ID
24883
Descripción
S0100 MAINTENANCE TOXICITY FORM Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=AEB51D80-6426-43A7-E034-0003BA12F5E7
Link
Palabras clave
Versiones (2)
- 19/9/12 19/9/12 -
- 22/8/17 22/8/17 -
Subido en
22 de agosto de 2017
DOI
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Licencia
Creative Commons BY-NC 3.0 Legacy
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S0100 MAINTENANCE TOXICITY FORM
Instructions: Please complete after each cycle of treatment. All dates are MONTH, DAY, YEAR. Explain any blank fields or blank dates in the Comments section. Place an X in appropriate boxes. Circle AMENDED items in red.
- StudyEvent: S0100 INDUCTION AND CONSOLIDATION TOXICITY FORM
Descripción
Ccrr Module For S0100 Maintenance Toxicity Form
Alias
- UMLS CUI-1
- C0013221 (Drug toxicity)
- SNOMED
- 7895008
- UMLS CUI-2
- C0040539 (Toxicity aspects)
- UMLS CUI-3
- C0677908 (Maintenance therapy)
- SNOMED
- 314122007
- UMLS CUI-4
- C0023418 (leukemia)
- SNOMED
- 93143009
Descripción
Patient ID
Tipo de datos
text
Alias
- UMLS CUI [1]
- C2348585 (Clinical Trial Subject Unique Identifier)
Descripción
Study Number
Tipo de datos
text
Alias
- UMLS CUI [1,1]
- C0008976 (Clinical Trials)
- SNOMED
- 110465008
- LOINC
- LP231796-6
- UMLS CUI [1,2]
- C0600091 (Identifier)
- SNOMED
- 118522005
- LOINC
- LP31795-5
Descripción
Registration Step
Tipo de datos
text
Alias
- UMLS CUI-1
- C1514821 (Registration)
Descripción
Patient Initials
Tipo de datos
text
Alias
- UMLS CUI [1]
- C2986440 (Person Initials)
Descripción
Institution
Tipo de datos
text
Alias
- UMLS CUI [1,1]
- C1301943 (Institution name)
- SNOMED
- 398321007
- UMLS CUI [1,2]
- C0600091 (Identifier)
- SNOMED
- 118522005
- LOINC
- LP31795-5
Descripción
Treating Physician
Tipo de datos
text
Alias
- NCI Thesaurus Property
- C25364 (undefined)
- NCI Thesaurus ObjectClass
- C25741 (undefined)
- NCI Thesaurus ObjectClass-2
- C25705 (undefined)
- UMLS CUI [1]
- C1710470 (Treating Physician)
Similar models
Instructions: Please complete after each cycle of treatment. All dates are MONTH, DAY, YEAR. Explain any blank fields or blank dates in the Comments section. Place an X in appropriate boxes. Circle AMENDED items in red.
- StudyEvent: S0100 INDUCTION AND CONSOLIDATION TOXICITY FORM
C0220825 (UMLS CUI [1,2])
C0220825 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
C0220825 (UMLS CUI [1,2])
C1516728 (UMLS CUI [1,2])
C0441800 (UMLS CUI [1,2])
C1516728 (UMLS CUI [1,3])
C1516728 (UMLS CUI [1,2])
C0013221 (UMLS CUI [1,2])
C0040539 (UMLS CUI-2)
C0677908 (UMLS CUI-3)
C0023418 (UMLS CUI-4)
C0600091 (UMLS CUI [1,2])
C0600091 (UMLS CUI [1,2])
C25741 (NCI Thesaurus ObjectClass)
C25705 (NCI Thesaurus ObjectClass-2)
C1710470 (UMLS CUI [1])
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