ID
42901
Description
E6508 Registration Worksheet (step 2) Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=683ADC5E-C8AE-081D-E040-BB89AD4336AC
Link
Keywords
Versions (3)
- 8/27/12 8/27/12 -
- 1/9/15 1/9/15 - Martin Dugas
- 9/17/21 9/17/21 -
Uploaded on
September 17, 2021
DOI
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License
Creative Commons BY-NC 3.0 Legacy
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Eligibility - E6508 Lung Cancer Registration Worksheet (step 2) - 2862658v1.0
No Instruction available.
- StudyEvent: E6508 Lung Cancer Registration Worksheet (step 2)
Description
Race
Description
Racial Group
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25372
- UMLS CUI-1
- C0034510
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C17049
Description
Patient Demographics / Pre-treatment Characteristics
Description
PatientSexCode
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C28421
- UMLS 2011AA Property
- C1522384
- NCI Thesaurus ValueDomain
- C25162
- UMLS 2011AA ValueDomain
- C0805701
- NCI Thesaurus ValueDomain-2
- C16960
- UMLS 2011AA ValueDomain-2
- C0030705
- NCI Thesaurus ValueDomain-3
- C28421
- UMLS 2011AA ValueDomain-3
- C1522384
Description
Birth Date
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C0421451
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25155
Description
AddressPostalCodeIdentifier
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C25407
- UMLS 2011AA ObjectClass
- C1442065
- NCI Thesaurus Property
- C25621
- UMLS 2011AA Property
- C1514254
- NCI Thesaurus ValueDomain
- C25364
- UMLS 2011AA ValueDomain
- C0600091
- NCI Thesaurus ValueDomain-2
- C25407
- UMLS 2011AA ValueDomain-2
- C1442065
- NCI Thesaurus ValueDomain-3
- C25621
- UMLS 2011AA ValueDomain-3
- C1514254
Description
Ethnic Group
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25372
- UMLS CUI-1
- C0015031
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C16564
Description
Medical Record Number
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C1301894
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25261
- NCI Thesaurus Property-2
- C25198
Description
Social Security Number
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C1301821
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25686
Description
PatientInternationalPaymentType
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25371
- UMLS 2011AA Property
- C0680264
- NCI Thesaurus Property-2
- C25541
- UMLS 2011AA Property-2
- C1512888
Description
AttendingPhysicianIdentifierIndividualsName
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS 2011AA ValueDomain
- C1547383
- NCI Thesaurus Property
- C25364
- UMLS 2011AA Property
- C0600091
- NCI Metathesaurus ObjectClass
- CL317115
Description
InstitutionContactPersonName
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS 2011AA ValueDomain
- C1547383
- NCI Thesaurus ObjectClass
- C21541
- UMLS 2011AA ObjectClass
- C0018704
- NCI Thesaurus Property
- C25364
- UMLS 2011AA Property
- C0600091
- NCI Thesaurus ObjectClass-2
- C25461
- UMLS 2011AA ObjectClass-2
- C0337611
Description
Protocol Registrar
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS CUI-1
- C1507394
- NCI Thesaurus Property
- C25364
- UMLS CUI-2
- C0557514
- NCI Thesaurus ObjectClass
- C25357
Description
PatientAddressCountryCode
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25162
- UMLS 2011AA ValueDomain
- C0805701
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25407
- UMLS 2011AA Property
- C1442065
Description
Research Comments
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C0947611
- NCI Thesaurus ObjectClass
- C15319
- NCI Thesaurus Property
- C25393
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No Instruction available.
- StudyEvent: E6508 Lung Cancer Registration Worksheet (step 2)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C0205435 (UMLS CUI-2)
C25536 (NCI Thesaurus Property)
C25509 (NCI Thesaurus Property-2)
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C0013893 (UMLS 2011AA ObjectClass)
C49073 (NCI Thesaurus Property-2)
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C25491 (NCI Thesaurus Property)
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C25673 (NCI Thesaurus Property-2)
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C1707660 (UMLS 2011AA Property-3)
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C0034510 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C17049 (NCI Thesaurus Property)
C0007457 (UMLS 2011AA)
C0085756 (UMLS 2011AA)
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C0078988 (UMLS 2011AA)
C1515945 (UMLS 2011AA)
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C0030705 (UMLS 2011AA ObjectClass)
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C0421451 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
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C1442065 (UMLS 2011AA ObjectClass)
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C25407 (NCI Thesaurus ValueDomain-2)
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C25621 (NCI Thesaurus ValueDomain-3)
C1514254 (UMLS 2011AA ValueDomain-3)
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C16960 (NCI Thesaurus ObjectClass)
C16564 (NCI Thesaurus Property)
C0086409 (UMLS 2011AA)
C1518424 (UMLS 2011AA)
C1706613 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C1301894 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25261 (NCI Thesaurus Property)
C25198 (NCI Thesaurus Property-2)
C1301821 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25686 (NCI Thesaurus Property)
C0332307 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
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C0600091 (UMLS 2011AA Property)
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C0337611 (UMLS 2011AA ObjectClass-2)
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C0805701 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25407 (NCI Thesaurus Property)
C1442065 (UMLS 2011AA Property)
C0002838 (UMLS 2011AA)
C0041698 (UMLS 2011AA)
C0001732 (UMLS 2011AA)
C0003354 (UMLS 2011AA)
C0003353 (UMLS 2011AA)
C0003798 (UMLS 2011AA)
C0003023 (UMLS 2011AA)
C0454691 (UMLS 2011AA)
C0003761 (UMLS 2011AA)
C0242536 (UMLS 2011AA)
C0004348 (UMLS 2011AA)
C0004340 (UMLS 2011AA)
C0282379 (UMLS 2011AA)
C0006036 (UMLS 2011AA)
C0004739 (UMLS 2011AA)
C0004732 (UMLS 2011AA)
C0004950 (UMLS 2011AA)
C0006409 (UMLS 2011AA)
C0006368 (UMLS 2011AA)
C0004684 (UMLS 2011AA)
C0006448 (UMLS 2011AA)
C0005126 (UMLS 2011AA)
C0006320 (UMLS 2011AA)
C0005918 (UMLS 2011AA)
C0006137 (UMLS 2011AA)
C0004683 (UMLS 2011AA)
C0005341 (UMLS 2011AA)
C1511278 (UMLS 2011AA)
C0006041 (UMLS 2011AA)
C0006539 (UMLS 2011AA)
C0004952 (UMLS 2011AA)
C0006823 (UMLS 2011AA)
C0009738 (UMLS 2011AA)
C0039021 (UMLS 2011AA)
C0009956 (UMLS 2011AA)
C0006802 (UMLS 2011AA)
C0008115 (UMLS 2011AA)
C3245499 (UMLS 2011AA)
C0010182 (UMLS 2011AA)
C0010435 (UMLS 2011AA)
C0006893 (UMLS 2011AA)
C0006888 (UMLS 2011AA)
C0010622 (UMLS 2011AA)
C0206578 (UMLS 2011AA)
C0019905 (UMLS 2011AA)
C0010343 (UMLS 2011AA)
C0018510 (UMLS 2011AA)
C0020174 (UMLS 2011AA)
C0021247 (UMLS 2011AA)
C0022067 (UMLS 2011AA)
C0022271 (UMLS 2011AA)
C0021201 (UMLS 2011AA)
C0022066 (UMLS 2011AA)
C0022065 (UMLS 2011AA)
C0020750 (UMLS 2011AA)
C0022277 (UMLS 2011AA)
C0022337 (UMLS 2011AA)
C0022418 (UMLS 2011AA)
C0022341 (UMLS 2011AA)
C0022558 (UMLS 2011AA)
C0006797 (UMLS 2011AA)
C0017550 (UMLS 2011AA)
C0009490 (UMLS 2011AA)
C0022804 (UMLS 2011AA)
C0007481 (UMLS 2011AA)
C0023190 (UMLS 2011AA)
C0036056 (UMLS 2011AA)
C0023668 (UMLS 2011AA)
C0038088 (UMLS 2011AA)
C0023617 (UMLS 2011AA)
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C0026544 (UMLS 2011AA)
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C0024443 (UMLS 2011AA)
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C0006416 (UMLS 2011AA)
C0026410 (UMLS 2011AA)
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C0024943 (UMLS 2011AA)
C0026514 (UMLS 2011AA)
C0024653 (UMLS 2011AA)
C0024944 (UMLS 2011AA)
C0024553 (UMLS 2011AA)
C0024548 (UMLS 2011AA)
C0025885 (UMLS 2011AA)
C0024552 (UMLS 2011AA)
C0026655 (UMLS 2011AA)
C0027366 (UMLS 2011AA)
C0028074 (UMLS 2011AA)
C0028366 (UMLS 2011AA)
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C0027778 (UMLS 2011AA)
C0028423 (UMLS 2011AA)
C0027689 (UMLS 2011AA)
C0027496 (UMLS 2011AA)
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C0028971 (UMLS 2011AA)
C0030266 (UMLS 2011AA)
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C0036243 (UMLS 2011AA)
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C0037334 (UMLS 2011AA)
C0206579 (UMLS 2011AA)
C0037063 (UMLS 2011AA)
C0036154 (UMLS 2011AA)
C0036644 (UMLS 2011AA)
C0037640 (UMLS 2011AA)
C0038944 (UMLS 2011AA)
C0013754 (UMLS 2011AA)
C0039138 (UMLS 2011AA)
C0038983 (UMLS 2011AA)
C0007928 (UMLS 2011AA)
C0040363 (UMLS 2011AA)
C0039725 (UMLS 2011AA)
C0220928 (UMLS 2011AA)
C0041403 (UMLS 2011AA)
C0041388 (UMLS 2011AA)
C1452561 (UMLS 2011AA)
C0041400 (UMLS 2011AA)
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C0041573 (UMLS 2011AA)
C0041700 (UMLS 2011AA)
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C0042177 (UMLS 2011AA)
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