ID

24965

Description

ECOG 4599 Follow-Up Disease Evaluation Form (RECIST) Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A1332372-319A-59AF-E034-080020C9C0E0

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A1332372-319A-59AF-E034-080020C9C0E0

Keywords

Versions (3)
  1. 9/19/12 9/19/12 -
  2. 8/23/17 8/23/17 -
  3. 8/23/17 8/23/17 -
Uploaded on

August 23, 2017

DOI

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License

Creative Commons BY-NC 3.0 Legacy
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ECOG 4599 Follow-Up Disease Evaluation Form (RECIST)

English

No Instruction available.

1 forms  
  1. StudyEvent: ECOG 4599 Follow-Up Disease Evaluation Form (RECIST)
    1. No Instruction available.
Follow-Up Disease Evaluation Form
Description

Follow-Up Disease Evaluation Form

Alias
UMLS CUI-1
C1522577
UMLS CUI-2
C0012634
UMLS CUI-3
C0220825
UMLS CUI-4
C0242379
Date of data transfer
Description

Date of data transfer

Data type

date

Alias
UMLS CUI [1,1]
C3272293
UMLS CUI [1,2]
C0011008
Transfer Method
Description

Method

Data type

text

Alias
UMLS CUI [1,1]
C3272293
UMLS CUI [1,2]
C0025663
Specify other transfer method
Description

transfer method

Data type

text

Alias
UMLS CUI [1,1]
C3272293
UMLS CUI [1,2]
C0025663
Step No.
Description

Identifier

Data type

text

Alias
UMLS CUI [1,1]
C1261552
UMLS CUI [1,2]
C0600091
Course Identification
Description

Course Identification

Data type

text

Alias
UMLS CUI [1,1]
C0750729
UMLS CUI [1,2]
C0600091
Patient Name
Description

Patient Name

Data type

text

Alias
UMLS CUI [1]
C1299487
Particip. Group Protocol Number
Description

Particip. Group Protocol Number

Data type

float

Alias
UMLS CUI [1,1]
C0008971
UMLS CUI [1,2]
C0441833
UMLS CUI [1,3]
C0600091
Patient Study ID, Participating Group
Description

Patient Study ID

Data type

text

Alias
UMLS CUI [1]
C2348585
Institution Name
Description

Institution Name

Data type

text

Alias
UMLS CUI [1]
C1301943
Affiliate Name
Description

Affiliate Name

Data type

text

Alias
UMLS CUI [1,1]
C1510825
UMLS CUI [1,2]
C0027365
Amended Data Ind
Description

Data amended

Data type

text

Alias
NCI Thesaurus ObjectClass
C25474
NCI Thesaurus Property
C25416
UMLS CUI [1,1]
C1511726
UMLS CUI [1,2]
C1691222
Lesion, Reference Number, Target
Description

Reference Number

Data type

text

Alias
UMLS CUI [1,1]
C2826265
UMLS CUI [1,2]
C0221198
UMLS CUI [2]
C1521840
Lesion, Anatomic Site, Target
Description

Anatomic Site

Data type

text

Alias
UMLS CUI [1,1]
C1515974
UMLS CUI [1,2]
C0221198
UMLS CUI [2]
C1521840
Site Code, Target
Description

Site Code

Data type

text

Alias
UMLS CUI [1,1]
C1515974
UMLS CUI [1,2]
C0600091
UMLS CUI [1,3]
C0221198
UMLS CUI [2]
C1521840
Assessment Type, Target
Description

Assessment Type

Data type

text

Alias
UMLS CUI [1]
C2911685
UMLS CUI [2]
C1521840
Assessment Date, Target
Description

Assessment Date

Data type

date

Alias
UMLS CUI [1,1]
C0220825
UMLS CUI [1,2]
C0011008
UMLS CUI [2]
C1521840
Lesion, Tumor Diameter
Description

Tumor Diameter

Data type

float

Alias
NCI Thesaurus ValueDomain
C25209
UMLS CUI [1,1]
C1301886
UMLS CUI [1,2]
C0221198
UMLS CUI [2]
C1521840
Lesion, Baseline Tumor Diameter
Description

Baseline Tumor Diameter

Data type

text

Alias
UMLS CUI [1,1]
C1301886
UMLS CUI [1,2]
C0221198
UMLS CUI [2]
C1521840
Lesion, Diameter, Longest Sum
Description

Longest Sum

Data type

float

Alias
UMLS CUI [1,1]
C3272914
UMLS CUI [1,2]
C0221198
UMLS CUI [2]
C1521840
Lesion, Reference Number, Nontarget
Description

Lesion,ReferenceNumber,Nontarget

Data type

text

Alias
UMLS CUI [1,1]
C2826265
UMLS CUI [1,2]
C0221198
UMLS CUI [2]
C1518389
Lesion, Anatomic Site, Nontarget
Description

Lesion,AnatomicSite,Nontarget

Data type

text

Alias
UMLS CUI [1,1]
C1515974
UMLS CUI [1,2]
C0221198
UMLS CUI [2]
C1518389
Site Code, Nontarget
Description

SiteCode,Nontarget

Data type

text

Alias
UMLS CUI [1,1]
C1515974
UMLS CUI [1,2]
C0600091
UMLS CUI [1,3]
C0221198
UMLS CUI [2]
C1518389
Assessment Type, Nontarget
Description

AssessmentType,Nontarget

Data type

text

Alias
UMLS CUI [1]
C2911685
UMLS CUI [2]
C1518389
Assessment Date, Nontarget
Description

AssessmentDate,Nontarget

Data type

date

Alias
UMLS CUI [1,1]
C0220825
UMLS CUI [1,2]
C0011008
UMLS CUI [2]
C1518389
Lesion, Follow-up Status
Description

Follow-up Status

Data type

text

Alias
UMLS CUI [1,1]
C0589120
UMLS CUI [1,2]
C0221198
UMLS CUI [2]
C1518389
Cytology Result, Nontarget
Description

Cytology Result

Data type

text

Alias
UMLS CUI [1,1]
C0010819
UMLS CUI [1,2]
C1274040
UMLS CUI [2]
C1518389
Other Specify
Description

Other Specify

Data type

text

Alias
UMLS CUI [1,1]
C0010819
UMLS CUI [1,2]
C1274040
UMLS CUI [2]
C1518389
New Lesion Ind
Description

New Lesion Ind

Data type

text

Alias
UMLS CUI [1,1]
C0221198
UMLS CUI [1,2]
C0205314
Lesion, Reference Number, New
Description

Lesion,ReferenceNumber,New

Data type

text

Alias
UMLS CUI [1,1]
C2826265
UMLS CUI [1,2]
C0221198
UMLS CUI [1,3]
C0205314
Lesion, Anatomic Site, New
Description

Lesion,AnatomicSite,New

Data type

text

Alias
UMLS CUI [1]
C1515974
UMLS CUI [2,1]
C0221198
UMLS CUI [2,2]
C0205314
Site Code, New
Description

SiteCode,New

Data type

text

Alias
UMLS CUI [1,1]
C1515974
UMLS CUI [1,2]
C0600091
UMLS CUI [2,1]
C0221198
UMLS CUI [2,2]
C0205314
Assessment Type, New
Description

AssessmentType,New

Data type

text

Alias
UMLS CUI [1]
C2911685
UMLS CUI [2,1]
C0221198
UMLS CUI [2,2]
C0205314
Assessment Date, New
Description

AssessmentDate,New

Data type

date

Alias
UMLS CUI [1,1]
C0220825
UMLS CUI [1,2]
C0011008
UMLS CUI [2,1]
C0221198
UMLS CUI [2,2]
C0205314
Cytology Result, New
Description

CytologyResult,New

Data type

text

Alias
UMLS CUI [1,1]
C0010819
UMLS CUI [1,2]
C1274040
UMLS CUI [2,1]
C0221198
UMLS CUI [2,2]
C0205314
Has Target Lesion Response Status Change
Description

Response Status

Data type

text

Alias
UMLS CUI [1,1]
C0871261
UMLS CUI [1,2]
C0449438
UMLS CUI [2,1]
C1521840
UMLS CUI [2,2]
C0221198
Target Lesion Response Status
Description

Target Lesion Response Status

Data type

text

Alias
UMLS CUI [1,1]
C0871261
UMLS CUI [1,2]
C0449438
UMLS CUI [2,1]
C1521840
UMLS CUI [2,2]
C0221198
Response Status Change
Description

Response Status Change

Data type

text

Alias
UMLS CUI [1,1]
C1515926
UMLS CUI [1,2]
C0871261
UMLS CUI [1,3]
C0449438
UMLS CUI [2,1]
C1521840
UMLS CUI [2,2]
C0221198
Overall Tumor Response
Description

Overall Tumor Response

Data type

text

Alias
UMLS CUI [1,1]
C3272903
UMLS CUI [1,2]
C0006826
Progressive Disease Observed Date
Description

Progressive Disease Observed Date

Data type

date

Alias
UMLS CUI [1,1]
C1335499
UMLS CUI [1,2]
C0011008
Response Confirmed Ind
Description

Response Confirmed

Data type

text

Alias
UMLS CUI [1,1]
C0871261
UMLS CUI [1,2]
C0750484
PR/CR First Observed Date
Description

remission

Data type

text

Alias
NCI Thesaurus Property
C18212
NCI Thesaurus ObjectClass
C9305
NCI Thesaurus Property-2
C4870
NCI Thesaurus Property-3
C25599
UMLS CUI [1,1]
C0544452
UMLS CUI [1,2]
C0006826
UMLS CUI [1,3]
C1441672
UMLS CUI [1,4]
C0011008
Symptomatic Deterioration Ind
Description

Symptomatic Deterioration

Data type

text

Alias
UMLS CUI [1]
C4086879
Symptomatic Deterioration Specify
Description

Symptomatic Deterioration

Data type

text

Alias
UMLS CUI [1]
C4086879
Symptomatic Deterioration Date
Description

Symptomatic Deterioration Date

Data type

date

Alias
UMLS CUI [1,1]
C4086879
UMLS CUI [1,2]
C0011008
Comments
Description

Comments

Data type

text

Alias
UMLS CUI [1,1]
C0947611
UMLS CUI [1,2]
C0242379
Comments2
Description

Comments2

Data type

text

Alias
UMLS CUI [1,1]
C0947611
UMLS CUI [1,2]
C0242379
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Similar models

No Instruction available.

1 forms
  1. StudyEvent: ECOG 4599 Follow-Up Disease Evaluation Form (RECIST)
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Follow-Up Disease Evaluation Form
C1522577 (UMLS CUI-1)
C0012634 (UMLS CUI-2)
C0220825 (UMLS CUI-3)
C0242379 (UMLS CUI-4)
Date of data transfer
Item
Date of data transfer
date
C3272293 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Method
Item
Transfer Method
text
C3272293 (UMLS CUI [1,1])
C0025663 (UMLS CUI [1,2])
transfer method
Item
Specify other transfer method
text
C3272293 (UMLS CUI [1,1])
C0025663 (UMLS CUI [1,2])
Identifier
Item
Step No.
text
C1261552 (UMLS CUI [1,1])
C0600091 (UMLS CUI [1,2])
Course Identification
Item
Course Identification
text
C0750729 (UMLS CUI [1,1])
C0600091 (UMLS CUI [1,2])
Patient Name
Item
Patient Name
text
C1299487 (UMLS CUI [1])
Particip. Group Protocol Number
Item
Particip. Group Protocol Number
float
C0008971 (UMLS CUI [1,1])
C0441833 (UMLS CUI [1,2])
C0600091 (UMLS CUI [1,3])
Patient Study ID
Item
Patient Study ID, Participating Group
text
C2348585 (UMLS CUI [1])
Institution Name
Item
Institution Name
text
C1301943 (UMLS CUI [1])
Affiliate Name
Item
Affiliate Name
text
C1510825 (UMLS CUI [1,1])
C0027365 (UMLS CUI [1,2])
Data amended
Item
Amended Data Ind
text
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
C1511726 (UMLS CUI [1,1])
C1691222 (UMLS CUI [1,2])
Reference Number
Item
Lesion, Reference Number, Target
text
C2826265 (UMLS CUI [1,1])
C0221198 (UMLS CUI [1,2])
C1521840 (UMLS CUI [2])
Anatomic Site
Item
Lesion, Anatomic Site, Target
text
C1515974 (UMLS CUI [1,1])
C0221198 (UMLS CUI [1,2])
C1521840 (UMLS CUI [2])
Site Code
Item
Site Code, Target
text
C1515974 (UMLS CUI [1,1])
C0600091 (UMLS CUI [1,2])
C0221198 (UMLS CUI [1,3])
C1521840 (UMLS CUI [2])
Assessment Type
Item
Assessment Type, Target
text
C2911685 (UMLS CUI [1])
C1521840 (UMLS CUI [2])
Assessment Date
Item
Assessment Date, Target
date
C0220825 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C1521840 (UMLS CUI [2])
Tumor Diameter
Item
Lesion, Tumor Diameter
float
C25209 (NCI Thesaurus ValueDomain)
C1301886 (UMLS CUI [1,1])
C0221198 (UMLS CUI [1,2])
C1521840 (UMLS CUI [2])
Baseline Tumor Diameter
Item
Lesion, Baseline Tumor Diameter
text
C1301886 (UMLS CUI [1,1])
C0221198 (UMLS CUI [1,2])
C1521840 (UMLS CUI [2])
Longest Sum
Item
Lesion, Diameter, Longest Sum
float
C3272914 (UMLS CUI [1,1])
C0221198 (UMLS CUI [1,2])
C1521840 (UMLS CUI [2])
Lesion,ReferenceNumber,Nontarget
Item
Lesion, Reference Number, Nontarget
text
C2826265 (UMLS CUI [1,1])
C0221198 (UMLS CUI [1,2])
C1518389 (UMLS CUI [2])
Lesion,AnatomicSite,Nontarget
Item
Lesion, Anatomic Site, Nontarget
text
C1515974 (UMLS CUI [1,1])
C0221198 (UMLS CUI [1,2])
C1518389 (UMLS CUI [2])
SiteCode,Nontarget
Item
Site Code, Nontarget
text
C1515974 (UMLS CUI [1,1])
C0600091 (UMLS CUI [1,2])
C0221198 (UMLS CUI [1,3])
C1518389 (UMLS CUI [2])
AssessmentType,Nontarget
Item
Assessment Type, Nontarget
text
C2911685 (UMLS CUI [1])
C1518389 (UMLS CUI [2])
AssessmentDate,Nontarget
Item
Assessment Date, Nontarget
date
C0220825 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C1518389 (UMLS CUI [2])
Follow-up Status
Item
Lesion, Follow-up Status
text
C0589120 (UMLS CUI [1,1])
C0221198 (UMLS CUI [1,2])
C1518389 (UMLS CUI [2])
Cytology Result
Item
Cytology Result, Nontarget
text
C0010819 (UMLS CUI [1,1])
C1274040 (UMLS CUI [1,2])
C1518389 (UMLS CUI [2])
Other Specify
Item
Other Specify
text
C0010819 (UMLS CUI [1,1])
C1274040 (UMLS CUI [1,2])
C1518389 (UMLS CUI [2])
New Lesion Ind
Item
New Lesion Ind
text
C0221198 (UMLS CUI [1,1])
C0205314 (UMLS CUI [1,2])
Lesion,ReferenceNumber,New
Item
Lesion, Reference Number, New
text
C2826265 (UMLS CUI [1,1])
C0221198 (UMLS CUI [1,2])
C0205314 (UMLS CUI [1,3])
Lesion,AnatomicSite,New
Item
Lesion, Anatomic Site, New
text
C1515974 (UMLS CUI [1])
C0221198 (UMLS CUI [2,1])
C0205314 (UMLS CUI [2,2])
SiteCode,New
Item
Site Code, New
text
C1515974 (UMLS CUI [1,1])
C0600091 (UMLS CUI [1,2])
C0221198 (UMLS CUI [2,1])
C0205314 (UMLS CUI [2,2])
AssessmentType,New
Item
Assessment Type, New
text
C2911685 (UMLS CUI [1])
C0221198 (UMLS CUI [2,1])
C0205314 (UMLS CUI [2,2])
AssessmentDate,New
Item
Assessment Date, New
date
C0220825 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C0221198 (UMLS CUI [2,1])
C0205314 (UMLS CUI [2,2])
CytologyResult,New
Item
Cytology Result, New
text
C0010819 (UMLS CUI [1,1])
C1274040 (UMLS CUI [1,2])
C0221198 (UMLS CUI [2,1])
C0205314 (UMLS CUI [2,2])
Response Status
Item
Has Target Lesion Response Status Change
text
C0871261 (UMLS CUI [1,1])
C0449438 (UMLS CUI [1,2])
C1521840 (UMLS CUI [2,1])
C0221198 (UMLS CUI [2,2])
Target Lesion Response Status
Item
Target Lesion Response Status
text
C0871261 (UMLS CUI [1,1])
C0449438 (UMLS CUI [1,2])
C1521840 (UMLS CUI [2,1])
C0221198 (UMLS CUI [2,2])
Response Status Change
Item
Response Status Change
text
C1515926 (UMLS CUI [1,1])
C0871261 (UMLS CUI [1,2])
C0449438 (UMLS CUI [1,3])
C1521840 (UMLS CUI [2,1])
C0221198 (UMLS CUI [2,2])
Overall Tumor Response
Item
Overall Tumor Response
text
C3272903 (UMLS CUI [1,1])
C0006826 (UMLS CUI [1,2])
Progressive Disease Observed Date
Item
Progressive Disease Observed Date
date
C1335499 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Response Confirmed
Item
Response Confirmed Ind
text
C0871261 (UMLS CUI [1,1])
C0750484 (UMLS CUI [1,2])
remission
Item
PR/CR First Observed Date
text
C18212 (NCI Thesaurus Property)
C9305 (NCI Thesaurus ObjectClass)
C4870 (NCI Thesaurus Property-2)
C25599 (NCI Thesaurus Property-3)
C0544452 (UMLS CUI [1,1])
C0006826 (UMLS CUI [1,2])
C1441672 (UMLS CUI [1,3])
C0011008 (UMLS CUI [1,4])
Symptomatic Deterioration
Item
Symptomatic Deterioration Ind
text
C4086879 (UMLS CUI [1])
Symptomatic Deterioration
Item
Symptomatic Deterioration Specify
text
C4086879 (UMLS CUI [1])
Symptomatic Deterioration Date
Item
Symptomatic Deterioration Date
date
C4086879 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Comments
Item
Comments
text
C0947611 (UMLS CUI [1,1])
C0242379 (UMLS CUI [1,2])
Comments2
Item
Comments2
text
C0947611 (UMLS CUI [1,1])
C0242379 (UMLS CUI [1,2])
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