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ID

11131

Beskrivning

CALGB: C-1001 NEW PRIMARY CANCER FORM [80303] NCT00088894 Gemcitabine With or Without Bevacizumab in Treating Patients With Locally Advanced or Metastatic Pancreatic Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=D5FEE4C9-F395-6F2C-E034-0003BA12F5E7

Länk

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=D5FEE4C9-F395-6F2C-E034-0003BA12F5E7

Nyckelord

  1. 2012-09-19 2012-09-19 -
  2. 2015-01-09 2015-01-09 - Martin Dugas
  3. 2015-06-21 2015-06-21 -
Uppladdad den

21 juni 2015

DOI

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Licens

Creative Commons BY-NC 3.0 Legacy

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    CALGB: C-1001 NEW PRIMARY CANCER FORM [80303] NCT00088894

    No Instruction available.

    1. StudyEvent: CALGB: C-1001 NEW PRIMARY CANCER FORM [80303]
      1. No Instruction available.
    Header
    Beskrivning

    Header

    CALGB Study No.
    Beskrivning

    Protocol ID CALGB

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337 (undefined)
    UMLS CUI-1
    C3274381 (Clinical Trial Registry Identifier)
    NCI Thesaurus ObjectClass
    C25320 (undefined)
    UMLS CUI-2
    C1516238 (Cancer and Leukemia Group B)
    LOINC
    LA4261-9
    NCI Thesaurus Property
    C25364 (undefined)
    NCI Thesaurus Property-2
    C25442 (undefined)
    CALGB Patient ID
    Beskrivning

    Trial subject ID CALGB

    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
    C1516238 (Cancer and Leukemia Group B)
    LOINC
    LA4261-9
    NCI Thesaurus Property
    C25364 (undefined)
    NCI Thesaurus Property-2
    C25442 (undefined)
    Are data amended?
    Beskrivning

    Data amended

    Datatyp

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38148 (undefined)
    UMLS CUI-1
    C0680532 (Amendment)
    NCI Thesaurus ObjectClass
    C25474 (undefined)
    NCI Thesaurus Property
    C25416 (undefined)
    Patient demographics
    Beskrivning

    Patient demographics

    Patient's 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
    Beskrivning

    Participating Group

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191 (undefined)
    UMLS CUI-1
    C2347449 (Participating Clinical Study Organization)
    NCI Thesaurus ObjectClass
    C25608 (undefined)
    NCI Thesaurus ObjectClass-2
    C17005 (undefined)
    NCI Thesaurus Property
    C25364 (undefined)
    Patient Hospital No.
    Beskrivning

    Medical Record Number

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337 (undefined)
    UMLS CUI-1
    C1301894 (Medical record number)
    SNOMED
    398225001
    LOINC
    MTHU047637
    NCI Thesaurus ObjectClass
    C16960 (undefined)
    NCI Thesaurus Property
    C25261 (undefined)
    NCI Thesaurus Property-2
    C25198 (undefined)
    Participating Group Protocol No.
    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)
    NEW PRIMARY CANCER ASSESSMENT
    Beskrivning

    NEW PRIMARY CANCER ASSESSMENT

    Site(s) of New Primary
    Beskrivning

    NewCancerSiteText

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704 (undefined)
    UMLS 2011AA ValueDomain
    C1527021 (Text)
    LOINC
    LP6885-0
    NCI Thesaurus ObjectClass
    C25586 (undefined)
    UMLS 2011AA ObjectClass
    C0205314 (New)
    SNOMED
    7147002
    LOINC
    LA9039-4
    NCI Thesaurus Property
    C25341 (undefined)
    UMLS 2011AA Property
    C0450429 (Location)
    SNOMED
    246267002
    LOINC
    LP149876-7
    NCI Thesaurus ObjectClass-2
    C9305 (undefined)
    UMLS 2011AA ObjectClass-2
    C0006826 (Malignant Neoplasms)
    SNOMED
    363346000
    LOINC
    LP100805-3
    New Primary, Histologic Type
    Beskrivning

    PrimaryTumorNewHistologicCategory

    Datatyp

    text

    Alias
    NCI Thesaurus ObjectClass
    C3262 (undefined)
    UMLS 2011AA ObjectClass
    C0027651 (Neoplasms)
    SNOMED
    108369006
    NCI Thesaurus ObjectClass-2
    C25251 (undefined)
    UMLS 2011AA ObjectClass-2
    C0205225 (Primary)
    SNOMED
    63161005
    LOINC
    LA21208-6
    NCI Thesaurus Property
    C25586 (undefined)
    UMLS 2011AA Property
    C0205314 (New)
    SNOMED
    7147002
    LOINC
    LA9039-4
    NCI Thesaurus Property-2
    C25161 (undefined)
    UMLS 2011AA Property-2
    C0008902 (Classification)
    SNOMED
    73504009
    NCI Thesaurus ValueDomain
    C25372 (undefined)
    UMLS 2011AA ValueDomain
    C0683312 (Categories)
    LOINC
    MTHU018876
    NCI Thesaurus ValueDomain-2
    C25526 (undefined)
    UMLS 2011AA ValueDomain-2
    C0205462 (Histologic)
    SNOMED
    67151002
    Date of Diagnosis
    Beskrivning

    NewCancerDiagnosisDate

    Datatyp

    date

    Alias
    NCI Thesaurus ObjectClass
    C25586 (undefined)
    UMLS 2011AA ObjectClass
    C0205314 (New)
    SNOMED
    7147002
    LOINC
    LA9039-4
    NCI Thesaurus ObjectClass-2
    C9305 (undefined)
    UMLS 2011AA ObjectClass-2
    C0006826 (Malignant Neoplasms)
    SNOMED
    363346000
    LOINC
    LP100805-3
    NCI Thesaurus Property
    C15220 (undefined)
    UMLS 2011AA Property
    C0011900 (Diagnosis)
    SNOMED
    439401001
    LOINC
    LP30831-9
    NCI Thesaurus ValueDomain
    C25164 (undefined)
    UMLS 2011AA ValueDomain
    C0011008 (Date in time)
    SNOMED
    410671006
    NCI Thesaurus ValueDomain-2
    C25367 (undefined)
    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)
    Completed by
    Beskrivning

    Person Completing Form

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191 (undefined)
    UMLS CUI-1
    C1550483 (data entry person)
    NCI Thesaurus ObjectClass
    C25657 (undefined)
    NCI Thesaurus Property
    C25364 (undefined)
    Date Form Completed
    Beskrivning

    Form Completion Date

    Datatyp

    date

    Alias
    NCI Thesaurus ObjectClass
    C19464 (undefined)
    UMLS CUI-1
    C1549507 (Report completion date/time)
    NCI Thesaurus Property
    C25250 (undefined)
    NCI Thesaurus Property-2
    C25604 (undefined)
    NCI Thesaurus ValueDomain
    C25164 (undefined)
    NCI Thesaurus ValueDomain-2
    C25367 (undefined)

    Similar models

    No Instruction available.

    1. StudyEvent: CALGB: C-1001 NEW PRIMARY CANCER FORM [80303]
      1. No Instruction available.
    Name
    Typ
    Description | Question | Decode (Coded Value)
    Datatyp
    Alias
    Item Group
    Header
    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)
    Item Group
    Patient demographics
    Patient Initials
    Item
    Patient's Initials
    text
    C25191 (NCI Thesaurus ValueDomain)
    C2986440 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C25536 (NCI Thesaurus Property)
    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)
    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)
    Study Number Participating Group
    Item
    Participating Group Protocol 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)
    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
    NEW PRIMARY CANCER ASSESSMENT
    NewCancerSiteText
    Item
    Site(s) of New Primary
    text
    C25704 (NCI Thesaurus ValueDomain)
    C1527021 (UMLS 2011AA ValueDomain)
    C25586 (NCI Thesaurus ObjectClass)
    C0205314 (UMLS 2011AA ObjectClass)
    C25341 (NCI Thesaurus Property)
    C0450429 (UMLS 2011AA Property)
    C9305 (NCI Thesaurus ObjectClass-2)
    C0006826 (UMLS 2011AA ObjectClass-2)
    PrimaryTumorNewHistologicCategory
    Item
    New Primary, Histologic Type
    text
    C3262 (NCI Thesaurus ObjectClass)
    C0027651 (UMLS 2011AA ObjectClass)
    C25251 (NCI Thesaurus ObjectClass-2)
    C0205225 (UMLS 2011AA ObjectClass-2)
    C25586 (NCI Thesaurus Property)
    C0205314 (UMLS 2011AA Property)
    C25161 (NCI Thesaurus Property-2)
    C0008902 (UMLS 2011AA Property-2)
    C25372 (NCI Thesaurus ValueDomain)
    C0683312 (UMLS 2011AA ValueDomain)
    C25526 (NCI Thesaurus ValueDomain-2)
    C0205462 (UMLS 2011AA ValueDomain-2)
    NewCancerDiagnosisDate
    Item
    Date of Diagnosis
    date
    C25586 (NCI Thesaurus ObjectClass)
    C0205314 (UMLS 2011AA ObjectClass)
    C9305 (NCI Thesaurus ObjectClass-2)
    C0006826 (UMLS 2011AA ObjectClass-2)
    C15220 (NCI Thesaurus Property)
    C0011900 (UMLS 2011AA Property)
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C25367 (NCI Thesaurus ValueDomain-2)
    Item Group
    Comments
    Research Comments
    Item
    Comments
    text
    C25704 (NCI Thesaurus ValueDomain)
    C0947611 (UMLS CUI-1)
    C15319 (NCI Thesaurus ObjectClass)
    C25393 (NCI Thesaurus Property)
    Person Completing Form
    Item
    Completed by
    text
    C25191 (NCI Thesaurus ValueDomain)
    C1550483 (UMLS CUI-1)
    C25657 (NCI Thesaurus ObjectClass)
    C25364 (NCI Thesaurus Property)
    Form Completion Date
    Item
    Date Form Completed
    date
    C19464 (NCI Thesaurus ObjectClass)
    C1549507 (UMLS CUI-1)
    C25250 (NCI Thesaurus Property)
    C25604 (NCI Thesaurus Property-2)
    C25164 (NCI Thesaurus ValueDomain)
    C25367 (NCI Thesaurus ValueDomain-2)

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