PatientStudyID,CoordinatingGroup
Item
text
PatientMedicalRecordNumber
Item
text
Patient Initials
Item
Patient Initials
text
C25191 (NCI Thesaurus ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C2986440 (UMLS CUI-1)
PatientStudyID,ParticipatingGroup
Item
text
NCIInstitutionNumber
Item
text
PatientSocialSecurityNumber
Item
double
InstitutionName
Item
text
RegisteredInvestigator
Item
text
VisitReportMonthSpecify
Item
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C29846 (NCI Thesaurus Property)
C0439231 (UMLS 2011AA Property)
C25375 (NCI Thesaurus ObjectClass)
C0684224 (UMLS 2011AA ObjectClass)
C25716 (NCI Thesaurus ObjectClass)
C0545082 (UMLS 2011AA ObjectClass)
Item
Röntgen Thorax
integer
C0039985 (UMLS CUI-1)
CL Item
Nicht durchgeführt (0)
CL Item
Auffällig, nicht maligne (2)
Item
CT/MR/Ultraschall oberes Abdomen
integer
Code List
CT/MR/Ultraschall oberes Abdomen
CL Item
Nicht durchgeführt (0)
CL Item
Auffällig, nicht maligne (2)
Item
Art der Untersuchung
integer
C2598109 (UMLS CUI-1)
Code List
Art der Untersuchung
Item
Knochen Scan
integer
C0203668 (UMLS CUI-1)
CL Item
Nicht durchgeführt (0)
CL Item
Auffällig, nicht maligne (2)
Item
CT Kopf
integer
C25284 (NCI Thesaurus ValueDomain)
C17204 (NCI Thesaurus ObjectClass)
C12419 (NCI Thesaurus ObjectClass)
C20200 (NCI Thesaurus Property)
C0412585 (UMLS CUI-1)
CL Item
CT Kopf nicht durchgeführt (0)
CL Item
CT Kopf negativ (1)
CL Item
CT Kopf auffällig, nicht maligne (2)
CL Item
CT Kopf positiv (3)
Item
Andere radiologische Untersuchung
integer
Code List
Andere radiologische Untersuchung
CL Item
Nicht durchgeführt (0)
CL Item
Auffällig, nicht maligne (2)
Assessment Type
Item
Art der Untersuchung
text
C2598109 (UMLS CUI-1)
Assessment date
Item
Untersuchungsdatum
date
C2985720 (UMLS CUI-1)
LoggedEntryInitials
Item
text
LoggedEntryDate
Item
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
CoordinatorReviewInitials
Item
text
CoordinatorReviewDate
Item
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
PhysicianReviewInitials
Item
text
DataEntryInitials
Item
text
DataVerificationInitials
Item
text
LungSiteInd
Item
Lung (* Local recurrence in the area of tumour bed or Hilum.)
boolean
LiverSiteInd
Item
Liver
boolean
PleuraSiteInd
Item
Pleura (to be discussed)
boolean
CNSSiteInd
Item
CNS (excluding brain)
boolean
BrainSiteInd
Item
Brain
boolean
BoneSiteInd
Item
Bone
boolean
OppositeLungInd
Item
Opposite Lung
boolean
RegionalLymphNode(s)Ind
Item
Regional Lymph nodes (** Mediastinal lymph nodes)
boolean
DistantLymphNode(s)Ind
Item
Distant Lymph Nodes (*** Spread of disease beyond limits specified as same lung or regional lymph)
boolean
DistantSkin/SubcutaneousTissueInd
Item
Distant Skin or Subcutaneous tissue
boolean
DistantLungSiteInd
Item
Distant Lung Site Ind
boolean
AscitesInd
Item
Ascites
boolean
PleuralEffusionInd
Item
Pleural Effusion
boolean
LocalLungSiteIndicator
Item
Local Lung Site Ind
boolean
OtherSiteInd
Item
Other
boolean
ProgressionSuspectedBeginDate
Item
date
ProgressionDefiniteBeginDate
Item
date
ProgressionCriteria
Item
text
C25331 (NCI Thesaurus ObjectClass)
C25466 (NCI Thesaurus Property)
C0243161 (UMLS 2011AA Property)
Item
Have You attached copies of
integer
Code List
Have You attached copies of
CL Item
CT of abdomen/pelvis (2)
CL Item
pathology/cytology report(s) (3)
CL Item
other radiology (4)
CL Item
Other: specify (6)
PersonCompletingForm,FirstName
Item
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
InvestigatorSignature
Item
text
C25678 (NCI Thesaurus Property)
C1519316 (UMLS 2011AA Property)
C17089 (NCI Thesaurus ObjectClass)
C0035173 (UMLS 2011AA ObjectClass)
PersonCompletingForm,LastName
Item
text
FormCompletionDate,Original
Item
date