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ID

43194

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Physical Exam form for C3D 3.12 Adopters Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=01603C3C-DD2D-4BA2-E044-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=01603C3C-DD2D-4BA2-E044-0003BA3F9857

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Versões (2)
  1. 20/09/2012 20/09/2012 -
  2. 20/09/2021 20/09/2021 -
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20 de setembro de 2021

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Creative Commons BY-NC 3.0 Legacy
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    On-Study - PHYSICAL EXAM - 2407645v1.0

    Inglês

    Dates will appear as "DD-MON-YYYY'

    1 Formulários  
    1. StudyEvent: PHYSICAL EXAM
      1. Dates will appear as "DD-MON-YYYY'
    Physical Exam
    Descrição

    Physical Exam

    Evaluation Date
    Descrição

    EvaluationDate

    Tipo de dados

    date

    Alias
    NCI Thesaurus Property
    C25164
    UMLS 2011AA Property
    C0011008
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ObjectClass
    C25214
    UMLS 2011AA ObjectClass
    C0220825
    Course Day Number
    Descrição

    CourseDayNumber

    Tipo de dados

    double

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS 2011AA ValueDomain
    C0237753
    NCI Thesaurus Property
    C25301
    UMLS 2011AA Property
    C0439228
    NCI Thesaurus ObjectClass
    C25379
    UMLS 2011AA ObjectClass
    C0750729
    Body System Type
    Descrição

    BodySystemType

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25284
    UMLS 2011AA ValueDomain
    C0332307
    NCI Thesaurus ObjectClass
    C13041
    UMLS 2011AA ObjectClass
    C1268086
    NCI Thesaurus Property
    C25700
    UMLS 2011AA Property
    C0449913
    Finding Results Indicator
    Descrição

    FindingResultIndicator

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C20200
    UMLS 2011AA ValueDomain
    C1274040
    NCI Thesaurus ObjectClass
    C3367
    UMLS 2011AA ObjectClass
    C0037088
    NCI Metathesaurus Property
    CL282989
    Research Comments Text
    Descrição

    ResearchCommentsText

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704
    UMLS 2011AA ValueDomain
    C1527021
    NCI Thesaurus ObjectClass
    C15319
    NCI Thesaurus Property
    C25393
    UMLS 2011AA Property
    C0282411
    Course Number (This is a derived field and may be displayed on the form, if needed.)
    Descrição

    CourseNumber

    Tipo de dados

    double

    Alias
    NCI Thesaurus Property
    C25337
    UMLS 2011AA Property
    C0237753
    NCI Thesaurus ValueDomain
    C25337
    UMLS 2011AA ValueDomain
    C0237753
    NCI Thesaurus ObjectClass
    C25379
    UMLS 2011AA ObjectClass
    C0750729
    Comments
    Descrição

    Comments

    Note Date
    Descrição

    NoteDate

    Tipo de dados

    date

    Alias
    NCI Thesaurus Property
    C25164
    UMLS 2011AA Property
    C0011008
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Metathesaurus ObjectClass
    C1317574
    Research Comments Text
    Descrição

    ResearchCommentsText

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704
    UMLS 2011AA ValueDomain
    C1527021
    NCI Thesaurus ObjectClass
    C15319
    NCI Thesaurus Property
    C25393
    UMLS 2011AA Property
    C0282411
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    Similar models

    Dates will appear as "DD-MON-YYYY'

    1 Formulários
    1. StudyEvent: PHYSICAL EXAM
      1. Dates will appear as "DD-MON-YYYY'
    Name
    Tipo
    Description | Question | Decode (Coded Value)
    Tipo de dados
    Alias
    Item Group
    Physical Exam
    EvaluationDate
    Item
    Evaluation Date
    date
    C25164 (NCI Thesaurus Property)
    C0011008 (UMLS 2011AA Property)
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C25214 (NCI Thesaurus ObjectClass)
    C0220825 (UMLS 2011AA ObjectClass)
    CourseDayNumber
    Item
    Course Day Number
    double
    C25337 (NCI Thesaurus ValueDomain)
    C0237753 (UMLS 2011AA ValueDomain)
    C25301 (NCI Thesaurus Property)
    C0439228 (UMLS 2011AA Property)
    C25379 (NCI Thesaurus ObjectClass)
    C0750729 (UMLS 2011AA ObjectClass)
    Item
    Body System Type
    text
    C25284 (NCI Thesaurus ValueDomain)
    C0332307 (UMLS 2011AA ValueDomain)
    C13041 (NCI Thesaurus ObjectClass)
    C1268086 (UMLS 2011AA ObjectClass)
    C25700 (NCI Thesaurus Property)
    C0449913 (UMLS 2011AA Property)
    CL.1
    Code List
    Body System Type
    CL Item
    Abdomen (ABDOMEN)
    C12664 (NCI Thesaurus)
    C0230168 (UMLS 2011AA)
    CL Item
    Allergy Or Drug Sensitivity History (Allergy/Drug Sensitivity)
    CL Item
    Appearance (Appearance)
    CL Item
    Body As A Whole (Body as a Whole)
    CL Item
    Breasts (BREASTS)
    C12971 (NCI Thesaurus)
    C0006141 (UMLS 2011AA)
    CL Item
    Cardiovascular (CARDIOVASCULAR)
    C25292 (NCI Thesaurus)
    C0007226 (UMLS 2011AA)
    CL Item
    Central Nervous System (Central Nervous System)
    C12438 (NCI Thesaurus)
    C3714787 (UMLS 2011AA)
    CL Item
    Chest (Chest)
    C25389 (NCI Thesaurus)
    C0817096 (UMLS 2011AA)
    CL Item
    Constitutional (Constitutional)
    C37931 (NCI Thesaurus)
    C1511487 (UMLS 2011AA)
    CL Item
    Dermatologic (DERMATOLOGIC)
    C0205489 (NCI Metathesaurus)
    CL Item
    Endocrine/metabolic (ENDOCRINE/METABOLIC)
    CL Item
    Extremities (Extremities)
    C30140 (NCI Thesaurus)
    CL Item
    Gastrointestinal (GASTROINTESTINAL)
    C13359 (NCI Thesaurus)
    C0521362 (UMLS 2011AA)
    CL Item
    Genitalia (GENITALIA)
    C25177 (NCI Thesaurus)
    C0017420 (UMLS 2011AA)
    CL Item
    Genitourinary (Genitourinary)
    CL Item
    H/e/e/n/t (H/E/E/N/T)
    CL Item
    Hematologic (HEMATOLOGIC)
    C0205488 (NCI Metathesaurus)
    CL Item
    Hematopoietic/lymph (HEMATOPOIETIC/LYMPH)
    C12745 (NCI Thesaurus)
    C0024204 (UMLS 2011AA)
    CL Item
    Hepatic (Hepatic)
    C13308 (NCI Thesaurus)
    C0205054 (UMLS 2011AA)
    CL Item
    Immune (IMMUNE)
    C17997 (NCI Thesaurus)
    C0439662 (UMLS 2011AA)
    CL Item
    Integumentary/hair (Integumentary/Hair)
    CL Item
    Musculoskeletal (MUSCULOSKELETAL)
    C25348 (NCI Thesaurus)
    C0497254 (UMLS 2011AA)
    CL Item
    Neck (NECK)
    C13063 (NCI Thesaurus)
    C0027530 (UMLS 2011AA)
    CL Item
    Neurologic (NEUROLOGIC)
    C25262 (NCI Thesaurus)
    C0205494 (UMLS 2011AA)
    CL Item
    Other (OTHER)
    C17649 (NCI Thesaurus)
    C0205394 (UMLS 2011AA)
    CL Item
    Pelvis (PELVIS)
    C12767 (NCI Thesaurus)
    C0030797 (UMLS 2011AA)
    CL Item
    Peripheral Vascular System (Peripheral Vascular)
    C0225806 (NCI Metathesaurus)
    CL Item
    Psychologic (PSYCHOLOGIC)
    CL Item
    Pulmonary (Pulmonary)
    C13304 (NCI Thesaurus)
    C2709248 (UMLS 2011AA)
    CL Item
    Rectal (Rectal)
    C25224 (NCI Thesaurus)
    C0205052 (UMLS 2011AA)
    CL Item
    Renal (Renal)
    C25225 (NCI Thesaurus)
    C0022646 (UMLS 2011AA)
    CL Item
    Reproductive History (Reproductive History)
    C17655 (NCI Thesaurus)
    C0206076 (UMLS 2011AA)
    CL Item
    Respiratory (RESPIRATORY)
    C25656 (NCI Thesaurus)
    C0521346 (UMLS 2011AA)
    CL Item
    Spleen (Spleen)
    C12432 (NCI Thesaurus)
    C0037993 (UMLS 2011AA)
    CL Item
    Substance Abuse/dependency (Substance abuse/Dependency)
    CL Item
    Transfusion History (Transfusion History)
    C30142 (NCI Thesaurus)
    C1519604 (UMLS 2011AA)
    CL Item
    Urinary (URINARY)
    C25711 (NCI Thesaurus)
    C1524119 (UMLS 2011AA)
    Item
    Finding Results Indicator
    text
    C20200 (NCI Thesaurus ValueDomain)
    C1274040 (UMLS 2011AA ValueDomain)
    C3367 (NCI Thesaurus ObjectClass)
    C0037088 (UMLS 2011AA ObjectClass)
    CL282989 (NCI Metathesaurus Property)
    CL.2
    Code List
    Finding Results Indicator
    CL Item
    Abnormal (A)
    C25401 (NCI Thesaurus)
    C0205161 (UMLS 2011AA)
    CL Item
    No Change (C)
    CL Item
    Equivocal (E)
    C86071 (NCI Thesaurus)
    C0332241 (UMLS 2011AA)
    CL Item
    Negative (G)
    C25247 (NCI Thesaurus)
    C0205160 (UMLS 2011AA)
    CL Item
    Improving (I)
    C94226 (NCI Thesaurus)
    CL Item
    Not Applicable (L)
    C48660 (NCI Thesaurus)
    C1272460 (UMLS 2011AA)
    CL Item
    Normal (N)
    C14165 (NCI Thesaurus)
    C0205307 (UMLS 2011AA)
    CL Item
    No Source Data (O)
    C53269 (NCI Thesaurus)
    C1546437 (UMLS 2011AA)
    CL Item
    Positive (P)
    C25246 (NCI Thesaurus)
    C1446409 (UMLS 2011AA)
    CL Item
    Stable (S)
    C30103 (NCI Thesaurus)
    C0205360 (UMLS 2011AA)
    CL Item
    Unstable (U)
    CL Item
    Not Evaluable (V)
    CL Item
    Worse (W)
    C71686 (NCI Thesaurus)
    C1457868 (UMLS 2011AA)
    CL Item
    Not Examined (X)
    ResearchCommentsText
    Item
    Research Comments Text
    text
    C25704 (NCI Thesaurus ValueDomain)
    C1527021 (UMLS 2011AA ValueDomain)
    C15319 (NCI Thesaurus ObjectClass)
    C25393 (NCI Thesaurus Property)
    C0282411 (UMLS 2011AA Property)
    CourseNumber
    Item
    Course Number (This is a derived field and may be displayed on the form, if needed.)
    double
    C25337 (NCI Thesaurus Property)
    C0237753 (UMLS 2011AA Property)
    C25337 (NCI Thesaurus ValueDomain)
    C0237753 (UMLS 2011AA ValueDomain)
    C25379 (NCI Thesaurus ObjectClass)
    C0750729 (UMLS 2011AA ObjectClass)
    Item Group
    Comments
    NoteDate
    Item
    Note Date
    date
    C25164 (NCI Thesaurus Property)
    C0011008 (UMLS 2011AA Property)
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C1317574 (NCI Metathesaurus ObjectClass)
    ResearchCommentsText
    Item
    Research Comments Text
    text
    C25704 (NCI Thesaurus ValueDomain)
    C1527021 (UMLS 2011AA ValueDomain)
    C15319 (NCI Thesaurus ObjectClass)
    C25393 (NCI Thesaurus Property)
    C0282411 (UMLS 2011AA Property)
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