ID
42648
Descrição
RTOG 1016 FQ: Radiation Therapy Oncology Group Phase III Head and Neck Cancer Work Status Questionnaire 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=953353B4-562C-83C2-E040-BB89AD433EAB
Link
Palavras-chave
Versões (3)
- 18/12/2014 18/12/2014 - Martin Dugas
- 09/01/2015 09/01/2015 - Martin Dugas
- 17/09/2021 17/09/2021 -
Transferido a
17 de setembro de 2021
DOI
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Licença
Creative Commons BY-NC 3.0 Legacy
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NCT01302834 Quality of Life - RTOG 1016 FQ: Radiation Therapy Oncology Group Phase III Head and Neck Cancer Work Status Questionnaire - 3160066v1.0
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 FQ: Radiation Therapy Oncology Group Phase III Head and Neck Cancer Work Status Questionnaire
Descrição
Eortc Qlq-h&n35
Descrição
PersonGenderTextType
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus Property
- C17357
- UMLS 2011AA Property
- C0079399
Descrição
PatientAgeValue
Tipo de dados
float
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS 2011AA ValueDomain
- C0237753
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25150
- UMLS 2011AA Property
- C0001779
Descrição
EthnicGroupCategoryText
Tipo de dados
text
Alias
- NCI Thesaurus Property
- C25372
- UMLS 2011AA Property
- C0683312
- NCI Thesaurus ValueDomain
- C25372
- UMLS 2011AA ValueDomain
- C0683312
- NCI Thesaurus ObjectClass
- C16564
- UMLS 2011AA ObjectClass
- C0015031
Descrição
RaceCategoryText
Tipo de dados
text
Alias
- NCI Thesaurus Property
- C25372
- UMLS 2011AA Property
- C0683312
- NCI Thesaurus ValueDomain
- C25372
- UMLS 2011AA ValueDomain
- C0683312
- NCI Thesaurus ObjectClass
- C17049
- UMLS 2011AA ObjectClass
- C0034510
Descrição
PaternalRaceCategory
Tipo de dados
text
Alias
- NCI Thesaurus Property
- C25372
- UMLS 2011AA Property
- C0683312
- NCI Thesaurus ValueDomain
- C25372
- UMLS 2011AA ValueDomain
- C0683312
- NCI Thesaurus ObjectClass
- C17049
- UMLS 2011AA ObjectClass
- C0034510
- NCI Metathesaurus Property
- CL162064
Descrição
MaternalRaceCategory
Tipo de dados
text
Alias
- NCI Thesaurus Property
- C25372
- UMLS 2011AA Property
- C0683312
- NCI Thesaurus ValueDomain
- C25372
- UMLS 2011AA ValueDomain
- C0683312
- NCI Thesaurus ObjectClass
- C17049
- UMLS 2011AA ObjectClass
- C0034510
- NCI Thesaurus Property-2
- C89336
Descrição
PersonMaritalStatusCategory
Tipo de dados
text
Alias
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus ValueDomain
- C25372
- UMLS 2011AA ValueDomain
- C0683312
- NCI Thesaurus Property
- C25188
- UMLS 2011AA Property
- C0024819
Descrição
PatientResidenceRadiationTherapyOncologyGroupType
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus ValueDomain-2
- C19778
- UMLS 2011AA ValueDomain-2
- C1514695
- NCI Thesaurus Property
- C25273
- UMLS 2011AA Property
- C0237096
Descrição
CurrentEmploymentDescriptionStatus
Tipo de dados
text
Alias
- NCI Thesaurus ObjectClass
- C25471
- UMLS 2011AA ObjectClass
- C0521116
- NCI Thesaurus ObjectClass-2
- C25172
- UMLS 2011AA ObjectClass-2
- C0014003
- NCI Thesaurus ValueDomain
- C25688
- UMLS 2011AA ValueDomain
- C0449438
- NCI Thesaurus Property
- C25365
- UMLS 2011AA Property
- C0678257
Descrição
CurrentEmploymentDescriptionSpecify
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
- NCI Thesaurus ObjectClass
- C25471
- UMLS 2011AA ObjectClass
- C0521116
- NCI Thesaurus ObjectClass-2
- C25172
- UMLS 2011AA ObjectClass-2
- C0014003
- NCI Thesaurus Property
- C25365
- UMLS 2011AA Property
- C0678257
Descrição
PersonEducationLevelSummaryRadiationTherapyOncologyGroupType
Tipo de dados
text
Alias
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus Property
- C17953
- UMLS 2011AA Property
- C0013658
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus ValueDomain-2
- C19778
- UMLS 2011AA ValueDomain-2
- C1514695
- NCI Thesaurus ValueDomain-3
- C17953
- UMLS 2011AA ValueDomain-3
- C0013658
- NCI Thesaurus ValueDomain-4
- C42581
- UMLS 2011AA ValueDomain-4
- C1706244
Descrição
EmploymentPastInteger::12MonthCount
Tipo de dados
text
Alias
- NCI Thesaurus ObjectClass
- C25172
- UMLS 2011AA ObjectClass
- C0014003
- NCI Thesaurus Property
- C45255
- UMLS 2011AA Property
- C1708523
- NCI Thesaurus Property-2
- C29846
- UMLS 2011AA Property-2
- C0439231
- NCI Thesaurus Property-3
- C25609
- UMLS 2011AA Property-3
- C1444637
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus ValueDomain-2
- C19778
- UMLS 2011AA ValueDomain-2
- C1514695
Descrição
EmploymentWeekHourCount
Tipo de dados
float
Alias
- NCI Thesaurus ValueDomain
- C25463
- UMLS 2011AA ValueDomain
- C0750480
- NCI Thesaurus Property
- C25529
- UMLS 2011AA Property
- C0439227
- NCI Thesaurus Property-2
- C29844
- UMLS 2011AA Property-2
- C0439230
- NCI Thesaurus ObjectClass
- C25172
- UMLS 2011AA ObjectClass
- C0014003
Descrição
EmploymentDescriptionType
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus ObjectClass
- C25172
- UMLS 2011AA ObjectClass
- C0014003
- NCI Thesaurus Property
- C25365
- UMLS 2011AA Property
- C0678257
Descrição
EmploymentDescriptionSpecify
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
- NCI Thesaurus ObjectClass
- C25172
- UMLS 2011AA ObjectClass
- C0014003
- NCI Thesaurus Property
- C25365
- UMLS 2011AA Property
- C0678257
Descrição
EmploymentCategoryDescriptionType
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus Property
- C25372
- UMLS 2011AA Property
- C0683312
- NCI Thesaurus ObjectClass
- C25172
- UMLS 2011AA ObjectClass
- C0014003
- NCI Thesaurus Property-2
- C25365
- UMLS 2011AA Property-2
- C0678257
Descrição
EmploymentCategoryDescriptionSpecify
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
- NCI Thesaurus Property
- C25372
- UMLS 2011AA Property
- C0683312
- NCI Thesaurus ObjectClass
- C25172
- UMLS 2011AA ObjectClass
- C0014003
- NCI Thesaurus Property-2
- C25365
- UMLS 2011AA Property-2
- C0678257
Descrição
EmploymentHealthInsuranceIndicator
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
- NCI Thesaurus Property
- C16745
- UMLS 2011AA Property
- C0021672
- NCI Thesaurus Property-2
- C25178
- UMLS 2011AA Property-2
- C0018684
- NCI Thesaurus ObjectClass
- C25172
- UMLS 2011AA ObjectClass
- C0014003
Descrição
EmploymentHealthOtherPersonInsuranceType
Tipo de dados
text
Alias
- NCI Thesaurus ObjectClass
- C25172
- UMLS 2011AA ObjectClass
- C0014003
- NCI Thesaurus Property
- C17649
- UMLS 2011AA Property
- C0205394
- NCI Thesaurus Property-2
- C25190
- UMLS 2011AA Property-2
- C0027361
- NCI Thesaurus Property-3
- C16745
- UMLS 2011AA Property-3
- C0021672
- NCI Thesaurus Property-4
- C25178
- UMLS 2011AA Property-4
- C0018684
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
Descrição
EmploymentBenefitsIndicator
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
- NCI Thesaurus ObjectClass
- C25172
- UMLS 2011AA ObjectClass
- C0014003
- NCI Thesaurus Property
- C25387
- UMLS 2011AA Property
- C0814225
Descrição
IndividualIncomeRange
Tipo de dados
text
Alias
- NCI Thesaurus Property
- C41150
- UMLS 2011AA Property
- C0021162
- NCI Thesaurus ObjectClass
- C17719
- NCI Thesaurus ValueDomain
- C38013
- UMLS 2011AA ValueDomain
- C1514721
Descrição
PersonHouseholdIncomeRange
Tipo de dados
text
Alias
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus Property
- C70811
- UMLS 2011AA Property
- C0557163
- NCI Thesaurus ValueDomain
- C38013
- UMLS 2011AA ValueDomain
- C1514721
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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
- StudyEvent: RTOG 1016 FQ: Radiation Therapy Oncology Group Phase III Head and Neck Cancer Work Status Questionnaire
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1514695 (UMLS CUI-2)
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C0680532 (UMLS CUI-1)
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C25372 (NCI Thesaurus ValueDomain)
C0683312 (UMLS 2011AA ValueDomain)
C16564 (NCI Thesaurus ObjectClass)
C0015031 (UMLS 2011AA ObjectClass)
C0086409 (UMLS 2011AA)
C1518424 (UMLS 2011AA)
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C1513907 (UMLS 2011AA)
C1706613 (UMLS 2011AA)
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C0007457 (UMLS 2011AA)
C0683312 (UMLS 2011AA Property)
C25372 (NCI Thesaurus ValueDomain)
C0683312 (UMLS 2011AA ValueDomain)
C17049 (NCI Thesaurus ObjectClass)
C0034510 (UMLS 2011AA ObjectClass)
CL162064 (NCI Metathesaurus Property)
C1515945 (UMLS 2011AA)
C0078988 (UMLS 2011AA)
C0085756 (UMLS 2011AA)
C1513907 (UMLS 2011AA)
C1706613 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C0007457 (UMLS 2011AA)
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C25372 (NCI Thesaurus ValueDomain)
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C0034510 (UMLS 2011AA ObjectClass)
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C1515945 (UMLS 2011AA)
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C0085756 (UMLS 2011AA)
C1513907 (UMLS 2011AA)
C1706613 (UMLS 2011AA)
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C0007457 (UMLS 2011AA)
C0027361 (UMLS 2011AA ObjectClass)
C25372 (NCI Thesaurus ValueDomain)
C0683312 (UMLS 2011AA ValueDomain)
C25188 (NCI Thesaurus Property)
C0024819 (UMLS 2011AA Property)
C0086170 (UMLS 2011AA)
C1549111 (UMLS 2011AA)
C0555047 (UMLS 2011AA)
C0027952 (UMLS 2011AA)
C0086972 (UMLS 2011AA)
C0206275 (UMLS 2011AA)
C0332307 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C19778 (NCI Thesaurus ValueDomain-2)
C1514695 (UMLS 2011AA ValueDomain-2)
C25273 (NCI Thesaurus Property)
C0237096 (UMLS 2011AA Property)
C0521116 (UMLS 2011AA ObjectClass)
C25172 (NCI Thesaurus ObjectClass-2)
C0014003 (UMLS 2011AA ObjectClass-2)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
C25365 (NCI Thesaurus Property)
C0678257 (UMLS 2011AA Property)
C0439673 (UMLS 2011AA)
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C25172 (NCI Thesaurus ObjectClass-2)
C0014003 (UMLS 2011AA ObjectClass-2)
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C17953 (NCI Thesaurus Property)
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C19778 (NCI Thesaurus ValueDomain-2)
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C42581 (NCI Thesaurus ValueDomain-4)
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C52581 (NCI Thesaurus-3)
C1711333 (UMLS 2011AA-4)
C75558 (NCI Thesaurus-5)
C2698884 (UMLS 2011AA-6)
C25354 (NCI Thesaurus-7)
C0542560 (UMLS 2011AA-8)
C1511035 (UMLS 2011AA)
C0683859 (UMLS 2011AA)
C0870649 (UMLS 2011AA)
C37998 (NCI Thesaurus-3)
C1518602 (UMLS 2011AA-4)
C67135 (NCI Thesaurus-5)
C1880947 (UMLS 2011AA-6)
C0557286 (UMLS 2011AA)
C2825140 (UMLS 2011AA)
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C71340 (NCI Thesaurus-3)
C1549943 (UMLS 2011AA-4)
C65099 (NCI Thesaurus-5)
C0205392 (UMLS 2011AA-6)
C61514 (NCI Thesaurus-7)
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C0439231 (UMLS 2011AA Property-2)
C25609 (NCI Thesaurus Property-3)
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C0013622 (UMLS 2011AA)
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C25172 (NCI Thesaurus ObjectClass)
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C0205394 (UMLS 2011AA Property)
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C16745 (NCI Thesaurus Property-3)
C0021672 (UMLS 2011AA Property-3)
C25178 (NCI Thesaurus Property-4)
C0018684 (UMLS 2011AA Property-4)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C25172 (NCI Thesaurus ObjectClass)
C0014003 (UMLS 2011AA ObjectClass)
C25387 (NCI Thesaurus Property)
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C0027361 (UMLS 2011AA ObjectClass)
C70811 (NCI Thesaurus Property)
C0557163 (UMLS 2011AA Property)
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C1514721 (UMLS 2011AA ValueDomain)