ID
11146
Descripción
CALGB: ADJUVANT RADIOTHERAPY REPORT FORM 2 NCT00041119 Four Versus Six Cycles of Cyclophosphamide/Doxorubicin or Paclitaxel in Adjuvant Breast Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=E03851EE-EEDC-5498-E034-0003BA12F5E7
Link
Palabras clave
Versiones (3)
- 26/8/12 26/8/12 -
- 9/1/15 9/1/15 - Martin Dugas
- 21/6/15 21/6/15 -
Subido en
21 de junio de 2015
DOI
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Licencia
Creative Commons BY-NC 3.0 Legacy
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CALGB: ADJUVANT RADIOTHERAPY REPORT FORM 2 NCT00041119
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.
- StudyEvent: CALGB: ADJUVANT RADIOTHERAPY REPORT FORM 2
Descripción
Patient demographics
Descripción
Patient Initials
Tipo de datos
text
Alias
- NCI Thesaurus ValueDomain
- C25191 (undefined)
- UMLS CUI-1
- C2986440 (Person Initials)
- NCI Thesaurus ObjectClass
- C16960 (undefined)
- NCI Thesaurus Property
- C25536 (undefined)
Descripción
Participating Group
Tipo de datos
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)
Descripción
Medical Record Number
Tipo de datos
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)
Descripción
Study Number Participating Group
Tipo de datos
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)
Descripción
Institution Name
Tipo de datos
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)
Descripción
Trial subject ID Participating Group
Tipo de datos
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)
Descripción
Radiation Treatment
Descripción
AdjuvantRadiationTherapyAdministeredInd-3
Tipo de datos
boolean
Alias
- NCI Thesaurus ValueDomain
- C38148 (undefined)
- UMLS 2011AA ValueDomain
- C1512699 (Yes, No, or Unknown Response)
- NCI Thesaurus ObjectClass
- C15313 (undefined)
- UMLS 2011AA ObjectClass
- C1522449 (Therapeutic radiology procedure)
- SNOMED
- 53438000
- LOINC
- LA4351-8
- NCI Thesaurus ObjectClass-2
- C2140 (undefined)
- UMLS 2011AA ObjectClass-2
- C0001552 (Pharmaceutical Adjuvants)
- NCI Thesaurus Property
- C25382 (undefined)
- UMLS 2011AA Property
- C1521801 (Having administered)
Descripción
AdjuvantRadiationTherapyBeginDate
Tipo de datos
date
Alias
- NCI Thesaurus ObjectClass
- C15313 (undefined)
- UMLS 2011AA ObjectClass
- C1522449 (Therapeutic radiology procedure)
- SNOMED
- 53438000
- LOINC
- LA4351-8
- NCI Thesaurus ObjectClass-2
- C2140 (undefined)
- UMLS 2011AA ObjectClass-2
- C0001552 (Pharmaceutical Adjuvants)
- NCI Thesaurus Property
- C25431 (undefined)
- UMLS 2011AA Property
- C0439659 (Beginning)
- SNOMED
- 255395001
- LOINC
- LP21371-7
- NCI Thesaurus Property-2
- C25275 (undefined)
- UMLS 2011AA Property-2
- C2745955 (Occurrence)
- SNOMED
- 246454002
- NCI Thesaurus ValueDomain
- C25164 (undefined)
- UMLS 2011AA ValueDomain
- C0011008 (Date in time)
- SNOMED
- 410671006
- NCI Thesaurus ValueDomain-2
- C25431 (undefined)
- UMLS 2011AA ValueDomain-2
- C0439659 (Beginning)
- SNOMED
- 255395001
- LOINC
- LP21371-7
Descripción
AdjuvantRadiationTherapyEndDate
Tipo de datos
date
Alias
- NCI Thesaurus ObjectClass
- C15313 (undefined)
- UMLS 2011AA ObjectClass
- C1522449 (Therapeutic radiology procedure)
- SNOMED
- 53438000
- LOINC
- LA4351-8
- NCI Thesaurus ObjectClass-2
- C2140 (undefined)
- UMLS 2011AA ObjectClass-2
- C0001552 (Pharmaceutical Adjuvants)
- NCI Thesaurus Property
- C25275 (undefined)
- UMLS 2011AA Property
- C2745955 (Occurrence)
- SNOMED
- 246454002
- NCI Thesaurus Property-2
- C25496 (undefined)
- UMLS 2011AA Property-2
- C2746065 (Stop (qualifier value))
- SNOMED
- 422117008
- NCI Thesaurus ValueDomain
- C25164 (undefined)
- UMLS 2011AA ValueDomain
- C0011008 (Date in time)
- SNOMED
- 410671006
Descripción
RadiationTherapyPerformedType
Tipo de datos
text
Alias
- NCI Thesaurus ValueDomain
- C25284 (undefined)
- UMLS 2011AA ValueDomain
- C0332307 (Type - attribute)
- SNOMED
- 261664005
- NCI Thesaurus ObjectClass
- C15313 (undefined)
- UMLS 2011AA ObjectClass
- C1522449 (Therapeutic radiology procedure)
- SNOMED
- 53438000
- LOINC
- LA4351-8
- NCI Thesaurus Property
- C38000 (undefined)
- UMLS 2011AA Property
- C0884358 (Performed)
- SNOMED
- 398166005
- LOINC
- LA19974-7
Descripción
Person Completing Form
Tipo de datos
text
Alias
- NCI Thesaurus ValueDomain
- C25191 (undefined)
- UMLS CUI-1
- C1550483 (data entry person)
- NCI Thesaurus ObjectClass
- C25657 (undefined)
- NCI Thesaurus Property
- C25364 (undefined)
Descripción
Date Form Completed
Tipo de datos
date
Alias
- NCI Thesaurus ValueDomain
- C25164 (undefined)
- UMLS CUI-1
- C1115437 (Date form completed)
- LOINC
- MTHU014518
- NCI Thesaurus ObjectClass
- C40988 (undefined)
- NCI Thesaurus Property
- C25250 (undefined)
- NCI Thesaurus ValueDomain-2
- C25367 (undefined)
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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.
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