ID
11327
Description
ANBL0321: PK Specimen Shipping Form NCT00053326 Fenretinide in Treating Children With Recurrent or Resistant Neuroblastoma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=C42AE414-4572-73E3-E034-0003BA12F5E7
Link
Keywords
Versions (3)
- 9/19/12 9/19/12 -
- 1/9/15 1/9/15 - Martin Dugas
- 7/3/15 7/3/15 -
Uploaded on
July 3, 2015
DOI
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License
Creative Commons BY-NC 3.0 Legacy
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ANBL0321: PK Specimen Shipping Form NCT00053326
No Instruction available.
- StudyEvent: ANBL0321: PK Specimen Shipping Form
Description
Patient Information
Description
Medical Record Number
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C1301894
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25261
- NCI Thesaurus Property-2
- C25198
Description
Cycle Number Chemotherapeutics
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C2045829
- NCI Thesaurus Property
- C25471
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus Property-2
- C25379
Description
SpecimenAccessionNumber
Data type
float
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS 2011AA ValueDomain
- C0237753
- NCI Thesaurus ObjectClass
- C19157
- UMLS 2011AA ObjectClass
- C0370003
- NCI Thesaurus Property
- C25402
- UMLS 2011AA Property
- C1510755
Description
PatientCOGIdentifierNumber
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS 2011AA ValueDomain
- C0237753
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25364
- UMLS 2011AA Property
- C0600091
- NCI Thesaurus Property-2
- C39353
- UMLS 2011AA Property-2
- C1516477
Description
Body Surface Area
Data type
float
Alias
- NCI Thesaurus ValueDomain
- C25209
- UMLS CUI-1
- C0005902
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25157
Description
Units [agent UOM]
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C1708
- NCI Thesaurus Property
- C25256
- NCI Thesaurus ValueDomain
- C25709
- UMLS CUI-1
- C1519795
Description
Units [agent UOM]
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C1708
- NCI Thesaurus Property
- C25256
- NCI Thesaurus ValueDomain
- C25709
- UMLS CUI-1
- C1519795
Description
Units [agent UOM]
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C1708
- NCI Thesaurus Property
- C25256
- NCI Thesaurus ValueDomain
- C25709
- UMLS CUI-1
- C1519795
Description
Concomitant Medication Daily Dose
Data type
float
Alias
- NCI Thesaurus ObjectClass
- C25473
- UMLS CUI-1
- C2826638
- NCI Thesaurus ObjectClass-2
- C1708
- NCI Thesaurus Property
- C25304
- NCI Thesaurus Property-2
- C25256
- NCI Thesaurus ValueDomain
- C25488
- NCI Thesaurus ValueDomain-2
- C1708
Description
Concomitant Medication Daily Dose
Data type
float
Alias
- NCI Thesaurus ObjectClass
- C25473
- UMLS CUI-1
- C2826638
- NCI Thesaurus ObjectClass-2
- C1708
- NCI Thesaurus Property
- C25304
- NCI Thesaurus Property-2
- C25256
- NCI Thesaurus ValueDomain
- C25488
- NCI Thesaurus ValueDomain-2
- C1708
Description
Concomitant Medication Daily Dose
Data type
float
Alias
- NCI Thesaurus ObjectClass
- C25473
- UMLS CUI-1
- C2826638
- NCI Thesaurus ObjectClass-2
- C1708
- NCI Thesaurus Property
- C25304
- NCI Thesaurus Property-2
- C25256
- NCI Thesaurus ValueDomain
- C25488
- NCI Thesaurus ValueDomain-2
- C1708
Description
Biopsy and Cytology Specimens
Description
Cycle Number Chemotherapeutics
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C2045829
- NCI Thesaurus Property
- C25471
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus Property-2
- C25379
Description
SpecimenCollectedDate
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C19157
- UMLS 2011AA ObjectClass
- C0370003
- NCI Thesaurus Property
- C25452
- NCI Thesaurus Property-2
- C25275
- UMLS 2011AA Property
- C2745955
Description
SpecimenCollectedDate
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C19157
- UMLS 2011AA ObjectClass
- C0370003
- NCI Thesaurus Property
- C25452
- NCI Thesaurus Property-2
- C25275
- UMLS 2011AA Property
- C2745955
Description
TreatmentAdministeredTime
Data type
time
Alias
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus Property
- C25382
- UMLS 2011AA Property
- C1521801
Description
SpecimenCollectedTime
Data type
time
Alias
- NCI Thesaurus ValueDomain
- C25207
- UMLS 2011AA ValueDomain
- C0040223
- NCI Thesaurus ObjectClass
- C19157
- UMLS 2011AA ObjectClass
- C0370003
- NCI Thesaurus Property
- C25452
- NCI Thesaurus Property-2
- C25275
- UMLS 2011AA Property
- C2745955
Description
SpecimenCollectedTime
Data type
time
Alias
- NCI Thesaurus ValueDomain
- C25207
- UMLS 2011AA ValueDomain
- C0040223
- NCI Thesaurus ObjectClass
- C19157
- UMLS 2011AA ObjectClass
- C0370003
- NCI Thesaurus Property
- C25452
- NCI Thesaurus Property-2
- C25275
- UMLS 2011AA Property
- C2745955
Description
Please check each box if sample being sent for course/timepoint
Data type
boolean
Alias
- NCI Thesaurus ValueDomain
- C25180
- NCI Thesaurus Property
- C25453
- NCI Thesaurus ObjectClass
- C19157
- UMLS CUI-1
- C1522602
- UMLS CUI-2
- C1516698
- UMLS CUI-3
- C0370003
Description
SpecimenCollectedAmount
Data type
float
Alias
- NCI Thesaurus ObjectClass
- C19157
- UMLS 2011AA ObjectClass
- C0370003
- NCI Thesaurus Property
- C25452
Description
Biopsy and Cytology Specimens shipment
Description
SpecimenLaboratoryReceivedName
Data type
text
Alias
- NCI Thesaurus Property
- C25639
- UMLS 2011AA Property
- C1514756
- NCI Thesaurus Property-2
- C37984
- UMLS 2011AA Property-2
- C0022877
- NCI Thesaurus ObjectClass
- C19157
- UMLS 2011AA ObjectClass
- C0370003
Description
ShippingCompanyIdentifierName
Data type
text
Alias
- NCI Thesaurus Property
- C25364
- UMLS 2011AA Property
- C0600091
- NCI Thesaurus ObjectClass
- C54131
- UMLS 2011AA ObjectClass
- C0683757
- NCI Thesaurus ObjectClass-2
- C40353
- UMLS 2011AA ObjectClass-2
- C1524049
- NCI Thesaurus ValueDomain
- C42614
- UMLS 2011AA ValueDomain
- C0027365
Description
InstitutionShippingCompanyIdentifierNumber
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C41206
- UMLS 2011AA ObjectClass
- C1272753
- NCI Thesaurus Property
- C25364
- UMLS 2011AA Property
- C0600091
- NCI Thesaurus Property-2
- C54131
- UMLS 2011AA Property-2
- C0683757
- NCI Thesaurus Property-3
- C40353
- UMLS 2011AA Property-3
- C1524049
- NCI Thesaurus ValueDomain
- C25337
- UMLS 2011AA ValueDomain
- C0237753
Description
SpecimenShippingCompanyIdentifierNumber
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C19157
- UMLS 2011AA ObjectClass
- C0370003
- NCI Thesaurus Property
- C25364
- UMLS 2011AA Property
- C0600091
- NCI Thesaurus Property-2
- C54131
- UMLS 2011AA Property-2
- C0683757
- NCI Thesaurus Property-3
- C40353
- UMLS 2011AA Property-3
- C1524049
- NCI Thesaurus ValueDomain
- C25337
- UMLS 2011AA ValueDomain
- C0237753
Description
SpecimenLabSubmittedDate
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus Property
- C25294
- UMLS 2011AA Property
- C0022885
- NCI Thesaurus ObjectClass
- C19157
- UMLS 2011AA ObjectClass
- C0370003
- NCI Thesaurus Property-2
- C25695
- UMLS 2011AA Property-2
- C1515023
Description
SpecimenLaboratoryReceivedDate
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus Property
- C25639
- UMLS 2011AA Property
- C1514756
- NCI Thesaurus Property-2
- C37984
- UMLS 2011AA Property-2
- C0022877
- NCI Thesaurus ObjectClass
- C19157
- UMLS 2011AA ObjectClass
- C0370003
Description
SpecimenSubmittedType
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus ObjectClass
- C19157
- UMLS 2011AA ObjectClass
- C0370003
- NCI Thesaurus Property
- C25695
- UMLS 2011AA Property
- C1515023
Description
Ccrr Module For Anbl0321: Pk Specimen Shipping Form
Similar models
No Instruction available.
- StudyEvent: ANBL0321: PK Specimen Shipping Form
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C21541 (NCI Thesaurus ValueDomain-2)
C25364 (NCI Thesaurus Property)
C3274381 (UMLS CUI-1)
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C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C39353 (NCI Thesaurus Property-2)
C1516477 (UMLS 2011AA Property-2)
C1549507 (UMLS CUI-1)
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C25604 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
C0011008 (UMLS 2011AA ValueDomain)
C25474 (NCI Thesaurus ObjectClass)
C1511726 (UMLS 2011AA ObjectClass)
C37949 (NCI Thesaurus Property)
C1521975 (UMLS 2011AA Property)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C1301894 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25261 (NCI Thesaurus Property)
C25198 (NCI Thesaurus Property-2)
C2045829 (UMLS CUI-1)
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C25379 (NCI Thesaurus Property-2)
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C0370003 (UMLS 2011AA ObjectClass)
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C0030705 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C39353 (NCI Thesaurus Property-2)
C1516477 (UMLS 2011AA Property-2)
C0005902 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25157 (NCI Thesaurus Property)
C25256 (NCI Thesaurus Property)
C25709 (NCI Thesaurus ValueDomain)
C1519795 (UMLS CUI-1)
C0439210 (UMLS 2011AA)
C25256 (NCI Thesaurus Property)
C25709 (NCI Thesaurus ValueDomain)
C1519795 (UMLS CUI-1)
C0439210 (UMLS 2011AA)
C25256 (NCI Thesaurus Property)
C25709 (NCI Thesaurus ValueDomain)
C1519795 (UMLS CUI-1)
C0439210 (UMLS 2011AA)
C2826638 (UMLS CUI-1)
C1708 (NCI Thesaurus ObjectClass-2)
C25304 (NCI Thesaurus Property)
C25256 (NCI Thesaurus Property-2)
C25488 (NCI Thesaurus ValueDomain)
C1708 (NCI Thesaurus ValueDomain-2)
C2826638 (UMLS CUI-1)
C1708 (NCI Thesaurus ObjectClass-2)
C25304 (NCI Thesaurus Property)
C25256 (NCI Thesaurus Property-2)
C25488 (NCI Thesaurus ValueDomain)
C1708 (NCI Thesaurus ValueDomain-2)
C2826638 (UMLS CUI-1)
C1708 (NCI Thesaurus ObjectClass-2)
C25304 (NCI Thesaurus Property)
C25256 (NCI Thesaurus Property-2)
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C1708 (NCI Thesaurus ValueDomain-2)
C2045829 (UMLS CUI-1)
C25471 (NCI Thesaurus Property)
C15368 (NCI Thesaurus ObjectClass)
C25379 (NCI Thesaurus Property-2)
C0011008 (UMLS 2011AA ValueDomain)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C25452 (NCI Thesaurus Property)
C25275 (NCI Thesaurus Property-2)
C2745955 (UMLS 2011AA Property)
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C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
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C1521801 (UMLS 2011AA Property)
C0040223 (UMLS 2011AA ValueDomain)
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C0370003 (UMLS 2011AA ObjectClass)
C25452 (NCI Thesaurus Property)
C25275 (NCI Thesaurus Property-2)
C2745955 (UMLS 2011AA Property)
C0040223 (UMLS 2011AA ValueDomain)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
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C25275 (NCI Thesaurus Property-2)
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C1524049 (UMLS 2011AA ObjectClass-2)
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C0600091 (UMLS 2011AA Property)
C54131 (NCI Thesaurus Property-2)
C0683757 (UMLS 2011AA Property-2)
C40353 (NCI Thesaurus Property-3)
C1524049 (UMLS 2011AA Property-3)
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C0370003 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C54131 (NCI Thesaurus Property-2)
C0683757 (UMLS 2011AA Property-2)
C40353 (NCI Thesaurus Property-3)
C1524049 (UMLS 2011AA Property-3)
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C0370003 (UMLS 2011AA ObjectClass)
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C1515023 (UMLS 2011AA Property-2)
C0011008 (UMLS 2011AA ValueDomain)
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C37984 (NCI Thesaurus Property-2)
C0022877 (UMLS 2011AA Property-2)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
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C19157 (NCI Thesaurus ObjectClass)
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