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11812

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Paclitaxel, Cisplatin, and Radiation Therapy With or Without Cetuximab in Treating Patients With Locally Advanced Esophageal Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=2A16F93C-C68B-2E25-E044-0003BA3F9857

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https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=2A16F93C-C68B-2E25-E044-0003BA3F9857

Nyckelord

Versioner (4)
  1. 2012-09-19 2012-09-19 -
  2. 2015-01-09 2015-01-09 - Martin Dugas
  3. 2015-06-21 2015-06-21 -
  4. 2015-08-04 2015-08-04 - Martin Dugas
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4 augusti 2015

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Creative Commons BY-NC 3.0 Legacy
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    Initial Evaluation Form Esophageal Cancer RTOG NCT00655876

    Engelsk

    No Instruction available.

    1 Formulär  
    1. StudyEvent: I1: Radiation Therapy Oncology Group Phase III Esophagus Initial Evaluation Form
      1. No Instruction available.
    Module 1
    Beskrivning

    Module 1

    RTOG Study No.
    Beskrivning

    Protocol ID RTOG

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C3274381
    NCI Thesaurus ObjectClass
    C25320
    UMLS CUI-2
    C1514695
    NCI Thesaurus Property
    C19778
    NCI Thesaurus Property-2
    C25364
    RTOG Case #
    Beskrivning

    RTOG Case #

    Datatyp

    text

    Alias
    NCI Thesaurus ObjectClass
    C16960
    NCI Thesaurus ObjectClass-2
    C19778
    NCI Thesaurus Property
    C25364
    NCI Thesaurus Property-2
    C49152
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI [1,1]
    C1514695
    UMLS CUI [1,2]
    C0600091
    Institution Name
    Beskrivning

    Institution Name

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS CUI-1
    C1301943
    NCI Thesaurus ObjectClass
    C21541
    NCI Thesaurus ValueDomain-2
    C21541
    NCI Thesaurus Property
    C25364
    Institution No.
    Beskrivning

    Institution Number

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C1301943
    NCI Thesaurus ObjectClass
    C21541
    UMLS CUI-2
    C0805701
    NCI Thesaurus Property
    C25364
    Patient Initials
    Beskrivning

    Patient Initials

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS CUI-1
    C2986440
    NCI Thesaurus ObjectClass
    C16960
    NCI Thesaurus Property
    C25536
    RTOG Patient ID
    Beskrivning

    Trial subject ID RTOG

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C2348585
    NCI Thesaurus ObjectClass
    C16960
    UMLS CUI-2
    C1514695
    NCI Thesaurus Property
    C19778
    NCI Thesaurus Property-2
    C25364
    AMENDED DATA
    Beskrivning

    Data amended

    Datatyp

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38148
    UMLS CUI-1
    C0680532
    NCI Thesaurus ObjectClass
    C25474
    NCI Thesaurus Property
    C25416
    Patient status assessment
    Beskrivning

    Patient status assessment

    Age
    Beskrivning

    Age

    Datatyp

    integer

    Måttenheter
    • years
    Alias
    NCI Thesaurus ObjectClass
    C16960
    NCI Thesaurus ValueDomain
    C29848
    NCI Thesaurus ValueDomain-2
    C25463
    NCI Thesaurus Property
    C25150
    UMLS CUI [1]
    C0001779
    years
    Performance Status (Zubrod)
    Beskrivning

    ZubrodPerformanceStatusScore

    Datatyp

    text

    Alias
    NCI Thesaurus Property
    C25367
    NCI Thesaurus ObjectClass
    C20641
    UMLS 2011AA ObjectClass
    C1518965
    NCI Thesaurus ValueDomain
    C25338
    UMLS 2011AA ValueDomain
    C0449820
    History of Prior Malignancy (except non melanomatous skin cancer)
    Beskrivning

    PatientPriorMalignantNeoplasmHistoryInd-2

    Datatyp

    boolean

    Alias
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus ObjectClass-2
    C25629
    UMLS 2011AA ObjectClass-2
    C0332152
    NCI Thesaurus Property
    C9305
    UMLS 2011AA Property
    C0006826
    NCI Thesaurus Property-2
    C25629
    UMLS 2011AA Property-2
    C0332152
    NCI Thesaurus Property-3
    C18772
    UMLS 2011AA Property-3
    C0262926
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    Site of Prior Cancer
    Beskrivning

    PriorCancerDiagnosisSite

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C13717
    UMLS 2011AA ValueDomain
    C1515974
    NCI Thesaurus ObjectClass
    C9305
    UMLS 2011AA ObjectClass
    C0006826
    NCI Thesaurus ObjectClass-2
    C25629
    UMLS 2011AA ObjectClass-2
    C0332152
    NCI Thesaurus Property
    C15220
    UMLS 2011AA Property
    C0011900
    Prior cancer date eradicated
    Beskrivning

    CancerAblationDate

    Datatyp

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ObjectClass
    C9305
    UMLS 2011AA ObjectClass
    C0006826
    NCI Thesaurus Property
    C20985
    UMLS 2011AA Property
    C0547070
    Weight
    Beskrivning

    Patient Weight

    Datatyp

    float

    Måttenheter
    • Kg
    Alias
    NCI Thesaurus ValueDomain
    C25209
    UMLS CUI-1
    C0005910
    NCI Thesaurus ObjectClass
    C16960
    NCI Thesaurus Property
    C25208
    Kg
    Extent of Dysphagia
    Beskrivning

    DysphagiaExtentStatus

    Datatyp

    text

    Alias
    NCI Thesaurus ObjectClass
    C2980
    UMLS 2011AA ObjectClass
    C0011168
    NCI Thesaurus ValueDomain
    C25688
    UMLS 2011AA ValueDomain
    C0449438
    NCI Thesaurus Property
    C25332
    UMLS 2011AA Property
    C0439792
    Oral alimentation
    Beskrivning

    NutritionalSupportOralRouteofAdministrationAdministeredInd-3

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    NCI Thesaurus Property
    C38288
    UMLS 2011AA Property
    C1527415
    NCI Thesaurus Property-2
    C25382
    UMLS 2011AA Property-2
    C1521801
    NCI Thesaurus ObjectClass
    C15433
    UMLS 2011AA ObjectClass
    C0242739
    Nasogastric tube feeding
    Beskrivning

    NutritionalSupportNasogastricRouteofAdministrationTubeAdministeredInd-3

    Datatyp

    text

    Alias
    NCI Thesaurus ObjectClass
    C15433
    UMLS 2011AA ObjectClass
    C0242739
    NCI Thesaurus Property
    C38285
    UMLS 2011AA Property
    C0694637
    NCI Thesaurus Property-2
    C41277
    UMLS 2011AA Property-2
    C1561954
    NCI Thesaurus Property-3
    C25382
    UMLS 2011AA Property-3
    C1521801
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    Ostomy feeding
    Beskrivning

    NutritionalSupportOstomyTubeAdministeredInd-3

    Datatyp

    text

    Alias
    NCI Thesaurus ObjectClass
    C15433
    UMLS 2011AA ObjectClass
    C0242739
    NCI Thesaurus Property
    C41277
    UMLS 2011AA Property
    C1561954
    NCI Thesaurus Property-2
    C15290
    UMLS 2011AA Property-2
    C0029473
    NCI Thesaurus Property-3
    C25382
    UMLS 2011AA Property-3
    C1521801
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    Intravenous hyperalimentation
    Beskrivning

    NutritionalSupportIntravenousRouteofAdministrationAdministeredind-3

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    NCI Thesaurus Property
    C38276
    UMLS 2011AA Property
    C1522726
    NCI Thesaurus Property-2
    C25382
    UMLS 2011AA Property-2
    C1521801
    NCI Thesaurus ObjectClass
    C15433
    UMLS 2011AA ObjectClass
    C0242739
    Other
    Beskrivning

    NutritionalSupportOtherAdministeredInd-3

    Datatyp

    text

    Alias
    NCI Thesaurus ObjectClass
    C37902
    UMLS 2011AA ObjectClass
    C1521721
    NCI Thesaurus ObjectClass-2
    C25597
    UMLS 2011AA ObjectClass-2
    C1521739
    NCI Thesaurus Property
    C17649
    UMLS 2011AA Property
    C0205394
    NCI Thesaurus Property-2
    C25382
    UMLS 2011AA Property-2
    C1521801
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    Other Specify
    Beskrivning

    NutritionalSupportAdministeredSpecify

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25685
    UMLS 2011AA ValueDomain
    C1521902
    NCI Thesaurus ObjectClass
    C37902
    UMLS 2011AA ObjectClass
    C1521721
    NCI Thesaurus Property
    C25382
    UMLS 2011AA Property
    C1521801
    NCI Thesaurus ObjectClass-2
    C25597
    UMLS 2011AA ObjectClass-2
    C1521739
    Estimate of daily caloric intake
    Beskrivning

    PersonEstimatedDailyCaloricIntakeAssessmentType

    Datatyp

    text

    Alias
    NCI Thesaurus ObjectClass
    C25190
    UMLS 2011AA ObjectClass
    C0027361
    NCI Thesaurus Property
    C20989
    UMLS 2011AA Property
    C0031809
    NCI Thesaurus Property-2
    C25473
    UMLS 2011AA Property-2
    C0332173
    NCI Thesaurus Property-3
    C25498
    UMLS 2011AA Property-3
    C0750572
    NCI Thesaurus Property-4
    C28135
    UMLS 2011AA Property-4
    C0006777
    NCI Thesaurus ValueDomain
    C25284
    UMLS 2011AA ValueDomain
    C0332307
    Prior Treatment
    Beskrivning

    Prior Treatment

    Prior Surgery (for esophageal cancer excludes diagnostic biopsy)
    Beskrivning

    PatientEsophagealCarcinomaSurgicalProcedurePersonalMedicalHistoryInd-2

    Datatyp

    boolean

    Alias
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C15329
    UMLS 2011AA Property
    C0543467
    NCI Thesaurus Property-2
    C18772
    UMLS 2011AA Property-2
    C0262926
    NCI Thesaurus Property-3
    C3513
    UMLS 2011AA Property-3
    C0152018
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    Prior chemotherapy (for study cancer)
    Beskrivning

    PatientEsophagealCarcinomaChemotherapyPersonalMedicalHistoryInd-2

    Datatyp

    boolean

    Alias
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C15632
    UMLS 2011AA Property
    C0392920
    NCI Thesaurus Property-2
    C18772
    UMLS 2011AA Property-2
    C0262926
    NCI Thesaurus Property-3
    C3513
    UMLS 2011AA Property-3
    C0152018
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    Prior chemotherapy (for other reasons)
    Beskrivning

    PatientChemotherapyPersonalMedicalHistoryInd-2

    Datatyp

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C15632
    UMLS 2011AA Property
    C0392920
    NCI Thesaurus Property-2
    C18772
    UMLS 2011AA Property-2
    C0262926
    Prior radiation therapy (to chest)
    Beskrivning

    PatientChestRadiationTherapyPersonalMedicalHistoryInd-2

    Datatyp

    boolean

    Alias
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C15313
    UMLS 2011AA Property
    C1522449
    NCI Thesaurus Property-2
    C25389
    UMLS 2011AA Property-2
    C0817096
    NCI Thesaurus Property-3
    C18772
    UMLS 2011AA Property-3
    C0262926
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    Prior therapy that targeted EGFR pathway
    Beskrivning

    PriorEpidermalGrowthFactorReceptorTherapyPerformedInd-3

    Datatyp

    boolean

    Alias
    NCI Thesaurus ObjectClass
    C25629
    UMLS 2011AA ObjectClass
    C0332152
    NCI Thesaurus ObjectClass-2
    C15368
    NCI Thesaurus ObjectClass-3
    C17068
    UMLS 2011AA ObjectClass-2
    C0034802
    NCI Thesaurus Property
    C38000
    UMLS 2011AA Property
    C0884358
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    Prior platinum based and/or paclitaxel based therapy
    Beskrivning

    PatientChemotherapyPersonalMedicalHistoryPlatinum-BasedTaxaneCompoundTherapeuticProcedureInd-2

    Datatyp

    boolean

    Alias
    NCI Thesaurus ObjectClass
    C16960
    NCI Thesaurus Property
    C49236
    NCI Thesaurus Property-2
    C18772
    NCI Thesaurus Property-3
    C25620
    NCI Thesaurus Property-4
    C1490
    NCI Thesaurus ValueDomain
    C38147
    UMLS CUI [1,1]
    C1514463
    UMLS CUI [1,2]
    C1514162
    UMLS CUI [1,3]
    C0796419
    Study Cancer
    Beskrivning

    Study Cancer

    Site of study cancer
    Beskrivning

    ClinicalStudyMalignantNeoplasmAnatomicSite

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C13717
    UMLS 2011AA ValueDomain
    C1515974
    NCI Thesaurus Property
    C25341
    UMLS 2011AA Property
    C0450429
    NCI Thesaurus ObjectClass
    C9305
    UMLS 2011AA ObjectClass
    C0006826
    NCI Thesaurus ObjectClass-2
    C15206
    UMLS 2011AA ObjectClass-2
    C0008972
    Histologic Type
    Beskrivning

    UpperGITumorHistologicClassificationCategory

    Datatyp

    text

    Alias
    NCI Thesaurus ObjectClass
    C3262
    UMLS 2011AA ObjectClass
    C0027651
    NCI Thesaurus ObjectClass-2
    C17639
    UMLS 2011AA ObjectClass-2
    C0203057
    NCI Thesaurus Property
    C25526
    UMLS 2011AA Property
    C0205462
    NCI Thesaurus Property-2
    C25161
    UMLS 2011AA Property-2
    C0008902
    NCI Thesaurus ValueDomain
    C25372
    UMLS 2011AA ValueDomain
    C0683312
    NCI Thesaurus ValueDomain-2
    C25526
    UMLS 2011AA ValueDomain-2
    C0205462
    Date of initial histologic diagnosis of malignancy
    Beskrivning

    MalignantNeoplasmInitialHistologicDiagnosisDate

    Datatyp

    date

    Alias
    NCI Thesaurus ObjectClass
    C9305
    UMLS 2011AA ObjectClass
    C0006826
    NCI Thesaurus Property
    C25536
    UMLS 2011AA Property
    C1555582
    NCI Thesaurus Property-2
    C25526
    UMLS 2011AA Property-2
    C0205462
    NCI Thesaurus Property-3
    C15220
    UMLS 2011AA Property-3
    C0011900
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    Cervical esophagus
    Beskrivning

    EsophagealCarcinomaCervicalEsophagusInvasionInd-2

    Datatyp

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    NCI Thesaurus Property
    C12250
    UMLS 2011AA Property
    C0227186
    NCI Thesaurus ObjectClass
    C3513
    UMLS 2011AA ObjectClass
    C0152018
    NCI Thesaurus Property-2
    C20625
    UMLS 2011AA Property-2
    C1269955
    Invasion into the trachea or major bronchi
    Beskrivning

    EsophagealCarcinomaTracheaBronchusInvasionInd-2

    Datatyp

    boolean

    Alias
    NCI Thesaurus ObjectClass
    C3513
    UMLS 2011AA ObjectClass
    C0152018
    NCI Thesaurus Property
    C12683
    UMLS 2011AA Property
    C0006255
    NCI Thesaurus Property-2
    C12428
    UMLS 2011AA Property-2
    C0040578
    NCI Thesaurus Property-3
    C20625
    UMLS 2011AA Property-3
    C1269955
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    Evidence of tracheoesophageal fistule
    Beskrivning

    EsophagealCarcinomaTracheoesophagealFistulaInvasionInd-2

    Datatyp

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    NCI Thesaurus ObjectClass
    C3513
    UMLS 2011AA ObjectClass
    C0152018
    NCI Thesaurus Property
    C20625
    UMLS 2011AA Property
    C1269955
    NCI Thesaurus Property-2
    C35080
    UMLS 2011AA Property-2
    C0040588
    Esophageal Tumor Clinical T Stage
    Beskrivning

    Esophageal Tumor Clinical T Stage

    Datatyp

    text

    Alias
    NCI Thesaurus ObjectClass
    C3262
    NCI Thesaurus ObjectClass-2
    C37950
    NCI Thesaurus Property
    C25398
    NCI Thesaurus Property-2
    C25728
    NCI Thesaurus ValueDomain
    C16899
    UMLS CUI [1,1]
    C0014859
    UMLS CUI [1,2]
    C0475455
    Is the tumor proximal thoracic
    Beskrivning

    MalignantNeoplasmProximalChestAnatomicSiteInd-2

    Datatyp

    boolean

    Alias
    NCI Thesaurus ObjectClass
    C9305
    UMLS 2011AA ObjectClass
    C0006826
    NCI Thesaurus Property
    C13717
    UMLS 2011AA Property
    C1515974
    NCI Thesaurus Property-2
    C25389
    UMLS 2011AA Property-2
    C0817096
    NCI Thesaurus Property-3
    C25236
    UMLS 2011AA Property-3
    C0205107
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    Clinical N Stage
    Beskrivning

    EsophagealTumorClinicalNStage

    Datatyp

    text

    Alias
    NCI Thesaurus ObjectClass
    C3262
    UMLS 2011AA ObjectClass
    C0027651
    NCI Thesaurus ObjectClass-2
    C37950
    UMLS 2011AA ObjectClass-2
    C1522619
    NCI Thesaurus Property
    C25398
    UMLS 2011AA Property
    C0205210
    NCI Thesaurus Property-2
    C25580
    UMLS 2011AA Property-2
    C0456532
    NCI Thesaurus ValueDomain
    C16899
    UMLS 2011AA ValueDomain
    C1300072
    Clinical M Stage
    Beskrivning

    EsophagealTumorClinicalMStage

    Datatyp

    text

    Alias
    NCI Thesaurus ObjectClass
    C3262
    UMLS 2011AA ObjectClass
    C0027651
    NCI Thesaurus ObjectClass-2
    C37950
    UMLS 2011AA ObjectClass-2
    C1522619
    NCI Thesaurus Property
    C25398
    UMLS 2011AA Property
    C0205210
    NCI Thesaurus Property-2
    C25727
    UMLS 2011AA Property-2
    C0456533
    NCI Thesaurus ValueDomain
    C16899
    UMLS 2011AA ValueDomain
    C1300072
    Celiac lymph nodes
    Beskrivning

    EsophagealCarcinomaCeliacLymphNodeMetastasisInd-2

    Datatyp

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    NCI Thesaurus Property
    C19151
    UMLS 2011AA Property
    C0027627
    NCI Thesaurus ObjectClass
    C3513
    UMLS 2011AA ObjectClass
    C0152018
    NCI Thesaurus Property-2
    C65166
    UMLS 2011AA Property-2
    C0229766
    Cervical lymph nodes
    Beskrivning

    EsophagealCarcinomaCervicalLymphNodeMetastasisInd-2

    Datatyp

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    NCI Thesaurus Property
    C19151
    UMLS 2011AA Property
    C0027627
    NCI Thesaurus ObjectClass
    C3513
    UMLS 2011AA ObjectClass
    C0152018
    NCI Thesaurus Property-2
    C32298
    UMLS 2011AA Property-2
    C0588054
    Supraclavicular lymph nodes
    Beskrivning

    EsophagealCarcinomaSupraclavicularLymphNodeMetastasisInd-2

    Datatyp

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    NCI Thesaurus Property
    C19151
    UMLS 2011AA Property
    C0027627
    NCI Thesaurus Property-2
    C12903
    UMLS 2011AA Property-2
    C0229730
    NCI Thesaurus ObjectClass
    C3513
    UMLS 2011AA ObjectClass
    C0152018
    Laboratory Tests
    Beskrivning

    Laboratory Tests

    Hemoglobin
    Beskrivning

    Hemoglobin

    Datatyp

    float

    Måttenheter
    • g/dL
    Alias
    NCI Thesaurus Property
    C16676
    NCI Thesaurus Property-2
    C20200
    NCI Thesaurus ObjectClass
    C25294
    NCI Thesaurus ValueDomain
    C25712
    UMLS CUI [1]
    C0019046
    g/dL
    ANC
    Beskrivning

    ANC

    Datatyp

    float

    Måttenheter
    • 1000/ul
    Alias
    NCI Thesaurus ObjectClass
    C25294
    NCI Thesaurus Property
    C20200
    NCI Thesaurus Property-2
    C63321
    NCI Thesaurus ValueDomain
    C38046
    NCI Thesaurus ValueDomain-2
    C25712
    UMLS CUI [1]
    C0200633
    1000/ul
    Peripheral Platelet Count
    Beskrivning

    Peripheral Platelet Count

    Datatyp

    float

    Måttenheter
    • 1000/uL
    Alias
    NCI Thesaurus ObjectClass
    C25294
    NCI Thesaurus Property
    C20200
    NCI Thesaurus Property-2
    C12520
    NCI Thesaurus ValueDomain
    C38046
    NCI Thesaurus ValueDomain-2
    C25712
    UMLS CUI [1]
    C0005821
    1000/uL
    Serum creatinine
    Beskrivning

    Serum creatinine

    Datatyp

    float

    Måttenheter
    • mg/dL
    Alias
    NCI Thesaurus ObjectClass
    C16960
    NCI Thesaurus Property
    C13325
    NCI Thesaurus Property-2
    C399
    UMLS CUI [1]
    C0201976
    mg/dL
    AST (SGOT)
    Beskrivning

    AST (SGOT)

    Datatyp

    float

    Måttenheter
    • U/L
    Alias
    NCI Thesaurus ObjectClass
    C13308
    NCI Thesaurus Property
    C25202
    NCI Thesaurus Property-2
    C37984
    NCI Thesaurus ValueDomain
    C38046
    NCI Thesaurus ValueDomain-2
    C25712
    UMLS CUI [1]
    C0201899
    U/L
    AST (SGOT) ULN
    Beskrivning

    AST (SGOT) ULN

    Datatyp

    float

    Måttenheter
    • U/L
    Alias
    NCI Thesaurus ObjectClass
    C25294
    NCI Thesaurus Property
    C25202
    NCI Thesaurus Property-2
    C20200
    NCI Thesaurus ValueDomain
    C25712
    NCI Thesaurus ValueDomain-2
    C25706
    UMLS CUI [1,1]
    C0242192
    UMLS CUI [1,2]
    C1519815
    U/L
    Bilirubin, total
    Beskrivning

    Bilirubin, total

    Datatyp

    float

    Måttenheter
    • mg/dL
    Alias
    NCI Thesaurus ObjectClass
    C25294
    NCI Thesaurus Property
    C20200
    NCI Thesaurus Property-2
    C38037
    NCI Thesaurus ValueDomain
    C25712
    NCI Thesaurus ValueDomain-2
    C38024
    UMLS CUI [1]
    C0201913
    mg/dL
    Total bilirubin ULN
    Beskrivning

    Bilirubin, Total ULN

    Datatyp

    float

    Måttenheter
    • mg/dL
    Alias
    NCI Thesaurus ObjectClass
    C25294
    UMLS CUI-1
    C0201913
    NCI Thesaurus Property
    C20200
    UMLS CUI-2
    C1519815
    NCI Thesaurus Property-2
    C38037
    NCI Thesaurus ValueDomain
    C25712
    NCI Thesaurus ValueDomain-2
    C38024
    NCI Thesaurus ValueDomain-3
    C25706
    mg/dL
    Date
    Beskrivning

    Laboratory Procedure Date

    Datatyp

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS CUI-1
    C0022885
    NCI Thesaurus Property
    C25214
    UMLS CUI-2
    C0011008
    NCI Thesaurus Property-2
    C38000
    NCI Thesaurus ObjectClass
    C25294
    Diagnosis Work-up
    Beskrivning

    Diagnosis Work-up

    History and Physical
    Beskrivning

    PersonalMedicalHistoryPhysicalExaminationPerformedInd-2

    Datatyp

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    NCI Thesaurus ObjectClass
    C20989
    UMLS 2011AA ObjectClass
    C0031809
    NCI Thesaurus Property
    C38000
    UMLS 2011AA Property
    C0884358
    NCI Thesaurus ObjectClass-2
    C18772
    UMLS 2011AA ObjectClass-2
    C0262926
    CT scan or MRI of the chest or abdomen
    Beskrivning

    MagneticResonanceImagingComputedTomographyDiagnosticImagingChestAbdominalCavityAssessmentInd-2

    Datatyp

    boolean

    Alias
    NCI Thesaurus ObjectClass
    C16502
    NCI Thesaurus ObjectClass-2
    C17204
    NCI Thesaurus ObjectClass-3
    C16809
    NCI Thesaurus Property
    C20989
    NCI Thesaurus Property-2
    C25389
    NCI Thesaurus Property-3
    C12664
    NCI Thesaurus ValueDomain
    C38147
    UMLS CUI [1,1]
    C0040405
    UMLS CUI [1,2]
    C0024485
    UMLS CUI [1,3]
    C0817096
    UMLS CUI [1,4]
    C0230168
    Endoscopic biopsy of esophageal tumor
    Beskrivning

    EndoscopicBiopsyDiagnosticProcedureEsophagealCarcinomaAssessmentInd-2

    Datatyp

    boolean

    Alias
    NCI Thesaurus ObjectClass
    C18020
    UMLS 2011AA ObjectClass
    C0430022
    NCI Thesaurus ObjectClass-2
    C15389
    UMLS 2011AA ObjectClass-2
    C0184980
    NCI Thesaurus Property
    C20989
    UMLS 2011AA Property
    C0031809
    NCI Thesaurus Property-2
    C3513
    UMLS 2011AA Property-2
    C0152018
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    EKG
    Beskrivning

    ElectrocardiographyDiagnosticProcedureAssessmentInd-2

    Datatyp

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    NCI Thesaurus Property
    C20989
    UMLS 2011AA Property
    C0031809
    NCI Thesaurus ObjectClass
    C38053
    UMLS 2011AA ObjectClass
    C1623258
    NCI Thesaurus ObjectClass-2
    C18020
    UMLS 2011AA ObjectClass-2
    C0430022
    Bronchoscopy
    Beskrivning

    BronchoscopyPerformedInd-2

    Datatyp

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38147
    NCI Thesaurus ObjectClass
    C16366
    NCI Thesaurus Property
    C38000
    UMLS CUI [1]
    C0006290
    PET/CT
    Beskrivning

    PositronEmissionTomographyComputedTomographyDiagnosticProcedureAssessmentInd-2

    Datatyp

    boolean

    Alias
    NCI Thesaurus ObjectClass
    C17007
    NCI Thesaurus ObjectClass-2
    C17204
    NCI Thesaurus ObjectClass-3
    C18020
    NCI Thesaurus Property
    C20989
    NCI Thesaurus ValueDomain
    C38147
    UMLS CUI [1,1]
    C0032743
    UMLS CUI [1,2]
    C0040405
    Date
    Beskrivning

    Assessment Date

    Datatyp

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS CUI-1
    C2985720
    NCI Thesaurus ObjectClass
    C25367
    NCI Thesaurus ValueDomain-2
    C25367
    NCI Thesaurus Property
    C38000
    Co-morbidties
    Beskrivning

    Co-morbidties

    Hospitalized for unstable angina and/or CHF in last 6 months
    Beskrivning

    UnstableAnginaHospitalizationInd-2

    Datatyp

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    NCI Thesaurus Property
    C25179
    UMLS 2011AA Property
    C0019993
    NCI Metathesaurus ObjectClass
    C0002965
    Transmural MI in last 6 months
    Beskrivning

    TransmuralMyocardialInfarctionConfirmedInd-2

    Datatyp

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    NCI Thesaurus Property
    C25458
    UMLS 2011AA Property
    C0750484
    NCI Thesaurus ObjectClass
    C27996
    UMLS 2011AA ObjectClass
    C0027051
    NCI Metathesaurus ObjectClass
    CL233186
    IV antibiotics at time of registration
    Beskrivning

    IntravenousAntibioticAtRegistrationInd-2

    Datatyp

    boolean

    Alias
    NCI Thesaurus ObjectClass
    C13346
    UMLS 2011AA ObjectClass
    C0348016
    NCI Thesaurus ObjectClass-2
    C258
    UMLS 2011AA ObjectClass-2
    C0003232
    NCI Thesaurus Property
    C25646
    UMLS 2011AA Property
    C1514821
    NCI Thesaurus Property-2
    C25427
    UMLS 2011AA Property-2
    C1516077
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    COPD exacerbation or other respiratory illness requiring hospitalization or precluding study therapy at registration
    Beskrivning

    ChronicObstructiveAirwaysDiseaseRespiratoryEventHospitalizationInd-2

    Datatyp

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    NCI Thesaurus Property
    C25179
    UMLS 2011AA Property
    C0019993
    NCI Thesaurus ObjectClass
    C3199
    UMLS 2011AA ObjectClass
    C0024117
    NCI Metathesaurus ObjectClass
    CL316903
    Prior allergic reaction to cisplatin
    Beskrivning

    CisplatinPriorAllergicReactionInd-2

    Datatyp

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    NCI Thesaurus ObjectClass
    C376
    UMLS 2011AA ObjectClass
    C0008838
    NCI Thesaurus Property
    C25629
    UMLS 2011AA Property
    C0332152
    NCI Metathesaurus Property
    CL240612
    Prior allergic reaction to C225
    Beskrivning

    CetuximabPriorAllergicReactionInd-3

    Datatyp

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    NCI Thesaurus ObjectClass
    C1723
    UMLS 2011AA ObjectClass
    C0879636
    NCI Thesaurus Property
    C25629
    UMLS 2011AA Property
    C0332152
    NCI Metathesaurus Property
    CL240612
    Prior allergic reaction to taxol
    Beskrivning

    PatientPaclitaxelHypersensitivityPersonalMedicalHistoryInd-3

    Datatyp

    boolean

    Alias
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C1411
    UMLS 2011AA Property
    C0144576
    NCI Thesaurus Property-2
    C3114
    UMLS 2011AA Property-2
    C0020517
    NCI Thesaurus Property-3
    C18772
    UMLS 2011AA Property-3
    C0262926
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    Prior severe infusion reaction to a monocolonal antibody
    Beskrivning

    PatientMonoclonalAntibodyInfusionHypersensitivityPersonalMedicalHistoryInd-2

    Datatyp

    boolean

    Alias
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C3114
    UMLS 2011AA Property
    C0020517
    NCI Thesaurus Property-2
    C15388
    UMLS 2011AA Property-2
    C0574032
    NCI Thesaurus Property-3
    C20401
    UMLS 2011AA Property-3
    C0003250
    NCI Thesaurus Property-4
    C18772
    UMLS 2011AA Property-4
    C0262926
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    Footer
    Beskrivning

    Footer

    Comments
    Beskrivning

    Research Comments

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704
    UMLS CUI-1
    C0947611
    NCI Thesaurus ObjectClass
    C15319
    NCI Thesaurus Property
    C25393
    Investigator Signature (The reported case report information has been reviewed and confirmed by the principal investigator)
    Beskrivning

    Investigator Signature

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704
    UMLS CUI-1
    C2346576
    NCI Thesaurus Property
    C25678
    NCI Thesaurus ObjectClass
    C17089
    Date
    Beskrivning

    Investigator Signature Date

    Datatyp

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS CUI-1
    C2346576
    NCI Thesaurus Property
    C25678
    UMLS CUI-2
    C0011008
    NCI Thesaurus ValueDomain-2
    C25367
    NCI Thesaurus ObjectClass
    C17089
    Tillbaka till toppen

    Similar models

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    1 Formulär
    1. StudyEvent: I1: Radiation Therapy Oncology Group Phase III Esophagus Initial Evaluation Form
      1. No Instruction available.
    Name
    Typ
    Description | Question | Decode (Coded Value)
    Datatyp
    Alias
    Item Group
    Module 1
    Protocol ID RTOG
    Item
    RTOG Study No.
    text
    C25337 (NCI Thesaurus ValueDomain)
    C3274381 (UMLS CUI-1)
    C25320 (NCI Thesaurus ObjectClass)
    C1514695 (UMLS CUI-2)
    C19778 (NCI Thesaurus Property)
    C25364 (NCI Thesaurus Property-2)
    RTOG Case number
    Item
    RTOG Case #
    text
    C16960 (NCI Thesaurus ObjectClass)
    C19778 (NCI Thesaurus ObjectClass-2)
    C25364 (NCI Thesaurus Property)
    C49152 (NCI Thesaurus Property-2)
    C25337 (NCI Thesaurus ValueDomain)
    C1514695 (UMLS CUI [1,1])
    C0600091 (UMLS CUI [1,2])
    Institution Name
    Item
    Institution Name
    text
    C25191 (NCI Thesaurus ValueDomain)
    C1301943 (UMLS CUI-1)
    C21541 (NCI Thesaurus ObjectClass)
    C21541 (NCI Thesaurus ValueDomain-2)
    C25364 (NCI Thesaurus Property)
    Institution Number
    Item
    Institution No.
    text
    C25337 (NCI Thesaurus ValueDomain)
    C1301943 (UMLS CUI-1)
    C21541 (NCI Thesaurus ObjectClass)
    C0805701 (UMLS CUI-2)
    C25364 (NCI Thesaurus Property)
    Patient Initials
    Item
    Patient Initials
    text
    C25191 (NCI Thesaurus ValueDomain)
    C2986440 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C25536 (NCI Thesaurus Property)
    Trial subject ID RTOG
    Item
    RTOG Patient ID
    text
    C25337 (NCI Thesaurus ValueDomain)
    C2348585 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C1514695 (UMLS CUI-2)
    C19778 (NCI Thesaurus Property)
    C25364 (NCI Thesaurus Property-2)
    Data amended
    Item
    AMENDED DATA
    boolean
    C38148 (NCI Thesaurus ValueDomain)
    C0680532 (UMLS CUI-1)
    C25474 (NCI Thesaurus ObjectClass)
    C25416 (NCI Thesaurus Property)
    Item Group
    Patient status assessment
    Age
    Item
    Age
    integer
    C16960 (NCI Thesaurus ObjectClass)
    C29848 (NCI Thesaurus ValueDomain)
    C25463 (NCI Thesaurus ValueDomain-2)
    C25150 (NCI Thesaurus Property)
    C0001779 (UMLS CUI [1])
    Item
    Performance Status (Zubrod)
    text
    C25367 (NCI Thesaurus Property)
    C20641 (NCI Thesaurus ObjectClass)
    C1518965 (UMLS 2011AA ObjectClass)
    C25338 (NCI Thesaurus ValueDomain)
    C0449820 (UMLS 2011AA ValueDomain)
    CL.2
    Code List
    Performance Status (Zubrod)
    CL Item
    Normal Activity (0)
    CL Item
    Symptoms, But Nearly Fully Ambulatory (1)
    CL Item
    Some Bed Time, But Needs To Be In Bed <50% Of Normal Daytime (2)
    CL Item
    Needs To Be In Bed > 50% Of Normal Daytime (3)
    CL Item
    Unable To Get Out Of Bed (4)
    PatientPriorMalignantNeoplasmHistoryInd-2
    Item
    History of Prior Malignancy (except non melanomatous skin cancer)
    boolean
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C25629 (NCI Thesaurus ObjectClass-2)
    C0332152 (UMLS 2011AA ObjectClass-2)
    C9305 (NCI Thesaurus Property)
    C0006826 (UMLS 2011AA Property)
    C25629 (NCI Thesaurus Property-2)
    C0332152 (UMLS 2011AA Property-2)
    C18772 (NCI Thesaurus Property-3)
    C0262926 (UMLS 2011AA Property-3)
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    PriorCancerDiagnosisSite
    Item
    Site of Prior Cancer
    text
    C13717 (NCI Thesaurus ValueDomain)
    C1515974 (UMLS 2011AA ValueDomain)
    C9305 (NCI Thesaurus ObjectClass)
    C0006826 (UMLS 2011AA ObjectClass)
    C25629 (NCI Thesaurus ObjectClass-2)
    C0332152 (UMLS 2011AA ObjectClass-2)
    C15220 (NCI Thesaurus Property)
    C0011900 (UMLS 2011AA Property)
    CancerAblationDate
    Item
    Prior cancer date eradicated
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C9305 (NCI Thesaurus ObjectClass)
    C0006826 (UMLS 2011AA ObjectClass)
    C20985 (NCI Thesaurus Property)
    C0547070 (UMLS 2011AA Property)
    Patient Weight
    Item
    Weight
    float
    C25209 (NCI Thesaurus ValueDomain)
    C0005910 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C25208 (NCI Thesaurus Property)
    Item
    Extent of Dysphagia
    text
    C2980 (NCI Thesaurus ObjectClass)
    C0011168 (UMLS 2011AA ObjectClass)
    C25688 (NCI Thesaurus ValueDomain)
    C0449438 (UMLS 2011AA ValueDomain)
    C25332 (NCI Thesaurus Property)
    C0439792 (UMLS 2011AA Property)
    CL.4
    Code List
    Extent of Dysphagia
    CL Item
    Asymptomatic (Asymptomatic)
    C3833 (NCI Thesaurus)
    C0231221 (UMLS 2011AA)
    CL Item
    Cannot Swallow (Cannot swallow)
    CL Item
    Symptomatic, Liquids Only (Symptomatic, liquids only)
    CL Item
    Symptomatic, Soft Foods Only (Symptomatic, soft foods only)
    CL Item
    Symptomatic, Unrestricted Diet (Symptomatic, unrestricted diet)
    CL Item
    Unknown (Unknown)
    C17998 (NCI Thesaurus)
    C0439673 (UMLS 2011AA)
    Item
    Oral alimentation
    text
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    C38288 (NCI Thesaurus Property)
    C1527415 (UMLS 2011AA Property)
    C25382 (NCI Thesaurus Property-2)
    C1521801 (UMLS 2011AA Property-2)
    C15433 (NCI Thesaurus ObjectClass)
    C0242739 (UMLS 2011AA ObjectClass)
    CL.5
    Code List
    Oral alimentation
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    CL Item
    Unknown (Unknown)
    C17998 (NCI Thesaurus)
    C0439673 (UMLS 2011AA)
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    Item
    Nasogastric tube feeding
    text
    C15433 (NCI Thesaurus ObjectClass)
    C0242739 (UMLS 2011AA ObjectClass)
    C38285 (NCI Thesaurus Property)
    C0694637 (UMLS 2011AA Property)
    C41277 (NCI Thesaurus Property-2)
    C1561954 (UMLS 2011AA Property-2)
    C25382 (NCI Thesaurus Property-3)
    C1521801 (UMLS 2011AA Property-3)
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    CL.6
    Code List
    Nasogastric tube feeding
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    CL Item
    Unknown (Unknown)
    C17998 (NCI Thesaurus)
    C0439673 (UMLS 2011AA)
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    Item
    Ostomy feeding
    text
    C15433 (NCI Thesaurus ObjectClass)
    C0242739 (UMLS 2011AA ObjectClass)
    C41277 (NCI Thesaurus Property)
    C1561954 (UMLS 2011AA Property)
    C15290 (NCI Thesaurus Property-2)
    C0029473 (UMLS 2011AA Property-2)
    C25382 (NCI Thesaurus Property-3)
    C1521801 (UMLS 2011AA Property-3)
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    CL.7
    Code List
    Ostomy feeding
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    CL Item
    Unknown (Unknown)
    C17998 (NCI Thesaurus)
    C0439673 (UMLS 2011AA)
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    Item
    Intravenous hyperalimentation
    text
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    C38276 (NCI Thesaurus Property)
    C1522726 (UMLS 2011AA Property)
    C25382 (NCI Thesaurus Property-2)
    C1521801 (UMLS 2011AA Property-2)
    C15433 (NCI Thesaurus ObjectClass)
    C0242739 (UMLS 2011AA ObjectClass)
    CL.8
    Code List
    Intravenous hyperalimentation
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    CL Item
    Unknown (Unknown)
    C17998 (NCI Thesaurus)
    C0439673 (UMLS 2011AA)
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    Item
    Other
    text
    C37902 (NCI Thesaurus ObjectClass)
    C1521721 (UMLS 2011AA ObjectClass)
    C25597 (NCI Thesaurus ObjectClass-2)
    C1521739 (UMLS 2011AA ObjectClass-2)
    C17649 (NCI Thesaurus Property)
    C0205394 (UMLS 2011AA Property)
    C25382 (NCI Thesaurus Property-2)
    C1521801 (UMLS 2011AA Property-2)
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    CL.9
    Code List
    Other
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    CL Item
    Unknown (Unknown)
    C17998 (NCI Thesaurus)
    C0439673 (UMLS 2011AA)
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    NutritionalSupportAdministeredSpecify
    Item
    Other Specify
    text
    C25685 (NCI Thesaurus ValueDomain)
    C1521902 (UMLS 2011AA ValueDomain)
    C37902 (NCI Thesaurus ObjectClass)
    C1521721 (UMLS 2011AA ObjectClass)
    C25382 (NCI Thesaurus Property)
    C1521801 (UMLS 2011AA Property)
    C25597 (NCI Thesaurus ObjectClass-2)
    C1521739 (UMLS 2011AA ObjectClass-2)
    Item
    Estimate of daily caloric intake
    text
    C25190 (NCI Thesaurus ObjectClass)
    C0027361 (UMLS 2011AA ObjectClass)
    C20989 (NCI Thesaurus Property)
    C0031809 (UMLS 2011AA Property)
    C25473 (NCI Thesaurus Property-2)
    C0332173 (UMLS 2011AA Property-2)
    C25498 (NCI Thesaurus Property-3)
    C0750572 (UMLS 2011AA Property-3)
    C28135 (NCI Thesaurus Property-4)
    C0006777 (UMLS 2011AA Property-4)
    C25284 (NCI Thesaurus ValueDomain)
    C0332307 (UMLS 2011AA ValueDomain)
    CL.10
    Code List
    Estimate of daily caloric intake
    CL Item
    < 1500 Cal/day (< 1500 cal/day)
    CL Item
    >= 1500 Cal/day (>= 1500 cal/day)
    Item Group
    Prior Treatment
    PatientEsophagealCarcinomaSurgicalProcedurePersonalMedicalHistoryInd-2
    Item
    Prior Surgery (for esophageal cancer excludes diagnostic biopsy)
    boolean
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C15329 (NCI Thesaurus Property)
    C0543467 (UMLS 2011AA Property)
    C18772 (NCI Thesaurus Property-2)
    C0262926 (UMLS 2011AA Property-2)
    C3513 (NCI Thesaurus Property-3)
    C0152018 (UMLS 2011AA Property-3)
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    PatientEsophagealCarcinomaChemotherapyPersonalMedicalHistoryInd-2
    Item
    Prior chemotherapy (for study cancer)
    boolean
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C15632 (NCI Thesaurus Property)
    C0392920 (UMLS 2011AA Property)
    C18772 (NCI Thesaurus Property-2)
    C0262926 (UMLS 2011AA Property-2)
    C3513 (NCI Thesaurus Property-3)
    C0152018 (UMLS 2011AA Property-3)
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    PatientChemotherapyPersonalMedicalHistoryInd-2
    Item
    Prior chemotherapy (for other reasons)
    boolean
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C15632 (NCI Thesaurus Property)
    C0392920 (UMLS 2011AA Property)
    C18772 (NCI Thesaurus Property-2)
    C0262926 (UMLS 2011AA Property-2)
    PatientChestRadiationTherapyPersonalMedicalHistoryInd-2
    Item
    Prior radiation therapy (to chest)
    boolean
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C15313 (NCI Thesaurus Property)
    C1522449 (UMLS 2011AA Property)
    C25389 (NCI Thesaurus Property-2)
    C0817096 (UMLS 2011AA Property-2)
    C18772 (NCI Thesaurus Property-3)
    C0262926 (UMLS 2011AA Property-3)
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    PriorEpidermalGrowthFactorReceptorTherapyPerformedInd-3
    Item
    Prior therapy that targeted EGFR pathway
    boolean
    C25629 (NCI Thesaurus ObjectClass)
    C0332152 (UMLS 2011AA ObjectClass)
    C15368 (NCI Thesaurus ObjectClass-2)
    C17068 (NCI Thesaurus ObjectClass-3)
    C0034802 (UMLS 2011AA ObjectClass-2)
    C38000 (NCI Thesaurus Property)
    C0884358 (UMLS 2011AA Property)
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    Prior platinum based and/or paclitaxel based therapy
    Item
    Prior platinum based and/or paclitaxel based therapy
    boolean
    C16960 (NCI Thesaurus ObjectClass)
    C49236 (NCI Thesaurus Property)
    C18772 (NCI Thesaurus Property-2)
    C25620 (NCI Thesaurus Property-3)
    C1490 (NCI Thesaurus Property-4)
    C38147 (NCI Thesaurus ValueDomain)
    C1514463 (UMLS CUI [1,1])
    C1514162 (UMLS CUI [1,2])
    C0796419 (UMLS CUI [1,3])
    Item Group
    Study Cancer
    Item
    Site of study cancer
    text
    C13717 (NCI Thesaurus ValueDomain)
    C1515974 (UMLS 2011AA ValueDomain)
    C25341 (NCI Thesaurus Property)
    C0450429 (UMLS 2011AA Property)
    C9305 (NCI Thesaurus ObjectClass)
    C0006826 (UMLS 2011AA ObjectClass)
    C15206 (NCI Thesaurus ObjectClass-2)
    C0008972 (UMLS 2011AA ObjectClass-2)
    CL.17
    Code List
    Site of study cancer
    CL Item
    Upper Thoracic Esophagus (Upper thoracic esophagus)
    C25355 (NCI Thesaurus)
    C1282910 (UMLS 2011AA)
    C12251 (NCI Thesaurus-3)
    C0227188 (UMLS 2011AA-4)
    CL Item
    Mid Thoracic Esophagus (Mid thoracic esophagus)
    CL Item
    Lower Thoracic Excludes Ge Junction (Lower thoracic excludes GE junction)
    CL Item
    Cervical Esophagus (Cervical Esophagus)
    C12250 (NCI Thesaurus)
    C0227186 (UMLS 2011AA)
    CL Item
    Gastroesophageal Junction, Siewert Type I (Gastroesophageal junction, Siewert Type I)
    CL Item
    Gastroesophageal Junction, Siewert Type Ii (Gastroesophageal junction, Siewert Type II)
    Item
    Histologic Type
    text
    C3262 (NCI Thesaurus ObjectClass)
    C0027651 (UMLS 2011AA ObjectClass)
    C17639 (NCI Thesaurus ObjectClass-2)
    C0203057 (UMLS 2011AA ObjectClass-2)
    C25526 (NCI Thesaurus Property)
    C0205462 (UMLS 2011AA Property)
    C25161 (NCI Thesaurus Property-2)
    C0008902 (UMLS 2011AA Property-2)
    C25372 (NCI Thesaurus ValueDomain)
    C0683312 (UMLS 2011AA ValueDomain)
    C25526 (NCI Thesaurus ValueDomain-2)
    C0205462 (UMLS 2011AA ValueDomain-2)
    CL.18
    Code List
    Histologic Type
    CL Item
    Squamous Cell Carcinoma (Squamous cell carcinoma)
    C2929 (NCI Thesaurus)
    C0007137 (UMLS 2011AA)
    CL Item
    Adenocarcinoma (Adenocarcinoma)
    C2852 (NCI Thesaurus)
    C0001418 (UMLS 2011AA)
    MalignantNeoplasmInitialHistologicDiagnosisDate
    Item
    Date of initial histologic diagnosis of malignancy
    date
    C9305 (NCI Thesaurus ObjectClass)
    C0006826 (UMLS 2011AA ObjectClass)
    C25536 (NCI Thesaurus Property)
    C1555582 (UMLS 2011AA Property)
    C25526 (NCI Thesaurus Property-2)
    C0205462 (UMLS 2011AA Property-2)
    C15220 (NCI Thesaurus Property-3)
    C0011900 (UMLS 2011AA Property-3)
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    EsophagealCarcinomaCervicalEsophagusInvasionInd-2
    Item
    Cervical esophagus
    boolean
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    C12250 (NCI Thesaurus Property)
    C0227186 (UMLS 2011AA Property)
    C3513 (NCI Thesaurus ObjectClass)
    C0152018 (UMLS 2011AA ObjectClass)
    C20625 (NCI Thesaurus Property-2)
    C1269955 (UMLS 2011AA Property-2)
    EsophagealCarcinomaTracheaBronchusInvasionInd-2
    Item
    Invasion into the trachea or major bronchi
    boolean
    C3513 (NCI Thesaurus ObjectClass)
    C0152018 (UMLS 2011AA ObjectClass)
    C12683 (NCI Thesaurus Property)
    C0006255 (UMLS 2011AA Property)
    C12428 (NCI Thesaurus Property-2)
    C0040578 (UMLS 2011AA Property-2)
    C20625 (NCI Thesaurus Property-3)
    C1269955 (UMLS 2011AA Property-3)
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    EsophagealCarcinomaTracheoesophagealFistulaInvasionInd-2
    Item
    Evidence of tracheoesophageal fistule
    boolean
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    C3513 (NCI Thesaurus ObjectClass)
    C0152018 (UMLS 2011AA ObjectClass)
    C20625 (NCI Thesaurus Property)
    C1269955 (UMLS 2011AA Property)
    C35080 (NCI Thesaurus Property-2)
    C0040588 (UMLS 2011AA Property-2)
    Item
    Esophageal Tumor Clinical T Stage
    text
    C3262 (NCI Thesaurus ObjectClass)
    C37950 (NCI Thesaurus ObjectClass-2)
    C25398 (NCI Thesaurus Property)
    C25728 (NCI Thesaurus Property-2)
    C16899 (NCI Thesaurus ValueDomain)
    C0014859 (UMLS CUI [1,1])
    C0475455 (UMLS CUI [1,2])
    CL.22
    Code List
    Esophageal Tumor Clinical T Stage
    CL Item
    Tumor Invades Lamina Propria Or Submucosa (T1)
    CL Item
    Tumor Invades Muscularis Propria (T2)
    CL Item
    Tumor Invades Adventitia (T3)
    CL Item
    Tumor Invades Adjacent Structures (T4)
    MalignantNeoplasmProximalChestAnatomicSiteInd-2
    Item
    Is the tumor proximal thoracic
    boolean
    C9305 (NCI Thesaurus ObjectClass)
    C0006826 (UMLS 2011AA ObjectClass)
    C13717 (NCI Thesaurus Property)
    C1515974 (UMLS 2011AA Property)
    C25389 (NCI Thesaurus Property-2)
    C0817096 (UMLS 2011AA Property-2)
    C25236 (NCI Thesaurus Property-3)
    C0205107 (UMLS 2011AA Property-3)
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    Item
    Clinical N Stage
    text
    C3262 (NCI Thesaurus ObjectClass)
    C0027651 (UMLS 2011AA ObjectClass)
    C37950 (NCI Thesaurus ObjectClass-2)
    C1522619 (UMLS 2011AA ObjectClass-2)
    C25398 (NCI Thesaurus Property)
    C0205210 (UMLS 2011AA Property)
    C25580 (NCI Thesaurus Property-2)
    C0456532 (UMLS 2011AA Property-2)
    C16899 (NCI Thesaurus ValueDomain)
    C1300072 (UMLS 2011AA ValueDomain)
    CL.24
    Code List
    Clinical N Stage
    CL Item
    No Regional Lymph Node Metastasis (N0)
    CL Item
    Regional Lymph Node Metastasis (N1)
    Item
    Clinical M Stage
    text
    C3262 (NCI Thesaurus ObjectClass)
    C0027651 (UMLS 2011AA ObjectClass)
    C37950 (NCI Thesaurus ObjectClass-2)
    C1522619 (UMLS 2011AA ObjectClass-2)
    C25398 (NCI Thesaurus Property)
    C0205210 (UMLS 2011AA Property)
    C25727 (NCI Thesaurus Property-2)
    C0456533 (UMLS 2011AA Property-2)
    C16899 (NCI Thesaurus ValueDomain)
    C1300072 (UMLS 2011AA ValueDomain)
    CL.25
    Code List
    Clinical M Stage
    CL Item
    No Distant Metastasis (M0)
    CL Item
    Metastases Present - See Figo And Ajcc Staging For Complete Details (M1a)
    EsophagealCarcinomaCeliacLymphNodeMetastasisInd-2
    Item
    Celiac lymph nodes
    boolean
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    C19151 (NCI Thesaurus Property)
    C0027627 (UMLS 2011AA Property)
    C3513 (NCI Thesaurus ObjectClass)
    C0152018 (UMLS 2011AA ObjectClass)
    C65166 (NCI Thesaurus Property-2)
    C0229766 (UMLS 2011AA Property-2)
    EsophagealCarcinomaCervicalLymphNodeMetastasisInd-2
    Item
    Cervical lymph nodes
    boolean
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    C19151 (NCI Thesaurus Property)
    C0027627 (UMLS 2011AA Property)
    C3513 (NCI Thesaurus ObjectClass)
    C0152018 (UMLS 2011AA ObjectClass)
    C32298 (NCI Thesaurus Property-2)
    C0588054 (UMLS 2011AA Property-2)
    EsophagealCarcinomaSupraclavicularLymphNodeMetastasisInd-2
    Item
    Supraclavicular lymph nodes
    boolean
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    C19151 (NCI Thesaurus Property)
    C0027627 (UMLS 2011AA Property)
    C12903 (NCI Thesaurus Property-2)
    C0229730 (UMLS 2011AA Property-2)
    C3513 (NCI Thesaurus ObjectClass)
    C0152018 (UMLS 2011AA ObjectClass)
    Item Group
    Laboratory Tests
    Hemoglobin
    Item
    Hemoglobin
    float
    C16676 (NCI Thesaurus Property)
    C20200 (NCI Thesaurus Property-2)
    C25294 (NCI Thesaurus ObjectClass)
    C25712 (NCI Thesaurus ValueDomain)
    C0019046 (UMLS CUI [1])
    Neutrophil count
    Item
    ANC
    float
    C25294 (NCI Thesaurus ObjectClass)
    C20200 (NCI Thesaurus Property)
    C63321 (NCI Thesaurus Property-2)
    C38046 (NCI Thesaurus ValueDomain)
    C25712 (NCI Thesaurus ValueDomain-2)
    C0200633 (UMLS CUI [1])
    Platelets
    Item
    Peripheral Platelet Count
    float
    C25294 (NCI Thesaurus ObjectClass)
    C20200 (NCI Thesaurus Property)
    C12520 (NCI Thesaurus Property-2)
    C38046 (NCI Thesaurus ValueDomain)
    C25712 (NCI Thesaurus ValueDomain-2)
    C0005821 (UMLS CUI [1])
    Creatinine, Serum
    Item
    Serum creatinine
    float
    C16960 (NCI Thesaurus ObjectClass)
    C13325 (NCI Thesaurus Property)
    C399 (NCI Thesaurus Property-2)
    C0201976 (UMLS CUI [1])
    AST
    Item
    AST (SGOT)
    float
    C13308 (NCI Thesaurus ObjectClass)
    C25202 (NCI Thesaurus Property)
    C37984 (NCI Thesaurus Property-2)
    C38046 (NCI Thesaurus ValueDomain)
    C25712 (NCI Thesaurus ValueDomain-2)
    C0201899 (UMLS CUI [1])
    AST ULN
    Item
    AST (SGOT) ULN
    float
    C25294 (NCI Thesaurus ObjectClass)
    C25202 (NCI Thesaurus Property)
    C20200 (NCI Thesaurus Property-2)
    C25712 (NCI Thesaurus ValueDomain)
    C25706 (NCI Thesaurus ValueDomain-2)
    C0242192 (UMLS CUI [1,1])
    C1519815 (UMLS CUI [1,2])
    Bilirubin, total
    Item
    Bilirubin, total
    float
    C25294 (NCI Thesaurus ObjectClass)
    C20200 (NCI Thesaurus Property)
    C38037 (NCI Thesaurus Property-2)
    C25712 (NCI Thesaurus ValueDomain)
    C38024 (NCI Thesaurus ValueDomain-2)
    C0201913 (UMLS CUI [1])
    Bilirubin, Total ULN
    Item
    Total bilirubin ULN
    float
    C25294 (NCI Thesaurus ObjectClass)
    C0201913 (UMLS CUI-1)
    C20200 (NCI Thesaurus Property)
    C1519815 (UMLS CUI-2)
    C38037 (NCI Thesaurus Property-2)
    C25712 (NCI Thesaurus ValueDomain)
    C38024 (NCI Thesaurus ValueDomain-2)
    C25706 (NCI Thesaurus ValueDomain-3)
    Laboratory Procedure Date
    Item
    Date
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0022885 (UMLS CUI-1)
    C25214 (NCI Thesaurus Property)
    C0011008 (UMLS CUI-2)
    C38000 (NCI Thesaurus Property-2)
    C25294 (NCI Thesaurus ObjectClass)
    Item Group
    Diagnosis Work-up
    PersonalMedicalHistoryPhysicalExaminationPerformedInd-2
    Item
    History and Physical
    boolean
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    C20989 (NCI Thesaurus ObjectClass)
    C0031809 (UMLS 2011AA ObjectClass)
    C38000 (NCI Thesaurus Property)
    C0884358 (UMLS 2011AA Property)
    C18772 (NCI Thesaurus ObjectClass-2)
    C0262926 (UMLS 2011AA ObjectClass-2)
    CT scan or MRI of the chest or abdomen
    Item
    CT scan or MRI of the chest or abdomen
    boolean
    C16502 (NCI Thesaurus ObjectClass)
    C17204 (NCI Thesaurus ObjectClass-2)
    C16809 (NCI Thesaurus ObjectClass-3)
    C20989 (NCI Thesaurus Property)
    C25389 (NCI Thesaurus Property-2)
    C12664 (NCI Thesaurus Property-3)
    C38147 (NCI Thesaurus ValueDomain)
    C0040405 (UMLS CUI [1,1])
    C0024485 (UMLS CUI [1,2])
    C0817096 (UMLS CUI [1,3])
    C0230168 (UMLS CUI [1,4])
    EndoscopicBiopsyDiagnosticProcedureEsophagealCarcinomaAssessmentInd-2
    Item
    Endoscopic biopsy of esophageal tumor
    boolean
    C18020 (NCI Thesaurus ObjectClass)
    C0430022 (UMLS 2011AA ObjectClass)
    C15389 (NCI Thesaurus ObjectClass-2)
    C0184980 (UMLS 2011AA ObjectClass-2)
    C20989 (NCI Thesaurus Property)
    C0031809 (UMLS 2011AA Property)
    C3513 (NCI Thesaurus Property-2)
    C0152018 (UMLS 2011AA Property-2)
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    ElectrocardiographyDiagnosticProcedureAssessmentInd-2
    Item
    EKG
    boolean
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    C20989 (NCI Thesaurus Property)
    C0031809 (UMLS 2011AA Property)
    C38053 (NCI Thesaurus ObjectClass)
    C1623258 (UMLS 2011AA ObjectClass)
    C18020 (NCI Thesaurus ObjectClass-2)
    C0430022 (UMLS 2011AA ObjectClass-2)
    Bronchoscopy
    Item
    Bronchoscopy
    boolean
    C38147 (NCI Thesaurus ValueDomain)
    C16366 (NCI Thesaurus ObjectClass)
    C38000 (NCI Thesaurus Property)
    C0006290 (UMLS CUI [1])
    PET/CT
    Item
    PET/CT
    boolean
    C17007 (NCI Thesaurus ObjectClass)
    C17204 (NCI Thesaurus ObjectClass-2)
    C18020 (NCI Thesaurus ObjectClass-3)
    C20989 (NCI Thesaurus Property)
    C38147 (NCI Thesaurus ValueDomain)
    C0032743 (UMLS CUI [1,1])
    C0040405 (UMLS CUI [1,2])
    Assessment Date
    Item
    Date
    date
    C25164 (NCI Thesaurus ValueDomain)
    C2985720 (UMLS CUI-1)
    C25367 (NCI Thesaurus ObjectClass)
    C25367 (NCI Thesaurus ValueDomain-2)
    C38000 (NCI Thesaurus Property)
    Item Group
    Co-morbidties
    UnstableAnginaHospitalizationInd-2
    Item
    Hospitalized for unstable angina and/or CHF in last 6 months
    boolean
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    C25179 (NCI Thesaurus Property)
    C0019993 (UMLS 2011AA Property)
    C0002965 (NCI Metathesaurus ObjectClass)
    TransmuralMyocardialInfarctionConfirmedInd-2
    Item
    Transmural MI in last 6 months
    boolean
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    C25458 (NCI Thesaurus Property)
    C0750484 (UMLS 2011AA Property)
    C27996 (NCI Thesaurus ObjectClass)
    C0027051 (UMLS 2011AA ObjectClass)
    CL233186 (NCI Metathesaurus ObjectClass)
    IntravenousAntibioticAtRegistrationInd-2
    Item
    IV antibiotics at time of registration
    boolean
    C13346 (NCI Thesaurus ObjectClass)
    C0348016 (UMLS 2011AA ObjectClass)
    C258 (NCI Thesaurus ObjectClass-2)
    C0003232 (UMLS 2011AA ObjectClass-2)
    C25646 (NCI Thesaurus Property)
    C1514821 (UMLS 2011AA Property)
    C25427 (NCI Thesaurus Property-2)
    C1516077 (UMLS 2011AA Property-2)
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    ChronicObstructiveAirwaysDiseaseRespiratoryEventHospitalizationInd-2
    Item
    COPD exacerbation or other respiratory illness requiring hospitalization or precluding study therapy at registration
    boolean
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    C25179 (NCI Thesaurus Property)
    C0019993 (UMLS 2011AA Property)
    C3199 (NCI Thesaurus ObjectClass)
    C0024117 (UMLS 2011AA ObjectClass)
    CL316903 (NCI Metathesaurus ObjectClass)
    CisplatinPriorAllergicReactionInd-2
    Item
    Prior allergic reaction to cisplatin
    boolean
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    C376 (NCI Thesaurus ObjectClass)
    C0008838 (UMLS 2011AA ObjectClass)
    C25629 (NCI Thesaurus Property)
    C0332152 (UMLS 2011AA Property)
    CL240612 (NCI Metathesaurus Property)
    CetuximabPriorAllergicReactionInd-3
    Item
    Prior allergic reaction to C225
    boolean
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    C1723 (NCI Thesaurus ObjectClass)
    C0879636 (UMLS 2011AA ObjectClass)
    C25629 (NCI Thesaurus Property)
    C0332152 (UMLS 2011AA Property)
    CL240612 (NCI Metathesaurus Property)
    PatientPaclitaxelHypersensitivityPersonalMedicalHistoryInd-3
    Item
    Prior allergic reaction to taxol
    boolean
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C1411 (NCI Thesaurus Property)
    C0144576 (UMLS 2011AA Property)
    C3114 (NCI Thesaurus Property-2)
    C0020517 (UMLS 2011AA Property-2)
    C18772 (NCI Thesaurus Property-3)
    C0262926 (UMLS 2011AA Property-3)
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    PatientMonoclonalAntibodyInfusionHypersensitivityPersonalMedicalHistoryInd-2
    Item
    Prior severe infusion reaction to a monocolonal antibody
    boolean
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C3114 (NCI Thesaurus Property)
    C0020517 (UMLS 2011AA Property)
    C15388 (NCI Thesaurus Property-2)
    C0574032 (UMLS 2011AA Property-2)
    C20401 (NCI Thesaurus Property-3)
    C0003250 (UMLS 2011AA Property-3)
    C18772 (NCI Thesaurus Property-4)
    C0262926 (UMLS 2011AA Property-4)
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    Item Group
    Footer
    Research Comments
    Item
    Comments
    text
    C25704 (NCI Thesaurus ValueDomain)
    C0947611 (UMLS CUI-1)
    C15319 (NCI Thesaurus ObjectClass)
    C25393 (NCI Thesaurus Property)
    Investigator Signature
    Item
    Investigator Signature (The reported case report information has been reviewed and confirmed by the principal investigator)
    text
    C25704 (NCI Thesaurus ValueDomain)
    C2346576 (UMLS CUI-1)
    C25678 (NCI Thesaurus Property)
    C17089 (NCI Thesaurus ObjectClass)
    Investigator Signature Date
    Item
    Date
    date
    C25164 (NCI Thesaurus ValueDomain)
    C2346576 (UMLS CUI-1)
    C25678 (NCI Thesaurus Property)
    C0011008 (UMLS CUI-2)
    C25367 (NCI Thesaurus ValueDomain-2)
    C17089 (NCI Thesaurus ObjectClass)
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