ID
11602
Description
S1011 Registration Worksheet Step 2 (#8470) Standard or Extended Pelvic Lymphadenectomy in Treating Patients Undergoing Surgery for Invasive Bladder Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=9386BABC-0E79-AC8D-E040-BB89AD4309BA
Link
Keywords
Versions (2)
- 8/26/12 8/26/12 -
- 7/8/15 7/8/15 -
Uploaded on
July 8, 2015
DOI
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License
Creative Commons BY-NC 3.0 Legacy
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S1011 Registration Worksheet Step 2 (#8470)
INSTRUCTIONS: All of the information on this Registration Worksheet and the Protocol Eligibility Section must be answered appropriately for a patient to be considered eligible for registration. This Registration Worksheet must be entirely filled out and referred to during the registration. Do NOT submit this worksheet as part of the patient data
- StudyEvent: S1011 Registration Worksheet Step 2 (#8470)
Description
Swog Patient Id
Description
SWOG Patient ID
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25364
- NCI Thesaurus Property-2
- C25699
- UMLS CUI-1
- C1519429
- UMLS CUI-2
- C3259154
Description
Registrar's SWOG Roster ID Number
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- NCI Thesaurus Property
- C25364
- NCI Thesaurus Property-2
- C25699
- NCI Thesaurus ObjectClass
- C25357
- UMLS CUI-1
- C0600091
- UMLS CUI-2
- C1519429
Description
SWOG Investigator Number
Data type
float
Alias
- NCI Thesaurus ValueDomain
- C25337
- NCI Thesaurus Property
- C25364
- NCI Thesaurus ObjectClass
- C25699
- NCI Thesaurus ObjectClass-2
- C17089
- UMLS CUI-1
- C0600091
- UMLS CUI-2
- C1519429
Description
SWOG Treating Institution Number
Data type
float
Alias
- NCI Thesaurus ObjectClass
- C25699
- NCI Thesaurus ObjectClass-2
- C25705
- NCI Thesaurus ObjectClass-3
- C41206
- NCI Thesaurus Property
- C25364
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C1519429
- UMLS CUI-2
- C1522326
- UMLS CUI-3
- C0600091
Description
Stratification Questions
Description
Chemotherapy basis
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C25320
- NCI Thesaurus Property
- C15632
- NCI Thesaurus Property-2
- C15665
- NCI Thesaurus Property-3
- C25689
- NCI Thesaurus ValueDomain
- C25162
- UMLS CUI-1
- C0600558
- UMLS CUI-2
- C3665472
Description
Clinical statge
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C15206
- NCI Thesaurus Property
- C4912
- NCI Thesaurus Property-2
- C16899
- NCI Thesaurus Property-3
- C25689
- NCI Thesaurus ValueDomain
- C25162
- UMLS CUI-1
- C0699885
- UMLS CUI-2
- C1300072
Description
Zubrod performance status
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25162
- NCI Thesaurus ObjectClass
- C25400
- NCI Thesaurus Property
- C25689
- UMLS CUI-1
- C3714786
Description
Patient Eligibility
Description
Eligibility Determination
Data type
boolean
Alias
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus ObjectClass-2
- C25699
- NCI Thesaurus Property
- C25646
- NCI Thesaurus Property-2
- C25171
- NCI Thesaurus ValueDomain
- C38147
- UMLS CUI-1
- C1519429
- UMLS CUI-2
- C0013893
Similar models
INSTRUCTIONS: All of the information on this Registration Worksheet and the Protocol Eligibility Section must be answered appropriately for a patient to be considered eligible for registration. This Registration Worksheet must be entirely filled out and referred to during the registration. Do NOT submit this worksheet as part of the patient data
- StudyEvent: S1011 Registration Worksheet Step 2 (#8470)
C25320 (NCI Thesaurus ObjectClass)
C64382 (NCI Thesaurus Property)
C41200 (NCI Thesaurus Property-2)
C1515882 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
C25551 (NCI Thesaurus ValueDomain-2)
C0011008 (UMLS CUI-1)
C1517741 (UMLS CUI-2)
C25646 (NCI Thesaurus ObjectClass)
C16154 (NCI Thesaurus Property)
C16154 (NCI Thesaurus ValueDomain-2)
C0585727 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)
C25699 (NCI Thesaurus Property-2)
C1519429 (UMLS CUI-1)
C3259154 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25699 (NCI Thesaurus Property-2)
C25357 (NCI Thesaurus ObjectClass)
C0600091 (UMLS CUI-1)
C1519429 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25699 (NCI Thesaurus ObjectClass)
C17089 (NCI Thesaurus ObjectClass-2)
C0600091 (UMLS CUI-1)
C1519429 (UMLS CUI-2)
C25705 (NCI Thesaurus ObjectClass-2)
C41206 (NCI Thesaurus ObjectClass-3)
C25364 (NCI Thesaurus Property)
C25337 (NCI Thesaurus ValueDomain)
C1519429 (UMLS CUI-1)
C1522326 (UMLS CUI-2)
C0600091 (UMLS CUI-3)
C15632 (NCI Thesaurus Property)
C15665 (NCI Thesaurus Property-2)
C25689 (NCI Thesaurus Property-3)
C25162 (NCI Thesaurus ValueDomain)
C0600558 (UMLS CUI-1)
C3665472 (UMLS CUI-2)
C0178499 (UMLS CUI-2)
C0178499 (UMLS CUI-2)
C0205394 (UMLS CUI-1)
C0549184 (UMLS CUI-1)
C4912 (NCI Thesaurus Property)
C16899 (NCI Thesaurus Property-2)
C25689 (NCI Thesaurus Property-3)
C25162 (NCI Thesaurus ValueDomain)
C0699885 (UMLS CUI-1)
C1300072 (UMLS CUI-2)
C25400 (NCI Thesaurus ObjectClass)
C25689 (NCI Thesaurus Property)
C3714786 (UMLS CUI-1)
C25699 (NCI Thesaurus ObjectClass-2)
C25646 (NCI Thesaurus Property)
C25171 (NCI Thesaurus Property-2)
C38147 (NCI Thesaurus ValueDomain)
C1519429 (UMLS CUI-1)
C0013893 (UMLS CUI-2)