ID

1718

Descripción

Follow-Up form for C3D 3.12 Adopters Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=015F32CE-0D72-1F20-E044-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=015F32CE-0D72-1F20-E044-0003BA3F9857

Palabras clave

Versiones (2)
  1. 19/9/12 19/9/12 -
  2. 15/7/17 15/7/17 - Martin Dugas
Subido en

19 de septiembre de 2012

DOI

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Licencia

Creative Commons BY-NC 3.0
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Follow-Up - FOLLOW-UP - 2407559v1.0

Inglés

Dates will appear as 'DD-MON-YYYY'

1 formularios  
Follow-up
Descripción

Follow-up

Last Contact Date
Descripción

LastContactDate

Tipo de datos

date

Alias
NCI Thesaurus Property
C25164
UMLS 2011AA Property
C0011008
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C47954
UMLS 2011AA ObjectClass
C1705415
NCI Thesaurus ObjectClass
C25551
UMLS 2011AA ObjectClass
C1517741
Patient Contact Type
Descripción

PatientContactType

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25461
UMLS 2011AA Property
C0337611
Treatment Since Last Contact Indicator
Descripción

TreatmentSinceLastContactIndicator

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
NCI Thesaurus ObjectClass
C15368
NCI Thesaurus Property
C25461
UMLS 2011AA Property
C0337611
NCI Thesaurus ObjectClass
C25551
UMLS 2011AA ObjectClass
C1517741
Patient Survival Status
Descripción

PatientSurvivalStatus

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25162
UMLS 2011AA ValueDomain
C0805701
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25688
UMLS 2011AA Property
C0449438
Survival Status, unknown explanation
Descripción

SurvivalStatus,unknownexplanation

Tipo de datos

text

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25688
UMLS 2011AA Property
C0449438
NCI Thesaurus ValueDomain
C45255
UMLS 2011AA ValueDomain
C1708523
NCI Thesaurus ValueDomain
C42614
UMLS 2011AA ValueDomain
C0027365
NCI Thesaurus ValueDomain
C68805
UMLS 2011AA ValueDomain
C2350015
Comments
Descripción

Comments

Note Date
Descripción

NoteDate

Tipo de datos

date

Alias
NCI Thesaurus Property
C25164
UMLS 2011AA Property
C0011008
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Metathesaurus ObjectClass
C1317574
Research Comments Text
Descripción

ResearchCommentsText

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus ObjectClass
C15319
NCI Thesaurus Property
C25393
UMLS 2011AA Property
C0282411
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Similar models

Dates will appear as 'DD-MON-YYYY'

1 formularios
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
Follow-up
LastContactDate
Item
Last Contact Date
date
C25164 (NCI Thesaurus Property)
C0011008 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C47954 (NCI Thesaurus ObjectClass)
C1705415 (UMLS 2011AA ObjectClass)
C25551 (NCI Thesaurus ObjectClass)
C1517741 (UMLS 2011AA ObjectClass)
Item
Patient Contact Type
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25461 (NCI Thesaurus Property)
C0337611 (UMLS 2011AA Property)
CL.1
Code List
Patient Contact Type
CL Item
Clinic Appointment (Clinic Appointment)
CL Item
Email Contact With Patient (Email Contact w/Patient)
CL Item
Mail Contact With Patient (Mail Contact w/Patient)
CL Item
Social Security Death Index (ssdi) (Social Security Death Index (SSDI))
CL Item
Telephone Contact With Patient (Telephone Contact w/Patient)
CL Item
Telephone Contact With Patient's Family (Telephone Contact w/Patient's Family)
CL Item
Telephone Contact With Patient's Local Physician (Telephone Contact w/Patient's Local Physician)
Item
Treatment Since Last Contact Indicator
text
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C15368 (NCI Thesaurus ObjectClass)
C25461 (NCI Thesaurus Property)
C0337611 (UMLS 2011AA Property)
C25551 (NCI Thesaurus ObjectClass)
C1517741 (UMLS 2011AA ObjectClass)
CL.2
Code List
Treatment Since Last Contact Indicator
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
Patient Survival Status
text
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25688 (NCI Thesaurus Property)
C0449438 (UMLS 2011AA Property)
CL.3
Code List
Patient Survival Status
CL Item
Alive With Disease (1)
CL Item
Alive With No Evidence Of Disease (2)
CL Item
Alive Disease Status Unknown (3)
CL Item
Unknown (4)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
CL Item
Died (5)
SurvivalStatus,unknownexplanation
Item
Survival Status, unknown explanation
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25688 (NCI Thesaurus Property)
C0449438 (UMLS 2011AA Property)
C45255 (NCI Thesaurus ValueDomain)
C1708523 (UMLS 2011AA ValueDomain)
C42614 (NCI Thesaurus ValueDomain)
C0027365 (UMLS 2011AA ValueDomain)
C68805 (NCI Thesaurus ValueDomain)
C2350015 (UMLS 2011AA ValueDomain)
Item Group
Comments
NoteDate
Item
Note Date
date
C25164 (NCI Thesaurus Property)
C0011008 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C1317574 (NCI Metathesaurus ObjectClass)
ResearchCommentsText
Item
Research Comments Text
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C0282411 (UMLS 2011AA Property)
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