ID
11148
Description
CALGB: 40101 HER-2/neu TESTING 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=FD4C7CA2-BB12-68FB-E034-0003BA3F9857
Link
Keywords
Versions (3)
- 8/26/12 8/26/12 -
- 1/9/15 1/9/15 - Martin Dugas
- 6/21/15 6/21/15 -
Uploaded on
June 21, 2015
DOI
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License
Creative Commons BY-NC 3.0 Legacy
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CALGB: 40101 HER-2/neu TESTING 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 HER-2/neu TESTING FORM
Description
Patient demographics
Description
Patient Initials
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS CUI-1
- C2986440
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25536
Description
Patient Hospital No
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C0421459
- NCI Thesaurus Property
- C16960
- NCI Thesaurus Property-2
- C25364
- NCI Thesaurus ObjectClass
- C16696
Description
Institution Name
Data type
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
Description
Participating Group
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS CUI-1
- C2347449
- NCI Thesaurus ObjectClass
- C25608
- NCI Thesaurus ObjectClass-2
- C17005
- NCI Thesaurus Property
- C25364
Description
Study Number Participating Group
Data type
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
Description
Trial subject ID Participating Group
Data type
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
Description
Testing Data
Description
StainingAntibody
Data type
text
Description
HerceptestScore
Data type
text
Description
LaboratoryProcedureHER2/neuImmunohistochemistryResultMonoclonalAntibodyCB11Score
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C16722
- NCI Thesaurus Property-2
- C20200
- UMLS 2011AA Property
- C1274040
- NCI Thesaurus Property-3
- C17756
- UMLS 2011AA Property-2
- C0242957
- NCI Thesaurus ValueDomain
- C20401
- UMLS 2011AA ValueDomain
- C0003250
- NCI Thesaurus ValueDomain-2
- C25338
- UMLS 2011AA ValueDomain-2
- C0449820
Description
StainingAntibody,Other
Data type
text
Description
LaboratoryProcedureHER2/neuImmunohistochemistryResultText
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C16722
- NCI Thesaurus Property-2
- C20200
- UMLS 2011AA Property
- C1274040
- NCI Thesaurus Property-3
- C17756
- UMLS 2011AA Property-2
- C0242957
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus ValueDomain-2
- C20200
- UMLS 2011AA ValueDomain-2
- C1274040
Description
FISHAssessmentTestType
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus ObjectClass
- C20989
- UMLS 2011AA ObjectClass
- C0031809
- NCI Thesaurus ObjectClass-2
- C17563
- UMLS 2011AA ObjectClass-2
- C0162789
- NCI Thesaurus Property
- C25294
- UMLS 2011AA Property
- C0022885
Description
FISHAssessmentChromosome17ResultHER2NeuNumber
Data type
float
Alias
- NCI Thesaurus ObjectClass
- C20989
- UMLS 2011AA ObjectClass
- C0031809
- NCI Thesaurus ObjectClass-2
- C17563
- UMLS 2011AA ObjectClass-2
- C0162789
- NCI Thesaurus Property
- C20200
- UMLS 2011AA Property
- C1274040
- NCI Thesaurus Property-2
- C13212
- UMLS 2011AA Property-2
- C0008659
- NCI Thesaurus ValueDomain
- C25337
- UMLS 2011AA ValueDomain
- C0237753
- NCI Thesaurus ValueDomain-2
- C17756
- UMLS 2011AA ValueDomain-2
- C0242957
Description
VentanaScore
Data type
text
Description
VentanaScore
Data type
text
Description
FISHAssessmentTestSpecify
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
- NCI Thesaurus ObjectClass
- C20989
- UMLS 2011AA ObjectClass
- C0031809
- NCI Thesaurus ObjectClass-2
- C17563
- UMLS 2011AA ObjectClass-2
- C0162789
- NCI Thesaurus Property
- C25294
- UMLS 2011AA Property
- C0022885
Description
FISHAssessmentTestResultText
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C20989
- UMLS 2011AA ObjectClass
- C0031809
- NCI Thesaurus ObjectClass-2
- C17563
- UMLS 2011AA ObjectClass-2
- C0162789
- NCI Thesaurus Property
- C25294
- UMLS 2011AA Property
- C0022885
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus ValueDomain-2
- C20200
- UMLS 2011AA ValueDomain-2
- C1274040
Description
Testing Results
Description
Footer
Description
Responsible Person Signature
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C1550483
- NCI Thesaurus ObjectClass
- C25190
- NCI Thesaurus ObjectClass-2
- C25657
- NCI Thesaurus Property
- C25678
Description
Date Form Completed
Data type
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 HER-2/neu TESTING FORM
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C0242957 (UMLS 2011AA ObjectClass)
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