ID

18807

Description

USMCI 8214/Z6091: SF-36 Patient Self Assessment Questionnaire NCT01167725 Standard Therapy With or Without Surgery and Mitomycin C in Treating Patients With Advanced Limited Peritoneal Dissemination of Colon Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=665C50CD-E1EF-DFF5-E040-BB89AD43117E

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=665C50CD-E1EF-DFF5-E040-BB89AD43117E

Keywords

Versions (1)
  1. 11/21/16 11/21/16 -
Uploaded on

November 21, 2016

DOI

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License

Creative Commons BY-NC 3.0
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USMCI 8214/Z6091: SF-36 Patient Self Assessment Questionnaire NCT01167725

German English

No Instruction available.

1 forms  
  1. StudyEvent: USMCI 8214/Z6091: SF-36 Patient Self Assessment Questionnaire
    1. No Instruction available.
Header Module
Description

Header Module

Patient ID
Description

Patient Study ID

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C2348585
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25462
NCI Thesaurus Property-2
C25364
Institution No.
Description

Institution Number

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C1301943
NCI Thesaurus ObjectClass
C21541
UMLS CUI-2
C0805701
NCI Thesaurus Property
C25364
Protocol No.
Description

ProtocolUnitedStatesMilitaryCancerInstituteIdentifierNumber

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C25320
UMLS 2011AA ObjectClass
C1507394
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus Property-2
C68638
UMLS 2011AA Property-2
C0026126
Patient Initials
Description

Patient Initials

Data type

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C2986440
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25536
SF36v2
Description

SF36v2

Alias
UMLS CUI-1
C1512346
UMLS CUI-2
C3640521
Visit Number
Description

Visit Number

Data type

integer

Alias
UMLS CUI [1]
C1549755
SF36 Score
Description

SF36 Score

Data type

text

Alias
UMLS CUI [1,1]
C3640521
UMLS CUI [1,2]
C0449820
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Similar models

No Instruction available.

1 forms
  1. StudyEvent: USMCI 8214/Z6091: SF-36 Patient Self Assessment Questionnaire
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Header Module
Patient Study ID
Item
Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25462 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
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)
ProtocolUnitedStatesMilitaryCancerInstituteIdentifierNumber
Item
Protocol No.
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C25320 (NCI Thesaurus ObjectClass)
C1507394 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C68638 (NCI Thesaurus Property-2)
C0026126 (UMLS 2011AA Property-2)
Patient Initials
Item
Patient Initials
text
C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
Item Group
SF36v2
C1512346 (UMLS CUI-1)
C3640521 (UMLS CUI-2)
Visit Number
Item
Visit Number
integer
C1549755 (UMLS CUI [1])
SF36 Score
Item
SF36 Score
text
C3640521 (UMLS CUI [1,1])
C0449820 (UMLS CUI [1,2])
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