ID
6675
Description
IBCSG Long Term Follow-Up Form (18-LTF) Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=889C3F60-2C47-8540-E040-BB89AD4303DD
Lien
Mots-clés
Versions (2)
- 26/08/2012 26/08/2012 -
- 08/01/2015 08/01/2015 - Martin Dugas
Téléchargé le
8 janvier 2015
DOI
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Licence
Creative Commons BY-NC 3.0 Legacy
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Breast Cancer Follow-Up - IBCSG Long Term Follow-Up Form (18-LTF) - 3108506v1.0
Instructions: This form is to be completed every year. Questions on this form refer to events during the time period covered in questions 1 and 2. Use minus one (-1) to indicate that an answer is unknown, unobtainable or not done
Description
Long Term Follow-up
Description
Reporting Period Start Date
Type de données
date
Alias
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus Property
- C25616
- UMLS CUI-1
- C2361257
- NCI Thesaurus Property-2
- C25651
- NCI Thesaurus ValueDomain
- C25164
- NCI Thesaurus ValueDomain-2
- C25431
Description
Reporting Period End Date
Type de données
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C2361259
- NCI Thesaurus Property
- C25616
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus Property-2
- C25651
Description
PersonSurvivalInformationSource
Type de données
text
Alias
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus ValueDomain
- C25683
- UMLS 2011AA ValueDomain
- C0449416
- NCI Thesaurus Property
- C48191
- UMLS 2011AA Property
- C1533716
- NCI Thesaurus Property-2
- C17177
- UMLS 2011AA Property-2
- C0038952
Description
PersonSurvivalInformationSpecify
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus Property
- C48191
- UMLS 2011AA Property
- C1533716
- NCI Thesaurus Property-2
- C17177
- UMLS 2011AA Property-2
- C0038952
Description
Off-TreatmentStudyFollow-UpSpecify
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
- NCI Thesaurus Property
- C16033
- UMLS 2011AA Property
- C1522577
- NCI Thesaurus ObjectClass
- C25601
- UMLS 2011AA ObjectClass
- C1518544
- NCI Thesaurus ObjectClass-2
- C15206
- UMLS 2011AA ObjectClass-2
- C0008972
Description
ECOG Performance Status
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS CUI-1
- C1520224
- NCI Thesaurus Property
- C25367
- NCI Thesaurus ValueDomain-2
- C25491
- NCI Thesaurus ObjectClass
- C20641
Description
Patient Weight
Type de données
float
Unités de mesure
- Kg
Alias
- NCI Thesaurus ValueDomain
- C25209
- UMLS CUI-1
- C0005910
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25208
Description
PatientInformationCurrentFollow-upCollectedStatus
Type de données
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus ObjectClass-2
- C48191
- UMLS 2011AA ObjectClass-2
- C1533716
- NCI Thesaurus Property
- C25471
- UMLS 2011AA Property
- C0521116
- NCI Thesaurus Property-2
- C16033
- UMLS 2011AA Property-2
- C1522577
- NCI Thesaurus Property-3
- C25452
- NCI Thesaurus ValueDomain
- C25688
- UMLS 2011AA ValueDomain
- C0449438
Description
Footer Module
Description
InvestigatorDesignatedSignatureText
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus Property
- C25678
- UMLS 2011AA Property
- C1519316
- NCI Thesaurus ObjectClass
- C17089
- UMLS 2011AA ObjectClass
- C0035173
- NCI Thesaurus Property-2
- C25479
- UMLS 2011AA Property-2
- C1524084
Description
Investigator Signature Date
Type de données
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
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Instructions: This form is to be completed every year. Questions on this form refer to events during the time period covered in questions 1 and 2. Use minus one (-1) to indicate that an answer is unknown, unobtainable or not done
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C25491 (NCI Thesaurus ValueDomain-2)
C20641 (NCI Thesaurus ObjectClass)
C0005910 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25208 (NCI Thesaurus Property)
C0030705 (UMLS 2011AA ObjectClass)
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