ID

2627

Beskrivning

E2410 Registration Worksheet (Step 2) Chemotherapy Based on PET Scan in Treating Patients With Stage I or Stage II Hodgkin Lymphoma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=B0DB2488-DEEB-F2F5-E040-BB89AD430E38

Länk

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=B0DB2488-DEEB-F2F5-E040-BB89AD430E38

Nyckelord

Versioner (2)
  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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Lymphoma NCT01390584 Eligibility - E2410 Registration Worksheet (Step 2) - 3299717v1.0

Engelsk

No Instruction available.

1 Formulär  
  1. StudyEvent: E2410 Registration Worksheet (Step 2)
    1. No Instruction available.
Eligibility
Beskrivning

Eligibility

Has the eligibility checklist been completed
Beskrivning

EligibilityDeterminationChecklistCompleteEligibilityInd-2

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus Property
C25250
UMLS 2011AA Property
C0205197
NCI Thesaurus ObjectClass
C25171
UMLS 2011AA ObjectClass
C0013893
NCI Thesaurus Property
C49073
UMLS 2011AA Property
C1707357
In the opinion of the investigator, is the patient eligible?
Beskrivning

PatientEligibilityIndicator

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25171
UMLS 2011AA Property
C0013893
Indicate the PET-CT scan result that was determined centrally and reported to you
Beskrivning

PositronEmissionTomographyComputedTomographyDiagnosticImagingClinicalTrialEligibilityCriteriaStatus

Datatyp

text

Alias
NCI Thesaurus ObjectClass
C17007
UMLS 2011AA ObjectClass
C0032743
NCI Thesaurus ObjectClass
C16502
UMLS 2011AA ObjectClass
C0011923
NCI Thesaurus ObjectClass
C17204
UMLS 2011AA ObjectClass
C0040405
NCI Thesaurus Property
C16112
UMLS 2011AA Property
C1516637
NCI Thesaurus ValueDomain
C25688
UMLS 2011AA ValueDomain
C0449438
Radiation Oncology Facility (Enter response)
Beskrivning

RadiationOncologyHealthcareFacilityRadiationTherapyPerformedText

Datatyp

text

Alias
NCI Thesaurus ObjectClass
C21541
UMLS 2011AA ObjectClass
C0018704
NCI Thesaurus ObjectClass
C17760
UMLS 2011AA ObjectClass
C0243005
NCI Thesaurus Property
C15313
UMLS 2011AA Property
C1522449
NCI Thesaurus Property
C38000
UMLS 2011AA Property
C0884358
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
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Similar models

No Instruction available.

1 Formulär
  1. StudyEvent: E2410 Registration Worksheet (Step 2)
    1. No Instruction available.
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Eligibility
Item
Has the eligibility checklist been completed
text
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C25171 (NCI Thesaurus ObjectClass)
C0013893 (UMLS 2011AA ObjectClass)
C49073 (NCI Thesaurus Property)
C1707357 (UMLS 2011AA Property)
CL.1
Code List
Has the eligibility checklist been completed
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
In the opinion of the investigator, is the patient eligible?
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25171 (NCI Thesaurus Property)
C0013893 (UMLS 2011AA Property)
CL.2
Code List
In the opinion of the investigator, is the patient eligible?
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
Indicate the PET-CT scan result that was determined centrally and reported to you
text
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C16502 (NCI Thesaurus ObjectClass)
C0011923 (UMLS 2011AA ObjectClass)
C17204 (NCI Thesaurus ObjectClass)
C0040405 (UMLS 2011AA ObjectClass)
C16112 (NCI Thesaurus Property)
C1516637 (UMLS 2011AA Property)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
CL.3
Code List
Indicate the PET-CT scan result that was determined centrally and reported to you
CL Item
Positron Emission Tomography Negative Finding (PET Negative)
C17007 (NCI Thesaurus)
C0032743 (UMLS 2011AA)
C38757 (NCI Thesaurus)
C1513916 (UMLS 2011AA)
CL Item
Positron Emission Tomography Positive (PET Positive)
C17007 (NCI Thesaurus)
C0032743 (UMLS 2011AA)
C0205159 (NCI Metathesaurus)
RadiationOncologyHealthcareFacilityRadiationTherapyPerformedText
Item
Radiation Oncology Facility (Enter response)
text
C21541 (NCI Thesaurus ObjectClass)
C0018704 (UMLS 2011AA ObjectClass)
C17760 (NCI Thesaurus ObjectClass)
C0243005 (UMLS 2011AA ObjectClass)
C15313 (NCI Thesaurus Property)
C1522449 (UMLS 2011AA Property)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
Tillbaka till toppen 

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