ID

43143

Descrição

SOUTHWEST ONCOLOGY GROUP EXTENSIVE SMALL CELL LUNG CARCINOMA PRESTUDY FORM S0124: Cisplatin Combined With Either Irinotecan or Etoposide in Treating Patients With Extensive-Stage Small Cell Lung Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=001A8323-2611-48BE-E044-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=001A8323-2611-48BE-E044-0003BA3F9857

Palavras-chave

  1. 19/09/2012 19/09/2012 -
  2. 09/01/2015 09/01/2015 - Martin Dugas
  3. 20/09/2021 20/09/2021 -
Transferido a

20 de setembro de 2021

DOI

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Licença

Creative Commons BY-NC 3.0 Legacy

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    Lung Cancer NCT00045162 Pre-Study - SOUTHWEST ONCOLOGY GROUP EXTENSIVE SMALL CELL LUNG CARCINOMA PRESTUDY FORM - 2402234v1.0

    No Instruction available.

    1. StudyEvent: SOUTHWEST ONCOLOGY GROUP EXTENSIVE SMALL CELL LUNG CARCINOMA PRESTUDY FORM
      1. No Instruction available.
    Header
    Descrição

    Header

    SWOG Patient ID
    Descrição

    Trial subject ID SWOG

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C2348585
    NCI Thesaurus ObjectClass
    C16960
    UMLS CUI-2
    C1519429
    NCI Thesaurus Property
    C25364
    NCI Thesaurus Property-2
    C25699
    SWOG Study No.
    Descrição

    Protocol ID SWOG

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C3274381
    NCI Thesaurus ObjectClass
    C25320
    UMLS CUI-2
    C1519429
    NCI Thesaurus Property
    C25364
    NCI Thesaurus Property-2
    C25699
    Registration Step
    Descrição

    Registration Number

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C1514821
    NCI Thesaurus ObjectClass
    C25646
    UMLS CUI-2
    C0237753
    NCI Thesaurus Property
    C16154
    NCI Thesaurus ValueDomain-2
    C16154
    Patient Initials (L, F M)
    Descrição

    Patient Initials

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS CUI-1
    C2986440
    NCI Thesaurus ObjectClass
    C16960
    NCI Thesaurus Property
    C25536
    Institution/Affiliate
    Descrição

    Institution Name

    Tipo de dados

    text

    Alias
    NCI Thesaurus ObjectClass
    C25454
    UMLS CUI-1
    C1301943
    NCI Thesaurus ObjectClass-2
    C21541
    NCI Thesaurus Property
    C25364
    NCI Thesaurus ValueDomain
    C25191
    NCI Thesaurus ValueDomain-2
    C21541
    Physician
    Descrição

    Investigator Name

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS CUI-1
    C2826892
    NCI Thesaurus Property
    C25364
    NCI Thesaurus ObjectClass
    C17089
    NCI Thesaurus ObjectClass-2
    C25644
    Participating Group Name
    Descrição

    Participating Group

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS CUI-1
    C2347449
    NCI Thesaurus ObjectClass
    C25608
    NCI Thesaurus ObjectClass-2
    C17005
    NCI Thesaurus Property
    C25364
    Participating Group Study No.
    Descrição

    Study Number Participating Group

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C3274381
    NCI Thesaurus ObjectClass
    C25320
    UMLS CUI-2
    C2347449
    NCI Thesaurus Property
    C25608
    NCI Thesaurus Property-2
    C25364
    Participating Group Patient ID
    Descrição

    Trial subject ID Participating Group

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C2348585
    NCI Thesaurus ObjectClass
    C16960
    UMLS CUI-2
    C2347449
    NCI Thesaurus Property
    C25608
    NCI Thesaurus Property-2
    C25364
    Patient And Disease Description
    Descrição

    Patient And Disease Description

    Performance Status
    Descrição

    ECOG Performance Status

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25664
    UMLS CUI-1
    C1520224
    NCI Thesaurus Property
    C25367
    NCI Thesaurus ValueDomain-2
    C25491
    NCI Thesaurus ObjectClass
    C20641
    Weight Loss in Previous Six Months
    Descrição

    Weight Loss past six months

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25664
    UMLS CUI-1
    C1262477
    NCI Thesaurus ObjectClass
    C16960
    UMLS CUI-2
    C3828652
    NCI Thesaurus Property
    C3445
    NCI Thesaurus ValueDomain-2
    C25613
    Metastatic Involvement
    Descrição

    CancerMetastaticInvolvementType

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25284
    UMLS 2011AA ValueDomain
    C0332307
    NCI Thesaurus Property
    C14174
    UMLS 2011AA Property
    C0036525
    NCI Thesaurus ObjectClass
    C9305
    UMLS 2011AA ObjectClass
    C0006826
    NCI Thesaurus Property-2
    C25548
    UMLS 2011AA Property-2
    C1314939
    Is a pleural effusion present?
    Descrição

    ImagePleuralEffusionInd

    Tipo de dados

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C25180
    UMLS 2011AA ValueDomain
    C1522602
    Is it Malignant?
    Descrição

    Malignant Pleural Effusion

    Tipo de dados

    boolean

    Alias
    NCI Thesaurus ObjectClass
    C12468
    UMLS CUI-1
    C0080032
    NCI Thesaurus Property
    C3003
    NCI Thesaurus Property-2
    C25223
    NCI Thesaurus ValueDomain
    C14143
    NCI Metathesaurus ValueDomain
    C0021212
    Current Laboratory Values
    Descrição

    Current Laboratory Values

    Albumin
    Descrição

    Albumin

    Tipo de dados

    float

    Alias
    NCI Thesaurus Property
    C20200
    UMLS CUI-1
    C0201838
    NCI Thesaurus Property-2
    C214
    NCI Thesaurus ObjectClass
    C25294
    NCI Thesaurus ValueDomain
    C25712
    Lactate Dehydrogenase (LDH)
    Descrição

    LDH

    Tipo de dados

    float

    Unidades de medida
    • U/L
    Alias
    NCI Thesaurus Property
    C20200
    UMLS CUI-1
    C0202113
    NCI Thesaurus ObjectClass
    C25294
    NCI Thesaurus ValueDomain
    C25712
    NCI Thesaurus Property-2
    C25184
    U/L
    Lactate Dehydrogenase ULN
    Descrição

    LDH ULN

    Tipo de dados

    float

    Unidades de medida
    • U/L
    Alias
    NCI Thesaurus ObjectClass
    C25294
    UMLS CUI-1
    C0202113
    NCI Thesaurus Property
    C20200
    UMLS CUI-2
    C1519815
    NCI Thesaurus Property-2
    C25184
    NCI Thesaurus ValueDomain
    C25712
    NCI Thesaurus ValueDomain-2
    C38024
    NCI Thesaurus ValueDomain-3
    C25706
    U/L
    Prior Treatment Related To This Cancer
    Descrição

    Prior Treatment Related To This Cancer

    Prior Surgery
    Descrição

    Prior Surgery

    Tipo de dados

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38148
    UMLS CUI-1
    C0744961
    NCI Thesaurus Property
    C38000
    NCI Thesaurus ObjectClass
    C15329
    NCI Thesaurus ObjectClass-2
    C25629
    Comments
    Descrição

    Comments

    Comments
    Descrição

    Research Comments

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704
    UMLS CUI-1
    C0947611
    NCI Thesaurus ObjectClass
    C15319
    NCI Thesaurus Property
    C25393

    Similar models

    No Instruction available.

    1. StudyEvent: SOUTHWEST ONCOLOGY GROUP EXTENSIVE SMALL CELL LUNG CARCINOMA PRESTUDY FORM
      1. No Instruction available.
    Name
    Tipo
    Description | Question | Decode (Coded Value)
    Tipo de dados
    Alias
    Item Group
    Header
    Trial subject ID SWOG
    Item
    SWOG Patient ID
    text
    C25337 (NCI Thesaurus ValueDomain)
    C2348585 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C1519429 (UMLS CUI-2)
    C25364 (NCI Thesaurus Property)
    C25699 (NCI Thesaurus Property-2)
    Protocol ID SWOG
    Item
    SWOG Study No.
    text
    C25337 (NCI Thesaurus ValueDomain)
    C3274381 (UMLS CUI-1)
    C25320 (NCI Thesaurus ObjectClass)
    C1519429 (UMLS CUI-2)
    C25364 (NCI Thesaurus Property)
    C25699 (NCI Thesaurus Property-2)
    Registration Number
    Item
    Registration Step
    text
    C25337 (NCI Thesaurus ValueDomain)
    C1514821 (UMLS CUI-1)
    C25646 (NCI Thesaurus ObjectClass)
    C0237753 (UMLS CUI-2)
    C16154 (NCI Thesaurus Property)
    C16154 (NCI Thesaurus ValueDomain-2)
    Patient Initials
    Item
    Patient Initials (L, F M)
    text
    C25191 (NCI Thesaurus ValueDomain)
    C2986440 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C25536 (NCI Thesaurus Property)
    Institution Name
    Item
    Institution/Affiliate
    text
    C25454 (NCI Thesaurus ObjectClass)
    C1301943 (UMLS CUI-1)
    C21541 (NCI Thesaurus ObjectClass-2)
    C25364 (NCI Thesaurus Property)
    C25191 (NCI Thesaurus ValueDomain)
    C21541 (NCI Thesaurus ValueDomain-2)
    Investigator Name
    Item
    Physician
    text
    C25191 (NCI Thesaurus ValueDomain)
    C2826892 (UMLS CUI-1)
    C25364 (NCI Thesaurus Property)
    C17089 (NCI Thesaurus ObjectClass)
    C25644 (NCI Thesaurus ObjectClass-2)
    Participating Group
    Item
    Participating Group Name
    text
    C25191 (NCI Thesaurus ValueDomain)
    C2347449 (UMLS CUI-1)
    C25608 (NCI Thesaurus ObjectClass)
    C17005 (NCI Thesaurus ObjectClass-2)
    C25364 (NCI Thesaurus Property)
    Study Number Participating Group
    Item
    Participating Group Study No.
    text
    C25337 (NCI Thesaurus ValueDomain)
    C3274381 (UMLS CUI-1)
    C25320 (NCI Thesaurus ObjectClass)
    C2347449 (UMLS CUI-2)
    C25608 (NCI Thesaurus Property)
    C25364 (NCI Thesaurus Property-2)
    Trial subject ID Participating Group
    Item
    Participating Group Patient ID
    text
    C25337 (NCI Thesaurus ValueDomain)
    C2348585 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C2347449 (UMLS CUI-2)
    C25608 (NCI Thesaurus Property)
    C25364 (NCI Thesaurus Property-2)
    Item Group
    Patient And Disease Description
    Item
    Performance Status
    text
    C25664 (NCI Thesaurus ValueDomain)
    C1520224 (UMLS CUI-1)
    C25367 (NCI Thesaurus Property)
    C25491 (NCI Thesaurus ValueDomain-2)
    C20641 (NCI Thesaurus ObjectClass)
    Code List
    Performance Status
    CL Item
    Fully Active, Able To Carry On All Pre-disease Performance Without Restriction. (0)
    CL Item
    Restricted In Physically Strenuous Activity But Ambulatory And Able To Carry Out Work Of A Light Or Sedentary Nature, E.g., Light Housework, Office Work. (1)
    CL Item
    Ambulatory And Capable Of All Selfcare But Unable To Carry Out Any Work Activities. Up And About More Than 50% Of Waking Hours. (2)
    CL Item
    Capable Of Only Limited Selfcare, Confined To Bed Or Chair More Than 50% Of Waking Hours. (3)
    CL Item
    Completely Disabled. Cannot Carry On Any Selfcare. Totally Confined To Bed Or Chair. (4)
    CL Item
    Dead (5)
    Item
    Weight Loss in Previous Six Months
    text
    C25664 (NCI Thesaurus ValueDomain)
    C1262477 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C3828652 (UMLS CUI-2)
    C3445 (NCI Thesaurus Property)
    C25613 (NCI Thesaurus ValueDomain-2)
    Code List
    Weight Loss in Previous Six Months
    CL Item
    <5% Of Body Weight (< 5% of body weight)
    CL Item
    5 To <10% Of Body Weight (5 to < 10% of body weight)
    CL Item
    10 To <20% Of Body Weight (10 -<20% of body weight)
    CL Item
    > Or = 20% Of Body Weight (> or = 20% of body weight)
    Item
    Metastatic Involvement
    text
    C25284 (NCI Thesaurus ValueDomain)
    C0332307 (UMLS 2011AA ValueDomain)
    C14174 (NCI Thesaurus Property)
    C0036525 (UMLS 2011AA Property)
    C9305 (NCI Thesaurus ObjectClass)
    C0006826 (UMLS 2011AA ObjectClass)
    C25548 (NCI Thesaurus Property-2)
    C1314939 (UMLS 2011AA Property-2)
    Code List
    Metastatic Involvement
    CL Item
    Multiple Lesions In Multiple Organs (Multiple lesions in multiple organs)
    CL Item
    Multiple Lesions In Single Organ (Multiple lesions in single site or organ)
    CL Item
    Single Lesion In Single Organ (Single lesion in single site or organ)
    ImagePleuralEffusionInd
    Item
    Is a pleural effusion present?
    boolean
    C25180 (NCI Thesaurus ValueDomain)
    C1522602 (UMLS 2011AA ValueDomain)
    Malignant Pleural Effusion
    Item
    Is it Malignant?
    boolean
    C12468 (NCI Thesaurus ObjectClass)
    C0080032 (UMLS CUI-1)
    C3003 (NCI Thesaurus Property)
    C25223 (NCI Thesaurus Property-2)
    C14143 (NCI Thesaurus ValueDomain)
    C0021212 (NCI Metathesaurus ValueDomain)
    Item Group
    Current Laboratory Values
    Albumin
    Item
    Albumin
    float
    C20200 (NCI Thesaurus Property)
    C0201838 (UMLS CUI-1)
    C214 (NCI Thesaurus Property-2)
    C25294 (NCI Thesaurus ObjectClass)
    C25712 (NCI Thesaurus ValueDomain)
    LDH
    Item
    Lactate Dehydrogenase (LDH)
    float
    C20200 (NCI Thesaurus Property)
    C0202113 (UMLS CUI-1)
    C25294 (NCI Thesaurus ObjectClass)
    C25712 (NCI Thesaurus ValueDomain)
    C25184 (NCI Thesaurus Property-2)
    LDH ULN
    Item
    Lactate Dehydrogenase ULN
    float
    C25294 (NCI Thesaurus ObjectClass)
    C0202113 (UMLS CUI-1)
    C20200 (NCI Thesaurus Property)
    C1519815 (UMLS CUI-2)
    C25184 (NCI Thesaurus Property-2)
    C25712 (NCI Thesaurus ValueDomain)
    C38024 (NCI Thesaurus ValueDomain-2)
    C25706 (NCI Thesaurus ValueDomain-3)
    Item Group
    Prior Treatment Related To This Cancer
    Prior Surgery
    Item
    Prior Surgery
    boolean
    C38148 (NCI Thesaurus ValueDomain)
    C0744961 (UMLS CUI-1)
    C38000 (NCI Thesaurus Property)
    C15329 (NCI Thesaurus ObjectClass)
    C25629 (NCI Thesaurus ObjectClass-2)
    Item Group
    Comments
    Research Comments
    Item
    Comments
    text
    C25704 (NCI Thesaurus ValueDomain)
    C0947611 (UMLS CUI-1)
    C15319 (NCI Thesaurus ObjectClass)
    C25393 (NCI Thesaurus Property)

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