ID
6205
Beskrivning
NCI COOPERATIVE GROUP Patient Information FORM (CALGB-90104) Combination Chemotherapy in Treating Patients With Bladder Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A9BED937-4416-2507-E034-0003BA12F5E7
Länk
Nyckelord
Versioner (3)
- 2014-12-18 2014-12-18 - Martin Dugas
- 2015-01-08 2015-01-08 - Martin Dugas
- 2021-09-20 2021-09-20 -
Uppladdad den
18 december 2014
DOI
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Licens
Creative Commons BY-NC 3.0 Legacy
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NCI COOPERATIVE GROUP Patient Information FORM (CALGB-90104)
No Instruction available.
- StudyEvent: NCI COOPERATIVE GROUP Patient Information FORM (CALGB-90104
Beskrivning
Protocol Administration
Beskrivning
IRB/REBApprovalDate
Datatyp
text
Beskrivning
PersonCompletingForm,LastName
Datatyp
text
Beskrivning
PersonCompletingForm,FirstName
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus Property
- C25364
- UMLS 2011AA Property
- C0600091
Beskrivning
InformedConsentDateSigned
Datatyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
Beskrivning
PersonCompletingForm,Phone
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
Beskrivning
PersonCompletingForm,Fax
Datatyp
double
Beskrivning
ProjectedTreatmentBeginDate
Datatyp
date
Beskrivning
RegistrationDate
Datatyp
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
Beskrivning
Patient Demographics / Pre-treatment Characteristics
Beskrivning
PatientName,Last
Datatyp
text
Beskrivning
PatientName,First
Datatyp
text
Beskrivning
PatientName,Middle
Datatyp
text
Beskrivning
PatientBirthDate
Datatyp
date
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25275
- UMLS 2011AA Property
- C2745955
Beskrivning
PatientGender
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25372
- UMLS 2011AA ValueDomain
- C0683312
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C17357
- UMLS 2011AA Property
- C0079399
Beskrivning
PatientRace/Ethnicity
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C17049
- UMLS 2011AA Property
- C0034510
Beskrivning
PatientSocialSecurityNumber
Datatyp
double
Beskrivning
Address,Line1
Datatyp
text
Beskrivning
Address,City
Datatyp
text
Beskrivning
Address,StateCode
Datatyp
text
Beskrivning
PatientAddress,PostalCode
Datatyp
double
Beskrivning
PatientAddress,Country
Datatyp
text
Beskrivning
PatientHeight
Datatyp
double
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25347
- UMLS 2011AA Property
- C0489786
Beskrivning
PatientWeight
Datatyp
double
Beskrivning
BodySurfaceArea
Datatyp
double
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25157
- UMLS 2011AA Property
- C0005902
Beskrivning
PerformanceStatus
Datatyp
text
Beskrivning
Certification Of Eligibility
Beskrivning
PatientEligibilityInd
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25171
- UMLS 2011AA Property
- C0013893
Beskrivning
Protocol Design
Beskrivning
Initial Patient Consent For Specimen Use
Beskrivning
PatientInitialConsent,Specimen,Patient'scancerresearchInd
Datatyp
text
Beskrivning
PatientInitialConsent,Specimen,Researchunrelatedtopatient'scancerInd
Datatyp
text
Beskrivning
PatientInitialConsent,Specimen,ContactInd
Datatyp
text
Beskrivning
InformedConsentDateSigned,SpecimenUse
Datatyp
date
Similar models
No Instruction available.
- StudyEvent: NCI COOPERATIVE GROUP Patient Information FORM (CALGB-90104
C0805701 (UMLS 2011AA ValueDomain)
C1507394 (UMLS 2011AA ObjectClass)
C42774 (NCI Thesaurus Property)
C1705823 (UMLS 2011AA Property)
C0805701 (UMLS 2011AA ValueDomain)
C0027361 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C0011008 (UMLS 2011AA ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C0030705 (UMLS 2011AA ObjectClass)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
C0683312 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C17357 (NCI Thesaurus Property)
C0079399 (UMLS 2011AA Property)
C1706180 (UMLS 2011AA)
C0015780 (UMLS 2011AA)
C0030705 (UMLS 2011AA ObjectClass)
C17049 (NCI Thesaurus Property)
C0034510 (UMLS 2011AA Property)
C0205394 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C0030705 (UMLS 2011AA ObjectClass)
C25347 (NCI Thesaurus Property)
C0489786 (UMLS 2011AA Property)
C0030705 (UMLS 2011AA ObjectClass)
C25157 (NCI Thesaurus Property)
C0005902 (UMLS 2011AA Property)
C0205448 (UMLS 2011AA)
C1522602 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25171 (NCI Thesaurus Property)
C0013893 (UMLS 2011AA Property)
C1705108 (UMLS 2011AA)
C1298908 (UMLS 2011AA)