ID

23123

Beschrijving

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

Trefwoorden

Versies (2)
  1. 27-08-12 27-08-12 -
  2. 24-06-17 24-06-17 - Martin Dugas
Geüploaded op

24 juni 2017

DOI

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Licentie

Creative Commons BY 4.0
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Cervical Cancer Cisplatin NCT00064077 GOG

Engels

FORM D2M

1 Formulieren  
  1. StudyEvent: GOG Solid Tumor Evaluation Form
    1. FORM D2M
Header Module
Beschrijving

Header Module

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

Form Completion Date, Original

Datatype

date

Alias
UMLS CUI [1]
C1549507
Date form amended
Beschrijving

Form Completion Date, amended

Datatype

date

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

Responsible Person Reporting Change LastName

Datatype

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
Beschrijving

Last Name

Datatype

text

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

First Name

Datatype

text

Alias
UMLS CUI [1]
C1443235
Patient Study ID
Beschrijving

Patient Study ID

Datatype

text

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

Person Completing Form, LastName

Datatype

text

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

Participating Group Code

Datatype

text

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

Participating Group Protocol Number

Datatype

text

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

Patient Participating Identifier Number

Datatype

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
Beschrijving

Comments

Datatype

text

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

Target Lesion(s) Evaluation

Alias
UMLS CUI-1
C2986546
Lesion number
Beschrijving

Lesion, Reference Number

Datatype

integer

Alias
UMLS CUI [1]
C0449791
Site of Lesion
Beschrijving

Lesion, Anatomic Site

Datatype

text

Alias
UMLS CUI [1]
C0449685
Date of Evaluation
Beschrijving

Assessment Date

Datatype

date

Maateenheden
  • m d y
Alias
UMLS CUI [1]
C2985720
m d y
Method of Evaluation (coded values)
Beschrijving

Assessment Type

Datatype

integer

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

Assessment Type, Specify

Datatype

text

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

Tumor Diameter

Datatype

float

Maateenheden
  • cm
Alias
NCI Thesaurus ValueDomain
C25209
UMLS CUI [1]
C3272927
cm
Sum of longest diameters of all target lesions
Beschrijving

Sum of Longest Diameters

Datatype

float

Maateenheden
  • cm
Alias
UMLS CUI [1]
C3272915
cm
Non-target Lesion(s) Evaluation
Beschrijving

Non-target Lesion(s) Evaluation

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

Non-target Lesion

Datatype

boolean

Alias
UMLS CUI [1]
C2986547
Lesion number
Beschrijving

Lesion, Reference Number

Datatype

integer

Alias
UMLS CUI [1]
C0449791
Site of Lesion
Beschrijving

Lesion, Anatomic Site

Datatype

text

Alias
UMLS CUI [1]
C0449685
Date of Evaluation
Beschrijving

Assessment Date

Datatype

date

Maateenheden
  • m d y
Alias
UMLS CUI [1]
C2985720
m d y
Method of Evaluation (coded values)
Beschrijving

Assessment Type

Datatype

integer

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

Assessment Type, Specify

Datatype

text

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

Lesion, Follow-up Status

Datatype

integer

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

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?
Beschrijving

New Lesion

Datatype

boolean

Alias
UMLS CUI [1]
C2986548
Lesion number
Beschrijving

Lesion, Reference Number

Datatype

integer

Alias
UMLS CUI [1]
C0449791
Site of Lesion
Beschrijving

Lesion, Anatomic Site

Datatype

text

Alias
UMLS CUI [1]
C0449685
Date of Evaluation
Beschrijving

Assessment Date

Datatype

date

Maateenheden
  • m d y
Alias
UMLS CUI [1]
C2985720
m d y
Method of Evaluation (coded values)
Beschrijving

Assessment Type

Datatype

integer

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

Assessment Type, Specify

Datatype

text

Alias
UMLS CUI [1]
C2598110
Overall Response
Beschrijving

Overall Response

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

Overall Tumor Response

Datatype

text

Alias
UMLS CUI [1]
C3272903
Response confirmed date
Beschrijving

Confirmed Response Date

Datatype

date

Maateenheden
  • 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 Formulieren
  1. StudyEvent: GOG Solid Tumor Evaluation Form
    1. FORM D2M
Name
Type
Description | Question | Decode (Coded Value)
Datatype
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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