ID

22280

Beskrivning

Study part: Tumor Assessment Worksheet & Tumor Assessment. 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"

Nyckelord

Versioner (1)
  1. 2017-05-29 2017-05-29 -
Rättsinnehavare

Roche

Uppladdad den

29 maj 2017

DOI

För en begäran logga in.

Licens

Creative Commons BY-NC 3.0
Modellkommentarer :

Här kan du kommentera modellen. Med hjälp av pratbubblor i Item-grupperna och Item kan du lägga in specifika kommentarer.

Tillbaka till modellkommentarer
Itemgroup-kommentar för :

Item-kommentar för :

Du måste vara inloggad för att kunna ladda ner formulär. Var vänlig logga in eller registrera dig utan kostnad.

TUMOR ASSESSMENT WORKSHEET & TUMOR ASSESSMENT Roche H0650g Breast Cancer

Engelsk

TUMOR ASSESSMENT WORKSHEET & TUMOR ASSESSMENT

1 Formulär  
TUMOR LOCATION
Beskrivning

TUMOR LOCATION

Alias
UMLS CUI-1
C0872338
PATIENT INT.
Beskrivning

Patient initial

Datatyp

text

Alias
UMLS CUI [1]
C2986440
PATIENT NUMBER
Beskrivning

Patient id

Datatyp

integer

Alias
UMLS CUI [1]
C2348585
CHEST WALL
Beskrivning

chest wall

Datatyp

text

Alias
UMLS CUI [1]
C0205076
ABDOMEN
Beskrivning

Abdomen

Datatyp

text

Alias
UMLS CUI [1]
C0000726
LIVER
Beskrivning

Liver

Datatyp

text

Alias
UMLS CUI [1]
C0023884
LUNGS
Beskrivning

Lungs

Datatyp

text

Alias
UMLS CUI [1]
C0024109
TUMOR ASSESSMENT
Beskrivning

TUMOR ASSESSMENT

Alias
UMLS CUI-1
C3889740
A. COMPLETE TUMOR ASSESSMENT WORKSHEET
Beskrivning

worksheet tumor assessment

Datatyp

boolean

Alias
UMLS CUI [1,1]
C2349155
UMLS CUI [1,2]
C3889740
B. DATE OF ASSESSMENT WHICH DETERMINED OVERALL RESPONSE/PROGRESSION·
Beskrivning

IN THE CASE OF PROGRESSIVE DISEASE. USE THE EARLIEST DATE THE PROGRESSION WAS DIAGNOSED. IN ALL OTHER CASES. THE DATE OF THE LAST ASSESSMENT (1.e., CT. X-RAY, ETC.) PERFORMED SHOULD BE RECORDED.

Datatyp

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C3889740
C. METHOD(S) OF ASSESSMENT USED: X-RAY
Beskrivning

X-ray

Datatyp

boolean

Alias
UMLS CUI [1]
C0043309
C. METHOD(S) OF ASSESSMENT USED: CT CHEST
Beskrivning

CT chest

Datatyp

boolean

Alias
UMLS CUI [1]
C0202823
C. METHOD(S) OF ASSESSMENT USED: CT ABDOMEN
Beskrivning

CT Abdomen

Datatyp

boolean

Alias
UMLS CUI [1]
C0412620
C. METHOD(S) OF ASSESSMENT USED: MRI
Beskrivning

MRI

Datatyp

boolean

Alias
UMLS CUI [1]
C0024485
C. METHOD(S) OF ASSESSMENT USED: ULTRASOUND
Beskrivning

ULTRASOUND

Datatyp

boolean

Alias
UMLS CUI [1]
C0041618
C. METHOD(S) OF ASSESSMENT USED: PHOTOGRAPH
Beskrivning

PHOTOGRAPH

Datatyp

boolean

Alias
UMLS CUI [1]
C0441468
C. METHOD(S) OF ASSESSMENT USED: PHYSICAL EXAMINATION
Beskrivning

PHYSICAL EXAMINATION

Datatyp

boolean

Alias
UMLS CUI [1]
C0031809
C. METHOD(S) OF ASSESSMENT USED: OTHER
Beskrivning

other

Datatyp

text

Alias
UMLS CUI [1]
C0205394
D INVESTIGATOR ASSESSMENT OF OVERALL RESPONSE (CHECK ONE):
Beskrivning

tumor response

Datatyp

integer

Alias
UMLS CUI [1]
C3539879
E. SITES OF PROGRESSION: BONE
Beskrivning

Tumor site Tumor Progression bone

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0475445
UMLS CUI [1,2]
C0178874
UMLS CUI [1,3]
C0262950
E. SITES OF PROGRESSION: LIVER
Beskrivning

Tumor site Tumor Progression Liver

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0475445
UMLS CUI [1,2]
C0178874
UMLS CUI [1,3]
C0023884
E. SITES OF PROGRESSION: LUNG
Beskrivning

Tumor site Tumor Progression LUNG

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0475445
UMLS CUI [1,2]
C0178874
UMLS CUI [1,3]
C0024109
E. SITES OF PROGRESSION: DISTAL LYMPH NODES
Beskrivning

Tumor site Tumor Progression LYMPH NODES

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0475445
UMLS CUI [1,2]
C0178874
UMLS CUI [1,3]
C0024204
E. SITES OF PROGRESSION: REGIONAL LYMPH NODES
Beskrivning

Tumor site Tumor Progression REGIONAL LYMPH NODES

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0475445
UMLS CUI [1,2]
C0178874
UMLS CUI [1,3]
C0807729
E. SITES OF PROGRESSION: CHEST WALL
Beskrivning

Tumor site Tumor Progression CHEST WALL

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0475445
UMLS CUI [1,2]
C0178874
UMLS CUI [1,3]
C0205076
E. SITES OF PROGRESSION: ABDOMEN
Beskrivning

Tumor site Tumor Progression abdomen

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0475445
UMLS CUI [1,2]
C0178874
UMLS CUI [1,3]
C0000726
E. SITES OF PROGRESSION: MEDIASTINUM
Beskrivning

Tumor site Tumor Progression Mediastinum

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0475445
UMLS CUI [1,2]
C0178874
UMLS CUI [1,3]
C0025066
E. SITES OF PROGRESSION: CNS
Beskrivning

Tumor site Tumor Progression CNS

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0475445
UMLS CUI [1,2]
C0178874
UMLS CUI [1,3]
C3714787
E. SITES OF PROGRESSION: OTHER
Beskrivning

Tumor site Tumor Progression Other

Datatyp

text

Alias
UMLS CUI [1,1]
C0475445
UMLS CUI [1,2]
C0178874
UMLS CUI [1,3]
C0205394
TUMOR LOCATION
Beskrivning

TUMOR LOCATION

Alias
UMLS CUI-1
C0872338
LYMPH NODES
Beskrivning

LYMPH NODES

Datatyp

text

Alias
UMLS CUI [1]
C0024204
BONE
Beskrivning

BONE

Datatyp

text

Alias
UMLS CUI [1]
C0262950
ABDOMEN
Beskrivning

ABDOMEN

Datatyp

text

Alias
UMLS CUI [1]
C0000726
OTHER
Beskrivning

OTHER

Datatyp

text

Alias
UMLS CUI [1]
C0205394
TUMOR ASSESSMENT WORKSHEET
Beskrivning

TUMOR ASSESSMENT WORKSHEET

Alias
UMLS CUI-1
C2349155
UMLS CUI-2
C3889740
LESION NUMBER
Beskrivning

Lesion number

Datatyp

integer

Alias
UMLS CUI [1]
C0449791
SITE OF LESION
Beskrivning

tumor site

Datatyp

integer

Alias
UMLS CUI [1]
C0475445
IF "OTHER" SITE, DESCRIBE:
Beskrivning

other

Datatyp

text

Alias
UMLS CUI [1]
C0205394
DATE OF ASSESSMENT PROCEDURE:
Beskrivning

Date Tumor assessment

Datatyp

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C3889740
METHOD OF ASSESSMENT
Beskrivning

METHOD OF ASSESSMENT

Datatyp

integer

Alias
UMLS CUI [1]
C2598110
IF "OTHER" METHOD, DESCRIBE:
Beskrivning

other

Datatyp

text

Alias
UMLS CUI [1]
C0205394
SIZE OF LESION
Beskrivning

lesion size

Datatyp

text

Måttenheter
  • cm x cm
Alias
UMLS CUI [1]
C0449453
cm x cm
MEASURABLE?
Beskrivning

Lesion size Measurable

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0449453
UMLS CUI [1,2]
C1513040
Tillbaka till toppen

Similar models

TUMOR ASSESSMENT WORKSHEET & TUMOR ASSESSMENT

1 Formulär
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
TUMOR LOCATION
C0872338 (UMLS CUI-1)
Patient initial
Item
PATIENT INT.
text
C2986440 (UMLS CUI [1])
Patient id
Item
PATIENT NUMBER
integer
C2348585 (UMLS CUI [1])
chest wall
Item
CHEST WALL
text
C0205076 (UMLS CUI [1])
Abdomen
Item
ABDOMEN
text
C0000726 (UMLS CUI [1])
Liver
Item
LIVER
text
C0023884 (UMLS CUI [1])
Lungs
Item
LUNGS
text
C0024109 (UMLS CUI [1])
Item Group
TUMOR ASSESSMENT
C3889740 (UMLS CUI-1)
worksheet tumor assessment
Item
A. COMPLETE TUMOR ASSESSMENT WORKSHEET
boolean
C2349155 (UMLS CUI [1,1])
C3889740 (UMLS CUI [1,2])
date Tumor assessment
Item
B. DATE OF ASSESSMENT WHICH DETERMINED OVERALL RESPONSE/PROGRESSION·
date
C0011008 (UMLS CUI [1,1])
C3889740 (UMLS CUI [1,2])
X-ray
Item
C. METHOD(S) OF ASSESSMENT USED: X-RAY
boolean
C0043309 (UMLS CUI [1])
CT chest
Item
C. METHOD(S) OF ASSESSMENT USED: CT CHEST
boolean
C0202823 (UMLS CUI [1])
CT Abdomen
Item
C. METHOD(S) OF ASSESSMENT USED: CT ABDOMEN
boolean
C0412620 (UMLS CUI [1])
MRI
Item
C. METHOD(S) OF ASSESSMENT USED: MRI
boolean
C0024485 (UMLS CUI [1])
ULTRASOUND
Item
C. METHOD(S) OF ASSESSMENT USED: ULTRASOUND
boolean
C0041618 (UMLS CUI [1])
PHOTOGRAPH
Item
C. METHOD(S) OF ASSESSMENT USED: PHOTOGRAPH
boolean
C0441468 (UMLS CUI [1])
PHYSICAL EXAMINATION
Item
C. METHOD(S) OF ASSESSMENT USED: PHYSICAL EXAMINATION
boolean
C0031809 (UMLS CUI [1])
other
Item
C. METHOD(S) OF ASSESSMENT USED: OTHER
text
C0205394 (UMLS CUI [1])
Item
D INVESTIGATOR ASSESSMENT OF OVERALL RESPONSE (CHECK ONE):
integer
C3539879 (UMLS CUI [1])
tumor response
Code List
D INVESTIGATOR ASSESSMENT OF OVERALL RESPONSE (CHECK ONE):
CL Item
COMPLETE RESPONSE: DISAPPEARANCE OF ALL RADIOGRAPHICALLY AND/OR VISUALLY APPARENT TUMOR. COMPLETE RESPONSE OF SKIN AND CHEST WALL MUST BE CONFIRMED BY BIOPSY.  (1)
CL Item
PARTIAL RESPONSE: REDUCTION OF AT LEAST 50% IN THE SUM OF THE PRODUCTS OF THE PERPENDICULAR DIAMETERS OF ALL MEASURABLE LESIONS. NO NEW LESIONS MAY HAVE APPEARED, NOR MAY ANY LESION HAVE PROGRESSED IN SIZE.  (2)
CL Item
MINOR RESPONSE: REDUCTION OF 25% TO 49% IN THE SUM OF THE PRODUCTS OF THE PERPENDICULAR DIAMETERS OF ALL MEASURABLE LESIONS. NO NEW LESIONS MAY HAVE APPEARED. NOR MAY ANY LESION HAVE PROGRESSED IN SIZE.  (3)
CL Item
STABLE DISEASE: NO CHANGE OF GREATER THAN 25% IN THE SIZE OF MEASURABLE LESIONS. NO NEW LESIONS MAY HAVE APPEARED. (4)
CL Item
PROGRESSIVE DISEASE: OBJECTIVE EVIDENCE OF AN INCREASE OF 25% OR MORE IN ANY MEASURABLE LESION OR THE APPEARANCE OF NEW LESIONS. IF PROGRESSION IS NOTED. COMPLETE QUESTION "E" (SITES OF PROGRESSION) AND STUDY TERMINATION SECTION OF THE CASE REPORT FORM. (5)
Tumor site Tumor Progression bone
Item
E. SITES OF PROGRESSION: BONE
boolean
C0475445 (UMLS CUI [1,1])
C0178874 (UMLS CUI [1,2])
C0262950 (UMLS CUI [1,3])
Tumor site Tumor Progression Liver
Item
E. SITES OF PROGRESSION: LIVER
boolean
C0475445 (UMLS CUI [1,1])
C0178874 (UMLS CUI [1,2])
C0023884 (UMLS CUI [1,3])
Tumor site Tumor Progression LUNG
Item
E. SITES OF PROGRESSION: LUNG
boolean
C0475445 (UMLS CUI [1,1])
C0178874 (UMLS CUI [1,2])
C0024109 (UMLS CUI [1,3])
Tumor site Tumor Progression LYMPH NODES
Item
E. SITES OF PROGRESSION: DISTAL LYMPH NODES
boolean
C0475445 (UMLS CUI [1,1])
C0178874 (UMLS CUI [1,2])
C0024204 (UMLS CUI [1,3])
Tumor site Tumor Progression REGIONAL LYMPH NODES
Item
E. SITES OF PROGRESSION: REGIONAL LYMPH NODES
boolean
C0475445 (UMLS CUI [1,1])
C0178874 (UMLS CUI [1,2])
C0807729 (UMLS CUI [1,3])
Tumor site Tumor Progression CHEST WALL
Item
E. SITES OF PROGRESSION: CHEST WALL
boolean
C0475445 (UMLS CUI [1,1])
C0178874 (UMLS CUI [1,2])
C0205076 (UMLS CUI [1,3])
Tumor site Tumor Progression abdomen
Item
E. SITES OF PROGRESSION: ABDOMEN
boolean
C0475445 (UMLS CUI [1,1])
C0178874 (UMLS CUI [1,2])
C0000726 (UMLS CUI [1,3])
Tumor site Tumor Progression Mediastinum
Item
E. SITES OF PROGRESSION: MEDIASTINUM
boolean
C0475445 (UMLS CUI [1,1])
C0178874 (UMLS CUI [1,2])
C0025066 (UMLS CUI [1,3])
Tumor site Tumor Progression CNS
Item
E. SITES OF PROGRESSION: CNS
boolean
C0475445 (UMLS CUI [1,1])
C0178874 (UMLS CUI [1,2])
C3714787 (UMLS CUI [1,3])
Tumor site Tumor Progression Other
Item
E. SITES OF PROGRESSION: OTHER
text
C0475445 (UMLS CUI [1,1])
C0178874 (UMLS CUI [1,2])
C0205394 (UMLS CUI [1,3])
Item Group
TUMOR LOCATION
C0872338 (UMLS CUI-1)
LYMPH NODES
Item
LYMPH NODES
text
C0024204 (UMLS CUI [1])
BONE
Item
BONE
text
C0262950 (UMLS CUI [1])
ABDOMEN
Item
ABDOMEN
text
C0000726 (UMLS CUI [1])
OTHER
Item
OTHER
text
C0205394 (UMLS CUI [1])
Item Group
TUMOR ASSESSMENT WORKSHEET
C2349155 (UMLS CUI-1)
C3889740 (UMLS CUI-2)
Lesion number
Item
LESION NUMBER
integer
C0449791 (UMLS CUI [1])
Item
SITE OF LESION
integer
C0475445 (UMLS CUI [1])
tumor site
Code List
SITE OF LESION
CL Item
BONE  (1)
CL Item
LIVER  (2)
CL Item
LUNG  (3)
CL Item
DISTAL LYMPH NODES  (4)
CL Item
REGIONAL LYMPH NODES  (5)
CL Item
CHEST WALL  (6)
CL Item
ABDOMEN. (EXCLUDING LIVER)  (7)
CL Item
MEDIASTINUM  (8)
CL Item
CNS  (9)
CL Item
OTHER (DESCRIBE) (10)
other
Item
IF "OTHER" SITE, DESCRIBE:
text
C0205394 (UMLS CUI [1])
Date Tumor assessment
Item
DATE OF ASSESSMENT PROCEDURE:
date
C0011008 (UMLS CUI [1,1])
C3889740 (UMLS CUI [1,2])
Item
METHOD OF ASSESSMENT
integer
C2598110 (UMLS CUI [1])
METHOD OF ASSESSMENT
Code List
METHOD OF ASSESSMENT
CL Item
X-RAY  (1)
CL Item
CT CHEST  (2)
CL Item
CT ABDOMEN  (3)
CL Item
MRI  (4)
CL Item
ULTRASOUND  (5)
CL Item
PHOTOGRAPH  (6)
CL Item
PHYSICAL EXAMINATION  (7)
CL Item
OTHER (DESCRIBE) (1O)
other
Item
IF "OTHER" METHOD, DESCRIBE:
text
C0205394 (UMLS CUI [1])
lesion size
Item
SIZE OF LESION
text
C0449453 (UMLS CUI [1])
Lesion size Measurable
Item
MEASURABLE?
boolean
C0449453 (UMLS CUI [1,1])
C1513040 (UMLS CUI [1,2])
Tillbaka till toppen 

Kontakt

Använd detta formulär för feedback, frågor och förslag på förbättringar.

Fält markerade med * är obligatoriska.

Hjälp

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial