ID
42992
Description
ACOSOG-Z1031 OPEN Registration Worksheet Exemestane, Letrozole, or Anastrozole in Treating Postmenopausal Women Who Are Undergoing Surgery for Stage II or Stage III Breast Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=8036B060-D675-EB4B-E040-BB89AD434531
Link
Keywords
Versions (4)
- 9/19/12 9/19/12 -
- 1/9/15 1/9/15 - Martin Dugas
- 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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Endometrial Cancer NCT00265759 Registration - ACOSOG-Z1031 OPEN Registration Worksheet - 3014513v1.0
No Instruction available.
- StudyEvent: ACOSOG-Z1031 OPEN Registration Worksheet
Description
Patient Information
Description
PersonBirthDate
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus Property
- C25155
- UMLS 2011AA Property
- C0005615
Description
PersonGenderTextType
Data type
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
EthnicGroupCategoryText
Data type
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
PersonAddressCountryName
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus ValueDomain
- C25464
- UMLS 2011AA ValueDomain
- C0454664
- NCI Thesaurus Property
- C25407
- UMLS 2011AA Property
- C1442065
- NCI Thesaurus ValueDomain-2
- C42614
- UMLS 2011AA ValueDomain-2
- C0027365
Description
PersonAddressPostalCode
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25162
- UMLS 2011AA ValueDomain
- C0805701
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus Property
- C25407
- UMLS 2011AA Property
- C1442065
Description
Racial Group
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25372
- UMLS CUI-1
- C0034510
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C17049
Description
PatientPaymentType
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
Description
General Information
Description
PatientIdentifier
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25364
- UMLS 2011AA Property
- C0600091
- NCI Thesaurus ValueDomain
- C25364
- UMLS 2011AA ValueDomain
- C0600091
Description
Patient Initials Last
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS CUI-1
- C2986440
- NCI Thesaurus ObjectClass
- C16960
- UMLS CUI-2
- C1517741
- NCI Thesaurus Property
- C25536
- NCI Thesaurus Property-2
- C25551
Description
Patient Initials First
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS CUI-1
- C2986440
- NCI Thesaurus ObjectClass
- C16960
- UMLS CUI-2
- C0205435
- NCI Thesaurus Property
- C25536
- NCI Thesaurus Property-2
- C25509
Description
PatientMiddleInitialsName
Data type
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
- NCI Thesaurus Property-2
- C25569
- UMLS 2011AA Property-2
- C0444598
Description
ResponsiblePersonE-mailAddressText
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus ObjectClass
- C25657
- UMLS 2011AA ObjectClass
- C1273518
- NCI Thesaurus Property
- C42775
- UMLS 2011AA Property
- C1705961
Description
PriorTherapyPatientAmericanCollegeofSurgeonsOncologyGroupStudyInd-2
Data type
boolean
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus ObjectClass-2
- C16124
- UMLS 2011AA ObjectClass-2
- C1514463
- NCI Thesaurus Property
- C19712
- UMLS 2011AA Property
- C1515944
- NCI Metathesaurus Property
- CL238692
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Description
Patient Study ID
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C2348585
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25462
- NCI Thesaurus Property-2
- C25364
Description
InformedConsentFormSignedDate
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ValueDomain-2
- C25367
- NCI Thesaurus ObjectClass
- C16468
- UMLS 2011AA ObjectClass
- C0009797
- NCI Thesaurus Property
- C25679
Description
HealthInsurancePortabilityandAccountabilityActAuthorizationIndicator
Data type
boolean
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
- NCI Thesaurus ObjectClass
- C62504
- UMLS 2011AA ObjectClass
- C0600593
- NCI Thesaurus Property
- C41192
- UMLS 2011AA Property
- C1524004
Description
PatientSignedDischargeMedicalRecordDate
Data type
date
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25679
- NCI Metathesaurus Property
- C0012621
- NCI Thesaurus Property-2
- C45258
- UMLS 2011AA Property
- C0025102
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
Description
Inclusion Criteria
Description
EasternCooperativeOncologyGroupPerformanceStatusAssessmentIndicator
Data type
boolean
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Thesaurus ObjectClass
- C25491
- UMLS 2011AA ObjectClass
- C1512162
- NCI Metathesaurus ObjectClass
- CL092952
Description
ECOG Performance Status
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS CUI-1
- C1520224
- NCI Thesaurus Property
- C25367
- NCI Thesaurus ValueDomain-2
- C25491
- NCI Thesaurus ObjectClass
- C20641
Description
PatientNorthCentralCancerTreatmentGroupAdvancedBreastCarcinomaCancerProgressionEligibilityDeterminationInd-2
Data type
boolean
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25581
- UMLS 2011AA Property
- C1518419
- NCI Thesaurus Property-2
- C25411
- UMLS 2011AA Property-2
- C0205179
- NCI Thesaurus Property-3
- C4872
- UMLS 2011AA Property-3
- C0678222
- NCI Thesaurus Property-4
- C25171
- UMLS 2011AA Property-4
- C0013893
- NCI Thesaurus Property-5
- C19987
- UMLS 2011AA Property-5
- C0242656
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Description
PatientMenopauseInd-2
Data type
boolean
Alias
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C3231
- UMLS 2011AA Property
- C0025320
Description
PatientAdvancedMalignantNeoplasmPriorRegistrationEligibilityDeterminationInd-2
Data type
boolean
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25646
- UMLS 2011AA Property
- C1514821
- NCI Thesaurus Property-2
- C25411
- UMLS 2011AA Property-2
- C0205179
- NCI Thesaurus Property-3
- C9305
- UMLS 2011AA Property-3
- C0006826
- NCI Thesaurus Property-4
- C25629
- UMLS 2011AA Property-4
- C0332152
- NCI Thesaurus Property-5
- C25171
- UMLS 2011AA Property-5
- C0013893
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Description
BreastCarcinomaTumorMarkerPositiveFindingEstrogenReceptorStatusInd-3
Data type
boolean
Alias
- NCI Thesaurus ObjectClass
- C4872
- UMLS 2011AA ObjectClass
- C0678222
- NCI Thesaurus ObjectClass-2
- C17220
- UMLS 2011AA ObjectClass-2
- C0041365
- NCI Thesaurus Property
- C38758
- UMLS 2011AA Property
- C1514241
- NCI Thesaurus Property-2
- C16150
- UMLS 2011AA Property-2
- C1516974
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
Description
MammogramPerformedInd-3
Data type
boolean
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
- NCI Thesaurus ObjectClass
- C20178
- UMLS 2011AA ObjectClass
- C0024671
- NCI Thesaurus Property
- C38000
- UMLS 2011AA Property
- C0884358
Description
MammogramPerformedDate
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C20178
- UMLS 2011AA ObjectClass
- C0024671
- NCI Thesaurus Property
- C38000
- UMLS 2011AA Property
- C0884358
Description
DiagnosticImagingUltrasoundImagingPerformedDate
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C16502
- UMLS 2011AA ObjectClass
- C0011923
- NCI Thesaurus Property
- C38000
- UMLS 2011AA Property
- C0884358
- NCI Thesaurus Property-2
- C17230
- UMLS 2011AA Property-2
- C0041618
Description
PriorCancerDiagnosisIndicator
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
- NCI Thesaurus ObjectClass
- C9305
- UMLS 2011AA ObjectClass
- C0006826
- NCI Thesaurus ObjectClass-2
- C25629
- UMLS 2011AA ObjectClass-2
- C0332152
- NCI Thesaurus Property
- C15220
- UMLS 2011AA Property
- C0011900
Description
Exclusion Criteria
Description
DermalLymphaticsInvasionInd-3
Data type
boolean
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
- NCI Thesaurus ObjectClass
- C25478
- UMLS 2011AA ObjectClass
- C0221928
- NCI Thesaurus ObjectClass-2
- C12746
- UMLS 2011AA ObjectClass-2
- C0024235
- NCI Thesaurus Property
- C20625
- UMLS 2011AA Property
- C1269955
Description
PriorCancerTreatmentInd-2
Data type
boolean
Alias
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
- NCI Thesaurus ObjectClass
- C9305
- UMLS 2011AA ObjectClass
- C0006826
- NCI Thesaurus ObjectClass-2
- C25629
- UMLS 2011AA ObjectClass-2
- C0332152
- NCI Thesaurus Property
- C49236
- UMLS 2011AA Property
- C0087111
Description
PatientBreastCarcinomaEndocrineTherapyAdministeredEligibilityDeterminationInd-2
Data type
boolean
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C15445
- UMLS 2011AA Property
- C0279025
- NCI Thesaurus Property-2
- C4872
- UMLS 2011AA Property-2
- C0678222
- NCI Thesaurus Property-3
- C25171
- UMLS 2011AA Property-3
- C0013893
- NCI Thesaurus Property-4
- C25382
- UMLS 2011AA Property-4
- C1521801
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Description
DistantMetastasisPresentInd-2
Data type
boolean
Alias
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
- NCI Thesaurus Property
- C25626
- UMLS 2011AA Property
- C0150312
- NCI Thesaurus ObjectClass
- C25321
- UMLS 2011AA ObjectClass
- C0443203
- NCI Thesaurus ObjectClass-2
- C19151
- UMLS 2011AA ObjectClass-2
- C0027627
Description
TotalMastectomyPerformedInd-2
Data type
boolean
Alias
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
- NCI Thesaurus Property
- C38000
- UMLS 2011AA Property
- C0884358
- NCI Thesaurus ObjectClass
- C15281
- UMLS 2011AA ObjectClass
- C0024886
Description
PriorSystemicTherapyInvasiveBreastCarcinomaAdministeredIndicator
Data type
boolean
Alias
- NCI Thesaurus ObjectClass
- C15698
- UMLS 2011AA ObjectClass
- C1515119
- NCI Thesaurus ObjectClass-2
- C25629
- UMLS 2011AA ObjectClass-2
- C0332152
- NCI Thesaurus Property
- C9245
- UMLS 2011AA Property
- C0853879
- NCI Thesaurus Property-2
- C25382
- UMLS 2011AA Property-2
- C1521801
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Description
SentinelNodeBiopsyInd-2
Data type
boolean
Alias
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
- NCI Thesaurus Property
- C15189
- UMLS 2011AA Property
- C0005558
- NCI Thesaurus ObjectClass
- C12947
- UMLS 2011AA ObjectClass
- C1522495
Description
Randomization
Description
AmericanCollegeofSurgeonsOncologyGroupTreatmentArmRandomizationAmericanCollegeofSurgeonsOncologyGroupTreatmentArmRandomizationType
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus Property
- C25196
- UMLS 2011AA Property
- C0034656
- NCI Thesaurus ObjectClass
- C19712
- UMLS 2011AA ObjectClass
- C1515944
- NCI Thesaurus ObjectClass-2
- C15538
- UMLS 2011AA ObjectClass-2
- C1522541
Similar models
No Instruction available.
- StudyEvent: ACOSOG-Z1031 OPEN Registration Worksheet
C0805701 (UMLS 2011AA ValueDomain)
C25705 (NCI Thesaurus ObjectClass)
C1522326 (UMLS 2011AA ObjectClass)
C19992 (NCI Thesaurus ObjectClass-2)
C1516607 (UMLS 2011AA ObjectClass-2)
CL281747 (NCI Metathesaurus Property)
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C2986303 (UMLS CUI-1)
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C51883 (NCI Thesaurus ObjectClass-3)
C1710470 (UMLS 2011AA ObjectClass-3)
C25936 (NCI Thesaurus ObjectClass-4)
C0035173 (UMLS 2011AA ObjectClass-4)
C25191 (NCI Thesaurus Property)
C1547383 (UMLS 2011AA Property)
C25191 (NCI Thesaurus ValueDomain)
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C1507394 (UMLS CUI-1)
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C0035173 (UMLS 2011AA ObjectClass)
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C0079399 (UMLS 2011AA Property)
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C0439673 (UMLS 2011AA)
C0683312 (UMLS 2011AA Property)
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C0013893 (UMLS 2011AA Property-4)
C19987 (NCI Thesaurus Property-5)
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C1512698 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C3231 (NCI Thesaurus Property)
C0025320 (UMLS 2011AA Property)
C0030705 (UMLS 2011AA ObjectClass)
C25646 (NCI Thesaurus Property)
C1514821 (UMLS 2011AA Property)
C25411 (NCI Thesaurus Property-2)
C0205179 (UMLS 2011AA Property-2)
C9305 (NCI Thesaurus Property-3)
C0006826 (UMLS 2011AA Property-3)
C25629 (NCI Thesaurus Property-4)
C0332152 (UMLS 2011AA Property-4)
C25171 (NCI Thesaurus Property-5)
C0013893 (UMLS 2011AA Property-5)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C0678222 (UMLS 2011AA ObjectClass)
C17220 (NCI Thesaurus ObjectClass-2)
C0041365 (UMLS 2011AA ObjectClass-2)
C38758 (NCI Thesaurus Property)
C1514241 (UMLS 2011AA Property)
C16150 (NCI Thesaurus Property-2)
C1516974 (UMLS 2011AA Property-2)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C20178 (NCI Thesaurus ObjectClass)
C0024671 (UMLS 2011AA ObjectClass)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C0011008 (UMLS 2011AA ValueDomain)
C20178 (NCI Thesaurus ObjectClass)
C0024671 (UMLS 2011AA ObjectClass)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C0011008 (UMLS 2011AA ValueDomain)
C16502 (NCI Thesaurus ObjectClass)
C0011923 (UMLS 2011AA ObjectClass)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C17230 (NCI Thesaurus Property-2)
C0041618 (UMLS 2011AA Property-2)
C1522602 (UMLS 2011AA ValueDomain)
C9305 (NCI Thesaurus ObjectClass)
C0006826 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus ObjectClass-2)
C0332152 (UMLS 2011AA ObjectClass-2)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)
C1705108 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
C1272460 (UMLS 2011AA)
C1512699 (UMLS 2011AA ValueDomain)
C25478 (NCI Thesaurus ObjectClass)
C0221928 (UMLS 2011AA ObjectClass)
C12746 (NCI Thesaurus ObjectClass-2)
C0024235 (UMLS 2011AA ObjectClass-2)
C20625 (NCI Thesaurus Property)
C1269955 (UMLS 2011AA Property)
C1512698 (UMLS 2011AA ValueDomain)
C9305 (NCI Thesaurus ObjectClass)
C0006826 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus ObjectClass-2)
C0332152 (UMLS 2011AA ObjectClass-2)
C49236 (NCI Thesaurus Property)
C0087111 (UMLS 2011AA Property)
C0030705 (UMLS 2011AA ObjectClass)
C15445 (NCI Thesaurus Property)
C0279025 (UMLS 2011AA Property)
C4872 (NCI Thesaurus Property-2)
C0678222 (UMLS 2011AA Property-2)
C25171 (NCI Thesaurus Property-3)
C0013893 (UMLS 2011AA Property-3)
C25382 (NCI Thesaurus Property-4)
C1521801 (UMLS 2011AA Property-4)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C25321 (NCI Thesaurus ObjectClass)
C0443203 (UMLS 2011AA ObjectClass)
C19151 (NCI Thesaurus ObjectClass-2)
C0027627 (UMLS 2011AA ObjectClass-2)
C1512698 (UMLS 2011AA ValueDomain)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C15281 (NCI Thesaurus ObjectClass)
C0024886 (UMLS 2011AA ObjectClass)
C1515119 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus ObjectClass-2)
C0332152 (UMLS 2011AA ObjectClass-2)
C9245 (NCI Thesaurus Property)
C0853879 (UMLS 2011AA Property)
C25382 (NCI Thesaurus Property-2)
C1521801 (UMLS 2011AA Property-2)
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C15189 (NCI Thesaurus Property)
C0005558 (UMLS 2011AA Property)
C12947 (NCI Thesaurus ObjectClass)
C1522495 (UMLS 2011AA ObjectClass)
C0332307 (UMLS 2011AA ValueDomain)
C25196 (NCI Thesaurus Property)
C0034656 (UMLS 2011AA Property)
C19712 (NCI Thesaurus ObjectClass)
C1515944 (UMLS 2011AA ObjectClass)
C15538 (NCI Thesaurus ObjectClass-2)
C1522541 (UMLS 2011AA ObjectClass-2)