ID

2830

Description

The collection of CDEs used in the Enrollment module. The enrollment process occurs when the center's registrar receives and reviews the registration information and makes a determination to accept or not accept the application. If the participant is deemed acceptable, the center enrolls the participant in the study and the coordinating center returns a notification to the registering institution indicating that the proposed participant is enrolled. Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=4C051B61-911C-226D-E044-0003BA3F9857

Lien

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=4C051B61-911C-226D-E044-0003BA3F9857

Mots-clés

Versions (1)
  1. 19/09/2012 19/09/2012 -
Téléchargé le

19 septembre 2012

DOI

Pour une demande vous connecter.

Licence

Creative Commons BY-NC 3.0 Legacy
Modèle Commentaires :

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Pre-Study - NCI Standard Enrollment Template - 2745052v1.0

Anglais

No Instruction available.

1 Formulaires  
  1. StudyEvent: NCI Standard Enrollment Template
    1. No Instruction available.
Mandatory
Description

Mandatory

Study Participant Identifier (Enter the identifier assigned to a participant.)
Description

PatientIdentifier

Type de données

text

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus ValueDomain
C25364
UMLS 2011AA ValueDomain
C0600091
Enrollment Date (Enter the date the participant is accepted into the study.)
Description

ParticipantEnrollmentDate

Type de données

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C29867
UMLS 2011AA ObjectClass
C0679646
NCI Thesaurus Property
C37948
UMLS 2011AA Property
C1516879
NCI Thesaurus ValueDomain
C37948
UMLS 2011AA ValueDomain
C1516879
Conditional Module
Description

Conditional Module

Treatment Arm (Enter the term that describes the assigned treatment arm.)
Description

ProtocolArmAssignmentText

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus ObjectClass
C15538
UMLS 2011AA ObjectClass
C1522541
NCI Thesaurus Property
C25426
UMLS 2011AA Property
C1516050
Intergroup Participant Identifier (Enter the identifier assigned to an intergroup clinical protocol participant.)
Description

PatientMultipleClinicalTrialsCooperativeGroupIdentifierNumber

Type de données

text

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus Property
C17648
UMLS 2011AA Property
C0439064
NCI Thesaurus Property
C18205
UMLS 2011AA Property
C1521808
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
Optional Participant Id Questions
Description

Optional Participant Id Questions

Site Registrar
Description

ProtocolRegistrarName

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus ObjectClass
C25357
UMLS 2011AA ObjectClass
C0557514
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Similar models

No Instruction available.

1 Formulaires
  1. StudyEvent: NCI Standard Enrollment Template
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Type de données
Alias
PatientIdentifier
Item
Study Participant Identifier (Enter the identifier assigned to a participant.)
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C25364 (NCI Thesaurus ValueDomain)
C0600091 (UMLS 2011AA ValueDomain)
ParticipantEnrollmentDate
Item
Enrollment Date (Enter the date the participant is accepted into the study.)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C29867 (NCI Thesaurus ObjectClass)
C0679646 (UMLS 2011AA ObjectClass)
C37948 (NCI Thesaurus Property)
C1516879 (UMLS 2011AA Property)
C37948 (NCI Thesaurus ValueDomain)
C1516879 (UMLS 2011AA ValueDomain)
Item Group
Conditional Module
ProtocolArmAssignmentText
Item
Treatment Arm (Enter the term that describes the assigned treatment arm.)
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C15538 (NCI Thesaurus ObjectClass)
C1522541 (UMLS 2011AA ObjectClass)
C25426 (NCI Thesaurus Property)
C1516050 (UMLS 2011AA Property)
PatientMultipleClinicalTrialsCooperativeGroupIdentifierNumber
Item
Intergroup Participant Identifier (Enter the identifier assigned to an intergroup clinical protocol participant.)
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C17648 (NCI Thesaurus Property)
C0439064 (UMLS 2011AA Property)
C18205 (NCI Thesaurus Property)
C1521808 (UMLS 2011AA Property)
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
Item Group
Optional Participant Id Questions
ProtocolRegistrarName
Item
Site Registrar
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C25357 (NCI Thesaurus ObjectClass)
C0557514 (UMLS 2011AA ObjectClass)
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