ID
5709
Descrição
GOG-0252 Medical History Form (Form MEDH) Bevacizumab and Intravenous or Intraperitoneal Chemotherapy in Treating Patients With Stage II, Stage III, or Stage IV Ovarian Epithelial Cancer, Fallopian Tube Cancer, or Primary Peritoneal Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=62A7BF0E-D4CA-903B-E040-BB89AD43563B
Link
Palavras-chave
Versões (4)
- 19/09/2012 19/09/2012 -
- 11/08/2014 11/08/2014 - Martin Dugas
- 11/08/2014 11/08/2014 - Martin Dugas
- 09/01/2015 09/01/2015 - Martin Dugas
Transferido a
11 de agosto de 2014
DOI
Para um pedido faça login.
Licença
Creative Commons BY-NC 3.0 Legacy
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Fallopian Tube Cancer NCT00951496 Pre-Study - GOG-0252 Medical History Form (Form MEDH) - 2838693v1.0
No Instruction available.
- StudyEvent: GOG-0252 Medical History Form (Form MEDH)
Descrição
Ovarian: Disease Description
Descrição
PersonHypertensionTherapeuticProcedurePersonalMedicalHistoryIndicator
Tipo de dados
text
Alias
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus Property
- C3117
- UMLS 2011AA Property
- C0020538
- NCI Thesaurus Property
- C49236
- UMLS 2011AA Property
- C0087111
- NCI Thesaurus Property
- C18772
- UMLS 2011AA Property
- C0262926
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Descrição
HistoryofPeripheralVascularDiseasePresentInd-3
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
- NCI Thesaurus Property
- C25626
- UMLS 2011AA Property
- C0150312
- NCI Thesaurus ObjectClass
- C66923
- UMLS 2011AA ObjectClass
- C1881056
Descrição
PatientCerebrovascularAccidentMyocardialInfarctionPersonalMedicalHistoryInd-3
Tipo de dados
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C27996
- UMLS 2011AA Property
- C0027051
- NCI Thesaurus Property
- C3390
- UMLS 2011AA Property
- C0038454
- NCI Thesaurus Property
- C18772
- UMLS 2011AA Property
- C0262926
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
Descrição
Current Smoker
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS CUI-1
- C3241966
- NCI Thesaurus Property
- C25471
- NCI Thesaurus ObjectClass
- C17934
- NCI Metathesaurus Property
- C0449865
Descrição
CigaretteAverageDailyPackUseCount
Tipo de dados
double
Alias
- NCI Thesaurus ObjectClass
- C1802
- UMLS 2011AA ObjectClass
- C0677453
- NCI Thesaurus Property
- C25473
- UMLS 2011AA Property
- C0332173
- NCI Thesaurus Property
- C62653
- UMLS 2011AA Property
- C2825051
- NCI Thesaurus Property
- C37917
- UMLS 2011AA Property
- C1510992
- NCI Thesaurus Property
- C25340
- UMLS 2011AA Property
- C0457083
- NCI Thesaurus ValueDomain
- C25463
- UMLS 2011AA ValueDomain
- C0750480
Descrição
CigarAverageDailyUseCount
Tipo de dados
double
Alias
- NCI Thesaurus ObjectClass
- C1813
- UMLS 2011AA ObjectClass
- C0182504
- NCI Thesaurus Property
- C25473
- UMLS 2011AA Property
- C0332173
- NCI Thesaurus Property
- C37917
- UMLS 2011AA Property
- C1510992
- NCI Thesaurus Property
- C25340
- UMLS 2011AA Property
- C0457083
- NCI Thesaurus ValueDomain
- C25463
- UMLS 2011AA ValueDomain
- C0750480
Descrição
Smoking Duration
Tipo de dados
double
Alias
- NCI Thesaurus ValueDomain
- C25463
- UMLS CUI-1
- C3694955
- NCI Thesaurus ObjectClass
- C17934
- NCI Thesaurus Property
- C25330
Descrição
PersonDiabetesMellitusTherapeuticProcedurePersonalMedicalHistoryIndicator
Tipo de dados
text
Alias
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus Property
- C2985
- UMLS 2011AA Property
- C0011849
- NCI Thesaurus Property
- C49236
- UMLS 2011AA Property
- C0087111
- NCI Thesaurus Property
- C18772
- UMLS 2011AA Property
- C0262926
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Descrição
Ovarian: Findings From Primary Surgery
Descrição
DiseasesandDisordersPatientSelf-ReportAutoimmuneDiseaseDiagnosisInd-3
Tipo de dados
text
Alias
- NCI Thesaurus ObjectClass
- C2991
- UMLS 2011AA ObjectClass
- C0012634
- NCI Thesaurus Property
- C15220
- UMLS 2011AA Property
- C0011900
- NCI Thesaurus Property
- C2889
- UMLS 2011AA Property
- C0004364
- NCI Thesaurus Property
- C21089
- UMLS 2011AA Property
- C0681906
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
Descrição
Ovarian: Post-operative Findings Following Primary Surgery
Descrição
PatientUlcerationPersonalMedicalHistoryInd-3
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C18772
- UMLS 2011AA Property
- C0262926
- NCI Thesaurus Property
- C25757
- UMLS 2011AA Property
- C0041582
Descrição
TumorIntestinalObstructionInd-3
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
- NCI Thesaurus ObjectClass
- C3262
- UMLS 2011AA ObjectClass
- C0027651
- NCI Thesaurus Property
- C25266
- UMLS 2011AA Property
- C0021853
- NCI Thesaurus Property
- C3284
- UMLS 2011AA Property
- C0028778
Descrição
PatientInflammatoryBowelDiseasePersonalMedicalHistoryIndicator
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C3138
- UMLS 2011AA Property
- C0021390
- NCI Thesaurus Property
- C18772
- UMLS 2011AA Property
- C0262926
Descrição
PatientInflammatoryBowelDiseaseTreatmentPersonalMedicalHistoryInd-2
Tipo de dados
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C15368
- NCI Thesaurus Property
- C3138
- UMLS 2011AA Property
- C0021390
- NCI Thesaurus Property
- C18772
- UMLS 2011AA Property
- C0262926
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Descrição
PatientDiverticulitisTreatmentPersonalMedicalHistoryInd-2
Tipo de dados
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C15368
- NCI Thesaurus Property
- C18772
- UMLS 2011AA Property
- C0262926
- NCI Thesaurus Property
- C26752
- UMLS 2011AA Property
- C0012813
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Descrição
PatientC.DifficileColitisPersonalMedicalHistoryInd-2
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C18772
- UMLS 2011AA Property
- C0262926
- NCI Thesaurus Property
- C35286
- UMLS 2011AA Property
- C0238106
Descrição
PatientSmallIntestineExcisionAnastomosisPersonalMedicalHistoryInd-2
Tipo de dados
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C12386
- UMLS 2011AA Property
- C0021852
- NCI Thesaurus Property
- C15609
- UMLS 2011AA Property
- C0677554
- NCI Thesaurus Property
- C15232
- UMLS 2011AA Property
- C0728940
- NCI Thesaurus Property
- C18772
- UMLS 2011AA Property
- C0262926
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Descrição
PatientSmallBowelExcisionAnastomosisDebulkingPersonalMedicalHistoryInd-2
Tipo de dados
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C12386
- UMLS 2011AA Property
- C0021852
- NCI Thesaurus Property
- C15609
- UMLS 2011AA Property
- C0677554
- NCI Thesaurus Property
- C15232
- UMLS 2011AA Property
- C0728940
- NCI Thesaurus Property
- C18772
- UMLS 2011AA Property
- C0262926
- NCI Thesaurus Property
- C15749
- UMLS 2011AA Property
- C0439805
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Descrição
PatientLargeIntestineExcisionAnastomosisPersonalMedicalHistoryInd-2
Tipo de dados
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C15609
- UMLS 2011AA Property
- C0677554
- NCI Thesaurus Property
- C12379
- UMLS 2011AA Property
- C0021851
- NCI Thesaurus Property
- C15232
- UMLS 2011AA Property
- C0728940
- NCI Thesaurus Property
- C18772
- UMLS 2011AA Property
- C0262926
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Descrição
PatientLargeIntestineExcisionAnastomosisDebulkingPersonalMedicalHistoryInd-2
Tipo de dados
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C15609
- UMLS 2011AA Property
- C0677554
- NCI Thesaurus Property
- C12379
- UMLS 2011AA Property
- C0021851
- NCI Thesaurus Property
- C15232
- UMLS 2011AA Property
- C0728940
- NCI Thesaurus Property
- C18772
- UMLS 2011AA Property
- C0262926
- NCI Thesaurus Property
- C15749
- UMLS 2011AA Property
- C0439805
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Descrição
Footer Module
Descrição
PatientCorticosteroidUsePersonalMedicalHistoryInd-2
Tipo de dados
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C2322
- UMLS 2011AA Property
- C0001617
- NCI Thesaurus Property
- C18772
- UMLS 2011AA Property
- C0262926
- NCI Thesaurus Property
- C25340
- UMLS 2011AA Property
- C0457083
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Descrição
PatientNonsteroidalAntiinflammatoryDrugRegularUsePersonalMedicalHistoryInd-2
Tipo de dados
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C18772
- UMLS 2011AA Property
- C0262926
- NCI Thesaurus Property
- C257
- UMLS 2011AA Property
- C0003211
- NCI Thesaurus Property
- C25340
- UMLS 2011AA Property
- C0457083
- NCI Thesaurus Property
- C25647
- UMLS 2011AA Property
- C0205272
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Descrição
Comments
Similar models
No Instruction available.
- StudyEvent: GOG-0252 Medical History Form (Form MEDH)
C0376315 (UMLS 2011AA ObjectClass)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C25604 (NCI Thesaurus Property)
C0205313 (UMLS 2011AA Property)
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C0600091 (UMLS 2011AA Property)
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C25657 (NCI Thesaurus ObjectClass)
C1273518 (UMLS 2011AA ObjectClass)
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C1517741 (UMLS 2011AA Property)
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C0262926 (UMLS 2011AA Property)
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C1522602 (UMLS 2011AA ValueDomain)
C1298908 (UMLS 2011AA)
C1512699 (UMLS 2011AA ValueDomain)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
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C1881056 (UMLS 2011AA ObjectClass)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
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C27996 (NCI Thesaurus Property)
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C3390 (NCI Thesaurus Property)
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C0262926 (UMLS 2011AA Property)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C3241966 (UMLS CUI-1)
C25471 (NCI Thesaurus Property)
C17934 (NCI Thesaurus ObjectClass)
C0449865 (NCI Metathesaurus Property)
C1298908 (UMLS 2011AA)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C0677453 (UMLS 2011AA ObjectClass)
C25473 (NCI Thesaurus Property)
C0332173 (UMLS 2011AA Property)
C62653 (NCI Thesaurus Property)
C2825051 (UMLS 2011AA Property)
C37917 (NCI Thesaurus Property)
C1510992 (UMLS 2011AA Property)
C25340 (NCI Thesaurus Property)
C0457083 (UMLS 2011AA Property)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
C0182504 (UMLS 2011AA ObjectClass)
C25473 (NCI Thesaurus Property)
C0332173 (UMLS 2011AA Property)
C37917 (NCI Thesaurus Property)
C1510992 (UMLS 2011AA Property)
C25340 (NCI Thesaurus Property)
C0457083 (UMLS 2011AA Property)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
C3694955 (UMLS CUI-1)
C17934 (NCI Thesaurus ObjectClass)
C25330 (NCI Thesaurus Property)
C0027361 (UMLS 2011AA ObjectClass)
C2985 (NCI Thesaurus Property)
C0011849 (UMLS 2011AA Property)
C49236 (NCI Thesaurus Property)
C0087111 (UMLS 2011AA Property)
C18772 (NCI Thesaurus Property)
C0262926 (UMLS 2011AA Property)
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C1298908 (UMLS 2011AA)
C0012634 (UMLS 2011AA ObjectClass)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)
C2889 (NCI Thesaurus Property)
C0004364 (UMLS 2011AA Property)
C21089 (NCI Thesaurus Property)
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C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
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C3262 (NCI Thesaurus ObjectClass)
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C3138 (NCI Thesaurus Property)
C0021390 (UMLS 2011AA Property)
C18772 (NCI Thesaurus Property)
C0262926 (UMLS 2011AA Property)
C1298908 (UMLS 2011AA)
C0030705 (UMLS 2011AA ObjectClass)
C15368 (NCI Thesaurus Property)
C3138 (NCI Thesaurus Property)
C0021390 (UMLS 2011AA Property)
C18772 (NCI Thesaurus Property)
C0262926 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0030705 (UMLS 2011AA ObjectClass)
C15368 (NCI Thesaurus Property)
C18772 (NCI Thesaurus Property)
C0262926 (UMLS 2011AA Property)
C26752 (NCI Thesaurus Property)
C0012813 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C1512698 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
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C1705108 (UMLS 2011AA)
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C12386 (NCI Thesaurus Property)
C0021852 (UMLS 2011AA Property)
C15609 (NCI Thesaurus Property)
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C15232 (NCI Thesaurus Property)
C0728940 (UMLS 2011AA Property)
C18772 (NCI Thesaurus Property)
C0262926 (UMLS 2011AA Property)
C15749 (NCI Thesaurus Property)
C0439805 (UMLS 2011AA Property)
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C1512698 (UMLS 2011AA ValueDomain)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0030705 (UMLS 2011AA ObjectClass)
C15609 (NCI Thesaurus Property)
C0677554 (UMLS 2011AA Property)
C12379 (NCI Thesaurus Property)
C0021851 (UMLS 2011AA Property)
C15232 (NCI Thesaurus Property)
C0728940 (UMLS 2011AA Property)
C18772 (NCI Thesaurus Property)
C0262926 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0030705 (UMLS 2011AA ObjectClass)
C15609 (NCI Thesaurus Property)
C0677554 (UMLS 2011AA Property)
C12379 (NCI Thesaurus Property)
C0021851 (UMLS 2011AA Property)
C15232 (NCI Thesaurus Property)
C0728940 (UMLS 2011AA Property)
C18772 (NCI Thesaurus Property)
C0262926 (UMLS 2011AA Property)
C15749 (NCI Thesaurus Property)
C0439805 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0030705 (UMLS 2011AA ObjectClass)
C2322 (NCI Thesaurus Property)
C0001617 (UMLS 2011AA Property)
C18772 (NCI Thesaurus Property)
C0262926 (UMLS 2011AA Property)
C25340 (NCI Thesaurus Property)
C0457083 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0030705 (UMLS 2011AA ObjectClass)
C18772 (NCI Thesaurus Property)
C0262926 (UMLS 2011AA Property)
C257 (NCI Thesaurus Property)
C0003211 (UMLS 2011AA Property)
C25340 (NCI Thesaurus Property)
C0457083 (UMLS 2011AA Property)
C25647 (NCI Thesaurus Property)
C0205272 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C1527021 (UMLS 2011AA ValueDomain)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C0282411 (UMLS 2011AA Property)