ID

23828

Description

Information concerning the patient's off study date and reason. Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=AD006CC7-CCBA-B0A3-E040-BB89AD437A16

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=AD006CC7-CCBA-B0A3-E040-BB89AD437A16

Keywords

Versions (2)
  1. 9/19/12 9/19/12 -
  2. 7/14/17 7/14/17 - Martin Dugas
Uploaded on

July 14, 2017

DOI

To request one please log in.

License

Creative Commons BY-NC 3.0
Model comments :

You can comment on the data model here. Via the speech bubbles at the itemgroups and items you can add comments to those specificially.

Back to model comments
Itemgroup comments for :

Item comments for :

In order to download data models you must be logged in. Please log in or register for free.

CCR 2011 Template

English

No Instruction available.

1 forms  
  1. StudyEvent: Off Study
    1. No Instruction available.
Off Study
Description

Off Study

Alias
UMLS CUI-1
C1518546
Visit Date
Description

(Enter the date the form is being completed.)

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
NCI Thesaurus ObjectClass
C40988
NCI Thesaurus Property
C25250
UMLS CUI [1]
C1115437
Date Off Study
Description

(For protocols with a specific follow-up period, enter the date that corresponds to the date when all protocol specific follow-up has been completed.)

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
NCI Thesaurus ObjectClass
C15206
NCI Thesaurus Property
C25275
UMLS CUI [1]
C2985813
Reason off study
Description

(For protocols without a protocol specific follow-up, use the same 'Reason Off Treatment' entered on the Off Treatment case report form.)

Data type

text

Alias
NCI Thesaurus ValueDomain
C25162
NCI Thesaurus Property
C25638
NCI Thesaurus ObjectClass
C15206
NCI Thesaurus ObjectClass
C40450
UMLS CUI [1]
C2985814
Explain ´Other´ Reason
Description

Off Study Reason, other

Data type

text

Alias
NCI Thesaurus ObjectClass
C15206
NCI Thesaurus ObjectClass
C40450
NCI Thesaurus Property
C25638
NCI Thesaurus ValueDomain
C45255
NCI Thesaurus ValueDomain
C42614
NCI Thesaurus ValueDomain
C68805
UMLS CUI [1,1]
C1518544
UMLS CUI [1,2]
C0566251
Date of Disease Progression
Description

Progression Date

Data type

date

Alias
NCI Thesaurus Property
C25164
NCI Thesaurus ValueDomain
C25164
NCI Thesaurus ObjectClass
C17747
UMLS CUI [1,1]
C0242656
UMLS CUI [1,2]
C0011008
Back to the top of the page

Similar models

No Instruction available.

1 forms
  1. StudyEvent: Off Study
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Off Study
C1518546 (UMLS CUI-1)
Form Completion Date
Item
Visit Date
date
C25164 (NCI Thesaurus ValueDomain)
C40988 (NCI Thesaurus ObjectClass)
C25250 (NCI Thesaurus Property)
C1115437 (UMLS CUI [1])
Off Study Date
Item
Date Off Study
date
C25164 (NCI Thesaurus ValueDomain)
C15206 (NCI Thesaurus ObjectClass)
C25275 (NCI Thesaurus Property)
C2985813 (UMLS CUI [1])
Item
Reason off study
text
C25162 (NCI Thesaurus ValueDomain)
C25638 (NCI Thesaurus Property)
C15206 (NCI Thesaurus ObjectClass)
C40450 (NCI Thesaurus ObjectClass)
C2985814 (UMLS CUI [1])
CL.1
Code List
Reason off study
CL Item
Patient Noncompliance (2)
C0376405 (NCI Metathesaurus)
C0457432 (UMLS CUI-1)
CL Item
Withdrawal Of Informed Consent (3)
C0021430 (UMLS CUI-1)
C1710677 (UMLS CUI-2)
CL Item
Alternative Medicine (A)
C19936 (NCI Thesaurus)
C1515928 (UMLS CUI-1)
CL Item
Disease Progression Before Treatment (B)
CL Item
Study Complete (C)
C2348577 (UMLS CUI-1)
CL Item
Death (D)
C26554 (NCI Thesaurus)
C1306577 (UMLS CUI-1)
CL Item
Late Adverse Events/side Effects (E)
C0877248 (UMLS CUI-1)
C0205087 (UMLS CUI-2)
CL Item
Cytogenetic Resistance (G)
CL Item
Follow-up Period Completed (H)
CL Item
Ineligible (I)
C40412 (NCI Thesaurus)
C1512714 (UMLS CUI-1)
CL Item
Lost To Follow-up (L)
C48227 (NCI Thesaurus)
C1302313 (UMLS CUI-1)
CL Item
Death During Follow-up Period (M)
CL Item
Not Treated (N)
C0746919 (UMLS CUI-1)
CL Item
Other (O)
C17649 (NCI Thesaurus)
C0205394 (UMLS CUI-1)
CL Item
Disease Progression (P)
C17747 (NCI Thesaurus)
C0242656 (UMLS CUI-1)
CL Item
Refused Further Treatment (R)
CL Item
Complicating Disease (S)
C16457 (NCI Thesaurus)
C0009488 (UMLS CUI-1)
CL Item
Toxicity (T)
C27990 (NCI Thesaurus)
C0600688 (UMLS CUI-1)
CL Item
Not Treated - Other Reasons (U)
CL Item
Protocol Violation (V)
C48251 (NCI Thesaurus)
C1709750 (UMLS CUI-1)
CL Item
Refused Further Follow-up (W)
CL Item
Declined To Participate (X)
C0679823 (UMLS CUI-1)
C1705116 (UMLS CUI-2)
CL Item
No Treatment, Per Protocol Criteria (Z)
Off Study Reason, other
Item
Explain ´Other´ Reason
text
C15206 (NCI Thesaurus ObjectClass)
C40450 (NCI Thesaurus ObjectClass)
C25638 (NCI Thesaurus Property)
C45255 (NCI Thesaurus ValueDomain)
C42614 (NCI Thesaurus ValueDomain)
C68805 (NCI Thesaurus ValueDomain)
C1518544 (UMLS CUI [1,1])
C0566251 (UMLS CUI [1,2])
Progression Date
Item
Date of Disease Progression
date
C25164 (NCI Thesaurus Property)
C25164 (NCI Thesaurus ValueDomain)
C17747 (NCI Thesaurus ObjectClass)
C0242656 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Back to the top of the page 

Contact

Please use this form for feedback, questions and suggestions for improvements.

Fields marked with * are required.

Help

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