ID
25153
Descrição
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
Link
Palavras-chave
Versões (2)
- 19/09/2012 19/09/2012 -
- 28/08/2017 28/08/2017 -
Transferido a
28 de agosto de 2017
DOI
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Licença
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
Descrição
Swog Patient Id
Descrição
SWOG Institutions
Alias
- UMLS CUI-1
- C1519429
- UMLS CUI-2
- C1320722
- UMLS CUI-3
- C0079744
Descrição
RegistrarSouthwestOncologyGroupIdentifierNumber
Tipo de dados
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
Descrição
SouthwestOncologyGroupInvestigatorIdentifierNumber
Tipo de dados
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
Descrição
SouthwestOncologyGroupTreatingInstitutionIdentifierNumber
Tipo de dados
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
Descrição
Patient Information
Alias
- UMLS CUI-1
- C1955348
- UMLS CUI-2
- C0079744
Descrição
Treatment Start Date
Tipo de dados
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
Descrição
Stratification Questions
Descrição
DiffuseLargeB-CellLymphomaPositronEmissionTomographyR-CHOPRegimenDiagnosisCode
Tipo de dados
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
Descrição
Patient Eligibility
Alias
- UMLS CUI-1
- C1516637
- UMLS CUI-2
- C0013893
- UMLS CUI-3
- C0079744
Descrição
SouthwestOncologyGroupPatientRegistrationEligibilityDeterminationInd-2
Tipo de dados
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
Descrição
Auxiliary Questions
Alias
- UMLS CUI-1
- C0587500
- UMLS CUI-2
- C1955348
- UMLS CUI-3
- C0079744
Descrição
Radiation Therapy Start Date
Tipo de dados
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
Descrição
InstitutionRadiationTherapyAdministrationName
Tipo de dados
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
Descrição
RadiationOncologyPhysicianName
Tipo de dados
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])