
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
Descripción
AnxietyFrequencyDiseaseProgressionQualityofLifeAssessmentScale
Tipo de datos
text
Alias
- NCI Thesaurus ObjectClass
- C26696
- UMLS 2011AA ObjectClass
- C0003467
- NCI Thesaurus ObjectClass-2
- C17747
- UMLS 2011AA ObjectClass-2
- C0242656
- NCI Thesaurus ObjectClass-3
- C25515
- UMLS 2011AA ObjectClass-3
- C0439603
- NCI Thesaurus Property
- C17047
- UMLS 2011AA Property
- C0518214
- NCI Thesaurus Property-2
- C25367
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
Descripción
AmountDistressDiseaseProgressionQualityofLifeAssessmentScale
Tipo de datos
text
Alias
- NCI Thesaurus ObjectClass
- C17747
- UMLS 2011AA ObjectClass
- C0242656
- NCI Thesaurus ObjectClass-2
- C37942
- UMLS 2011AA ObjectClass-2
- C0231303
- NCI Thesaurus ObjectClass-3
- C25417
- NCI Thesaurus Property
- C17047
- UMLS 2011AA Property
- C0518214
- NCI Thesaurus Property-2
- C25367
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
Descripción
Footer Module
Descripción
Person Completing Form
Tipo de datos
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS CUI-1
- C1550483
- NCI Thesaurus ObjectClass
- C25657
- NCI Thesaurus Property
- C25364
Descripción
Date Form Completed
Tipo de datos
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C1115437
- NCI Thesaurus ObjectClass
- C40988
- NCI Thesaurus Property
- C25250
- NCI Thesaurus ValueDomain-2
- C25367
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INSTRUCTIONS: Complete and submit this form as required by the protocol. Information in the upper right box must be completed for this form to be accepted. For optimal accuracy use black ink. Mark an X in the appropriate box for fields with a choice
- StudyEvent: CALGB-10501 Concerns About Cancer Progression Form
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C1549755 (UMLS CUI-1)
C16696 (NCI Thesaurus ObjectClass)
C25385 (NCI Thesaurus Property)
C0003467 (UMLS 2011AA ObjectClass)
C17747 (NCI Thesaurus ObjectClass-2)
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C25330 (NCI Thesaurus ObjectClass-3)
C0449238 (UMLS 2011AA ObjectClass-3)
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C0349674 (UMLS 2011AA ValueDomain)
C0205448 (UMLS 2011AA)
C0003467 (UMLS 2011AA ObjectClass)
C17747 (NCI Thesaurus ObjectClass-2)
C0242656 (UMLS 2011AA ObjectClass-2)
C25417 (NCI Thesaurus ObjectClass-3)
C17047 (NCI Thesaurus Property)
C0518214 (UMLS 2011AA Property)
C25367 (NCI Thesaurus Property-2)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C0205448 (UMLS 2011AA)
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