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ID
11396
Beschrijving
Southwest Oncology Group S0201 Pathology Submission Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A8BA7D80-B069-121E-E034-0003BA12F5E7
Link
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Versies (3)
- 19-09-12 19-09-12 -
- 09-01-15 09-01-15 - Martin Dugas
- 03-07-15 03-07-15 -
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3 juli 2015
DOI
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Creative Commons BY-NC 3.0 Legacy
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Southwest Oncology Group S0201 Pathology Submission Form
No Instruction available.
- StudyEvent: Southwest Oncology Group S0201 Pathology Submission Form
Similar models
No Instruction available.
- StudyEvent: Southwest Oncology Group S0201 Pathology Submission Form
Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
SWOGPatientID
Item
SWOG Patient ID
text
Patient Initials
Item
Patient Initials (L, F M)
text
C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
Disease
Item
Disease
text
MainMemberInstitution/Affiliate
Item
Institution/Member
text
TreatingPhysician
Item
Physician (Groups other than SWOG)
text
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C25741 (NCI Thesaurus ObjectClass)
C0031831 (UMLS 2011AA ObjectClass)
C25705 (NCI Thesaurus ObjectClass-2)
C1522326 (UMLS 2011AA ObjectClass-2)
C0600091 (UMLS 2011AA Property)
C25741 (NCI Thesaurus ObjectClass)
C0031831 (UMLS 2011AA ObjectClass)
C25705 (NCI Thesaurus ObjectClass-2)
C1522326 (UMLS 2011AA ObjectClass-2)
GroupName
Item
Group Name
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C17005 (NCI Thesaurus ObjectClass)
C1257890 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C1547383 (UMLS 2011AA ValueDomain)
C17005 (NCI Thesaurus ObjectClass)
C1257890 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
StudyNo.
Item
Study No.
text
Pt.ID
Item
Pt. No
text
SpecimenSlideCount
Item
No. of slides
text
SpecimenBlockSubmissionCount
Item
No. of blocks
text
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
C25436 (NCI Thesaurus Property)
C1533157 (UMLS 2011AA Property)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C25694 (NCI Thesaurus Property-2)
C1515022 (UMLS 2011AA Property-2)
C0750480 (UMLS 2011AA ValueDomain)
C25436 (NCI Thesaurus Property)
C1533157 (UMLS 2011AA Property)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C25694 (NCI Thesaurus Property-2)
C1515022 (UMLS 2011AA Property-2)
SpecimenCollectionDate
Item
Date sample obtained
date
OnerepresentativeH&Estainedsectionfromeachblockoftheprimarytumor
Item
One representative H&E stained section from each block of the primary tumor
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
Sectionofsentinelregionallymphnode(s)(ind)
Item
Section of sentinel regional lymph node(s) (ind)
boolean
Sectionsofnon-sentinellymphnode(s)(Ind)
Item
Sections of non-sentinel lymph node(s) (Ind)
boolean
Operativereports(ind)
Item
Operative reports (ind)
boolean
Pathologyreports(ind)
Item
Pathology reports (ind)
boolean
SpecimenID
Item
Specimen Number
float
Comments
Item
Comments
text