ID
6742
Beschrijving
Southwest Oncology Group S0931 Treatment Form (Form #44488) Everolimus in Treating Patients With Kidney Cancer Who Have Undergone Surgery Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=7E001FA4-EC45-AE5A-E040-BB89AD432C94
Link
Trefwoorden
Versies (2)
- 19-09-12 19-09-12 -
- 08-01-15 08-01-15 - Martin Dugas
Geüploaded op
8 januari 2015
DOI
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Licentie
Creative Commons BY-NC 3.0 Legacy
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Kidney Cancer NCT01120249 Treatment - Southwest Oncology Group S0931 Treatment Form (Form #44488) - 2992372v1.0
Instructions: Please complete this form after every cycle (1 cycle = 42 days, regardless of dose delays). All dates are MONTH, DAY, YEAR. Explain any blank dates or fields in a Comments section. Place an X in appropriate boxes. Circle AMENDED items in red and write AMENDED across the top of the form
- StudyEvent: Southwest Oncology Group S0931 Treatment Form (Form #44488)
Beschrijving
Status
Beschrijving
Patient Status
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS CUI-1
- C3846084
- NCI Thesaurus ValueDomain
- C18003
- NCI Thesaurus ValueDomain-2
- C25688
- NCI Thesaurus Property
- C25717
Beschrijving
Date last contact
Datatype
date
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS CUI-1
- C0805839
- NCI Thesaurus Property
- C25461
- NCI Thesaurus Property-2
- C25551
- NCI Thesaurus ValueDomain
- C25164
- NCI Thesaurus ValueDomain-2
- C25367
Beschrijving
Tumor Progression
Datatype
boolean
Alias
- NCI Thesaurus ValueDomain
- C38147
- UMLS CUI-1
- C0178874
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25320
- NCI Thesaurus Property-2
- C19987
Beschrijving
Treatment For This Cycle
Beschrijving
Reporting Period Start Date
Datatype
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
Beschrijving
Reporting Period End Date
Datatype
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C2361259
- NCI Thesaurus Property
- C25616
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus Property-2
- C25651
Beschrijving
Treatment Begin Date
Datatype
date
Alias
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus Property
- C25431
- UMLS CUI-1
- C3173309
- NCI Thesaurus Property-2
- C25275
- NCI Thesaurus ValueDomain
- C25164
- NCI Thesaurus ValueDomain-2
- C25431
Beschrijving
LastTreatmentDate
Datatype
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus ObjectClass-2
- C25551
- UMLS 2011AA ObjectClass
- C1517741
- NCI Thesaurus Property
- C25275
- UMLS 2011AA Property
- C2745955
Beschrijving
ECOG Performance Status
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS CUI-1
- C1520224
- NCI Thesaurus Property
- C25367
- NCI Thesaurus ValueDomain-2
- C25491
- NCI Thesaurus ObjectClass
- C20641
Beschrijving
Patient Weight
Datatype
float
Maateenheden
- Kg
Alias
- NCI Thesaurus ValueDomain
- C25209
- UMLS CUI-1
- C0005910
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25208
Beschrijving
DiagnosticImagingPneumoniaConfirmedIndicator
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
- NCI Thesaurus Property
- C25458
- UMLS 2011AA Property
- C0750484
- NCI Thesaurus ObjectClass
- C16502
- UMLS 2011AA ObjectClass
- C0011923
- NCI Thesaurus Property-2
- C3333
- UMLS 2011AA Property-2
- C0032285
Beschrijving
Dose Modification
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS CUI-1
- C1707811
- NCI Thesaurus ObjectClass
- C25256
- NCI Thesaurus Property
- C25572
- NCI Thesaurus ValueDomain-2
- C25572
Beschrijving
Treatment
Beschrijving
Agent
Datatype
text
Alias
- NCI Thesaurus Property
- C25364
- UMLS CUI-1
- C1521826
- NCI Thesaurus ObjectClass
- C1708
- NCI Thesaurus ValueDomain
- C1708
- NCI Thesaurus ValueDomain-2
- C42614
Beschrijving
TherapeuticProcedureDoseCoursePlanValue
Datatype
float
Maateenheden
- mg/24 hours
Alias
- NCI Thesaurus ObjectClass
- C49236
- UMLS 2011AA ObjectClass
- C0087111
- NCI Thesaurus Property
- C25619
- UMLS 2011AA Property
- C1301732
- NCI Thesaurus Property-2
- C25379
- UMLS 2011AA Property-2
- C0750729
- NCI Thesaurus Property-3
- C25488
- UMLS 2011AA Property-3
- C0178602
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
Beschrijving
TherapeuticProcedureDoseCourseAdministeredValue
Datatype
float
Maateenheden
- mg/24 hours
Alias
- NCI Thesaurus ObjectClass
- C49236
- UMLS 2011AA ObjectClass
- C0087111
- NCI Thesaurus Property
- C25379
- UMLS 2011AA Property
- C0750729
- NCI Thesaurus Property-2
- C25488
- UMLS 2011AA Property-2
- C0178602
- NCI Thesaurus Property-3
- C25382
- UMLS 2011AA Property-3
- C1521801
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
Beschrijving
Cumulative Dose Agent
Datatype
float
Alias
- NCI Thesaurus ObjectClass
- C1708
- UMLS CUI-1
- C2986497
- NCI Thesaurus ObjectClass-2
- C25470
- UMLS CUI-2
- C1521826
- NCI Thesaurus Property
- C25304
- NCI Thesaurus Property-2
- C25256
- NCI Thesaurus ValueDomain
- C25304
- NCI Thesaurus ValueDomain-2
- C25488
Beschrijving
Dose Modification Status
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C25488
- UMLS CUI-1
- C1707811
- NCI Thesaurus ValueDomain
- C25688
- NCI Thesaurus Property
- C25572
Beschrijving
Dose Modification Reason
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25638
- UMLS CUI-1
- C1707811
- NCI Thesaurus ObjectClass
- C25488
- UMLS CUI-2
- C0392360
- NCI Thesaurus Property
- C25572
Beschrijving
Dose Modification Reason, other
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS CUI-1
- C1707811
- NCI Thesaurus ObjectClass
- C25488
- UMLS CUI-2
- C3840932
- NCI Thesaurus Property
- C25572
Beschrijving
Delay of drug therapy
Datatype
float
Alias
- NCI Thesaurus Property
- C25477
- NCI Thesaurus ObjectClass
- C1708
- UMLS CUI-1
- C1299700
- NCI Thesaurus Property-2
- C25409
- NCI Thesaurus ValueDomain
- C25330
Beschrijving
Adverse Event causing Dose Modification
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25638
- UMLS CUI-1
- C0877248
- NCI Thesaurus Property
- C41331
- UMLS CUI-2
- C1707811
- NCI Thesaurus ObjectClass
- C25488
- UMLS CUI-3
- C0392360
- NCI Thesaurus Property-2
- C25572
Beschrijving
Adverse Event causing Dose Modification, other
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS CUI-1
- C0877248
- NCI Thesaurus Property
- C41331
- UMLS CUI-2
- C1707811
- NCI Thesaurus ObjectClass
- C25488
- UMLS CUI-3
- C3840932
- NCI Thesaurus Property-2
- C25572
Beschrijving
Comments
Similar models
Instructions: Please complete this form after every cycle (1 cycle = 42 days, regardless of dose delays). All dates are MONTH, DAY, YEAR. Explain any blank dates or fields in a Comments section. Place an X in appropriate boxes. Circle AMENDED items in red and write AMENDED across the top of the form
- StudyEvent: Southwest Oncology Group S0931 Treatment Form (Form #44488)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1519429 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25699 (NCI Thesaurus Property-2)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1519429 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25699 (NCI Thesaurus Property-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)
C15368 (NCI Thesaurus ObjectClass)
C25379 (NCI Thesaurus Property)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C25191 (NCI Thesaurus ValueDomain)
C21541 (NCI Thesaurus ValueDomain-2)
C2826892 (UMLS CUI-1)
C25364 (NCI Thesaurus Property)
C17089 (NCI Thesaurus ObjectClass)
C25644 (NCI Thesaurus ObjectClass-2)
C2347449 (UMLS CUI-1)
C25608 (NCI Thesaurus ObjectClass)
C17005 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
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)
C3846084 (UMLS CUI-1)
C18003 (NCI Thesaurus ValueDomain)
C25688 (NCI Thesaurus ValueDomain-2)
C25717 (NCI Thesaurus Property)
C0805839 (UMLS CUI-1)
C25461 (NCI Thesaurus Property)
C25551 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
C0178874 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25320 (NCI Thesaurus Property)
C19987 (NCI Thesaurus Property-2)
C25616 (NCI Thesaurus Property)
C2361257 (UMLS CUI-1)
C25651 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25431 (NCI Thesaurus ValueDomain-2)
C2361259 (UMLS CUI-1)
C25616 (NCI Thesaurus Property)
C15368 (NCI Thesaurus ObjectClass)
C25651 (NCI Thesaurus Property-2)
C25431 (NCI Thesaurus Property)
C3173309 (UMLS CUI-1)
C25275 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25431 (NCI Thesaurus ValueDomain-2)
C0011008 (UMLS 2011AA ValueDomain)
C15368 (NCI Thesaurus ObjectClass)
C25551 (NCI Thesaurus ObjectClass-2)
C1517741 (UMLS 2011AA ObjectClass)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
C1520224 (UMLS CUI-1)
C25367 (NCI Thesaurus Property)
C25491 (NCI Thesaurus ValueDomain-2)
C20641 (NCI Thesaurus ObjectClass)
C0005910 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25208 (NCI Thesaurus Property)
C1522602 (UMLS 2011AA ValueDomain)
C25458 (NCI Thesaurus Property)
C0750484 (UMLS 2011AA Property)
C16502 (NCI Thesaurus ObjectClass)
C0011923 (UMLS 2011AA ObjectClass)
C3333 (NCI Thesaurus Property-2)
C0032285 (UMLS 2011AA Property-2)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C1707811 (UMLS CUI-1)
C25256 (NCI Thesaurus ObjectClass)
C25572 (NCI Thesaurus Property)
C25572 (NCI Thesaurus ValueDomain-2)
C1298908 (UMLS 2011AA)
C1521826 (UMLS CUI-1)
C1708 (NCI Thesaurus ObjectClass)
C1708 (NCI Thesaurus ValueDomain)
C42614 (NCI Thesaurus ValueDomain-2)
C0087111 (UMLS 2011AA ObjectClass)
C25619 (NCI Thesaurus Property)
C1301732 (UMLS 2011AA Property)
C25379 (NCI Thesaurus Property-2)
C0750729 (UMLS 2011AA Property-2)
C25488 (NCI Thesaurus Property-3)
C0178602 (UMLS 2011AA Property-3)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C0087111 (UMLS 2011AA ObjectClass)
C25379 (NCI Thesaurus Property)
C0750729 (UMLS 2011AA Property)
C25488 (NCI Thesaurus Property-2)
C0178602 (UMLS 2011AA Property-2)
C25382 (NCI Thesaurus Property-3)
C1521801 (UMLS 2011AA Property-3)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C2986497 (UMLS CUI-1)
C25470 (NCI Thesaurus ObjectClass-2)
C1521826 (UMLS CUI-2)
C25304 (NCI Thesaurus Property)
C25256 (NCI Thesaurus Property-2)
C25304 (NCI Thesaurus ValueDomain)
C25488 (NCI Thesaurus ValueDomain-2)
C1707811 (UMLS CUI-1)
C25688 (NCI Thesaurus ValueDomain)
C25572 (NCI Thesaurus Property)
C1707814 (UMLS 2011AA)
C49505 (NCI Thesaurus-3)
C1707814 (UMLS 2011AA-4)
C1707811 (UMLS CUI-1)
C25488 (NCI Thesaurus ObjectClass)
C0392360 (UMLS CUI-2)
C25572 (NCI Thesaurus Property)
C0877248 (UMLS 2011AA)
C0242656 (UMLS 2011AA)
C0011065 (UMLS 2011AA)
C0205394 (UMLS 2011AA)
C1707811 (UMLS CUI-1)
C25488 (NCI Thesaurus ObjectClass)
C3840932 (UMLS CUI-2)
C25572 (NCI Thesaurus Property)
C1708 (NCI Thesaurus ObjectClass)
C1299700 (UMLS CUI-1)
C25409 (NCI Thesaurus Property-2)
C25330 (NCI Thesaurus ValueDomain)
C0877248 (UMLS CUI-1)
C41331 (NCI Thesaurus Property)
C1707811 (UMLS CUI-2)
C25488 (NCI Thesaurus ObjectClass)
C0392360 (UMLS CUI-3)
C25572 (NCI Thesaurus Property-2)
C1522601 (UMLS 2011AA)
C0521362 (UMLS 2011AA)
C0009450 (UMLS 2011AA)
C0027855 (UMLS 2011AA)
C0030193 (UMLS 2011AA)
C1801960 (UMLS 2011AA)
C0205394 (UMLS 2011AA)
C0877248 (UMLS CUI-1)
C41331 (NCI Thesaurus Property)
C1707811 (UMLS CUI-2)
C25488 (NCI Thesaurus ObjectClass)
C3840932 (UMLS CUI-3)
C25572 (NCI Thesaurus Property-2)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)