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ID

369

Descrizione

E1900 Cover Page for Hematology Form Combination Chemotherapy With or Without Monoclonal Antibody Therapy Followed by Stem Cell Transplant in Treating Patients With Acute Myeloid Leukemia Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=B19AB29D-AC61-25E1-E034-0003BA12F5E7

collegamento

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=B19AB29D-AC61-25E1-E034-0003BA12F5E7

Keywords

versioni (2)
  1. 25/05/12 25/05/12 -
  2. 09/01/15 09/01/15 - Martin Dugas
Caricato su

25 maggio 2012

DOI

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Licenza

Creative Commons BY-NC 3.0 Legacy
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    Leukemia NCT00049517 Lab - E1900 Cover Page for Hematology Form - 2075140v3.0

    Inglese

    No Instruction available.

    1 moduli  
    1. StudyEvent: E1900 Cover Page for Hematology Form
      1. No Instruction available.
    Unnamed1
    Descrizione

    Unnamed1

    DCI Name
    Descrizione

    CollectedDataFormName

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS 2011AA ValueDomain
    C1547383
    NCI Thesaurus Property
    C19464
    UMLS 2011AA Property
    C0376315
    NCI Thesaurus ObjectClass
    C25474
    UMLS 2011AA ObjectClass
    C1511726
    NCI Thesaurus ObjectClass
    C25452
    Patient Initials
    Descrizione

    PatientInitialsName

    Tipo di dati

    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
    ECOG Protocol Number
    Descrizione

    ECOGProtocolNumber

    Tipo di dati

    text

    ECOG Protocol Number
    Descrizione

    ECOGProtocolNumber

    Tipo di dati

    text

    ECOG Protocol Number
    Descrizione

    ECOGProtocolNumber

    Tipo di dati

    text

    ECOG Patient ID
    Descrizione

    ECOGPatientID

    Tipo di dati

    text

    ECOG Patient ID
    Descrizione

    ECOGPatientID

    Tipo di dati

    text

    Participating Group Protocol No.
    Descrizione

    ParticipatingGroupProtocolNo.

    Tipo di dati

    text

    Participating Group Patient ID
    Descrizione

    ParticipatingGroupPatientID

    Tipo di dati

    text

    Institution/Affiliate
    Descrizione

    MainMemberInstitution/Affiliate

    Tipo di dati

    text

    On Treatment
    Descrizione

    On Treatment

    On Treatment Time Period
    Descrizione

    OnTreatmentTimePeriod

    Tipo di dati

    text

    Off Treatment
    Descrizione

    Off Treatment

    Off Treatment Time Period
    Descrizione

    OffTreatmentTimePeriod

    Tipo di dati

    text

    Alias
    NCI Thesaurus ObjectClass
    C25190
    UMLS 2011AA ObjectClass
    C0027361
    NCI Thesaurus Property
    C25616
    UMLS 2011AA Property
    C1948053
    NCI Thesaurus Property
    C25601
    UMLS 2011AA Property
    C1518544
    NCI Thesaurus Property
    C25207
    UMLS 2011AA Property
    C0040223
    NCI Thesaurus ValueDomain
    C25284
    UMLS 2011AA ValueDomain
    C0332307
    Ccrr Module For E1900 Cover Page For Hematology Form
    Descrizione

    Ccrr Module For E1900 Cover Page For Hematology Form

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    Similar models

    No Instruction available.

    1 moduli
    1. StudyEvent: E1900 Cover Page for Hematology Form
      1. No Instruction available.
    Name
    genere
    Description | Question | Decode (Coded Value)
    Tipo di dati
    Alias
    Item Group
    Unnamed1
    CollectedDataFormName
    Item
    DCI Name
    text
    C25191 (NCI Thesaurus ValueDomain)
    C1547383 (UMLS 2011AA ValueDomain)
    C19464 (NCI Thesaurus Property)
    C0376315 (UMLS 2011AA Property)
    C25474 (NCI Thesaurus ObjectClass)
    C1511726 (UMLS 2011AA ObjectClass)
    C25452 (NCI Thesaurus ObjectClass)
    PatientInitialsName
    Item
    Patient Initials
    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)
    ECOGProtocolNumber
    Item
    ECOG Protocol Number
    text
    ECOGProtocolNumber
    Item
    ECOG Protocol Number
    text
    ECOGProtocolNumber
    Item
    ECOG Protocol Number
    text
    ECOGPatientID
    Item
    ECOG Patient ID
    text
    ECOGPatientID
    Item
    ECOG Patient ID
    text
    ParticipatingGroupProtocolNo.
    Item
    Participating Group Protocol No.
    text
    ParticipatingGroupPatientID
    Item
    Participating Group Patient ID
    text
    MainMemberInstitution/Affiliate
    Item
    Institution/Affiliate
    text
    Item Group
    On Treatment
    Item
    On Treatment Time Period
    text
    CL.1
    Code List
    On Treatment Time Period
    CL Item
    Induction (Induction)
    CL042203 (NCI Metathesaurus)
    CL Item
    Induction, Additional Forms (Induction, additional Forms)
    CL Item
    Consolidation (Consolidation)
    CL Item
    Post-transplant (Post-Transplant)
    Item Group
    Off Treatment
    Item
    Off Treatment Time Period
    text
    C25190 (NCI Thesaurus ObjectClass)
    C0027361 (UMLS 2011AA ObjectClass)
    C25616 (NCI Thesaurus Property)
    C1948053 (UMLS 2011AA Property)
    C25601 (NCI Thesaurus Property)
    C1518544 (UMLS 2011AA Property)
    C25207 (NCI Thesaurus Property)
    C0040223 (UMLS 2011AA Property)
    C25284 (NCI Thesaurus ValueDomain)
    C0332307 (UMLS 2011AA ValueDomain)
    CL.2
    Code List
    Off Treatment Time Period
    CL Item
    3 Months (3 months)
    CL Item
    6 Months (6 months)
    CL Item
    9 Months (9 months)
    CL Item
    12 Months (12 months)
    CL Item
    15 Months (15 months)
    CL Item
    18 Months (18 months)
    CL Item
    24 Months (24 months)
    CL Item
    30 Months (30 months)
    CL Item
    36 Months (36 months)
    CL Item
    42 Months (42 months)
    CL Item
    48 Months (48 months)
    CL Item
    54 Months (54 months)
    CL Item
    60 Months (60 months)
    CL Item
    2 Years (2 years)
    CL Item
    3 Years (3 years)
    CL Item
    4 Years (4 years)
    CL Item
    5 Years (5 years)
    CL Item
    6 Years (6 years)
    CL Item
    7 Years (7 years)
    CL Item
    8 Years (8 years)
    CL Item
    9 Years (9 years)
    CL Item
    10 Years (10 years)
    Item Group
    Ccrr Module For E1900 Cover Page For Hematology Form
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