ID

23123

Descripción

Comparison of Four Combination Chemotherapy Regimens Using Cisplatin in Treating Patients With Stage IVB, Recurrent, or Persistent Cancer of the Cervix https://clinicaltrials.gov/ct2/show/NCT00064077 Response - GOG Solid Tumor Evaluation Form - 2059416v3.0

Link

https://clinicaltrials.gov/ct2/show/NCT00064077

Palabras clave

Versiones (2)
  1. 27/8/12 27/8/12 -
  2. 24/6/17 24/6/17 - Martin Dugas
Subido en

24 de junio de 2017

DOI

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Licencia

Creative Commons BY 4.0
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Cervical Cancer Cisplatin NCT00064077 GOG

Inglés

FORM D2M

1 formularios  
  1. StudyEvent: GOG Solid Tumor Evaluation Form
    1. FORM D2M
Header Module
Descripción

Header Module

Alias
UMLS CUI-1
C1320722
Date form originally completed (m d y)
Descripción

Form Completion Date, Original

Tipo de datos

date

Alias
UMLS CUI [1]
C1549507
Date form amended
Descripción

Form Completion Date, amended

Tipo de datos

date

Alias
UMLS CUI [1,1]
C0680532
UMLS CUI [1,2]
C0011008
Person amending form, last name
Descripción

Responsible Person Reporting Change LastName

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25191
NCI Thesaurus ObjectClass
C25190
NCI Thesaurus Property
C25364
UMLS CUI [1,1]
C0680532
UMLS CUI [1,2]
C1547383
Patient Name, Last
Descripción

Last Name

Tipo de datos

text

Alias
UMLS CUI [1]
C1301584
Patient Name, First
Descripción

First Name

Tipo de datos

text

Alias
UMLS CUI [1]
C1443235
Patient Study ID
Descripción

Patient Study ID

Tipo de datos

text

Alias
UMLS CUI [1]
C2348585
Person Completing Form, Last Name
Descripción

Person Completing Form, LastName

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1550483
UMLS CUI [1,2]
C1301584
Participating Group Code
Descripción

Participating Group Code

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25162
UMLS CUI [1]
C2986314
Participating Group Protocol No.
Descripción

Participating Group Protocol Number

Tipo de datos

text

Alias
UMLS CUI [1,1]
C3274381
UMLS CUI [1,2]
C2347449
Participating Patient Study ID
Descripción

Patient Participating Identifier Number

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25337
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25608
NCI Thesaurus Property-2
C25364
UMLS CUI [1,1]
C2348585
UMLS CUI [1,2]
C2347449
COMMENTS
Descripción

Comments

Tipo de datos

text

Alias
UMLS CUI [1]
C0947611
Target Lesion(s) Evaluation
Descripción

Target Lesion(s) Evaluation

Alias
UMLS CUI-1
C2986546
Lesion number
Descripción

Lesion, Reference Number

Tipo de datos

integer

Alias
UMLS CUI [1]
C0449791
Site of Lesion
Descripción

Lesion, Anatomic Site

Tipo de datos

text

Alias
UMLS CUI [1]
C0449685
Date of Evaluation
Descripción

Assessment Date

Tipo de datos

date

Unidades de medida
  • m d y
Alias
UMLS CUI [1]
C2985720
m d y
Method of Evaluation (coded values)
Descripción

Assessment Type

Tipo de datos

integer

Alias
UMLS CUI [1]
C2911685
If Other, specify (Method of Eval)
Descripción

Assessment Type, Specify

Tipo de datos

text

Alias
UMLS CUI [1]
C2598110
Longest Diameter of Lesion(s)
Descripción

Tumor Diameter

Tipo de datos

float

Unidades de medida
  • cm
Alias
NCI Thesaurus ValueDomain
C25209
UMLS CUI [1]
C3272927
cm
Sum of longest diameters of all target lesions
Descripción

Sum of Longest Diameters

Tipo de datos

float

Unidades de medida
  • cm
Alias
UMLS CUI [1]
C3272915
cm
Non-target Lesion(s) Evaluation
Descripción

Non-target Lesion(s) Evaluation

Alias
UMLS CUI-1
C2986547
Are there any nontarget lesions?
Descripción

Non-target Lesion

Tipo de datos

boolean

Alias
UMLS CUI [1]
C2986547
Lesion number
Descripción

Lesion, Reference Number

Tipo de datos

integer

Alias
UMLS CUI [1]
C0449791
Site of Lesion
Descripción

Lesion, Anatomic Site

Tipo de datos

text

Alias
UMLS CUI [1]
C0449685
Date of Evaluation
Descripción

Assessment Date

Tipo de datos

date

Unidades de medida
  • m d y
Alias
UMLS CUI [1]
C2985720
m d y
Method of Evaluation (coded values)
Descripción

Assessment Type

Tipo de datos

integer

Alias
UMLS CUI [1]
C2911685
If Other, specify (Method of Eval)
Descripción

Assessment Type, Specify

Tipo de datos

text

Alias
UMLS CUI [1]
C2598110
Follow-Up Status of Lesion(s)
Descripción

Lesion, Follow-up Status

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C0221198
UMLS CUI [1,2]
C0589120
New Target Lesion(s) At Follow-up Evaluation
Descripción

New Target Lesion(s) At Follow-up Evaluation

Alias
UMLS CUI-1
C2986548
Was the appearance of any new lesions documented since the baseline evaluation?
Descripción

New Lesion

Tipo de datos

boolean

Alias
UMLS CUI [1]
C2986548
Lesion number
Descripción

Lesion, Reference Number

Tipo de datos

integer

Alias
UMLS CUI [1]
C0449791
Site of Lesion
Descripción

Lesion, Anatomic Site

Tipo de datos

text

Alias
UMLS CUI [1]
C0449685
Date of Evaluation
Descripción

Assessment Date

Tipo de datos

date

Unidades de medida
  • m d y
Alias
UMLS CUI [1]
C2985720
m d y
Method of Evaluation (coded values)
Descripción

Assessment Type

Tipo de datos

integer

Alias
UMLS CUI [1]
C2911685
If Other, specify (Method of Eval)
Descripción

Assessment Type, Specify

Tipo de datos

text

Alias
UMLS CUI [1]
C2598110
Overall Response
Descripción

Overall Response

Alias
UMLS CUI-1
C3272903
Overall response status at this assessment (check one)
Descripción

Overall Tumor Response

Tipo de datos

text

Alias
UMLS CUI [1]
C3272903
Response confirmed date
Descripción

Confirmed Response Date

Tipo de datos

date

Unidades de medida
  • m d y
Alias
NCI Thesaurus ObjectClass
C25755
NCI Thesaurus Property
C25458
UMLS CUI [1,1]
C0521982
UMLS CUI [1,2]
C0750484
UMLS CUI [1,3]
C0011008
m d y
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Similar models

FORM D2M

1 formularios
  1. StudyEvent: GOG Solid Tumor Evaluation Form
    1. FORM D2M
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
Header Module
C1320722 (UMLS CUI-1)
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])
Item Group
Target Lesion(s) Evaluation
C2986546 (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])
CL.9
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])
Item Group
Non-target Lesion(s) Evaluation
C2986547 (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])
CL.9
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])
CL.6
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)
Item Group
New Target Lesion(s) At Follow-up Evaluation
C2986548 (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])
CL.9
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 Group
Overall Response
C3272903 (UMLS CUI-1)
Item
Overall response status at this assessment (check one)
text
C3272903 (UMLS CUI [1])
CL.10
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])
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