ID
42648
Description
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
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Versions (3)
- 18/12/2014 18/12/2014 - Martin Dugas
- 09/01/2015 09/01/2015 - Martin Dugas
- 17/09/2021 17/09/2021 -
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17 septembre 2021
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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
Description
Eortc Qlq-h&n35
Description
PersonGenderTextType
Type de données
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
Description
PatientAgeValue
Type de données
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
Description
EthnicGroupCategoryText
Type de données
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
Description
RaceCategoryText
Type de données
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
Description
PaternalRaceCategory
Type de données
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
Description
MaternalRaceCategory
Type de données
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
Description
PersonMaritalStatusCategory
Type de données
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
Description
PatientResidenceRadiationTherapyOncologyGroupType
Type de données
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
Description
CurrentEmploymentDescriptionStatus
Type de données
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
Description
CurrentEmploymentDescriptionSpecify
Type de données
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
Description
PersonEducationLevelSummaryRadiationTherapyOncologyGroupType
Type de données
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
Description
EmploymentPastInteger::12MonthCount
Type de données
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
Description
EmploymentWeekHourCount
Type de données
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
Description
EmploymentDescriptionType
Type de données
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
Description
EmploymentDescriptionSpecify
Type de données
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
Description
EmploymentCategoryDescriptionType
Type de données
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
Description
EmploymentCategoryDescriptionSpecify
Type de données
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
Description
EmploymentHealthInsuranceIndicator
Type de données
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
Description
EmploymentHealthOtherPersonInsuranceType
Type de données
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
Description
EmploymentBenefitsIndicator
Type de données
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
Description
IndividualIncomeRange
Type de données
text
Alias
- NCI Thesaurus Property
- C41150
- UMLS 2011AA Property
- C0021162
- NCI Thesaurus ObjectClass
- C17719
- NCI Thesaurus ValueDomain
- C38013
- UMLS 2011AA ValueDomain
- C1514721
Description
PersonHouseholdIncomeRange
Type de données
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)
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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)
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C0086972 (UMLS 2011AA)
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C0030705 (UMLS 2011AA ObjectClass)
C19778 (NCI Thesaurus ValueDomain-2)
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C0237096 (UMLS 2011AA Property)
C0521116 (UMLS 2011AA ObjectClass)
C25172 (NCI Thesaurus ObjectClass-2)
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C25688 (NCI Thesaurus ValueDomain)
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C19778 (NCI Thesaurus ValueDomain-2)
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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)
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C65099 (NCI Thesaurus-5)
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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)
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C0014003 (UMLS 2011AA ObjectClass)
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C0027361 (UMLS 2011AA ObjectClass)
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