Form Completion Date, Original
Item
Date form originally completed (m d y)
date
C1549507 (UMLS CUI [1])
Form Completion Date, amended
Item
Date form amended
date
C0680532 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Responsible Person Reporting Change LastName
Item
Person amending form, last name
text
C25191 (NCI Thesaurus ValueDomain)
C25190 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)
C0680532 (UMLS CUI [1,1])
C1547383 (UMLS CUI [1,2])
Last Name
Item
Patient Name, Last
text
C1301584 (UMLS CUI [1])
First Name
Item
Patient Name, First
text
C1443235 (UMLS CUI [1])
Patient Study ID
Item
Patient Study ID
text
C2348585 (UMLS CUI [1])
Person Completing Form, LastName
Item
Person Completing Form, Last Name
text
C1550483 (UMLS CUI [1,1])
C1301584 (UMLS CUI [1,2])
Participating Group Code
Item
Participating Group Code
text
C25162 (NCI Thesaurus ValueDomain)
C2986314 (UMLS CUI [1])
Participating Group Protocol Number
Item
Participating Group Protocol No.
text
C3274381 (UMLS CUI [1,1])
C2347449 (UMLS CUI [1,2])
Patient Participating Identifier Number
Item
Participating Patient Study ID
text
C25337 (NCI Thesaurus ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
C2348585 (UMLS CUI [1,1])
C2347449 (UMLS CUI [1,2])
Comments
Item
COMMENTS
text
C0947611 (UMLS CUI [1])
Lesion, Reference Number
Item
Lesion number
integer
C0449791 (UMLS CUI [1])
Lesion, Anatomic Site
Item
Site of Lesion
text
C0449685 (UMLS CUI [1])
Assessment Date
Item
Date of Evaluation
date
C2985720 (UMLS CUI [1])
Item
Method of Evaluation (coded values)
integer
C2911685 (UMLS CUI [1])
Code List
Method of Evaluation (coded values)
CL Item
Clinical Examination (1)
C1456356 (UMLS CUI-1)
CL Item
Chest X-ray (2)
C0039985 (UMLS CUI-1)
CL Item
CT Scan (3)
C0040405 (UMLS CUI-1)
CL Item
Spiral CT Scan (4)
C0860888 (UMLS CUI-1)
CL Item
MRI (NMR) (5)
C0024485 (UMLS CUI-1)
CL Item
Ultrasound (6)
C1456803 (UMLS CUI-1)
CL Item
Other (7)
C0205394 (UMLS CUI-1)
Assessment Type, Specify
Item
If Other, specify (Method of Eval)
text
C2598110 (UMLS CUI [1])
Tumor Diameter
Item
Longest Diameter of Lesion(s)
float
C25209 (NCI Thesaurus ValueDomain)
C3272927 (UMLS CUI [1])
Sum of Longest Diameters
Item
Sum of longest diameters of all target lesions
float
C3272915 (UMLS CUI [1])
Non-target Lesion
Item
Are there any nontarget lesions?
boolean
C2986547 (UMLS CUI [1])
Lesion, Reference Number
Item
Lesion number
integer
C0449791 (UMLS CUI [1])
Lesion, Anatomic Site
Item
Site of Lesion
text
C0449685 (UMLS CUI [1])
Assessment Date
Item
Date of Evaluation
date
C2985720 (UMLS CUI [1])
Item
Method of Evaluation (coded values)
integer
C2911685 (UMLS CUI [1])
Code List
Method of Evaluation (coded values)
CL Item
Clinical Examination (1)
C1456356 (UMLS CUI-1)
CL Item
Chest X-ray (2)
C0039985 (UMLS CUI-1)
CL Item
CT Scan (3)
C0040405 (UMLS CUI-1)
CL Item
Spiral CT Scan (4)
C0860888 (UMLS CUI-1)
CL Item
MRI (NMR) (5)
C0024485 (UMLS CUI-1)
CL Item
Ultrasound (6)
C1456803 (UMLS CUI-1)
CL Item
Other (7)
C0205394 (UMLS CUI-1)
Assessment Type, Specify
Item
If Other, specify (Method of Eval)
text
C2598110 (UMLS CUI [1])
Item
Follow-Up Status of Lesion(s)
integer
C0221198 (UMLS CUI [1,1])
C0589120 (UMLS CUI [1,2])
Code List
Follow-Up Status of Lesion(s)
CL Item
Present (1)
C0150312 (UMLS CUI-1)
CL Item
Absent (2)
C0332197 (UMLS CUI-1)
CL Item
Unequivocal Progression (3)
C3272925 (UMLS CUI-1)
CL Item
Complete Response (CR) (4)
C0677874 (UMLS CUI-1)
CL Item
Progressive Disease (PD) (5)
C1335499 (UMLS CUI-1)
CL Item
Stable Disease (SD) (6)
C0677946 (UMLS CUI-1)
New Lesion
Item
Was the appearance of any new lesions documented since the baseline evaluation?
boolean
C2986548 (UMLS CUI [1])
Lesion, Reference Number
Item
Lesion number
integer
C0449791 (UMLS CUI [1])
Lesion, Anatomic Site
Item
Site of Lesion
text
C0449685 (UMLS CUI [1])
Assessment Date
Item
Date of Evaluation
date
C2985720 (UMLS CUI [1])
Item
Method of Evaluation (coded values)
integer
C2911685 (UMLS CUI [1])
Code List
Method of Evaluation (coded values)
CL Item
Clinical Examination (1)
C1456356 (UMLS CUI-1)
CL Item
Chest X-ray (2)
C0039985 (UMLS CUI-1)
CL Item
CT Scan (3)
C0040405 (UMLS CUI-1)
CL Item
Spiral CT Scan (4)
C0860888 (UMLS CUI-1)
CL Item
MRI (NMR) (5)
C0024485 (UMLS CUI-1)
CL Item
Ultrasound (6)
C1456803 (UMLS CUI-1)
CL Item
Other (7)
C0205394 (UMLS CUI-1)
Assessment Type, Specify
Item
If Other, specify (Method of Eval)
text
C2598110 (UMLS CUI [1])
Item
Overall response status at this assessment (check one)
text
C3272903 (UMLS CUI [1])
Code List
Overall response status at this assessment (check one)
CL Item
Complete Response (CR)
C1275810 (UMLS CUI-1)
CL Item
Progressive Disease (PD)
C35571 (NCI Thesaurus)
C1335499 (UMLS CUI-1)
CL Item
Partial Response (PR)
C18212 (NCI Thesaurus)
C1521726 (UMLS CUI-1)
CL Item
Stable Disease (SD)
C18213 (NCI Thesaurus)
C0677946 (UMLS CUI-1)
CL Item
Insufficient evaluation to determine response status (NA)
C0205412 (UMLS CUI-1)
C0220825 (UMLS CUI-2)
Confirmed Response Date
Item
Response confirmed date
date
C25755 (NCI Thesaurus ObjectClass)
C25458 (NCI Thesaurus Property)
C0521982 (UMLS CUI [1,1])
C0750484 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])