ID
2202
Beschrijving
ECOG-E1505 Baseline Smoking Survey Chemotherapy With or Without Bevacizumab in Treating Patients With Stage IB, Stage II, or Stage IIIA Non-Small Lung Cancer That Was Removed By Surgery Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=080E30C9-4544-68FF-E044-0003BA3F9857
Link
Trefwoorden
Versies (5)
- 19-09-12 19-09-12 -
- 11-08-14 11-08-14 - Martin Dugas
- 11-08-14 11-08-14 - Martin Dugas
- 11-08-14 11-08-14 - Martin Dugas
- 09-01-15 09-01-15 - Martin Dugas
Geüploaded op
19 september 2012
DOI
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Licentie
Creative Commons BY-NC 3.0 Legacy
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Lung Cancer NCT00324805 Demographic - ECOG-E1505 Baseline Smoking Survey - 2438323v1.0
INSTRUCTIONS: Use this form to capture the first occurrence of non-protocol anti-tumor therapy per registration step
- StudyEvent: ECOG-E1505 Baseline Smoking Survey
Beschrijving
Unnamed2
Beschrijving
PatientInitialsName
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS 2011AA ValueDomain
- C1547383
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25536
- UMLS 2011AA Property
- C1555582
Beschrijving
ProtocolECOGIdentifierNumber
Datatype
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
- C25491
- UMLS 2011AA Property
- C1512162
Beschrijving
ProtocolParticipatingIdentifierNumber
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS 2011AA ValueDomain
- C0237753
- NCI Thesaurus ObjectClass
- C25320
- UMLS 2011AA ObjectClass
- C1507394
- NCI Thesaurus Property
- C25608
- UMLS 2011AA Property
- C0679823
- NCI Thesaurus Property
- C25364
- UMLS 2011AA Property
- C0600091
Beschrijving
CombinedInstitutionName
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C25454
- UMLS 2011AA ObjectClass
- C0205195
- NCI Thesaurus ObjectClass
- C21541
- UMLS 2011AA ObjectClass
- C0018704
- NCI Thesaurus Property
- C25364
- UMLS 2011AA Property
- C0600091
- NCI Thesaurus ValueDomain
- C25191
- UMLS 2011AA ValueDomain
- C1547383
- NCI Thesaurus ValueDomain
- C21541
- UMLS 2011AA ValueDomain
- C0018704
Beschrijving
PatientECOGIdentifierNumber
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS 2011AA ValueDomain
- C0237753
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25364
- UMLS 2011AA Property
- C0600091
- NCI Thesaurus Property
- C25491
- UMLS 2011AA Property
- C1512162
Beschrijving
PatientParticipatingIdentifierNumber
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS 2011AA ValueDomain
- C0237753
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25608
- UMLS 2011AA Property
- C0679823
- NCI Thesaurus Property
- C25364
- UMLS 2011AA Property
- C0600091
Beschrijving
Unnamed3
Beschrijving
DataAmendedText
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus ObjectClass
- C25474
- UMLS 2011AA ObjectClass
- C1511726
- NCI Thesaurus Property
- C25416
- UMLS 2011AA Property
- C1691222
Beschrijving
DataAmendedDate
Datatype
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C25474
- UMLS 2011AA ObjectClass
- C1511726
- NCI Thesaurus Property
- C25416
- UMLS 2011AA Property
- C1691222
- NCI Thesaurus ValueDomain
- C25367
Beschrijving
Unnamed4
Beschrijving
DataObtainedDate
Datatype
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C25474
- UMLS 2011AA ObjectClass
- C1511726
- NCI Thesaurus Property
- C52349
- UMLS 2011AA Property
- C1301820
Beschrijving
SmokingUseIndicator
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
- NCI Thesaurus ObjectClass
- C17934
- UMLS 2011AA ObjectClass
- C0453996
- NCI Thesaurus Property
- C25340
- UMLS 2011AA Property
- C0457083
Beschrijving
SmokingQuantityIndicator
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
- NCI Thesaurus ObjectClass
- C17934
- UMLS 2011AA ObjectClass
- C0453996
- NCI Thesaurus Property
- C25256
- UMLS 2011AA Property
- C1265611
Beschrijving
PatientInitialCigaretteSmokingAgeYearCount
Datatype
double
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25536
- UMLS 2011AA Property
- C1555582
- NCI Thesaurus Property
- C18270
- UMLS 2011AA Property
- C0700219
- NCI Thesaurus ValueDomain
- C29848
- UMLS 2011AA ValueDomain
- C0439234
- NCI Thesaurus ValueDomain
- C25463
- UMLS 2011AA ValueDomain
- C0750480
Beschrijving
SmokingCurrentUseIndicator
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
- NCI Thesaurus Property
- C25471
- UMLS 2011AA Property
- C0521116
- NCI Thesaurus ObjectClass
- C17934
- UMLS 2011AA ObjectClass
- C0453996
- NCI Metathesaurus Property
- C0449865
Beschrijving
PatientSmokingCessationAgeYear
Datatype
double
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus ValueDomain
- C29848
- UMLS 2011AA ValueDomain
- C0439234
- NCI Thesaurus ValueDomain
- C25463
- UMLS 2011AA ValueDomain
- C0750480
- NCI Metathesaurus Property
- C0085134
Beschrijving
PostDiagnosisSmokingEndUseIndicator
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C38008
- UMLS 2011AA ObjectClass
- C0687676
- NCI Thesaurus ObjectClass
- C15220
- UMLS 2011AA ObjectClass
- C0011900
- NCI Thesaurus ObjectClass
- C17934
- UMLS 2011AA ObjectClass
- C0453996
- NCI Thesaurus Property
- C25496
- UMLS 2011AA Property
- C2746065
- NCI Thesaurus Property
- C25340
- UMLS 2011AA Property
- C0457083
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Beschrijving
SmokingUseAverageNumber
Datatype
double
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS 2011AA ValueDomain
- C0237753
- NCI Thesaurus ObjectClass
- C17934
- UMLS 2011AA ObjectClass
- C0453996
- NCI Thesaurus Property
- C25340
- UMLS 2011AA Property
- C0457083
Beschrijving
CigarSmokingUseIndicator
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
- NCI Thesaurus ObjectClass
- C1813
- UMLS 2011AA ObjectClass
- C0182504
- NCI Thesaurus ObjectClass
- C17934
- UMLS 2011AA ObjectClass
- C0453996
- NCI Thesaurus Property
- C25340
- UMLS 2011AA Property
- C0457083
Beschrijving
CigarAverageDailyUseCount
Datatype
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
Beschrijving
Nic Alert Test Result
Beschrijving
LaboratoryProcedureCotinineResultInd-2
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
- NCI Thesaurus Property
- C20200
- UMLS 2011AA Property
- C1274040
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C70941
- UMLS 2011AA Property
- C0010194
Beschrijving
LaboratoryProcedureCotinineResultStatus
Datatype
text
Alias
- NCI Thesaurus Property
- C20200
- UMLS 2011AA Property
- C1274040
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus ValueDomain
- C25688
- UMLS 2011AA ValueDomain
- C0449438
- NCI Thesaurus Property
- C70941
- UMLS 2011AA Property
- C0010194
Beschrijving
LaboratoryProcedureCotinineResultDate
Datatype
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus Property
- C20200
- UMLS 2011AA Property
- C1274040
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C70941
- UMLS 2011AA Property
- C0010194
Beschrijving
Comments
Beschrijving
InvestigatorSignatureText
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus Property
- C25678
- UMLS 2011AA Property
- C1519316
- NCI Thesaurus ObjectClass
- C17089
- UMLS 2011AA ObjectClass
- C0035173
Beschrijving
InvestigatorSignatureDate
Datatype
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus Property
- C25678
- UMLS 2011AA Property
- C1519316
- NCI Thesaurus ValueDomain
- C25367
- NCI Thesaurus ObjectClass
- C17089
- UMLS 2011AA ObjectClass
- C0035173
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