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

Lien

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

Mots-clés

Versions (3)
  1. 19/09/2012 19/09/2012 -
  2. 23/08/2017 23/08/2017 -
  3. 23/08/2017 23/08/2017 -
Téléchargé le

23 août 2017

DOI

Pour une demande vous connecter.

Licence

Creative Commons BY-NC 3.0 Legacy
Modèle Commentaires :

Ici, vous pouvez faire des commentaires sur le modèle. À partir des bulles de texte, vous pouvez laisser des commentaires spécifiques sur les groupes Item et les Item.

Retour au modèle Commentaires
Groupe Item commentaires pour :

Item commentaires pour :

Vous devez être connecté pour pouvoir télécharger des formulaires. Veuillez vous connecter ou s’inscrire gratuitement.

ECOG 4599 Follow-Up Disease Evaluation Form (RECIST)

Anglais

No Instruction available.

1 Formulaires  
  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

Type de données

date

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

Method

Type de données

text

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

transfer method

Type de données

text

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

Identifier

Type de données

text

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

Course Identification

Type de données

text

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

Patient Name

Type de données

text

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

Particip. Group Protocol Number

Type de données

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

Type de données

text

Alias
UMLS CUI [1]
C2348585
Institution Name
Description

Institution Name

Type de données

text

Alias
UMLS CUI [1]
C1301943
Affiliate Name
Description

Affiliate Name

Type de données

text

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

Data amended

Type de données

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

Type de données

text

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

Anatomic Site

Type de données

text

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

Site Code

Type de données

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

Type de données

text

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

Assessment Date

Type de données

date

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

Tumor Diameter

Type de données

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

Type de données

text

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

Longest Sum

Type de données

float

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

Lesion,ReferenceNumber,Nontarget

Type de données

text

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

Lesion,AnatomicSite,Nontarget

Type de données

text

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

SiteCode,Nontarget

Type de données

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

Type de données

text

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

AssessmentDate,Nontarget

Type de données

date

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

Follow-up Status

Type de données

text

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

Cytology Result

Type de données

text

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

Other Specify

Type de données

text

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

New Lesion Ind

Type de données

text

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

Lesion,ReferenceNumber,New

Type de données

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

Type de données

text

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

SiteCode,New

Type de données

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

Type de données

text

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

AssessmentDate,New

Type de données

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

Type de données

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

Type de données

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

Type de données

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

Type de données

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

Type de données

text

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

Progressive Disease Observed Date

Type de données

date

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

Response Confirmed

Type de données

text

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

remission

Type de données

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

Type de données

text

Alias
UMLS CUI [1]
C4086879
Symptomatic Deterioration Specify
Description

Symptomatic Deterioration

Type de données

text

Alias
UMLS CUI [1]
C4086879
Symptomatic Deterioration Date
Description

Symptomatic Deterioration Date

Type de données

date

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

Comments

Type de données

text

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

Comments2

Type de données

text

Alias
UMLS CUI [1,1]
C0947611
UMLS CUI [1,2]
C0242379
Retour au début de la page

Similar models

No Instruction available.

1 Formulaires
  1. StudyEvent: ECOG 4599 Follow-Up Disease Evaluation Form (RECIST)
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Type de données
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])
Retour au début de la page 

Contact

Utilisez ce formulaire pour les retours, les questions et les améliorations suggérées.

Les champs marqués d’un * sont obligatoires.

Aide

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