ID
1449
Description
The Division of Cancer Prevention's screening case report form (CRF) template. Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=516F6F73-F6A7-27F0-E044-0003BA3F9857
Link
Keywords
Versions (2)
- 8/27/12 8/27/12 -
- 1/9/15 1/9/15 - Martin Dugas
Uploaded on
August 27, 2012
DOI
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License
Creative Commons BY-NC 3.0 Legacy
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Eligibility - Screening - 2762748v1.0
No Instruction available.
- StudyEvent: Screening
Description
Screening
Description
ScreeningInformedConsentSignedDate
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C48261
- UMLS 2011AA ObjectClass
- C1710032
- NCI Thesaurus ObjectClass
- C16735
- UMLS 2011AA ObjectClass
- C0021430
- NCI Thesaurus Property
- C25679
Description
NotObtainedIndicator
Data type
text
Alias
- NCI Thesaurus Property
- C25180
- UMLS 2011AA Property
- C1522602
- NCI Metathesaurus ObjectClass
- CL310460
- NCI Metathesaurus ObjectClass
- CL052458
- NCI Metathesaurus ValueDomain
- C0021212
Description
NotObtainedIndicator
Data type
text
Alias
- NCI Thesaurus Property
- C25180
- UMLS 2011AA Property
- C1522602
- NCI Metathesaurus ObjectClass
- CL310460
- NCI Metathesaurus ObjectClass
- CL052458
- NCI Metathesaurus ValueDomain
- C0021212
Description
ScreenDate
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus Property
- C48261
- UMLS 2011AA Property
- C1710032
- NCI Thesaurus ObjectClass
- C15207
Description
ProtocolScreenIndicator
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
- NCI Thesaurus Property
- C48261
- UMLS 2011AA Property
- C1710032
- NCI Thesaurus ObjectClass
- C15207
Description
ProtocolScreenFailureReasonType
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus ValueDomain
- C25638
- UMLS 2011AA ValueDomain
- C0392360
- NCI Thesaurus Property
- C48261
- UMLS 2011AA Property
- C1710032
- NCI Thesaurus ObjectClass
- C15207
Description
OtherSpecifyText
Data type
text
Alias
- NCI Thesaurus Property
- C25685
- UMLS 2011AA Property
- C1521902
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus ObjectClass
- C17649
- UMLS 2011AA ObjectClass
- C0205394
- NCI Thesaurus Property
- C25638
- UMLS 2011AA Property
- C0392360
Description
ResearchCommentsText
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus ObjectClass
- C15319
- NCI Thesaurus Property
- C25393
- UMLS 2011AA Property
- C0282411
Description
PatientReferralSourceName
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25683
- UMLS 2011AA Property
- C0449416
- NCI Thesaurus Property
- C52582
- UMLS 2011AA Property
- C0034927
- NCI Thesaurus ValueDomain
- C25683
- UMLS 2011AA ValueDomain
- C0449416
- NCI Thesaurus ValueDomain
- C42614
- UMLS 2011AA ValueDomain
- C0027365
- NCI Thesaurus ValueDomain
- C52582
- UMLS 2011AA ValueDomain
- C0034927
Description
PatientReferralSourceOtherSpecify
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25683
- UMLS 2011AA Property
- C0449416
- NCI Thesaurus Property
- C52582
- UMLS 2011AA Property
- C0034927
Description
ParticipantDiscoverStudySourceName
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C29867
- UMLS 2011AA ObjectClass
- C0679646
- NCI Thesaurus Property
- C63536
- UMLS 2011AA Property
- C2603343
- NCI Thesaurus Property
- C62262
- UMLS 2011AA Property
- C1880355
- NCI Thesaurus ValueDomain
- C25683
- UMLS 2011AA ValueDomain
- C0449416
- NCI Thesaurus ValueDomain
- C42614
- UMLS 2011AA ValueDomain
- C0027365
- NCI Thesaurus ValueDomain
- C62262
- UMLS 2011AA ValueDomain
- C1880355
Description
ParticipantDiscoverStudyOtherSpecify
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus ObjectClass
- C29867
- UMLS 2011AA ObjectClass
- C0679646
- NCI Thesaurus Property
- C63536
- UMLS 2011AA Property
- C2603343
- NCI Thesaurus Property
- C62262
- UMLS 2011AA Property
- C1880355
Description
Dcp Template Footer
Description
ProtocolTitleName
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS 2011AA ValueDomain
- C1547383
- NCI Thesaurus ObjectClass
- C25320
- UMLS 2011AA ObjectClass
- C1507394
- NCI Thesaurus Property
- C42774
- UMLS 2011AA Property
- C1705823
Description
ProtocolVersion
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus ObjectClass
- C25320
- UMLS 2011AA ObjectClass
- C1507394
- NCI Thesaurus Property
- C25364
- UMLS 2011AA Property
- C0600091
Description
ProtocolVersion
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus ObjectClass
- C25320
- UMLS 2011AA ObjectClass
- C1507394
- NCI Thesaurus Property
- C25364
- UMLS 2011AA Property
- C0600091
Description
ProtocolVersionDate
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C25320
- UMLS 2011AA ObjectClass
- C1507394
- NCI Thesaurus Property
- C25364
- UMLS 2011AA Property
- C0600091
- NCI Thesaurus ValueDomain
- C25367
Description
PageNumber
Data type
double
Alias
- NCI Thesaurus Property
- C25337
- UMLS 2011AA Property
- C0237753
- NCI Thesaurus ValueDomain
- C25337
- UMLS 2011AA ValueDomain
- C0237753
- NCI Metathesaurus ObjectClass
- C0439643
Description
CaseReportFormTotalPageNumber
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C40988
- UMLS 2011AA ObjectClass
- C1516308
- NCI Thesaurus Property
- C25337
- UMLS 2011AA Property
- C0237753
- NCI Thesaurus Property
- C25304
- UMLS 2011AA Property
- C0439810
- NCI Thesaurus Property
- C42783
- UMLS 2011AA Property
- C1704732
- NCI Thesaurus ValueDomain
- C25337
- UMLS 2011AA ValueDomain
- C0237753
Description
DCPTemplateVersionText
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Metathesaurus ObjectClass
- C0728990
- NCI Thesaurus Property
- C25714
- UMLS 2011AA Property
- C0333052
Similar models
No Instruction available.
- StudyEvent: Screening
C0237753 (UMLS 2011AA ValueDomain)
C25320 (NCI Thesaurus ObjectClass)
C1507394 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C19202 (NCI Thesaurus Property)
C1513882 (UMLS 2011AA Property)
C0805701 (UMLS 2011AA ValueDomain)
C21541 (NCI Thesaurus ObjectClass)
C0018704 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C0030705 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C25364 (NCI Thesaurus ValueDomain)
C0600091 (UMLS 2011AA ValueDomain)
C0332307 (UMLS 2011AA Property)
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C25716 (NCI Thesaurus ObjectClass)
C0545082 (UMLS 2011AA ObjectClass)
C0011008 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain)
C25716 (NCI Thesaurus ObjectClass)
C0545082 (UMLS 2011AA ObjectClass)
C0011008 (UMLS 2011AA ValueDomain)
C48261 (NCI Thesaurus ObjectClass)
C1710032 (UMLS 2011AA ObjectClass)
C16735 (NCI Thesaurus ObjectClass)
C0021430 (UMLS 2011AA ObjectClass)
C25679 (NCI Thesaurus Property)
C1522602 (UMLS 2011AA Property)
CL310460 (NCI Metathesaurus ObjectClass)
CL052458 (NCI Metathesaurus ObjectClass)
C0021212 (NCI Metathesaurus ValueDomain)
C1272460 (UMLS 2011AA)
C1522602 (UMLS 2011AA Property)
CL310460 (NCI Metathesaurus ObjectClass)
CL052458 (NCI Metathesaurus ObjectClass)
C0021212 (NCI Metathesaurus ValueDomain)
C1272460 (UMLS 2011AA)
C0011008 (UMLS 2011AA ValueDomain)
C48261 (NCI Thesaurus Property)
C1710032 (UMLS 2011AA Property)
C15207 (NCI Thesaurus ObjectClass)
C1522602 (UMLS 2011AA ValueDomain)
C48261 (NCI Thesaurus Property)
C1710032 (UMLS 2011AA Property)
C15207 (NCI Thesaurus ObjectClass)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0332307 (UMLS 2011AA ValueDomain)
C25638 (NCI Thesaurus ValueDomain)
C0392360 (UMLS 2011AA ValueDomain)
C48261 (NCI Thesaurus Property)
C1710032 (UMLS 2011AA Property)
C15207 (NCI Thesaurus ObjectClass)
C1521902 (UMLS 2011AA Property)
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C17649 (NCI Thesaurus ObjectClass)
C0205394 (UMLS 2011AA ObjectClass)
C25638 (NCI Thesaurus Property)
C0392360 (UMLS 2011AA Property)
C1527021 (UMLS 2011AA ValueDomain)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C0282411 (UMLS 2011AA Property)
C0030705 (UMLS 2011AA ObjectClass)
C25683 (NCI Thesaurus Property)
C0449416 (UMLS 2011AA Property)
C52582 (NCI Thesaurus Property)
C0034927 (UMLS 2011AA Property)
C25683 (NCI Thesaurus ValueDomain)
C0449416 (UMLS 2011AA ValueDomain)
C42614 (NCI Thesaurus ValueDomain)
C0027365 (UMLS 2011AA ValueDomain)
C52582 (NCI Thesaurus ValueDomain)
C0034927 (UMLS 2011AA ValueDomain)
C0031831 (UMLS 2011AA)
C0018724 (UMLS 2011AA)
C0015576 (UMLS 2011AA)
C72884 (NCI Thesaurus)
C0079382 (UMLS 2011AA)
C0036588 (UMLS 2011AA)
C0205394 (UMLS 2011AA)
C1527021 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25683 (NCI Thesaurus Property)
C0449416 (UMLS 2011AA Property)
C52582 (NCI Thesaurus Property)
C0034927 (UMLS 2011AA Property)
C0679646 (UMLS 2011AA ObjectClass)
C63536 (NCI Thesaurus Property)
C2603343 (UMLS 2011AA Property)
C62262 (NCI Thesaurus Property)
C1880355 (UMLS 2011AA Property)
C25683 (NCI Thesaurus ValueDomain)
C0449416 (UMLS 2011AA ValueDomain)
C42614 (NCI Thesaurus ValueDomain)
C0027365 (UMLS 2011AA ValueDomain)
C62262 (NCI Thesaurus ValueDomain)
C1880355 (UMLS 2011AA ValueDomain)
C0031831 (UMLS 2011AA)
C0028661 (UMLS 2011AA)
C0015576 (UMLS 2011AA)
C72884 (NCI Thesaurus)
C0079382 (UMLS 2011AA)
C1513882 (UMLS 2011AA)
C67518 (NCI Thesaurus)
C2349146 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C1521902 (UMLS 2011AA)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
C1527021 (UMLS 2011AA ValueDomain)
C29867 (NCI Thesaurus ObjectClass)
C0679646 (UMLS 2011AA ObjectClass)
C63536 (NCI Thesaurus Property)
C2603343 (UMLS 2011AA Property)
C62262 (NCI Thesaurus Property)
C1880355 (UMLS 2011AA Property)
C1547383 (UMLS 2011AA ValueDomain)
C25320 (NCI Thesaurus ObjectClass)
C1507394 (UMLS 2011AA ObjectClass)
C42774 (NCI Thesaurus Property)
C1705823 (UMLS 2011AA Property)
C1527021 (UMLS 2011AA ValueDomain)
C25320 (NCI Thesaurus ObjectClass)
C1507394 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C1527021 (UMLS 2011AA ValueDomain)
C25320 (NCI Thesaurus ObjectClass)
C1507394 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C0011008 (UMLS 2011AA ValueDomain)
C25320 (NCI Thesaurus ObjectClass)
C1507394 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C25367 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA Property)
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C0439643 (NCI Metathesaurus ObjectClass)
C1516308 (UMLS 2011AA ObjectClass)
C25337 (NCI Thesaurus Property)
C0237753 (UMLS 2011AA Property)
C25304 (NCI Thesaurus Property)
C0439810 (UMLS 2011AA Property)
C42783 (NCI Thesaurus Property)
C1704732 (UMLS 2011AA Property)
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C0728990 (NCI Metathesaurus ObjectClass)
C25714 (NCI Thesaurus Property)
C0333052 (UMLS 2011AA Property)