ID

1684

Description

The course assessment information when the course is completed, and the patient is evaluated or taken off treatment. Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=ACEDB2DF-2AE4-2B69-E040-BB89AD437A84

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=ACEDB2DF-2AE4-2B69-E040-BB89AD437A84

Keywords

Versions (2)
  1. 9/19/12 9/19/12 -
  2. 7/15/17 7/15/17 - Martin Dugas
Uploaded on

September 19, 2012

DOI

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License

Creative Commons BY-NC 3.0
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Follow-Up - Course Assessment - 3274692v1.0

English

No Instruction available.

1 forms  
  1. StudyEvent: Course Assessment
    1. No Instruction available.
Course Assessment
Description

Course Assessment

Visit Date (Enter the date the course started.)
Description

FormCompletionDate

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C40988
UMLS 2011AA ObjectClass
C1516308
NCI Thesaurus Property
C25250
UMLS 2011AA Property
C0205197
Start Date of Course (Cycle)
Description

CourseStartDate

Data type

date

Alias
NCI Thesaurus ObjectClass
C25379
UMLS 2011AA ObjectClass
C0750729
NCI Metathesaurus ObjectClass
CL219258
NCI Thesaurus Property
C25164
UMLS 2011AA Property
C0011008
NCI Thesaurus Property
C25431
UMLS 2011AA Property
C0439659
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
Dose Change from TAC Entered on Course Initiation CRF?
Description

PreviousDoseChangeIndicator

Data type

double

Alias
NCI Thesaurus ObjectClass
C25627
UMLS 2011AA ObjectClass
C0205156
NCI Thesaurus Property
C25446
UMLS 2011AA Property
C0392747
NCI Thesaurus ObjectClass
C25488
UMLS 2011AA ObjectClass
C0178602
Course Disposition (Select one of the following values:)
Description

CourseDisposition

Data type

text

Alias
NCI Thesaurus ObjectClass
C25379
UMLS 2011AA ObjectClass
C0750729
NCI Metathesaurus Property
C0743223
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ValueDomain
C25379
UMLS 2011AA ValueDomain
C0750729
NCI Thesaurus ValueDomain
C41205
UMLS 2011AA ValueDomain
C0743223
Response Assessment
Description

ResponseAssessmentType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C25755
UMLS 2011AA ObjectClass
C0871261
NCI Thesaurus Property
C25367
Response Note (Enter the reason why the Response Assessment is Not Evaluable NE or Not Assessed NA.)
Description

ResponseNoteText

Data type

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus Property
C25755
UMLS 2011AA Property
C0871261
NCI Thesaurus ObjectClass
C2991
UMLS 2011AA ObjectClass
C0012634
Date of Response (Note: The original date of onset of response should be used for responses that persist through several courses.)
Description

ResponseObservedDate

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C25755
UMLS 2011AA ObjectClass
C0871261
NCI Thesaurus Property
C15722
UMLS 2011AA Property
C0700325
Date of Progression
Description

ProgressionDate

Data type

date

Alias
NCI Thesaurus Property
C25164
UMLS 2011AA Property
C0011008
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C17747
UMLS 2011AA ObjectClass
C0242656
Any Adverse Events in this Course? (Note: The events must be recorded on the Adverse Events case report form.)
Description

AdverseEventOccurrenceIndicator

Data type

text

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
NCI Thesaurus ObjectClass
C41331
UMLS 2011AA ObjectClass
C0877248
NCI Metathesaurus Property
CL209504
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Similar models

No Instruction available.

1 forms
  1. StudyEvent: Course Assessment
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Course Assessment
FormCompletionDate
Item
Visit Date (Enter the date the course started.)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C40988 (NCI Thesaurus ObjectClass)
C1516308 (UMLS 2011AA ObjectClass)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
CourseStartDate
Item
Start Date of Course (Cycle)
date
C25379 (NCI Thesaurus ObjectClass)
C0750729 (UMLS 2011AA ObjectClass)
CL219258 (NCI Metathesaurus ObjectClass)
C25164 (NCI Thesaurus Property)
C0011008 (UMLS 2011AA Property)
C25431 (NCI Thesaurus Property)
C0439659 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
Item
Dose Change from TAC Entered on Course Initiation CRF?
double
C25627 (NCI Thesaurus ObjectClass)
C0205156 (UMLS 2011AA ObjectClass)
C25446 (NCI Thesaurus Property)
C0392747 (UMLS 2011AA Property)
C25488 (NCI Thesaurus ObjectClass)
C0178602 (UMLS 2011AA ObjectClass)
CL.1
Code List
Dose Change from TAC Entered on Course Initiation CRF?
CL Item
Yes, Planned (1)
CL Item
Yes, Unplanned (2)
CL Item
No (3)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Unknown (9)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Course Disposition (Select one of the following values:)
text
C25379 (NCI Thesaurus ObjectClass)
C0750729 (UMLS 2011AA ObjectClass)
C0743223 (NCI Metathesaurus Property)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C25379 (NCI Thesaurus ValueDomain)
C0750729 (UMLS 2011AA ValueDomain)
C41205 (NCI Thesaurus ValueDomain)
C0743223 (UMLS 2011AA ValueDomain)
CL.2
Code List
Course Disposition (Select one of the following values:)
CL Item
Completed (Completed)
CL Item
Discontinued (Discontinued)
C25484 (NCI Thesaurus)
C1444662 (UMLS 2011AA)
Item
Response Assessment
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C25755 (NCI Thesaurus ObjectClass)
C0871261 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
CL.3
Code List
Response Assessment
CL Item
Not Evauable (NE)
CL Item
Not Assessed (NA)
CL Item
Not Applicable Per Protocol (NP)
CL Item
Too Early (TE)
CL Item
Complete Response Unconfirmed (CRU)
CL Item
Complete Response (CR)
CL Item
Partial Response (PR)
C18212 (NCI Thesaurus)
CL Item
Less Than Partial Response (MR)
CL Item
Progressive Disease (PD)
C35571 (NCI Thesaurus)
C1335499 (UMLS 2011AA)
CL Item
Stable Disease (SD)
C18213 (NCI Thesaurus)
C0677946 (UMLS 2011AA)
CL Item
Disease Unchanged (DU)
ResponseNoteText
Item
Response Note (Enter the reason why the Response Assessment is Not Evaluable NE or Not Assessed NA.)
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
ResponseObservedDate
Item
Date of Response (Note: The original date of onset of response should be used for responses that persist through several courses.)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25755 (NCI Thesaurus ObjectClass)
C0871261 (UMLS 2011AA ObjectClass)
C15722 (NCI Thesaurus Property)
C0700325 (UMLS 2011AA Property)
ProgressionDate
Item
Date of Progression
date
C25164 (NCI Thesaurus Property)
C0011008 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C17747 (NCI Thesaurus ObjectClass)
C0242656 (UMLS 2011AA ObjectClass)
Item
Any Adverse Events in this Course? (Note: The events must be recorded on the Adverse Events case report form.)
text
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
CL209504 (NCI Metathesaurus Property)
CL.4
Code List
Any Adverse Events in this Course? (Note: The events must be recorded on the Adverse Events case report form.)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
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