ID
25153
Beskrivning
S1001 Registration Worksheet Step 2 PET-Directed Therapy in Treating Patients With Limited-Stage Diffuse Large B-Cell Lymphoma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A55DBEC7-1F59-3244-E040-BB89AD43434F
Länk
Nyckelord
Versioner (2)
- 2012-09-19 2012-09-19 -
- 2017-08-28 2017-08-28 -
Uppladdad den
28 augusti 2017
DOI
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Licens
Creative Commons BY-NC 3.0 Legacy
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S1001 Registration Worksheet Step 2
INSTRUCTIONS: All of the information on this Registration Worksheet and the Protocol Eligibility Section must be answered appropriately for a patient to be considered eligible for registration. This Registration Worksheet must be entirely filled out and referred to during the registration. Do NOT submit this worksheet as part of the patient data.
- StudyEvent: S1001 Registration Worksheet Step 2
Beskrivning
Swog Patient Id
Beskrivning
SWOG Institutions
Alias
- UMLS CUI-1
- C1519429
- UMLS CUI-2
- C1320722
- UMLS CUI-3
- C0079744
Beskrivning
RegistrarSouthwestOncologyGroupIdentifierNumber
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- NCI Thesaurus Property
- C25364
- NCI Thesaurus Property-2
- C25699
- NCI Thesaurus ObjectClass
- C25357
- UMLS CUI [1,1]
- C0557514
- UMLS CUI [1,2]
- C0237753
- UMLS CUI [1,3]
- C0600091
- UMLS CUI [1,4]
- C1519429
Beskrivning
SouthwestOncologyGroupInvestigatorIdentifierNumber
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- NCI Thesaurus Property
- C25364
- NCI Thesaurus ObjectClass
- C25699
- NCI Thesaurus ObjectClass-2
- C17089
- UMLS CUI [1,1]
- C2986286
- UMLS CUI [1,2]
- C1519429
Beskrivning
SouthwestOncologyGroupTreatingInstitutionIdentifierNumber
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C25699
- NCI Thesaurus ObjectClass-2
- C25705
- NCI Thesaurus ObjectClass-3
- C41206
- NCI Thesaurus Property
- C25364
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI [1,1]
- C1519429
- UMLS CUI [1,2]
- C1272753
- UMLS CUI [1,3]
- C0600091
Beskrivning
Patient Information
Alias
- UMLS CUI-1
- C1955348
- UMLS CUI-2
- C0079744
Beskrivning
Treatment Start Date
Datatyp
date
Alias
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus ObjectClass-2
- C25631
- NCI Thesaurus Property
- C25431
- NCI Thesaurus Property-2
- C25275
- NCI Thesaurus ValueDomain
- C25164
- NCI Thesaurus ValueDomain-2
- C25431
- UMLS CUI [1,1]
- C0087111
- UMLS CUI [1,2]
- C0808070
Beskrivning
Stratification Questions
Beskrivning
DiffuseLargeB-CellLymphomaPositronEmissionTomographyR-CHOPRegimenDiagnosisCode
Datatyp
boolean
Alias
- NCI Thesaurus ObjectClass
- C8851
- NCI Thesaurus Property
- C17007
- NCI Thesaurus Property-2
- C15220
- NCI Thesaurus Property-3
- C9760
- NCI Thesaurus ValueDomain
- C25162
- UMLS CUI [1,1]
- C0079744
- UMLS CUI [1,2]
- C0032743
- UMLS CUI [1,3]
- C0011900
Beskrivning
Patient Eligibility
Alias
- UMLS CUI-1
- C1516637
- UMLS CUI-2
- C0013893
- UMLS CUI-3
- C0079744
Beskrivning
SouthwestOncologyGroupPatientRegistrationEligibilityDeterminationInd-2
Datatyp
boolean
Alias
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus ObjectClass-2
- C25699
- NCI Thesaurus Property
- C25646
- NCI Thesaurus Property-2
- C25171
- NCI Thesaurus ValueDomain
- C38147
- UMLS CUI [1,1]
- C0013893
- UMLS CUI [1,2]
- C1519429
Beskrivning
Auxiliary Questions
Alias
- UMLS CUI-1
- C0587500
- UMLS CUI-2
- C1955348
- UMLS CUI-3
- C0079744
Beskrivning
Radiation Therapy Start Date
Datatyp
date
Alias
- NCI Thesaurus ObjectClass
- C15313
- NCI Thesaurus Property
- C25431
- NCI Thesaurus Property-2
- C25275
- NCI Thesaurus ValueDomain
- C25164
- NCI Thesaurus ValueDomain-2
- C25367
- UMLS CUI [1,1]
- C1522449
- UMLS CUI [1,2]
- C0808070
Beskrivning
InstitutionRadiationTherapyAdministrationName
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C41206
- NCI Thesaurus Property
- C15313
- NCI Thesaurus Property-2
- C25409
- NCI Thesaurus ValueDomain
- C25191
- NCI Thesaurus ValueDomain-2
- C21541
- UMLS CUI [1,1]
- C1301943
- UMLS CUI [1,2]
- C1522449
Beskrivning
RadiationOncologyPhysicianName
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- NCI Thesaurus Property
- C25678
- NCI Thesaurus ObjectClass
- C25741
- NCI Thesaurus ObjectClass-2
- C17833
- UMLS CUI [1,1]
- C0260194
- UMLS CUI [1,2]
- C1547383
- UMLS CUI [1,3]
- C0600091
Similar models
INSTRUCTIONS: All of the information on this Registration Worksheet and the Protocol Eligibility Section must be answered appropriately for a patient to be considered eligible for registration. This Registration Worksheet must be entirely filled out and referred to during the registration. Do NOT submit this worksheet as part of the patient data.
- StudyEvent: S1001 Registration Worksheet Step 2
C25320 (NCI Thesaurus ObjectClass)
C64382 (NCI Thesaurus Property)
C41200 (NCI Thesaurus Property-2)
C1879547 (UMLS CUI [1,1])
C1507394 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
C25551 (NCI Thesaurus ValueDomain-2)
C1691222 (UMLS CUI [1,1])
C1517741 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
C25646 (NCI Thesaurus ObjectClass)
C16154 (NCI Thesaurus Property)
C16154 (NCI Thesaurus ValueDomain-2)
C1514821 (UMLS CUI [1,1])
C0237753 (UMLS CUI [1,2])
C1519429 (UMLS CUI [1,2])
C16960 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)
C25699 (NCI Thesaurus Property-2)
C2348585 (UMLS CUI-1)
C1519429 (UMLS CUI-2)
C1320722 (UMLS CUI-2)
C0079744 (UMLS CUI-3)
C25364 (NCI Thesaurus Property)
C25699 (NCI Thesaurus Property-2)
C25357 (NCI Thesaurus ObjectClass)
C0557514 (UMLS CUI [1,1])
C0237753 (UMLS CUI [1,2])
C0600091 (UMLS CUI [1,3])
C1519429 (UMLS CUI [1,4])
C25364 (NCI Thesaurus Property)
C25699 (NCI Thesaurus ObjectClass)
C17089 (NCI Thesaurus ObjectClass-2)
C2986286 (UMLS CUI [1,1])
C1519429 (UMLS CUI [1,2])
C25705 (NCI Thesaurus ObjectClass-2)
C41206 (NCI Thesaurus ObjectClass-3)
C25364 (NCI Thesaurus Property)
C25337 (NCI Thesaurus ValueDomain)
C1519429 (UMLS CUI [1,1])
C1272753 (UMLS CUI [1,2])
C0600091 (UMLS CUI [1,3])
C25631 (NCI Thesaurus ObjectClass-2)
C25431 (NCI Thesaurus Property)
C25275 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25431 (NCI Thesaurus ValueDomain-2)
C0087111 (UMLS CUI [1,1])
C0808070 (UMLS CUI [1,2])
C17007 (NCI Thesaurus Property)
C15220 (NCI Thesaurus Property-2)
C9760 (NCI Thesaurus Property-3)
C25162 (NCI Thesaurus ValueDomain)
C0079744 (UMLS CUI [1,1])
C0032743 (UMLS CUI [1,2])
C0011900 (UMLS CUI [1,3])
C0013893 (UMLS CUI-2)
C0079744 (UMLS CUI-3)
C25699 (NCI Thesaurus ObjectClass-2)
C25646 (NCI Thesaurus Property)
C25171 (NCI Thesaurus Property-2)
C38147 (NCI Thesaurus ValueDomain)
C0013893 (UMLS CUI [1,1])
C1519429 (UMLS CUI [1,2])
C1955348 (UMLS CUI-2)
C0079744 (UMLS CUI-3)
C25431 (NCI Thesaurus Property)
C25275 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
C1522449 (UMLS CUI [1,1])
C0808070 (UMLS CUI [1,2])
C15313 (NCI Thesaurus Property)
C25409 (NCI Thesaurus Property-2)
C25191 (NCI Thesaurus ValueDomain)
C21541 (NCI Thesaurus ValueDomain-2)
C1301943 (UMLS CUI [1,1])
C1522449 (UMLS CUI [1,2])
C25678 (NCI Thesaurus Property)
C25741 (NCI Thesaurus ObjectClass)
C17833 (NCI Thesaurus ObjectClass-2)
C0260194 (UMLS CUI [1,1])
C1547383 (UMLS CUI [1,2])
C0600091 (UMLS CUI [1,3])