ID

2563

Beskrivning

Follow-up Assessment (FA) Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=B122D2BC-9A32-4DD0-E034-0003BA12F5E7

Länk

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=B122D2BC-9A32-4DD0-E034-0003BA12F5E7

Nyckelord

  1. 2012-09-19 2012-09-19 -
  2. 2015-01-09 2015-01-09 - Martin Dugas
Uppladdad den

19 september 2012

DOI

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Licens

Creative Commons BY-NC 3.0 Legacy

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Melanoma (Skin) Follow-Up - Follow-up Assessment (FA) - 2074729v3.0

No Instruction available.

  1. StudyEvent: Follow-up Assessment (FA)
    1. No Instruction available.
Ccrr Module For Follow-up Assessment (fa)
Beskrivning

Ccrr Module For Follow-up Assessment (fa)

Patient ID (Pt. ID issued during registration or previously issued patient ID)
Beskrivning

Pt.ID

Datatyp

text

Institution ID:
Beskrivning

InstitutionNo.

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
Patient Initials: (F ML)
Beskrivning

PatientInitialsName

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25536
UMLS 2011AA Property
C1555582
Institution:
Beskrivning

InstitutionName

Datatyp

text

Date of History and Physical:
Beskrivning

DateofHistoryandPhysical:

Datatyp

text

Alias
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus Property
C38000
UMLS 2011AA Property
C0884358
NCI Thesaurus ObjectClass
C18772
UMLS 2011AA ObjectClass
C0262926
Date of P/A and Lateral Chest X-ray
Beskrivning

DateofP/AandLateralChestX-ray

Datatyp

text

Date of LDH: (Year Month Day)
Beskrivning

DateLDHObtained

Datatyp

text

Is LDH greater than upper limit of institutional norm:
Beskrivning

IsLDHgreaterthanupperlimitofinstitutionalnorm:

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
Completed by:
Beskrivning

CompletedBy

Datatyp

text

Date: (Year Month Day)
Beskrivning

FormCompletionDate,Original

Datatyp

date

Similar models

No Instruction available.

  1. StudyEvent: Follow-up Assessment (FA)
    1. No Instruction available.
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Ccrr Module For Follow-up Assessment (fa)
Pt.ID
Item
Patient ID (Pt. ID issued during registration or previously issued patient ID)
text
InstitutionNo.
Item
Institution ID:
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
PatientInitialsName
Item
Patient Initials: (F ML)
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25536 (NCI Thesaurus Property)
C1555582 (UMLS 2011AA Property)
InstitutionName
Item
Institution:
text
DateofHistoryandPhysical:
Item
Date of History and Physical:
text
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C18772 (NCI Thesaurus ObjectClass)
C0262926 (UMLS 2011AA ObjectClass)
DateofP/AandLateralChestX-ray
Item
Date of P/A and Lateral Chest X-ray
text
DateLDHObtained
Item
Date of LDH: (Year Month Day)
text
Item
Is LDH greater than upper limit of institutional norm:
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
Code List
Is LDH greater than upper limit of institutional norm:
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CompletedBy
Item
Completed by:
text
FormCompletionDate,Original
Item
Date: (Year Month Day)
date

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