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ID

43112

Description

The collection of CDEs used in the Participant ID module. Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=46716FCE-3AD1-70D5-E044-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=46716FCE-3AD1-70D5-E044-0003BA3F9857

Keywords

Versions (3)
  1. 9/20/12 9/20/12 -
  2. 1/9/15 1/9/15 - Martin Dugas
  3. 9/20/21 9/20/21 -
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September 20, 2021

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Creative Commons BY-NC 3.0 Legacy
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    Pre-Study - NCI Standard Participant Identification Template - 2729615v1.0

    English

    No Instruction available.

    1 forms  
    1. StudyEvent: NCI Standard Participant Identification Template
      1. No Instruction available.
    Mandatory Participant Id Questions
    Description

    Mandatory Participant Id Questions

    Participant Last Name
    Description

    PersonFamily/LastName

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS 2011AA ValueDomain
    C1547383
    NCI Thesaurus ObjectClass
    C25190
    UMLS 2011AA ObjectClass
    C0027361
    NCI Thesaurus Property
    C25364
    UMLS 2011AA Property
    C0600091
    NCI Thesaurus Property-2
    C40975
    UMLS 2011AA Property-2
    C1301584
    Participant First Name
    Description

    PersonGiven/FirstName

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS 2011AA ValueDomain
    C1547383
    NCI Thesaurus ObjectClass
    C25190
    UMLS 2011AA ObjectClass
    C0027361
    NCI Thesaurus Property
    C25364
    UMLS 2011AA Property
    C0600091
    NCI Thesaurus Property-2
    C40974
    UMLS 2011AA Property-2
    C1443235
    Optional Participant Id Questions
    Description

    Optional Participant Id Questions

    Participant Middle Name
    Description

    PersonMiddleName

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS 2011AA ValueDomain
    C1547383
    NCI Thesaurus ObjectClass
    C25190
    UMLS 2011AA ObjectClass
    C0027361
    NCI Thesaurus Property
    C25364
    UMLS 2011AA Property
    C0600091
    NCI Metathesaurus Property
    CL316906
    Person Name Suffix
    Description

    IndividualGenealogySuffixCode

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25162
    UMLS 2011AA ValueDomain
    C0805701
    NCI Thesaurus ObjectClass
    C17719
    NCI Metathesaurus Property
    C0017299
    Participant Home Street Address
    Description

    PersonAddressName

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS 2011AA ValueDomain
    C1547383
    NCI Thesaurus ObjectClass
    C25190
    UMLS 2011AA ObjectClass
    C0027361
    NCI Thesaurus Property
    C25407
    UMLS 2011AA Property
    C1442065
    Participant City
    Description

    AddressCityName

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C25407
    UMLS 2011AA ObjectClass
    C1442065
    NCI Thesaurus ValueDomain
    C42614
    UMLS 2011AA ValueDomain
    C0027365
    NCI Thesaurus Property
    C25160
    UMLS 2011AA Property
    C0008848
    Participant State
    Description

    AddressState/ProvinceName

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C25407
    UMLS 2011AA ObjectClass
    C1442065
    NCI Thesaurus ValueDomain
    C42614
    UMLS 2011AA ValueDomain
    C0027365
    NCI Thesaurus Property
    C87194
    UMLS 2011AA Property
    C1301808
    Participant Postal Code
    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
    Telephone Number Type
    Description

    TelephoneNumberType

    Data type

    text

    Alias
    NCI Thesaurus Property
    C25284
    UMLS 2011AA Property
    C0332307
    NCI Metathesaurus ObjectClass
    C0039449
    NCI Metathesaurus ValueDomain
    C0332307
    Participant Phone
    Description

    TelephoneNumber

    Data type

    text

    Alias
    NCI Thesaurus Property
    C25337
    UMLS 2011AA Property
    C0237753
    NCI Thesaurus ValueDomain
    C25337
    UMLS 2011AA ValueDomain
    C0237753
    NCI Thesaurus ObjectClass
    C25395
    UMLS 2011AA ObjectClass
    C0039457
    NCI Thesaurus ValueDomain-2
    C17188
    UMLS 2011AA ValueDomain-2
    C0039449
    Participant Initials
    Description

    Patient Initials

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS CUI-1
    C2986440
    NCI Thesaurus ObjectClass
    C16960
    NCI Thesaurus Property
    C25536
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    Similar models

    No Instruction available.

    1 forms
    1. StudyEvent: NCI Standard Participant Identification Template
      1. No Instruction available.
    Name
    Type
    Description | Question | Decode (Coded Value)
    Data type
    Alias
    Item Group
    Mandatory Participant Id Questions
    PersonFamily/LastName
    Item
    Participant Last Name
    text
    C25191 (NCI Thesaurus ValueDomain)
    C1547383 (UMLS 2011AA ValueDomain)
    C25190 (NCI Thesaurus ObjectClass)
    C0027361 (UMLS 2011AA ObjectClass)
    C25364 (NCI Thesaurus Property)
    C0600091 (UMLS 2011AA Property)
    C40975 (NCI Thesaurus Property-2)
    C1301584 (UMLS 2011AA Property-2)
    PersonGiven/FirstName
    Item
    Participant First Name
    text
    C25191 (NCI Thesaurus ValueDomain)
    C1547383 (UMLS 2011AA ValueDomain)
    C25190 (NCI Thesaurus ObjectClass)
    C0027361 (UMLS 2011AA ObjectClass)
    C25364 (NCI Thesaurus Property)
    C0600091 (UMLS 2011AA Property)
    C40974 (NCI Thesaurus Property-2)
    C1443235 (UMLS 2011AA Property-2)
    Item Group
    Optional Participant Id Questions
    PersonMiddleName
    Item
    Participant Middle Name
    text
    C25191 (NCI Thesaurus ValueDomain)
    C1547383 (UMLS 2011AA ValueDomain)
    C25190 (NCI Thesaurus ObjectClass)
    C0027361 (UMLS 2011AA ObjectClass)
    C25364 (NCI Thesaurus Property)
    C0600091 (UMLS 2011AA Property)
    CL316906 (NCI Metathesaurus Property)
    Item
    Person Name Suffix
    text
    C25162 (NCI Thesaurus ValueDomain)
    C0805701 (UMLS 2011AA ValueDomain)
    C17719 (NCI Thesaurus ObjectClass)
    C0017299 (NCI Metathesaurus Property)
    CL.1
    Code List
    Person Name Suffix
    CL Item
    First (I)
    C25509 (NCI Thesaurus)
    C1279901 (UMLS 2011AA)
    CL Item
    Second: C49463 (II)
    C49463 (NCI Thesaurus)
    C1705190 (UMLS 2011AA)
    CL Item
    Third (III)
    C49464 (NCI Thesaurus)
    C1705160 (UMLS 2011AA)
    CL Item
    Fourth (IV)
    C49465 (NCI Thesaurus)
    C1706303 (UMLS 2011AA)
    CL Item
    Junior (Jr.)
    C49466 (NCI Thesaurus)
    C1708595 (UMLS 2011AA)
    CL Item
    Senior (Sr.)
    C49467 (NCI Thesaurus)
    C1705825 (UMLS 2011AA)
    PersonAddressName
    Item
    Participant Home Street Address
    text
    C25191 (NCI Thesaurus ValueDomain)
    C1547383 (UMLS 2011AA ValueDomain)
    C25190 (NCI Thesaurus ObjectClass)
    C0027361 (UMLS 2011AA ObjectClass)
    C25407 (NCI Thesaurus Property)
    C1442065 (UMLS 2011AA Property)
    AddressCityName
    Item
    Participant City
    text
    C25407 (NCI Thesaurus ObjectClass)
    C1442065 (UMLS 2011AA ObjectClass)
    C42614 (NCI Thesaurus ValueDomain)
    C0027365 (UMLS 2011AA ValueDomain)
    C25160 (NCI Thesaurus Property)
    C0008848 (UMLS 2011AA Property)
    Item
    Participant State
    text
    C25407 (NCI Thesaurus ObjectClass)
    C1442065 (UMLS 2011AA ObjectClass)
    C42614 (NCI Thesaurus ValueDomain)
    C0027365 (UMLS 2011AA ValueDomain)
    C87194 (NCI Thesaurus Property)
    C1301808 (UMLS 2011AA Property)
    CL.2
    Code List
    Participant State
    CL Item
    Aguascalientes (Aguascalientes)
    CL Item
    Alabama (Alabama)
    C0001895 (NCI Metathesaurus)
    CL Item
    Alaska (Alaska)
    C0001905 (NCI Metathesaurus)
    CL Item
    Alberta (Alberta)
    CL Item
    American Samoa (American Samoa)
    C17739 (NCI Thesaurus)
    C0242536 (UMLS 2011AA)
    CL Item
    Arizona (Arizona)
    C0003787 (NCI Metathesaurus)
    CL Item
    Arkansas (Arkansas)
    C0003790 (NCI Metathesaurus)
    CL Item
    Baja California (Baja California)
    CL Item
    Baja California Sur (Baja California Sur)
    CL Item
    British Columbia (British Columbia)
    C0006193 (NCI Metathesaurus)
    CL Item
    California (California)
    C0006754 (NCI Metathesaurus)
    CL Item
    Campeche (Campeche)
    CL Item
    Chiapas (Chiapas)
    CL Item
    Chihuahua (Chihuahua)
    CL Item
    Coahuila De Zaragoza (Coahuila de Zaragoza)
    CL Item
    Colima (Colima)
    CL Item
    Colorado (Colorado)
    C43501 (NCI Thesaurus)
    C0009399 (UMLS 2011AA)
    CL Item
    Connecticut (Connecticut)
    C0009778 (NCI Metathesaurus)
    CL Item
    Delaware (Delaware)
    C0011198 (NCI Metathesaurus)
    CL Item
    District Of Columbia (District of Columbia)
    C43456 (NCI Thesaurus)
    C0012764 (UMLS 2011AA)
    CL Item
    Distrito Federal (Distrito Federal)
    CL Item
    Durango (Durango)
    CL Item
    Florida (Florida)
    C43478 (NCI Thesaurus)
    C0016253 (UMLS 2011AA)
    CL Item
    Georgia (Georgia)
    C43477 (NCI Thesaurus)
    C0017452 (UMLS 2011AA)
    CL Item
    Guam (Guam)
    C16652 (NCI Thesaurus)
    C0018309 (UMLS 2011AA)
    CL Item
    Guanajuato (Guanajuato)
    CL Item
    Guerrero (Guerrero)
    CL Item
    Hawaii (Hawaii)
    C43510 (NCI Thesaurus)
    C0018619 (UMLS 2011AA)
    CL Item
    Hildalgo (Hildalgo)
    CL Item
    Idaho (Idaho)
    C43499 (NCI Thesaurus)
    C0020787 (UMLS 2011AA)
    CL Item
    Illinois (Illinois)
    C43491 (NCI Thesaurus)
    C0020898 (UMLS 2011AA)
    CL Item
    Indiana (Indiana)
    C43483 (NCI Thesaurus)
    C0021206 (UMLS 2011AA)
    CL Item
    Iowa (Iowa)
    C43487 (NCI Thesaurus)
    C0022037 (UMLS 2011AA)
    CL Item
    Jalisco (Jalisco)
    CL Item
    Kansas (Kansas)
    C43493 (NCI Thesaurus)
    C0022497 (UMLS 2011AA)
    CL Item
    Kentucky (Kentucky)
    C43484 (NCI Thesaurus)
    C0022557 (UMLS 2011AA)
    CL Item
    Louisiana (Louisiana)
    C43496 (NCI Thesaurus)
    C0024024 (UMLS 2011AA)
    CL Item
    Maine (Maine)
    C43457 (NCI Thesaurus)
    C0024497 (UMLS 2011AA)
    CL Item
    Manitoba (Manitoba)
    C0024726 (NCI Metathesaurus)
    CL Item
    Marshall Islands (Marshall Islands)
    C16822 (NCI Thesaurus)
    C0024851 (UMLS 2011AA)
    CL Item
    Maryland (Maryland)
    C43471 (NCI Thesaurus)
    C0024858 (UMLS 2011AA)
    CL Item
    Massachusetts (Massachusetts)
    C43463 (NCI Thesaurus)
    C0024874 (UMLS 2011AA)
    CL Item
    Mexico (Mexico)
    C16850 (NCI Thesaurus)
    C0025885 (UMLS 2011AA)
    CL Item
    Michigan (Michigan)
    C43481 (NCI Thesaurus)
    C0025939 (UMLS 2011AA)
    CL Item
    Michoacan De Ocampo (Michoacan de Ocampo)
    CL Item
    Micronesia (Micronesia)
    C0026001 (NCI Metathesaurus)
    CL Item
    Minnesota (Minnesota)
    C43486 (NCI Thesaurus)
    C0026183 (UMLS 2011AA)
    CL Item
    Mississippi (Mississippi)
    C43480 (NCI Thesaurus)
    C0026221 (UMLS 2011AA)
    CL Item
    Missouri (Missouri)
    C43492 (NCI Thesaurus)
    C0026222 (UMLS 2011AA)
    CL Item
    Montana (Montana)
    C43490 (NCI Thesaurus)
    C0026506 (UMLS 2011AA)
    CL Item
    Morelos (Morelos)
    CL Item
    Nayarit (Nayarit)
    CL Item
    Nebraska (Nebraska)
    C43494 (NCI Thesaurus)
    C0027523 (UMLS 2011AA)
    CL Item
    Nevada (Nevada)
    C43503 (NCI Thesaurus)
    C0027951 (UMLS 2011AA)
    CL Item
    New Brunswick (New Brunswick)
    C0027963 (NCI Metathesaurus)
    CL Item
    New Hampshire (New Hampshire)
    C43460 (NCI Thesaurus)
    C0027969 (UMLS 2011AA)
    CL Item
    New Jersey (New Jersey)
    C43467 (NCI Thesaurus)
    C0027971 (UMLS 2011AA)
    CL Item
    New Mexico (New Mexico)
    C43504 (NCI Thesaurus)
    C0027972 (UMLS 2011AA)
    CL Item
    New York (New York)
    C43468 (NCI Thesaurus)
    C0027976 (UMLS 2011AA)
    CL Item
    Newfoundland (Newfoundland)
    C0027985 (NCI Metathesaurus)
    CL Item
    North Carolina (North Carolina)
    C43474 (NCI Thesaurus)
    C0028407 (UMLS 2011AA)
    CL Item
    North Dakota (North Dakota)
    C43488 (NCI Thesaurus)
    C0028408 (UMLS 2011AA)
    CL Item
    Northern Mariana Islands (Northern Mariana Islands)
    C17882 (NCI Thesaurus)
    C0282245 (UMLS 2011AA)
    CL Item
    Northwest Territories (Northwest Territories)
    C0028417 (NCI Metathesaurus)
    CL Item
    Nova Scotia (Nova Scotia)
    C0028441 (NCI Metathesaurus)
    CL Item
    Nuevo Leon (Nuevo Leon)
    CL Item
    Nunavut (Nunavut)
    C0752343 (NCI Metathesaurus)
    CL Item
    Oaxaca (Oaxaca)
    CL Item
    Ohio (Ohio)
    C43482 (NCI Thesaurus)
    C0028905 (UMLS 2011AA)
    CL Item
    Oklahoma (Oklahoma)
    C43497 (NCI Thesaurus)
    C0028914 (UMLS 2011AA)
    CL Item
    Ontario (Ontario)
    C0029040 (NCI Metathesaurus)
    CL Item
    Oregon (Oregon)
    C43508 (NCI Thesaurus)
    C0029195 (UMLS 2011AA)
    CL Item
    Palau (Palau)
    C17733 (NCI Thesaurus)
    C0242397 (UMLS 2011AA)
    CL Item
    Pennsylvania (Pennsylvania)
    C43469 (NCI Thesaurus)
    C0030853 (UMLS 2011AA)
    CL Item
    Prince Edward Island (Prince Edward Island)
    C0033157 (NCI Metathesaurus)
    CL Item
    Puebla (Puebla)
    CL Item
    Puerto Rico (Puerto Rico)
    C17043 (NCI Thesaurus)
    C0034044 (UMLS 2011AA)
    CL Item
    Quebec (Quebec)
    C0034390 (NCI Metathesaurus)
    CL Item
    Queretaro De Arteaga (Queretaro de Arteaga)
    CL Item
    Quintana Roo (Quintana Roo)
    CL Item
    Rhode Island (Rhode Island)
    C43464 (NCI Thesaurus)
    C0035487 (UMLS 2011AA)
    CL Item
    San Luis Potosi (San Luis Potosi)
    CL Item
    Saskatchewan (Saskatchewan)
    C0036234 (NCI Metathesaurus)
    CL Item
    Sinaloa (Sinaloa)
    CL Item
    Sonora (Sonora)
    CL Item
    South Carolina (South Carolina)
    C43475 (NCI Thesaurus)
    C0037716 (UMLS 2011AA)
    CL Item
    South Dakota (South Dakota)
    C43489 (NCI Thesaurus)
    C0037717 (UMLS 2011AA)
    CL Item
    Tabasco (Tabasco)
    CL Item
    Tamaulipas (Tamaulipas)
    CL Item
    Tennessee (Tennessee)
    C43476 (NCI Thesaurus)
    C0039514 (UMLS 2011AA)
    CL Item
    Texas (Texas)
    C43498 (NCI Thesaurus)
    C0039711 (UMLS 2011AA)
    CL Item
    Tlaxcala (Tlaxcala)
    CL Item
    Us Minor Outlying Islands (US Minor Outlying Islands)
    CL Item
    Utah (Utah)
    C43502 (NCI Thesaurus)
    C0042124 (UMLS 2011AA)
    CL Item
    Veracruz-llave (Veracruz-Llave)
    CL Item
    Vermont (Vermont)
    C43462 (NCI Thesaurus)
    C0042537 (UMLS 2011AA)
    CL Item
    Virgin Islands Of The Us (Virgin Islands of the US)
    CL Item
    Virginia (Virginia)
    C43472 (NCI Thesaurus)
    C0042753 (UMLS 2011AA)
    CL Item
    Washington (Washington)
    C43507 (NCI Thesaurus)
    C0043038 (UMLS 2011AA)
    CL Item
    West Virginia (West Virginia)
    C43473 (NCI Thesaurus)
    C0043127 (UMLS 2011AA)
    CL Item
    Wisconsin (Wisconsin)
    C43485 (NCI Thesaurus)
    C0043193 (UMLS 2011AA)
    CL Item
    Wyoming (Wyoming)
    C43500 (NCI Thesaurus)
    C0043287 (UMLS 2011AA)
    CL Item
    Yucatan (Yucatan)
    CL Item
    Yukon Territory (Yukon Territory)
    C0043438 (NCI Metathesaurus)
    CL Item
    Zacatecas (Zacatecas)
    AddressPostalCodeIdentifier
    Item
    Participant Postal Code
    text
    C25407 (NCI Thesaurus ObjectClass)
    C1442065 (UMLS 2011AA ObjectClass)
    C25621 (NCI Thesaurus Property)
    C1514254 (UMLS 2011AA Property)
    C25364 (NCI Thesaurus ValueDomain)
    C0600091 (UMLS 2011AA ValueDomain)
    C25407 (NCI Thesaurus ValueDomain-2)
    C1442065 (UMLS 2011AA ValueDomain-2)
    C25621 (NCI Thesaurus ValueDomain-3)
    C1514254 (UMLS 2011AA ValueDomain-3)
    Item
    Telephone Number Type
    text
    C25284 (NCI Thesaurus Property)
    C0332307 (UMLS 2011AA Property)
    C0039449 (NCI Metathesaurus ObjectClass)
    C0332307 (NCI Metathesaurus ValueDomain)
    CL.3
    Code List
    Telephone Number Type
    CL Item
    Cellular Telephone (Cellular)
    C60787 (NCI Thesaurus)
    C1136359 (UMLS 2011AA)
    CL Item
    Facsimile Machine (Facsimile)
    C60789 (NCI Thesaurus)
    C1880669 (UMLS 2011AA)
    CL Item
    Home (Home)
    C18002 (NCI Thesaurus)
    C0442519 (UMLS 2011AA)
    CL Item
    Mobile Telephone (Mobile Telephone)
    C60786 (NCI Thesaurus)
    C1136360 (UMLS 2011AA)
    CL Item
    Modem Device Component (Modem)
    C50072 (NCI Thesaurus)
    C0011007 (UMLS 2011AA)
    CL Item
    Pager (Pager)
    C64350 (NCI Thesaurus)
    C0179284 (UMLS 2011AA)
    CL Item
    Worksite: C17556 (Work)
    C17556 (NCI Thesaurus)
    C0162579 (UMLS 2011AA)
    TelephoneNumber
    Item
    Participant Phone
    text
    C25337 (NCI Thesaurus Property)
    C0237753 (UMLS 2011AA Property)
    C25337 (NCI Thesaurus ValueDomain)
    C0237753 (UMLS 2011AA ValueDomain)
    C25395 (NCI Thesaurus ObjectClass)
    C0039457 (UMLS 2011AA ObjectClass)
    C17188 (NCI Thesaurus ValueDomain-2)
    C0039449 (UMLS 2011AA ValueDomain-2)
    Patient Initials
    Item
    Participant Initials
    text
    C25191 (NCI Thesaurus ValueDomain)
    C2986440 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C25536 (NCI Thesaurus Property)
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