ID
3019
Descripción
RTOG 1016 FM: Radiation Therapy Oncology Group Phase III Head and Neck Cancer Work Status Questionnaire Follow-Up Survey Radiation Therapy With Cisplatin or Cetuximab in Treating Patients With Oropharyngeal Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=9F2D8F51-F2B1-6515-E040-BB89AD434E1D
Link
Palabras clave
Versiones (2)
- 19/9/12 19/9/12 -
- 9/1/15 9/1/15 - Martin Dugas
Subido en
19 de septiembre de 2012
DOI
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Licencia
Creative Commons BY-NC 3.0 Legacy
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NCT01302834 Quality of Life - RTOG 1016 FM: Radiation Therapy Oncology Group Phase III Head and Neck Cancer Work Status Questionnaire Follow-Up Survey - 3209056v1.0
INSTRUCTIONS: Complete and submit this form as required by the protocol. Information in the upper right box must be completed for this form to be accepted. For optimal accuracy use black ink. Mark an X in the appropriate box for fields with a choice
- StudyEvent: RTOG 1016 FM: Radiation Therapy Oncology Group Phase III Head and Neck Cancer Work Status Questionnaire Follow-Up Survey
Descripción
Follow-up Survey
Descripción
CurrentEmploymentDescriptionStatus
Tipo de datos
text
Alias
- NCI Thesaurus ObjectClass
- C25471
- UMLS 2011AA ObjectClass
- C0521116
- NCI Thesaurus ObjectClass
- C25172
- UMLS 2011AA ObjectClass
- C0014003
- NCI Thesaurus ValueDomain
- C25688
- UMLS 2011AA ValueDomain
- C0449438
- NCI Thesaurus Property
- C25365
- UMLS 2011AA Property
- C0678257
Descripción
CurrentEmploymentDescriptionSpecify
Tipo de datos
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
- NCI Thesaurus ObjectClass
- C25471
- UMLS 2011AA ObjectClass
- C0521116
- NCI Thesaurus ObjectClass
- C25172
- UMLS 2011AA ObjectClass
- C0014003
- NCI Thesaurus Property
- C25365
- UMLS 2011AA Property
- C0678257
Descripción
EmploymentWeekHourCount
Tipo de datos
double
Alias
- NCI Thesaurus ValueDomain
- C25463
- UMLS 2011AA ValueDomain
- C0750480
- NCI Thesaurus Property
- C25529
- UMLS 2011AA Property
- C0439227
- NCI Thesaurus Property
- C29844
- UMLS 2011AA Property
- C0439230
- NCI Thesaurus ObjectClass
- C25172
- UMLS 2011AA ObjectClass
- C0014003
Descripción
PatientEmploymentAbsentDayCount
Tipo de datos
double
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C48190
- UMLS 2011AA Property
- C0332197
- NCI Thesaurus Property
- C25172
- UMLS 2011AA Property
- C0014003
- NCI Thesaurus ValueDomain
- C25301
- UMLS 2011AA ValueDomain
- C0439228
- NCI Thesaurus ValueDomain
- C25463
- UMLS 2011AA ValueDomain
- C0750480
Descripción
EmployerFlexibleStatus
Tipo de datos
text
Alias
- NCI Thesaurus ValueDomain
- C25688
- UMLS 2011AA ValueDomain
- C0449438
- NCI Thesaurus ObjectClass
- C54144
- UMLS 2011AA ObjectClass
- C1274022
- NCI Thesaurus Property
- C80495
- UMLS 2011AA Property
- C0443220
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INSTRUCTIONS: Complete and submit this form as required by the protocol. Information in the upper right box must be completed for this form to be accepted. For optimal accuracy use black ink. Mark an X in the appropriate box for fields with a choice
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