ID
11147
Descrição
CALGB: 40101 TRASTUZUMAB MONITORING FORM 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=FD4BCDD9-1BFD-6EE8-E034-0003BA3F9857
Link
Palavras-chave
Versões (3)
- 26/08/2012 26/08/2012 -
- 09/01/2015 09/01/2015 - Martin Dugas
- 21/06/2015 21/06/2015 -
Transferido a
21 de junho de 2015
DOI
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Licença
Creative Commons BY-NC 3.0 Legacy
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CALGB: 40101 TRASTUZUMAB MONITORING FORM 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: 40101 TRASTUZUMAB MONITORING FORM
Descrição
Patient demographics
Descrição
Patient Initials
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS CUI-1
- C2986440
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25536
Descrição
Patient Hospital No
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C0421459
- NCI Thesaurus Property
- C16960
- NCI Thesaurus Property-2
- C25364
- NCI Thesaurus ObjectClass
- C16696
Descrição
Institution Name
Tipo de dados
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
Descrição
Participating Group
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS CUI-1
- C2347449
- NCI Thesaurus ObjectClass
- C25608
- NCI Thesaurus ObjectClass-2
- C17005
- NCI Thesaurus Property
- C25364
Descrição
Study Number Participating Group
Tipo de dados
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
Descrição
Trial subject ID Participating Group
Tipo de dados
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
Descrição
Testing Results
Descrição
TrastuzumabAgentAdministrationInd-2
Tipo de dados
boolean
Alias
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
- NCI Thesaurus ObjectClass
- C1647
- UMLS 2011AA ObjectClass
- C0338204
- NCI Thesaurus ObjectClass-2
- C1708
- UMLS 2011AA ObjectClass-2
- C0450442
- NCI Thesaurus Property
- C25409
- UMLS 2011AA Property
- C1533734
Descrição
TrastuzumabAgentNotAdministrationSpecify
Tipo de dados
text
Alias
- NCI Thesaurus ObjectClass
- C1647
- UMLS 2011AA ObjectClass
- C0338204
- NCI Thesaurus ObjectClass-2
- C1708
- UMLS 2011AA ObjectClass-2
- C0450442
- NCI Thesaurus Property
- C25594
- UMLS 2011AA Property
- C1518422
- NCI Thesaurus Property-2
- C25409
- UMLS 2011AA Property-2
- C1533734
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
Descrição
TrastuzumabAgentAdministrationBeginDate
Tipo de dados
date
Alias
- NCI Thesaurus ObjectClass
- C1647
- UMLS 2011AA ObjectClass
- C0338204
- NCI Thesaurus ObjectClass-2
- C1708
- UMLS 2011AA ObjectClass-2
- C0450442
- NCI Thesaurus Property
- C25409
- UMLS 2011AA Property
- C1533734
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ValueDomain-2
- C25431
- UMLS 2011AA ValueDomain-2
- C0439659
Descrição
TrastuzumabAgentAdministrationEndDate
Tipo de dados
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C1647
- UMLS 2011AA ObjectClass
- C0338204
- NCI Thesaurus ObjectClass-2
- C1708
- UMLS 2011AA ObjectClass-2
- C0450442
- NCI Thesaurus Property
- C25409
- UMLS 2011AA Property
- C1533734
Descrição
TrastuzumabAgentAdministrationDiscontinuedReason
Tipo de dados
text
Alias
- NCI Thesaurus ObjectClass
- C1647
- UMLS 2011AA ObjectClass
- C0338204
- NCI Thesaurus ObjectClass-2
- C1708
- UMLS 2011AA ObjectClass-2
- C0450442
- NCI Thesaurus Property
- C25409
- UMLS 2011AA Property
- C1533734
- NCI Thesaurus ValueDomain
- C25638
- UMLS 2011AA ValueDomain
- C0392360
- NCI Thesaurus ValueDomain-2
- C25484
- UMLS 2011AA ValueDomain-2
- C1444662
Descrição
TrastuzumabAgentAdministrationDiscontinuedSpecify
Tipo de dados
text
Alias
- NCI Thesaurus ObjectClass
- C1647
- UMLS 2011AA ObjectClass
- C0338204
- NCI Thesaurus ObjectClass-2
- C1708
- UMLS 2011AA ObjectClass-2
- C0450442
- NCI Thesaurus Property
- C25409
- UMLS 2011AA Property
- C1533734
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
- NCI Thesaurus ValueDomain-2
- C25484
- UMLS 2011AA ValueDomain-2
- C1444662
Descrição
Footer
Descrição
Responsible Person Signature
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C1550483
- NCI Thesaurus ObjectClass
- C25190
- NCI Thesaurus ObjectClass-2
- C25657
- NCI Thesaurus Property
- C25678
Descrição
Date Form Completed
Tipo de dados
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.
- StudyEvent: CALGB: 40101 TRASTUZUMAB MONITORING FORM
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