ID
43318
Beskrivning
E2905 Baseline Step 1 Disease Evaluation Form NCT00843882 Lenalidomide With or Without Epoetin Alfa in Treating Patients With Myelodysplastic Syndrome and Anemia Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=0EAB4E64-72BE-45B3-E044-0003BA3F9857
Länk
Nyckelord
Versioner (5)
- 2014-12-18 2014-12-18 - Martin Dugas
- 2015-01-08 2015-01-08 - Martin Dugas
- 2015-01-09 2015-01-09 - Martin Dugas
- 2015-06-16 2015-06-16 -
- 2021-09-20 2021-09-20 -
Uppladdad den
20 september 2021
DOI
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Licens
Creative Commons BY-NC 3.0 Legacy
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E2905 Baseline Step 1 Disease Evaluation Form NCT00843882
INSTRUCTIONS: Complete this form and submit original to the ECOG Coordinating Center within one week of registration. Keep a copy for your files
- StudyEvent: E2905 Baseline Step 1 Disease Evaluation Form
Beskrivning
Patient demographics
Beskrivning
Patient Initials
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS CUI-1
- C2986440
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25536
Beskrivning
Protocol Number ECOG
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C3274381
- NCI Thesaurus ObjectClass
- C25320
- UMLS CUI-2
- C1512162
- NCI Thesaurus Property
- C25364
- NCI Thesaurus Property-2
- C25491
Beskrivning
Patient ID ECOG
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C2348585
- NCI Thesaurus ObjectClass
- C16960
- UMLS CUI-2
- C1512162
- NCI Thesaurus Property
- C25364
- NCI Thesaurus Property-2
- C25491
Beskrivning
Study Number Participating Group
Datatyp
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
Beskrivning
Trial subject ID Participating Group
Datatyp
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
Beskrivning
Institution Name
Datatyp
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
Beskrivning
Data amendment
Beskrivning
Data amended
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C0680532
- NCI Thesaurus ObjectClass
- C25474
- NCI Thesaurus Property
- C25416
Beskrivning
Data amended date
Datatyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C0680532
- NCI Thesaurus ObjectClass
- C25474
- UMLS CUI-2
- C0011008
- NCI Thesaurus Property
- C25416
- NCI Thesaurus ValueDomain-2
- C25367
Beskrivning
Pre-registration Hematology/chemistry
Beskrivning
Hemoglobin LLN
Datatyp
float
Måttenheter
- g/dL
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS CUI-1
- C0019046
- NCI Thesaurus Property
- C16676
- UMLS CUI-2
- C1518030
- NCI Thesaurus Property-2
- C20200
- NCI Thesaurus ValueDomain
- C25712
- NCI Thesaurus ValueDomain-2
- C38024
- NCI Thesaurus ValueDomain-3
- C25555
Beskrivning
LaboratoryProcedureHemoglobinResultSpecifiedValue
Datatyp
float
Måttenheter
- g/dL
Alias
- NCI Thesaurus Property
- C16676
- UMLS 2011AA Property
- C0019046
- NCI Thesaurus Property-2
- C20200
- UMLS 2011AA Property-2
- C1274040
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
Beskrivning
LaboratoryProcedureHemoglobinResultDate
Datatyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus Property
- C16676
- UMLS 2011AA Property
- C0019046
- NCI Thesaurus Property-2
- C20200
- UMLS 2011AA Property-2
- C1274040
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
Beskrivning
Platelets LLN
Datatyp
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS CUI-1
- C0005821
- NCI Thesaurus Property
- C20200
- UMLS CUI-2
- C1518030
- NCI Thesaurus Property-2
- C12520
- NCI Thesaurus ValueDomain
- C25712
- NCI Thesaurus ValueDomain-2
- C25555
Beskrivning
Platelets
Datatyp
float
Måttenheter
- 1000/uL
Alias
- NCI Thesaurus Property
- C20200
- UMLS CUI-1
- C0005821
- NCI Thesaurus Property-2
- C12520
- NCI Thesaurus ObjectClass
- C25294
- NCI Thesaurus ValueDomain
- C25712
Beskrivning
Platelets date
Datatyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C0005821
- NCI Thesaurus Property
- C20200
- UMLS CUI-2
- C0011008
- NCI Thesaurus Property-2
- C12520
- NCI Thesaurus ObjectClass
- C25294
Beskrivning
LaboratoryProcedureGranulocyteResultLowerLimitofNormalCount
Datatyp
float
Måttenheter
- mm3
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C20200
- UMLS 2011AA Property
- C1274040
- NCI Thesaurus Property-2
- C12530
- UMLS 2011AA Property-2
- C0018183
- NCI Thesaurus ValueDomain
- C25463
- UMLS 2011AA ValueDomain
- C0750480
- NCI Thesaurus ValueDomain-2
- C25555
- UMLS 2011AA ValueDomain-2
- C1518030
Beskrivning
Granulocyte count
Datatyp
float
Måttenheter
- 1000/uL
Alias
- NCI Thesaurus Property
- C20200
- UMLS CUI-1
- C0857490
- NCI Thesaurus Property-2
- C12530
- NCI Thesaurus ValueDomain
- C25463
- NCI Thesaurus ObjectClass
- C25294
Beskrivning
LaboratoryProcedureNeutrophilResultDate
Datatyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus Property
- C12533
- UMLS 2011AA Property
- C0027950
- NCI Thesaurus Property-2
- C20200
- UMLS 2011AA Property-2
- C1274040
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
Beskrivning
LaboratoryProcedureLeukocyteResultSpecifiedValue
Datatyp
float
Måttenheter
- 1000/uL
Alias
- NCI Thesaurus Property
- C12529
- UMLS 2011AA Property
- C0023516
- NCI Thesaurus Property-2
- C20200
- UMLS 2011AA Property-2
- C1274040
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
- NCI Thesaurus ValueDomain-2
- C38024
- UMLS 2011AA ValueDomain-2
- C0205369
Beskrivning
LaboratoryProcedureLeukocyteResultLowerLimitofNormalValue
Datatyp
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C12529
- UMLS 2011AA Property
- C0023516
- NCI Thesaurus Property-2
- C20200
- UMLS 2011AA Property-2
- C1274040
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
- NCI Thesaurus ValueDomain-2
- C25555
- UMLS 2011AA ValueDomain-2
- C1518030
Beskrivning
LaboratoryProcedureLeukocyteResultDate
Datatyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus Property
- C12529
- UMLS 2011AA Property
- C0023516
- NCI Thesaurus Property-2
- C20200
- UMLS 2011AA Property-2
- C1274040
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
Beskrivning
Creatinine, Serum
Datatyp
float
Måttenheter
- mg/dL
Alias
- NCI Thesaurus Property
- C20200
- UMLS CUI-1
- C0201976
- NCI Thesaurus Property-2
- C399
- NCI Thesaurus ObjectClass
- C25294
- NCI Thesaurus ValueDomain
- C25712
Beskrivning
Creatinine, serum ULN
Datatyp
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS CUI-1
- C0201976
- NCI Thesaurus Property
- C20200
- UMLS CUI-2
- C1519815
- NCI Thesaurus Property-2
- C399
- NCI Thesaurus ValueDomain
- C25712
- NCI Thesaurus ValueDomain-2
- C25706
Beskrivning
Laboratory Procedure Date
Datatyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C0022885
- NCI Thesaurus Property
- C25214
- UMLS CUI-2
- C0011008
- NCI Thesaurus Property-2
- C38000
- NCI Thesaurus ObjectClass
- C25294
Beskrivning
LaboratoryProcedureHemoglobinPriorBloodTransfusionOutcomeUnspecifiedValue
Datatyp
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C16676
- UMLS 2011AA Property
- C0019046
- NCI Thesaurus Property-2
- C25629
- UMLS 2011AA Property-2
- C0332152
- NCI Thesaurus Property-3
- C20200
- UMLS 2011AA Property-3
- C1274040
- NCI Thesaurus Property-4
- C15192
- UMLS 2011AA Property-4
- C0005841
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
Beskrivning
Leukemia Assessment
Beskrivning
MyelodysplasticSyndromeWorldHealthOrganizationClassificationCategory
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25372
- UMLS 2011AA ValueDomain
- C0683312
- NCI Thesaurus ObjectClass
- C3247
- UMLS 2011AA ObjectClass
- C3463824
- NCI Thesaurus Property
- C25161
- UMLS 2011AA Property
- C0008902
- NCI Thesaurus Property-2
- C75419
- UMLS 2011AA Property-2
- C0043237
Beskrivning
CancerInitialDiagnosisDate
Datatyp
date
Alias
- NCI Thesaurus ObjectClass
- C9305
- UMLS 2011AA ObjectClass
- C0006826
- NCI Thesaurus Property
- C25509
- UMLS 2011AA Property
- C1279901
- NCI Thesaurus Property-2
- C15220
- UMLS 2011AA Property-2
- C0011900
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ValueDomain-2
- C25367
Beskrivning
BoneMarrowBiopsyDate
Datatyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ValueDomain-2
- C25367
- NCI Thesaurus Property
- C15189
- UMLS 2011AA Property
- C0005558
- NCI Thesaurus ObjectClass
- C12431
- UMLS 2011AA ObjectClass
- C0005953
Beskrivning
Blasts, Bone Marrow
Datatyp
float
Måttenheter
- %
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS CUI-1
- C1982687
- NCI Thesaurus Property
- C12431
- NCI Thesaurus Property-2
- C20200
- NCI Thesaurus Property-3
- C12918
- NCI Thesaurus ValueDomain
- C25613
- NCI Thesaurus ValueDomain-2
- C25712
Beskrivning
Bone Marrow Cellularity
Datatyp
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS CUI-1
- C1561532
- NCI Thesaurus Property
- C12431
- NCI Thesaurus Property-2
- C20200
- NCI Thesaurus Property-3
- C37923
- NCI Thesaurus ValueDomain
- C25613
- NCI Thesaurus ValueDomain-2
- C25712
Beskrivning
LaboratoryProcedureBoneMarrowCellularityNegationReportOutcomeReason
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C25594
- UMLS 2011AA Property
- C1518422
- NCI Thesaurus Property-2
- C12431
- UMLS 2011AA Property-2
- C0005953
- NCI Thesaurus Property-3
- C25375
- UMLS 2011AA Property-3
- C0684224
- NCI Thesaurus Property-4
- C20200
- UMLS 2011AA Property-4
- C1274040
- NCI Thesaurus Property-5
- C37923
- UMLS 2011AA Property-5
- C1516377
- NCI Thesaurus ValueDomain
- C25638
- UMLS 2011AA ValueDomain
- C0392360
Beskrivning
DysplasiaPresentInd-3
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
- NCI Thesaurus Property
- C25626
- UMLS 2011AA Property
- C0150312
- NCI Thesaurus ObjectClass
- C4086
- UMLS 2011AA ObjectClass
- C0334044
Beskrivning
DysplasiaHistologyType
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus Property
- C16681
- UMLS 2011AA Property
- C0019638
- NCI Thesaurus ObjectClass
- C4086
- UMLS 2011AA ObjectClass
- C0334044
Beskrivning
CytogeneticAbnormalityPresentIndicator
Datatyp
text
Alias
- NCI Thesaurus Property
- C25626
- UMLS 2011AA Property
- C0150312
- NCI Thesaurus ObjectClass
- C2950
- UMLS 2011AA ObjectClass
- C0008625
- NCI Metathesaurus ValueDomain
- C0021212
Beskrivning
PackedRedBloodCellTransfusionRequirementInd-3
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
- NCI Thesaurus ObjectClass
- C15409
- UMLS 2011AA ObjectClass
- C0199962
- NCI Thesaurus Property
- C25382
- UMLS 2011AA Property
- C1521801
Beskrivning
PackedRedBloodCellTransfusionReceivedUnitCount
Datatyp
float
Alias
- NCI Thesaurus ValueDomain
- C44278
- UMLS 2011AA ValueDomain
- C0439148
- NCI Thesaurus Property
- C25639
- UMLS 2011AA Property
- C1514756
- NCI Thesaurus ValueDomain-2
- C25463
- UMLS 2011AA ValueDomain-2
- C0750480
- NCI Thesaurus ObjectClass
- C15409
- UMLS 2011AA ObjectClass
- C0199962
Beskrivning
PackedRedBloodCellTransfusionReceivedFirstDate
Datatyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus Property
- C25639
- UMLS 2011AA Property
- C1514756
- NCI Thesaurus ValueDomain-2
- C25509
- UMLS 2011AA ValueDomain-2
- C1279901
- NCI Thesaurus ObjectClass
- C15409
- UMLS 2011AA ObjectClass
- C0199962
Beskrivning
PackedRedBloodCellTransfusionReceivedMostRecentDate
Datatyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus Property
- C25639
- UMLS 2011AA Property
- C1514756
- NCI Thesaurus ObjectClass
- C15409
- UMLS 2011AA ObjectClass
- C0199962
- NCI Thesaurus ValueDomain-2
- C25577
- UMLS 2011AA ValueDomain-2
- C1513491
Beskrivning
International Prognostic Score (ipss)
Beskrivning
Blasts, Bone Marrow
Datatyp
float
Måttenheter
- %
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS CUI-1
- C1982687
- NCI Thesaurus Property
- C12431
- NCI Thesaurus Property-2
- C20200
- NCI Thesaurus Property-3
- C12918
- NCI Thesaurus ValueDomain
- C25613
- NCI Thesaurus ValueDomain-2
- C25712
Beskrivning
Blasts, Bone Marrow
Datatyp
float
Måttenheter
- %
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS CUI-1
- C1982687
- NCI Thesaurus Property
- C12431
- NCI Thesaurus Property-2
- C20200
- NCI Thesaurus Property-3
- C12918
- NCI Thesaurus ValueDomain
- C25613
- NCI Thesaurus ValueDomain-2
- C25712
Beskrivning
MyelodysplasticSyndromeInternationalPrognosticScoreSystemDate
Datatyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C3247
- UMLS 2011AA ObjectClass
- C3463824
- NCI Thesaurus Property
- C20118
- UMLS 2011AA Property
- C1512894
Beskrivning
MyelodysplasticSyndromeInternationalPrognosticScoreSystemDate
Datatyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C3247
- UMLS 2011AA ObjectClass
- C3463824
- NCI Thesaurus Property
- C20118
- UMLS 2011AA Property
- C1512894
Beskrivning
KaryotypeDescriptionType
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus ObjectClass
- C25215
- UMLS 2011AA ObjectClass
- C1261273
- NCI Thesaurus Property
- C25365
- UMLS 2011AA Property
- C0678257
Beskrivning
KaryotypeDescriptionType
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus ObjectClass
- C25215
- UMLS 2011AA ObjectClass
- C1261273
- NCI Thesaurus Property
- C25365
- UMLS 2011AA Property
- C0678257
Beskrivning
CytopeniaAssessmentCount
Datatyp
float
Alias
- NCI Thesaurus Property
- C25367
- NCI Thesaurus ValueDomain
- C25463
- UMLS 2011AA ValueDomain
- C0750480
- NCI Thesaurus ObjectClass
- C2979
- UMLS 2011AA ObjectClass
- C0010828
Beskrivning
CytopeniaAssessmentCount
Datatyp
float
Alias
- NCI Thesaurus Property
- C25367
- NCI Thesaurus ValueDomain
- C25463
- UMLS 2011AA ValueDomain
- C0750480
- NCI Thesaurus ObjectClass
- C2979
- UMLS 2011AA ObjectClass
- C0010828
Beskrivning
MyelodysplasticSyndromeInternationalPrognosticScoreSystemScore
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C3247
- UMLS 2011AA ObjectClass
- C3463824
- NCI Thesaurus Property
- C20118
- UMLS 2011AA Property
- C1512894
- NCI Thesaurus ValueDomain
- C25338
- UMLS 2011AA ValueDomain
- C0449820
Beskrivning
MyelodysplasticSyndromeInternationalPrognosticScoreSystemScore
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C3247
- UMLS 2011AA ObjectClass
- C3463824
- NCI Thesaurus Property
- C20118
- UMLS 2011AA Property
- C1512894
- NCI Thesaurus ValueDomain
- C25338
- UMLS 2011AA ValueDomain
- C0449820
Beskrivning
Baseline Abnormalities
Beskrivning
AdverseEventCommonTerminologyforAdverseEventsVersion4TermName
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C41331
- UMLS 2011AA ObjectClass
- C0877248
- NCI Thesaurus Property
- C49704
- UMLS 2011AA Property
- C1516728
- NCI Thesaurus Property-2
- C45559
- UMLS 2011AA Property-2
- C1705313
- NCI Thesaurus ValueDomain
- C45255
- UMLS 2011AA ValueDomain
- C1708523
- NCI Thesaurus ValueDomain-2
- C49704
- UMLS 2011AA ValueDomain-2
- C1516728
- NCI Thesaurus ValueDomain-3
- C42614
- UMLS 2011AA ValueDomain-3
- C0027365
- NCI Thesaurus ValueDomain-4
- C45559
- UMLS 2011AA ValueDomain-4
- C1705313
- NCI Thesaurus ValueDomain-5
- C25714
- UMLS 2011AA ValueDomain-5
- C0333052
Beskrivning
AdverseEventSeverityGrade
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C41331
- UMLS 2011AA ObjectClass
- C0877248
- NCI Thesaurus Property
- C48309
- UMLS 2011AA Property
- C0441800
- NCI Thesaurus Property-2
- C49705
- UMLS 2011AA Property-2
- C1710065
- NCI Thesaurus Property-3
- C25676
- UMLS 2011AA Property-3
- C0439793
- NCI Thesaurus ValueDomain
- C41331
- UMLS 2011AA ValueDomain
- C0877248
- NCI Thesaurus ValueDomain-2
- C48309
- UMLS 2011AA ValueDomain-2
- C0441800
- NCI Thesaurus ValueDomain-3
- C25676
- UMLS 2011AA ValueDomain-3
- C0439793
Beskrivning
Comments
Beskrivning
Investigator Signature
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C2346576
- NCI Thesaurus Property
- C25678
- NCI Thesaurus ObjectClass
- C17089
Beskrivning
Investigator Signature Date
Datatyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C2346576
- NCI Thesaurus Property
- C25678
- UMLS CUI-2
- C0011008
- NCI Thesaurus ValueDomain-2
- C25367
- NCI Thesaurus ObjectClass
- C17089
Similar models
INSTRUCTIONS: Complete this form and submit original to the ECOG Coordinating Center within one week of registration. Keep a copy for your files
- StudyEvent: E2905 Baseline Step 1 Disease Evaluation Form
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1512162 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25491 (NCI Thesaurus Property-2)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1512162 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25491 (NCI Thesaurus Property-2)
C3242750 (UMLS CUI-1)
C19464 (NCI Thesaurus Property)
C25474 (NCI Thesaurus ObjectClass)
C25452 (NCI Thesaurus ObjectClass-2)
C1514821 (UMLS CUI-1)
C25646 (NCI Thesaurus ObjectClass)
C0237753 (UMLS CUI-2)
C16154 (NCI Thesaurus Property)
C16154 (NCI Thesaurus ValueDomain-2)
C2045829 (UMLS CUI-1)
C25214 (NCI Thesaurus Property)
C25616 (NCI Thesaurus Property-2)
C15368 (NCI Thesaurus ObjectClass)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1512162 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25491 (NCI Thesaurus Property-2)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1512162 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25491 (NCI Thesaurus Property-2)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C25191 (NCI Thesaurus ValueDomain)
C21541 (NCI Thesaurus ValueDomain-2)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C0011008 (UMLS CUI-2)
C25416 (NCI Thesaurus Property)
C25367 (NCI Thesaurus ValueDomain-2)
C0019046 (UMLS CUI-1)
C16676 (NCI Thesaurus Property)
C1518030 (UMLS CUI-2)
C20200 (NCI Thesaurus Property-2)
C25712 (NCI Thesaurus ValueDomain)
C38024 (NCI Thesaurus ValueDomain-2)
C25555 (NCI Thesaurus ValueDomain-3)
C0019046 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property-2)
C1274040 (UMLS 2011AA Property-2)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C16676 (NCI Thesaurus Property)
C0019046 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property-2)
C1274040 (UMLS 2011AA Property-2)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C0005821 (UMLS CUI-1)
C20200 (NCI Thesaurus Property)
C1518030 (UMLS CUI-2)
C12520 (NCI Thesaurus Property-2)
C25712 (NCI Thesaurus ValueDomain)
C25555 (NCI Thesaurus ValueDomain-2)
C0005821 (UMLS CUI-1)
C12520 (NCI Thesaurus Property-2)
C25294 (NCI Thesaurus ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C0005821 (UMLS CUI-1)
C20200 (NCI Thesaurus Property)
C0011008 (UMLS CUI-2)
C12520 (NCI Thesaurus Property-2)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C12530 (NCI Thesaurus Property-2)
C0018183 (UMLS 2011AA Property-2)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
C25555 (NCI Thesaurus ValueDomain-2)
C1518030 (UMLS 2011AA ValueDomain-2)
C0857490 (UMLS CUI-1)
C12530 (NCI Thesaurus Property-2)
C25463 (NCI Thesaurus ValueDomain)
C25294 (NCI Thesaurus ObjectClass)
C0011008 (UMLS 2011AA ValueDomain)
C12533 (NCI Thesaurus Property)
C0027950 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property-2)
C1274040 (UMLS 2011AA Property-2)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C0023516 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property-2)
C1274040 (UMLS 2011AA Property-2)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C38024 (NCI Thesaurus ValueDomain-2)
C0205369 (UMLS 2011AA ValueDomain-2)
C0022885 (UMLS 2011AA ObjectClass)
C12529 (NCI Thesaurus Property)
C0023516 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property-2)
C1274040 (UMLS 2011AA Property-2)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25555 (NCI Thesaurus ValueDomain-2)
C1518030 (UMLS 2011AA ValueDomain-2)
C0011008 (UMLS 2011AA ValueDomain)
C12529 (NCI Thesaurus Property)
C0023516 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property-2)
C1274040 (UMLS 2011AA Property-2)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C0201976 (UMLS CUI-1)
C399 (NCI Thesaurus Property-2)
C25294 (NCI Thesaurus ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C0201976 (UMLS CUI-1)
C20200 (NCI Thesaurus Property)
C1519815 (UMLS CUI-2)
C399 (NCI Thesaurus Property-2)
C25712 (NCI Thesaurus ValueDomain)
C25706 (NCI Thesaurus ValueDomain-2)
C0022885 (UMLS CUI-1)
C25214 (NCI Thesaurus Property)
C0011008 (UMLS CUI-2)
C38000 (NCI Thesaurus Property-2)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C16676 (NCI Thesaurus Property)
C0019046 (UMLS 2011AA Property)
C25629 (NCI Thesaurus Property-2)
C0332152 (UMLS 2011AA Property-2)
C20200 (NCI Thesaurus Property-3)
C1274040 (UMLS 2011AA Property-3)
C15192 (NCI Thesaurus Property-4)
C0005841 (UMLS 2011AA Property-4)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C0683312 (UMLS 2011AA ValueDomain)
C3247 (NCI Thesaurus ObjectClass)
C3463824 (UMLS 2011AA ObjectClass)
C25161 (NCI Thesaurus Property)
C0008902 (UMLS 2011AA Property)
C75419 (NCI Thesaurus Property-2)
C0043237 (UMLS 2011AA Property-2)
C0023480 (UMLS 2011AA)
C1292779 (UMLS 2011AA)
C0854809 (UMLS 2011AA)
C0002893 (UMLS 2011AA)
C1318550 (UMLS 2011AA)
C1318551 (UMLS 2011AA)
C1264195 (UMLS 2011AA)
C0796466 (UMLS 2011AA)
C1301356 (UMLS 2011AA)
C0006826 (UMLS 2011AA ObjectClass)
C25509 (NCI Thesaurus Property)
C1279901 (UMLS 2011AA Property)
C15220 (NCI Thesaurus Property-2)
C0011900 (UMLS 2011AA Property-2)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
C15189 (NCI Thesaurus Property)
C0005558 (UMLS 2011AA Property)
C12431 (NCI Thesaurus ObjectClass)
C0005953 (UMLS 2011AA ObjectClass)
C1982687 (UMLS CUI-1)
C12431 (NCI Thesaurus Property)
C20200 (NCI Thesaurus Property-2)
C12918 (NCI Thesaurus Property-3)
C25613 (NCI Thesaurus ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)
C1561532 (UMLS CUI-1)
C12431 (NCI Thesaurus Property)
C20200 (NCI Thesaurus Property-2)
C37923 (NCI Thesaurus Property-3)
C25613 (NCI Thesaurus ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)
C0022885 (UMLS 2011AA ObjectClass)
C25594 (NCI Thesaurus Property)
C1518422 (UMLS 2011AA Property)
C12431 (NCI Thesaurus Property-2)
C0005953 (UMLS 2011AA Property-2)
C25375 (NCI Thesaurus Property-3)
C0684224 (UMLS 2011AA Property-3)
C20200 (NCI Thesaurus Property-4)
C1274040 (UMLS 2011AA Property-4)
C37923 (NCI Thesaurus Property-5)
C1516377 (UMLS 2011AA Property-5)
C25638 (NCI Thesaurus ValueDomain)
C0392360 (UMLS 2011AA ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C4086 (NCI Thesaurus ObjectClass)
C0334044 (UMLS 2011AA ObjectClass)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C0332307 (UMLS 2011AA ValueDomain)
C16681 (NCI Thesaurus Property)
C0019638 (UMLS 2011AA Property)
C4086 (NCI Thesaurus ObjectClass)
C0334044 (UMLS 2011AA ObjectClass)
C1516960 (UMLS 2011AA)
C0025166 (UMLS 2011AA)
C0439677 (UMLS 2011AA)
C0150312 (UMLS 2011AA Property)
C2950 (NCI Thesaurus ObjectClass)
C0008625 (UMLS 2011AA ObjectClass)
C0021212 (NCI Metathesaurus ValueDomain)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C1512699 (UMLS 2011AA ValueDomain)
C15409 (NCI Thesaurus ObjectClass)
C0199962 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C0439148 (UMLS 2011AA ValueDomain)
C25639 (NCI Thesaurus Property)
C1514756 (UMLS 2011AA Property)
C25463 (NCI Thesaurus ValueDomain-2)
C0750480 (UMLS 2011AA ValueDomain-2)
C15409 (NCI Thesaurus ObjectClass)
C0199962 (UMLS 2011AA ObjectClass)
C0011008 (UMLS 2011AA ValueDomain)
C25639 (NCI Thesaurus Property)
C1514756 (UMLS 2011AA Property)
C25509 (NCI Thesaurus ValueDomain-2)
C1279901 (UMLS 2011AA ValueDomain-2)
C15409 (NCI Thesaurus ObjectClass)
C0199962 (UMLS 2011AA ObjectClass)
C0011008 (UMLS 2011AA ValueDomain)
C25639 (NCI Thesaurus Property)
C1514756 (UMLS 2011AA Property)
C15409 (NCI Thesaurus ObjectClass)
C0199962 (UMLS 2011AA ObjectClass)
C25577 (NCI Thesaurus ValueDomain-2)
C1513491 (UMLS 2011AA ValueDomain-2)
C1982687 (UMLS CUI-1)
C12431 (NCI Thesaurus Property)
C20200 (NCI Thesaurus Property-2)
C12918 (NCI Thesaurus Property-3)
C25613 (NCI Thesaurus ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)
C1982687 (UMLS CUI-1)
C12431 (NCI Thesaurus Property)
C20200 (NCI Thesaurus Property-2)
C12918 (NCI Thesaurus Property-3)
C25613 (NCI Thesaurus ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)
C0011008 (UMLS 2011AA ValueDomain)
C3247 (NCI Thesaurus ObjectClass)
C3463824 (UMLS 2011AA ObjectClass)
C20118 (NCI Thesaurus Property)
C1512894 (UMLS 2011AA Property)
C0011008 (UMLS 2011AA ValueDomain)
C3247 (NCI Thesaurus ObjectClass)
C3463824 (UMLS 2011AA ObjectClass)
C20118 (NCI Thesaurus Property)
C1512894 (UMLS 2011AA Property)
C0332307 (UMLS 2011AA ValueDomain)
C25215 (NCI Thesaurus ObjectClass)
C1261273 (UMLS 2011AA ObjectClass)
C25365 (NCI Thesaurus Property)
C0678257 (UMLS 2011AA Property)
C0332307 (UMLS 2011AA ValueDomain)
C25215 (NCI Thesaurus ObjectClass)
C1261273 (UMLS 2011AA ObjectClass)
C25365 (NCI Thesaurus Property)
C0678257 (UMLS 2011AA Property)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
C2979 (NCI Thesaurus ObjectClass)
C0010828 (UMLS 2011AA ObjectClass)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
C2979 (NCI Thesaurus ObjectClass)
C0010828 (UMLS 2011AA ObjectClass)
C3463824 (UMLS 2011AA ObjectClass)
C20118 (NCI Thesaurus Property)
C1512894 (UMLS 2011AA Property)
C25338 (NCI Thesaurus ValueDomain)
C0449820 (UMLS 2011AA ValueDomain)
C3463824 (UMLS 2011AA ObjectClass)
C20118 (NCI Thesaurus Property)
C1512894 (UMLS 2011AA Property)
C25338 (NCI Thesaurus ValueDomain)
C0449820 (UMLS 2011AA ValueDomain)
C0877248 (UMLS 2011AA ObjectClass)
C49704 (NCI Thesaurus Property)
C1516728 (UMLS 2011AA Property)
C45559 (NCI Thesaurus Property-2)
C1705313 (UMLS 2011AA Property-2)
C45255 (NCI Thesaurus ValueDomain)
C1708523 (UMLS 2011AA ValueDomain)
C49704 (NCI Thesaurus ValueDomain-2)
C1516728 (UMLS 2011AA ValueDomain-2)
C42614 (NCI Thesaurus ValueDomain-3)
C0027365 (UMLS 2011AA ValueDomain-3)
C45559 (NCI Thesaurus ValueDomain-4)
C1705313 (UMLS 2011AA ValueDomain-4)
C25714 (NCI Thesaurus ValueDomain-5)
C0333052 (UMLS 2011AA ValueDomain-5)
C0877248 (UMLS 2011AA ObjectClass)
C48309 (NCI Thesaurus Property)
C0441800 (UMLS 2011AA Property)
C49705 (NCI Thesaurus Property-2)
C1710065 (UMLS 2011AA Property-2)
C25676 (NCI Thesaurus Property-3)
C0439793 (UMLS 2011AA Property-3)
C41331 (NCI Thesaurus ValueDomain)
C0877248 (UMLS 2011AA ValueDomain)
C48309 (NCI Thesaurus ValueDomain-2)
C0441800 (UMLS 2011AA ValueDomain-2)
C25676 (NCI Thesaurus ValueDomain-3)
C0439793 (UMLS 2011AA ValueDomain-3)
C1513302 (UMLS 2011AA)
C1513374 (UMLS 2011AA)
C2919019 (UMLS 2011AA)
C1517874 (UMLS 2011AA)
C2346576 (UMLS CUI-1)
C25678 (NCI Thesaurus Property)
C17089 (NCI Thesaurus ObjectClass)
C2346576 (UMLS CUI-1)
C25678 (NCI Thesaurus Property)
C0011008 (UMLS CUI-2)
C25367 (NCI Thesaurus ValueDomain-2)
C17089 (NCI Thesaurus ObjectClass)
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