ID
1707
Beskrivning
GOG-0252 Medical History Form (Form MEDH) Bevacizumab and Intravenous or Intraperitoneal Chemotherapy in Treating Patients With Stage II, Stage III, or Stage IV Ovarian Epithelial Cancer, Fallopian Tube Cancer, or Primary Peritoneal Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=62A7BF0E-D4CA-903B-E040-BB89AD43563B
Länk
Nyckelord
Versioner (4)
- 2012-09-19 2012-09-19 -
- 2014-08-11 2014-08-11 - Martin Dugas
- 2014-08-11 2014-08-11 - Martin Dugas
- 2015-01-09 2015-01-09 - Martin Dugas
Uppladdad den
19 september 2012
DOI
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Licens
Creative Commons BY-NC 3.0 Legacy
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Fallopian Tube Cancer NCT00951496 Pre-Study - GOG-0252 Medical History Form (Form MEDH) - 2838693v1.0
No Instruction available.
- StudyEvent: GOG-0252 Medical History Form (Form MEDH)
Beskrivning
Ovarian: Disease Description
Beskrivning
PersonHypertensionTherapeuticProcedurePersonalMedicalHistoryIndicator
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus Property
- C3117
- UMLS 2011AA Property
- C0020538
- NCI Thesaurus Property
- C49236
- UMLS 2011AA Property
- C0087111
- NCI Thesaurus Property
- C18772
- UMLS 2011AA Property
- C0262926
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Beskrivning
HistoryofPeripheralVascularDiseasePresentInd-3
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
- NCI Thesaurus Property
- C25626
- UMLS 2011AA Property
- C0150312
- NCI Thesaurus ObjectClass
- C66923
- UMLS 2011AA ObjectClass
- C1881056
Beskrivning
PatientCerebrovascularAccidentMyocardialInfarctionPersonalMedicalHistoryInd-3
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C27996
- UMLS 2011AA Property
- C0027051
- NCI Thesaurus Property
- C3390
- UMLS 2011AA Property
- C0038454
- NCI Thesaurus Property
- C18772
- UMLS 2011AA Property
- C0262926
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
Beskrivning
SmokingCurrentUseInd-3
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
- NCI Thesaurus Property
- C25471
- UMLS 2011AA Property
- C0521116
- NCI Thesaurus ObjectClass
- C17934
- UMLS 2011AA ObjectClass
- C0453996
- NCI Metathesaurus Property
- C0449865
Beskrivning
CigaretteAverageDailyPackUseCount
Datatyp
double
Alias
- NCI Thesaurus ObjectClass
- C1802
- UMLS 2011AA ObjectClass
- C0677453
- NCI Thesaurus Property
- C25473
- UMLS 2011AA Property
- C0332173
- NCI Thesaurus Property
- C62653
- UMLS 2011AA Property
- C2825051
- NCI Thesaurus Property
- C37917
- UMLS 2011AA Property
- C1510992
- NCI Thesaurus Property
- C25340
- UMLS 2011AA Property
- C0457083
- NCI Thesaurus ValueDomain
- C25463
- UMLS 2011AA ValueDomain
- C0750480
Beskrivning
CigarAverageDailyUseCount
Datatyp
double
Alias
- NCI Thesaurus ObjectClass
- C1813
- UMLS 2011AA ObjectClass
- C0182504
- NCI Thesaurus Property
- C25473
- UMLS 2011AA Property
- C0332173
- NCI Thesaurus Property
- C37917
- UMLS 2011AA Property
- C1510992
- NCI Thesaurus Property
- C25340
- UMLS 2011AA Property
- C0457083
- NCI Thesaurus ValueDomain
- C25463
- UMLS 2011AA ValueDomain
- C0750480
Beskrivning
SmokingDurationCount
Datatyp
double
Alias
- NCI Thesaurus ValueDomain
- C25463
- UMLS 2011AA ValueDomain
- C0750480
- NCI Thesaurus ObjectClass
- C17934
- UMLS 2011AA ObjectClass
- C0453996
- NCI Thesaurus Property
- C25330
- UMLS 2011AA Property
- C0449238
Beskrivning
PersonDiabetesMellitusTherapeuticProcedurePersonalMedicalHistoryIndicator
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus Property
- C2985
- UMLS 2011AA Property
- C0011849
- NCI Thesaurus Property
- C49236
- UMLS 2011AA Property
- C0087111
- NCI Thesaurus Property
- C18772
- UMLS 2011AA Property
- C0262926
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Beskrivning
Ovarian: Findings From Primary Surgery
Beskrivning
DiseasesandDisordersPatientSelf-ReportAutoimmuneDiseaseDiagnosisInd-3
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C2991
- UMLS 2011AA ObjectClass
- C0012634
- NCI Thesaurus Property
- C15220
- UMLS 2011AA Property
- C0011900
- NCI Thesaurus Property
- C2889
- UMLS 2011AA Property
- C0004364
- NCI Thesaurus Property
- C21089
- UMLS 2011AA Property
- C0681906
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
Beskrivning
Ovarian: Post-operative Findings Following Primary Surgery
Beskrivning
PatientUlcerationPersonalMedicalHistoryInd-3
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C18772
- UMLS 2011AA Property
- C0262926
- NCI Thesaurus Property
- C25757
- UMLS 2011AA Property
- C0041582
Beskrivning
TumorIntestinalObstructionInd-3
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
- NCI Thesaurus ObjectClass
- C3262
- UMLS 2011AA ObjectClass
- C0027651
- NCI Thesaurus Property
- C25266
- UMLS 2011AA Property
- C0021853
- NCI Thesaurus Property
- C3284
- UMLS 2011AA Property
- C0028778
Beskrivning
PatientInflammatoryBowelDiseasePersonalMedicalHistoryIndicator
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C3138
- UMLS 2011AA Property
- C0021390
- NCI Thesaurus Property
- C18772
- UMLS 2011AA Property
- C0262926
Beskrivning
PatientInflammatoryBowelDiseaseTreatmentPersonalMedicalHistoryInd-2
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C15368
- NCI Thesaurus Property
- C3138
- UMLS 2011AA Property
- C0021390
- NCI Thesaurus Property
- C18772
- UMLS 2011AA Property
- C0262926
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Beskrivning
PatientDiverticulitisTreatmentPersonalMedicalHistoryInd-2
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C15368
- NCI Thesaurus Property
- C18772
- UMLS 2011AA Property
- C0262926
- NCI Thesaurus Property
- C26752
- UMLS 2011AA Property
- C0012813
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Beskrivning
PatientC.DifficileColitisPersonalMedicalHistoryInd-2
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C18772
- UMLS 2011AA Property
- C0262926
- NCI Thesaurus Property
- C35286
- UMLS 2011AA Property
- C0238106
Beskrivning
PatientSmallIntestineExcisionAnastomosisPersonalMedicalHistoryInd-2
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C12386
- UMLS 2011AA Property
- C0021852
- NCI Thesaurus Property
- C15609
- UMLS 2011AA Property
- C0677554
- NCI Thesaurus Property
- C15232
- UMLS 2011AA Property
- C0728940
- NCI Thesaurus Property
- C18772
- UMLS 2011AA Property
- C0262926
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Beskrivning
PatientSmallBowelExcisionAnastomosisDebulkingPersonalMedicalHistoryInd-2
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C12386
- UMLS 2011AA Property
- C0021852
- NCI Thesaurus Property
- C15609
- UMLS 2011AA Property
- C0677554
- NCI Thesaurus Property
- C15232
- UMLS 2011AA Property
- C0728940
- NCI Thesaurus Property
- C18772
- UMLS 2011AA Property
- C0262926
- NCI Thesaurus Property
- C15749
- UMLS 2011AA Property
- C0439805
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Beskrivning
PatientLargeIntestineExcisionAnastomosisPersonalMedicalHistoryInd-2
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C15609
- UMLS 2011AA Property
- C0677554
- NCI Thesaurus Property
- C12379
- UMLS 2011AA Property
- C0021851
- NCI Thesaurus Property
- C15232
- UMLS 2011AA Property
- C0728940
- NCI Thesaurus Property
- C18772
- UMLS 2011AA Property
- C0262926
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Beskrivning
PatientLargeIntestineExcisionAnastomosisDebulkingPersonalMedicalHistoryInd-2
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C15609
- UMLS 2011AA Property
- C0677554
- NCI Thesaurus Property
- C12379
- UMLS 2011AA Property
- C0021851
- NCI Thesaurus Property
- C15232
- UMLS 2011AA Property
- C0728940
- NCI Thesaurus Property
- C18772
- UMLS 2011AA Property
- C0262926
- NCI Thesaurus Property
- C15749
- UMLS 2011AA Property
- C0439805
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Beskrivning
Footer Module
Beskrivning
PatientCorticosteroidUsePersonalMedicalHistoryInd-2
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C2322
- UMLS 2011AA Property
- C0001617
- NCI Thesaurus Property
- C18772
- UMLS 2011AA Property
- C0262926
- NCI Thesaurus Property
- C25340
- UMLS 2011AA Property
- C0457083
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Beskrivning
PatientNonsteroidalAntiinflammatoryDrugRegularUsePersonalMedicalHistoryInd-2
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C18772
- UMLS 2011AA Property
- C0262926
- NCI Thesaurus Property
- C257
- UMLS 2011AA Property
- C0003211
- NCI Thesaurus Property
- C25340
- UMLS 2011AA Property
- C0457083
- NCI Thesaurus Property
- C25647
- UMLS 2011AA Property
- C0205272
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Beskrivning
Comments
Similar models
No Instruction available.
- StudyEvent: GOG-0252 Medical History Form (Form MEDH)
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C1705108 (UMLS 2011AA)
C1512699 (UMLS 2011AA ValueDomain)
C25471 (NCI Thesaurus Property)
C0521116 (UMLS 2011AA Property)
C17934 (NCI Thesaurus ObjectClass)
C0453996 (UMLS 2011AA ObjectClass)
C0449865 (NCI Metathesaurus Property)
C1298908 (UMLS 2011AA)
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C0750480 (UMLS 2011AA ValueDomain)
C0182504 (UMLS 2011AA ObjectClass)
C25473 (NCI Thesaurus Property)
C0332173 (UMLS 2011AA Property)
C37917 (NCI Thesaurus Property)
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C0453996 (UMLS 2011AA ObjectClass)
C25330 (NCI Thesaurus Property)
C0449238 (UMLS 2011AA Property)
C0027361 (UMLS 2011AA ObjectClass)
C2985 (NCI Thesaurus Property)
C0011849 (UMLS 2011AA Property)
C49236 (NCI Thesaurus Property)
C0087111 (UMLS 2011AA Property)
C18772 (NCI Thesaurus Property)
C0262926 (UMLS 2011AA Property)
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C1298908 (UMLS 2011AA)
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C0030705 (UMLS 2011AA ObjectClass)
C3138 (NCI Thesaurus Property)
C0021390 (UMLS 2011AA Property)
C18772 (NCI Thesaurus Property)
C0262926 (UMLS 2011AA Property)
C1298908 (UMLS 2011AA)
C0030705 (UMLS 2011AA ObjectClass)
C15368 (NCI Thesaurus Property)
C3138 (NCI Thesaurus Property)
C0021390 (UMLS 2011AA Property)
C18772 (NCI Thesaurus Property)
C0262926 (UMLS 2011AA Property)
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C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
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C18772 (NCI Thesaurus Property)
C0262926 (UMLS 2011AA Property)
C26752 (NCI Thesaurus Property)
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C1512698 (UMLS 2011AA ValueDomain)
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C0728940 (UMLS 2011AA Property)
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C15749 (NCI Thesaurus Property)
C0439805 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0030705 (UMLS 2011AA ObjectClass)
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C12379 (NCI Thesaurus Property)
C0021851 (UMLS 2011AA Property)
C15232 (NCI Thesaurus Property)
C0728940 (UMLS 2011AA Property)
C18772 (NCI Thesaurus Property)
C0262926 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0030705 (UMLS 2011AA ObjectClass)
C15609 (NCI Thesaurus Property)
C0677554 (UMLS 2011AA Property)
C12379 (NCI Thesaurus Property)
C0021851 (UMLS 2011AA Property)
C15232 (NCI Thesaurus Property)
C0728940 (UMLS 2011AA Property)
C18772 (NCI Thesaurus Property)
C0262926 (UMLS 2011AA Property)
C15749 (NCI Thesaurus Property)
C0439805 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0030705 (UMLS 2011AA ObjectClass)
C2322 (NCI Thesaurus Property)
C0001617 (UMLS 2011AA Property)
C18772 (NCI Thesaurus Property)
C0262926 (UMLS 2011AA Property)
C25340 (NCI Thesaurus Property)
C0457083 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0030705 (UMLS 2011AA ObjectClass)
C18772 (NCI Thesaurus Property)
C0262926 (UMLS 2011AA Property)
C257 (NCI Thesaurus Property)
C0003211 (UMLS 2011AA Property)
C25340 (NCI Thesaurus Property)
C0457083 (UMLS 2011AA Property)
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C0205272 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
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C1705108 (UMLS 2011AA)
C1527021 (UMLS 2011AA ValueDomain)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C0282411 (UMLS 2011AA Property)