ID

22133

Description

Study part: Follow-up survival form. A phase III multinational, randomized, single-blind study of recombinant humanized anti-p185HER2 monoclonal antibody (rhuMAb HER2) in patients with HER2/neu overexpression who have not received prior cytotoxic chemotherapy for metastatic breast cancer. "Terms of use: You may not use this document or the information contained herein to a regulatory authority in connection with an application for a marketing authorization or any other regulatory submission without the express written consent of Roche"

Keywords

Versions (1)
  1. 5/20/17 5/20/17 -
Copyright Holder

Roche

Uploaded on

May 20, 2017

DOI

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License

Creative Commons BY-NC 3.0
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FOLLOW-UP SURVIVAL FORM Roche H0650g Breast Cancer

English

FOLLOW-UP SURVIVAL FORM

1 forms  
FOLLOW-UP SURVIVAL FORM
Description

FOLLOW-UP SURVIVAL FORM

Alias
UMLS CUI-1
C1522577
PATIENT INT.
Description

Patient initial

Data type

text

Alias
UMLS CUI [1]
C2986440
PATIENT NUMBER
Description

Patient id

Data type

integer

Alias
UMLS CUI [1]
C1269815
FOLLOW-UP MONTH
Description

(FROM FOLLOW-UP WORKSHEET)

Data type

text

Alias
UMLS CUI [1,1]
C0439231
UMLS CUI [1,2]
C1522577
PATIENT STATUS
Description

Patient status

Data type

text

Alias
UMLS CUI [1]
C0449437
DATE OF STATUS:
Description

(IF ALIVE OR LOST TO FOLLOW-UP. LAST DATE KNOWN ALIVE; IF DIED AND NO DEATH REPORT. DATE OF DEATH)

Data type

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C0449437
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Similar models

FOLLOW-UP SURVIVAL FORM

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
FOLLOW-UP SURVIVAL FORM
C1522577 (UMLS CUI-1)
Patient initial
Item
PATIENT INT.
text
C2986440 (UMLS CUI [1])
Patient id
Item
PATIENT NUMBER
integer
C1269815 (UMLS CUI [1])
month follow-up
Item
FOLLOW-UP MONTH
text
C0439231 (UMLS CUI [1,1])
C1522577 (UMLS CUI [1,2])
Item
PATIENT STATUS
text
C0449437 (UMLS CUI [1])
Patient status
Code List
PATIENT STATUS
CL Item
ALIVE  (1)
CL Item
DEAD (PLEASE COMPLETE STUDY PATIENT DEATH REPORT FORM)  (2)
CL Item
UNKNOWN (LOST TO FOLLOW-UP) (3)
date Patient status
Item
DATE OF STATUS:
date
C0011008 (UMLS CUI [1,1])
C0449437 (UMLS CUI [1,2])
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