ID

2355

Beskrivning

Southwest Oncology Group S0201 Pathology Submission Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A8BA7D80-B069-121E-E034-0003BA12F5E7

Länk

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A8BA7D80-B069-121E-E034-0003BA12F5E7

Nyckelord

Versioner (3)
  1. 2012-09-19 2012-09-19 -
  2. 2015-01-09 2015-01-09 - Martin Dugas
  3. 2015-07-03 2015-07-03 -
Uppladdad den

19 september 2012

DOI

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Licens

Creative Commons BY-NC 3.0 Legacy
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Melanoma (Skin) null Pathology - Southwest Oncology Group S0201 Pathology Submission Form - 2055787v3.0

Engelsk

No Instruction available.

1 Formulär  
  1. StudyEvent: Southwest Oncology Group S0201 Pathology Submission Form
    1. No Instruction available.
Unnamed 1
Beskrivning

Unnamed 1

SWOG Patient ID
Beskrivning

SWOGPatientID

Datatyp

text

Patient Initials (L, F M)
Beskrivning

PatientInitialsName

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25536
UMLS 2011AA Property
C1555582
Disease
Beskrivning

Disease

Datatyp

text

Institution/Member
Beskrivning

MainMemberInstitution/Affiliate

Datatyp

text

Physician (Groups other than SWOG)
Beskrivning

TreatingPhysician

Datatyp

text

Alias
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus ObjectClass
C25741
UMLS 2011AA ObjectClass
C0031831
NCI Thesaurus ObjectClass
C25705
UMLS 2011AA ObjectClass
C1522326
Group Name
Beskrivning

GroupName

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ObjectClass
C17005
UMLS 2011AA ObjectClass
C1257890
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Study No.
Beskrivning

StudyNo.

Datatyp

text

Pt. No
Beskrivning

Pt.ID

Datatyp

text

Unnamed1
Beskrivning

Unnamed1

No. of slides
Beskrivning

SpecimenSlideCount

Datatyp

text

No. of blocks
Beskrivning

SpecimenBlockSubmissionCount

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25463
UMLS 2011AA ValueDomain
C0750480
NCI Thesaurus Property
C25436
UMLS 2011AA Property
C1533157
NCI Thesaurus ObjectClass
C19157
UMLS 2011AA ObjectClass
C0370003
NCI Thesaurus Property
C25694
UMLS 2011AA Property
C1515022
Date sample obtained
Beskrivning

SpecimenCollectionDate

Datatyp

date

One representative H&E stained section from each block of the primary tumor
Beskrivning

OnerepresentativeH&Estainedsectionfromeachblockoftheprimarytumor

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
Section of sentinel regional lymph node(s) (ind)
Beskrivning

Sectionofsentinelregionallymphnode(s)(ind)

Datatyp

text

Sections of non-sentinel lymph node(s) (Ind)
Beskrivning

Sectionsofnon-sentinellymphnode(s)(Ind)

Datatyp

text

Operative reports (ind)
Beskrivning

Operativereports(ind)

Datatyp

text

Pathology reports (ind)
Beskrivning

Pathologyreports(ind)

Datatyp

text

Specimen Number
Beskrivning

SpecimenID

Datatyp

double

Comments
Beskrivning

Comments

Datatyp

text

Ccrr Module For Southwest Oncology Group S0201 Pathology Submission Form
Beskrivning

Ccrr Module For Southwest Oncology Group S0201 Pathology Submission Form

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Similar models

No Instruction available.

1 Formulär
  1. StudyEvent: Southwest Oncology Group S0201 Pathology Submission Form
    1. No Instruction available.
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Unnamed 1
SWOGPatientID
Item
SWOG Patient ID
text
PatientInitialsName
Item
Patient Initials (L, F M)
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25536 (NCI Thesaurus Property)
C1555582 (UMLS 2011AA Property)
Disease
Item
Disease
text
MainMemberInstitution/Affiliate
Item
Institution/Member
text
TreatingPhysician
Item
Physician (Groups other than SWOG)
text
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C25741 (NCI Thesaurus ObjectClass)
C0031831 (UMLS 2011AA ObjectClass)
C25705 (NCI Thesaurus ObjectClass)
C1522326 (UMLS 2011AA ObjectClass)
GroupName
Item
Group Name
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C17005 (NCI Thesaurus ObjectClass)
C1257890 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
StudyNo.
Item
Study No.
text
Pt.ID
Item
Pt. No
text
Item Group
Unnamed1
SpecimenSlideCount
Item
No. of slides
text
SpecimenBlockSubmissionCount
Item
No. of blocks
text
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
C25436 (NCI Thesaurus Property)
C1533157 (UMLS 2011AA Property)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C25694 (NCI Thesaurus Property)
C1515022 (UMLS 2011AA Property)
SpecimenCollectionDate
Item
Date sample obtained
date
Item
One representative H&E stained section from each block of the primary tumor
text
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
CL.1
Code List
One representative H&E stained section from each block of the primary tumor
CL Item
Yes (yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (no)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Item
Section of sentinel regional lymph node(s) (ind)
text
CL.2
Code List
Section of sentinel regional lymph node(s) (ind)
CL Item
Yes (yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (no)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Item
Sections of non-sentinel lymph node(s) (Ind)
text
CL.3
Code List
Sections of non-sentinel lymph node(s) (Ind)
CL Item
Yes (yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (no)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Item
Operative reports (ind)
text
CL.4
Code List
Operative reports (ind)
CL Item
Yes (yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (no)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Item
Pathology reports (ind)
text
CL.5
Code List
Pathology reports (ind)
CL Item
Yes (yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (no)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
SpecimenID
Item
Specimen Number
double
Comments
Item
Comments
text
Item Group
Ccrr Module For Southwest Oncology Group S0201 Pathology Submission Form
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