ID
43215
Beschrijving
Lung Cancer NCT00499330 Registration - CALGB 140503 INTRA-OPERATIVE REGISTRATION/RANDOMIZATION WORKSHEET - 2916823v1.0 CALGB 140503 INTRA-OPERATIVE REGISTRATION/RANDOMIZATION WORKSHEET Comparison of Different Types of Surgery in Treating Patients With Stage IA Non-Small Cell Lung Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=6E4AB7DA-A794-776C-E040-BB89AD430B3B
Link
Trefwoorden
Versies (5)
- 19-09-12 19-09-12 -
- 09-01-15 09-01-15 - Martin Dugas
- 09-01-15 09-01-15 - Martin Dugas
- 29-07-15 29-07-15 - Martin Dugas
- 20-09-21 20-09-21 -
Geüploaded op
20 september 2021
DOI
Voor een aanvraag inloggen.
Licentie
Creative Commons BY-NC 3.0 Legacy
Model Commentaren :
Hier kunt u commentaar leveren op het model. U kunt de tekstballonnen bij de itemgroepen en items gebruiken om er specifiek commentaar op te geven.
Itemgroep Commentaren voor :
Item Commentaren voor :
U moet ingelogd zijn om formulieren te downloaden. AUB inloggen of schrijf u gratis in.
Intra-operative Registration/Randomization Lung Cancer CALGB 140503 NCT00499330
A Phase III Randomized Trial of Lobectomy versus Sublobar Resection for Small ( <= 2 cm) Peripheral NSCLC. CALGB INSTRUCTIONS: To perform the intra-operative registration/randomization select the "Register a Patient" link in the CALGB Web-based Patient Registration System CTSU INSTRUCTIONS: On day of surgery fax worksheet, with as much as data completed as possible. During surgery call the CTSU cell phone (301-704-2376) to complete the randomization.
- StudyEvent: CALGB 140503 INTRA-OPERATIVE REGISTRATION/RANDOMIZATION WORKSHEET
Beschrijving
Patient Demographics/pre-treatment Characteristics
Beschrijving
Patient Initials
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS CUI-1
- C2986440
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25536
Beschrijving
Patient date of birth
Datatype
date
Maateenheden
- DD.MM.YYYY
Alias
- NCI Thesaurus ValueDomain
- C25164
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus ValueDomain-2
- C25367
- NCI Thesaurus Property
- C25155
- UMLS CUI-1-1
- C0421451
Beschrijving
PatientPersonSocialSecurityNumber
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS 2011AA ValueDomain
- C0237753
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus Property
- C25686
- UMLS 2011AA Property
- C1301821
Beschrijving
Medical Record Number
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C1301894
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25261
- NCI Thesaurus Property-2
- C25198
Beschrijving
Gender
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25372
- UMLS CUI-1
- C0079399
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C17357
Beschrijving
Patient Demographics/pre-treatment Characteristics2
Beschrijving
ECOG Performance Status
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS CUI-1
- C1520224
- NCI Thesaurus Property
- C25367
- NCI Thesaurus ValueDomain-2
- C25491
- NCI Thesaurus ObjectClass
- C20641
Beschrijving
Height
Datatype
float
Maateenheden
- cm
Alias
- NCI Thesaurus ValueDomain
- C25209
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25347
- UMLS CUI-1-1
- C0005890
Beschrijving
Body weight
Datatype
float
Maateenheden
- kg
Alias
- NCI Thesaurus ValueDomain
- C25209
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25208
- UMLS CUI-1-1
- C0005910
Beschrijving
PatientPaymentType
Datatype
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
Beschrijving
Patient Demographics/pre-treatment Characteristics3
Beschrijving
Certification Of Eligibility
Beschrijving
Eligibility for trial
Datatype
boolean
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS CUI-1
- C1302261
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25171
Beschrijving
Protocol Design
Beschrijving
AmericanCollegeofSurgeonsOncologyGroupPatientMalignantNeoplasmSizeEligibilityDeterminationType
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus ObjectClass-2
- C19712
- NCI Thesaurus Property
- C9305
- NCI Thesaurus Property-2
- C25171
- NCI Thesaurus Property-3
- C25681
- NCI Thesaurus ValueDomain
- C25284
- UMLS CUI-1-1
- C0475440
Beschrijving
Histologic Type
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C3262
- UMLS CUI-1
- C0449574
- NCI Thesaurus ObjectClass-2
- C12468
- NCI Thesaurus Property
- C25526
- NCI Thesaurus Property-2
- C25161
- NCI Thesaurus ValueDomain
- C25372
- NCI Thesaurus ValueDomain-2
- C25526
Beschrijving
Smoking Status
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C1802
- NCI Metathesaurus ObjectClass
- C0037369
- NCI Metathesaurus Property
- C0449438
- NCI Thesaurus ValueDomain
- C25284
- NCI Thesaurus ValueDomain-2
- C25704
- UMLS CUI-1-1
- C1519386
Beschrijving
Protocol Treatment Arm
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus ObjectClass-2
- C42651
- UMLS CUI-1
- C1522541
- NCI Thesaurus Property
- C32141
- NCI Thesaurus Property-2
- C25426
- NCI Thesaurus ValueDomain
- C25284
Beschrijving
Study Companion 580602 (mandatory)
Beschrijving
Eligibility for trial
Datatype
boolean
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS CUI-1
- C1302261
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25171
Beschrijving
Notes:
Beschrijving
ClinicalResearchAssociateResponsiblePersonName
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS 2011AA ValueDomain
- C1547383
- NCI Thesaurus ObjectClass
- C25657
- UMLS 2011AA ObjectClass
- C1273518
- NCI Thesaurus Property
- C25364
- UMLS 2011AA Property
- C0600091
- NCI Thesaurus ObjectClass-2
- C25465
- UMLS 2011AA ObjectClass-2
- C1516627
Beschrijving
ClinicalResearchAssociatePersonEmailAddressText
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus ObjectClass-2
- C25465
- UMLS 2011AA ObjectClass-2
- C1516627
- NCI Thesaurus Property
- C42775
- UMLS 2011AA Property
- C1705961
Beschrijving
ClinicalResearchAssociatePersonTelephoneNumber
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS 2011AA ValueDomain
- C0237753
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus Property
- C25395
- UMLS 2011AA Property
- C0039457
- NCI Thesaurus ObjectClass-2
- C25465
- UMLS 2011AA ObjectClass-2
- C1516627
Similar models
A Phase III Randomized Trial of Lobectomy versus Sublobar Resection for Small ( <= 2 cm) Peripheral NSCLC. CALGB INSTRUCTIONS: To perform the intra-operative registration/randomization select the "Register a Patient" link in the CALGB Web-based Patient Registration System CTSU INSTRUCTIONS: On day of surgery fax worksheet, with as much as data completed as possible. During surgery call the CTSU cell phone (301-704-2376) to complete the randomization.
- StudyEvent: CALGB 140503 INTRA-OPERATIVE REGISTRATION/RANDOMIZATION WORKSHEET
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
C16468 (NCI Thesaurus ObjectClass)
C0009797 (UMLS 2011AA ObjectClass)
C25679 (NCI Thesaurus Property)
C0030705 (UMLS 2011AA ObjectClass)
C25679 (NCI Thesaurus Property)
C0012621 (NCI Metathesaurus Property)
C45258 (NCI Thesaurus Property-2)
C0025102 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25631 (NCI Thesaurus ObjectClass-2)
C25431 (NCI Thesaurus Property)
C3173309 (UMLS CUI-1)
C25275 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25431 (NCI Thesaurus ValueDomain-2)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C25191 (NCI Thesaurus ValueDomain)
C21541 (NCI Thesaurus ValueDomain-2)
C0205549 (UMLS 2011AA ObjectClass)
C18843 (NCI Thesaurus ObjectClass-2)
C1704382 (UMLS 2011AA ObjectClass-2)
C25741 (NCI Thesaurus Property)
C0031831 (UMLS 2011AA Property)
C38000 (NCI Thesaurus Property-2)
C0884358 (UMLS 2011AA Property-2)
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C19202 (NCI Thesaurus ObjectClass)
C1513882 (UMLS 2011AA ObjectClass)
C19924 (NCI Thesaurus ObjectClass-2)
C1521895 (UMLS 2011AA ObjectClass-2)
C0805701 (UMLS 2011AA ValueDomain)
C21541 (NCI Thesaurus ObjectClass)
C0018704 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C19202 (NCI Thesaurus ObjectClass-2)
C1513882 (UMLS 2011AA ObjectClass-2)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C16960 (NCI Thesaurus ObjectClass)
C25367 (NCI Thesaurus ValueDomain-2)
C25155 (NCI Thesaurus Property)
C0421451 (UMLS CUI-1-1)
C0237753 (UMLS 2011AA ValueDomain)
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25686 (NCI Thesaurus Property)
C1301821 (UMLS 2011AA Property)
C1301894 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25261 (NCI Thesaurus Property)
C25198 (NCI Thesaurus Property-2)
C0079399 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C17357 (NCI Thesaurus Property)
C1706180 (UMLS 2011AA)
C0086287 (UMLS 2011AA)
C1520224 (UMLS CUI-1)
C25367 (NCI Thesaurus Property)
C25491 (NCI Thesaurus ValueDomain-2)
C20641 (NCI Thesaurus ObjectClass)
C16960 (NCI Thesaurus ObjectClass)
C25347 (NCI Thesaurus Property)
C0005890 (UMLS CUI-1-1)
C16960 (NCI Thesaurus ObjectClass)
C25208 (NCI Thesaurus Property)
C0005910 (UMLS CUI-1-1)
C0332307 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25371 (NCI Thesaurus Property)
C0680264 (UMLS 2011AA Property)
C0018717 (UMLS 2011AA)
C0205394 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C1527021 (UMLS 2011AA ValueDomain)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C25365 (NCI Thesaurus Property)
C0678257 (UMLS 2011AA Property)
C1302261 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25171 (NCI Thesaurus Property)
C19712 (NCI Thesaurus ObjectClass-2)
C9305 (NCI Thesaurus Property)
C25171 (NCI Thesaurus Property-2)
C25681 (NCI Thesaurus Property-3)
C25284 (NCI Thesaurus ValueDomain)
C0475440 (UMLS CUI-1-1)
C0449574 (UMLS CUI-1)
C12468 (NCI Thesaurus ObjectClass-2)
C25526 (NCI Thesaurus Property)
C25161 (NCI Thesaurus Property-2)
C25372 (NCI Thesaurus ValueDomain)
C25526 (NCI Thesaurus ValueDomain-2)
C0007137 (UMLS 2011AA)
C0001418 (UMLS 2011AA)
C0205394 (UMLS 2011AA)
C17649 (NCI Thesaurus-3)
C0205394 (UMLS 2011AA-4)
C0037369 (NCI Metathesaurus ObjectClass)
C0449438 (NCI Metathesaurus Property)
C25284 (NCI Thesaurus ValueDomain)
C25704 (NCI Thesaurus ValueDomain-2)
C1519386 (UMLS CUI-1-1)
C0337671 (UMLS 2011AA)
C0337664 (UMLS 2011AA)
C42651 (NCI Thesaurus ObjectClass-2)
C1522541 (UMLS CUI-1)
C32141 (NCI Thesaurus Property)
C25426 (NCI Thesaurus Property-2)
C25284 (NCI Thesaurus ValueDomain)
C1302261 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25171 (NCI Thesaurus Property)
C1547383 (UMLS 2011AA ValueDomain)
C25657 (NCI Thesaurus ObjectClass)
C1273518 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C25465 (NCI Thesaurus ObjectClass-2)
C1516627 (UMLS 2011AA ObjectClass-2)
C1527021 (UMLS 2011AA ValueDomain)
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25465 (NCI Thesaurus ObjectClass-2)
C1516627 (UMLS 2011AA ObjectClass-2)
C42775 (NCI Thesaurus Property)
C1705961 (UMLS 2011AA Property)
C0237753 (UMLS 2011AA ValueDomain)
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25395 (NCI Thesaurus Property)
C0039457 (UMLS 2011AA Property)
C25465 (NCI Thesaurus ObjectClass-2)
C1516627 (UMLS 2011AA ObjectClass-2)