Inglés

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1 formularios  
  1. StudyEvent: Upper Gastrointestinal Cancers - Treatment Form (for Periodic Reporting)
    1. No Instruction available.
Crf Header
Descripción

Crf Header

Coordinating Group Protocol Number
Descripción

CoordinatingGroupProtocolNumber

Tipo de datos

text

Coordinating Group Code
Descripción

CoordinatingGroupCode

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25162
UMLS 2011AA ValueDomain
C0805701
Protocol Title
Descripción

Protocol Title

Tipo de datos

text

Alias
NCI Thesaurus ObjectClass
C25320
UMLS CUI-1
C2986303
NCI Thesaurus Property
C42774
Patient Study ID, Coordinating Group
Descripción

PatientStudyID,CoordinatingGroup

Tipo de datos

text

Patient Study ID, Participating Group
Descripción

PatientStudyID,ParticipatingGroup

Tipo de datos

text

Participating Group Code
Descripción

ParticipatingGroupCode

Tipo de datos

text

Institution Name
Descripción

InstitutionName

Tipo de datos

text

Affiliate Name
Descripción

AffiliateName

Tipo de datos

text

Patient Name, Last
Descripción

PatientName,Last

Tipo de datos

text

Patient Name, First
Descripción

PatientName,First

Tipo de datos

text

Patient Name, Middle
Descripción

PatientName,Middle

Tipo de datos

text

Gi: Treatment Reporting Interval
Descripción

Gi: Treatment Reporting Interval

Interval Report From Date
Descripción

IntervalReportFromDate

Tipo de datos

date

Interval Report To Date
Descripción

IntervalReportToDate

Tipo de datos

date

Gi: Treatment Schedule - Radiation Therapy
Descripción

Gi: Treatment Schedule - Radiation Therapy

Protocol Treatment, RT Ind
Descripción

ProtocolTreatment,RTInd

Tipo de datos

text

RT Begin Date
Descripción

RTBeginDate

Tipo de datos

date

RT End Date
Descripción

RTEndDate

Tipo de datos

date

RT Type
Descripción

RTType

Tipo de datos

text

RT Type, Other
Descripción

RTType,Other

Tipo de datos

text

RT Site
Descripción

RTSite

Tipo de datos

text

RT Total Dose
Descripción

RTTotalDose

Tipo de datos

float

RT Interruptions Ind
Descripción

RTInterruptionsInd

Tipo de datos

text

RT Interruptions Reason
Descripción

RTInterruptionsReason

Tipo de datos

text

Gi: Treatment Cycle Information - Systemic Therapy
Descripción

Gi: Treatment Cycle Information - Systemic Therapy

Protocol Treatment, Systemic Therapy Ind
Descripción

ProtocolTreatment,SystemicTherapyInd

Tipo de datos

text

Total Course Number
Descripción

TotalCourseNumber

Tipo de datos

float

First Treatment Start Date
Descripción

FirstTreatmentStartDate

Tipo de datos

date

Last Treatment Date
Descripción

LastTreatmentDate

Tipo de datos

date

Systemic Therapy Type
Descripción

SystemicTherapyType

Tipo de datos

text

Systemic Therapy Type, Other
Descripción

SystemicTherapyType,Other

Tipo de datos

text

Agent Name
Descripción

AgentName

Tipo de datos

text

Agent Total Dose (per course)
Descripción

AgentTotalDose(percourse)

Tipo de datos

float

Agent Dose Units
Descripción

AgentDoseUnits

Tipo de datos

text

Dose Modification (Change)
Descripción

DoseModification(Change)

Tipo de datos

text

Therapy Modification Name
Descripción

TherapyModificationName

Tipo de datos

text

Therapy Modification Reason
Descripción

TherapyModificationReason

Tipo de datos

text

Allows Documentation Of Any Additional Cooments
Descripción

Allows Documentation Of Any Additional Cooments

Comments
Descripción

Comments

Tipo de datos

text

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Similar models

No Instruction available.

1 formularios
  1. StudyEvent: Upper Gastrointestinal Cancers - Treatment Form (for Periodic Reporting)
    1. No Instruction available.
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
Crf Header
CoordinatingGroupProtocolNumber
Item
Coordinating Group Protocol Number
text
CoordinatingGroupCode
Item
Coordinating Group Code
text
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
Protocol Title
Item
Protocol Title
text
C25320 (NCI Thesaurus ObjectClass)
C2986303 (UMLS CUI-1)
C42774 (NCI Thesaurus Property)
PatientStudyID,CoordinatingGroup
Item
Patient Study ID, Coordinating Group
text
PatientStudyID,ParticipatingGroup
Item
Patient Study ID, Participating Group
text
Item
Participating Group Code
text
CL.1
Code List
Participating Group Code
CL Item
Http://ctep.info.nih.gov. (http://ctep.info.nih.gov.)
InstitutionName
Item
Institution Name
text
AffiliateName
Item
Affiliate Name
text
PatientName,Last
Item
Patient Name, Last
text
PatientName,First
Item
Patient Name, First
text
PatientName,Middle
Item
Patient Name, Middle
text
Item Group
Gi: Treatment Reporting Interval
IntervalReportFromDate
Item
Interval Report From Date
date
IntervalReportToDate
Item
Interval Report To Date
date
Item Group
Gi: Treatment Schedule - Radiation Therapy
Item
Protocol Treatment, RT Ind
text
CL.2
Code List
Protocol Treatment, RT Ind
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
RTBeginDate
Item
RT Begin Date
date
RTEndDate
Item
RT End Date
date
Item
RT Type
text
CL.3
Code List
RT Type
CL Item
Adjuvant Radiation Therapy (Adjuvant RT)
CL Item
Brachytherapy (Brachytherapy)
CL054378 (NCI Metathesaurus)
CL Item
Palliative Radiation Therapy (Palliative RT)
CL Item
Neoadjuvant Radiation Therapy (Neoadjuvant RT)
CL Item
Other, Specify (Other, specify)
CL Item
External Beam Radiation (External beam radiation)
RTType,Other
Item
RT Type, Other
text
RTSite
Item
RT Site
text
RTTotalDose
Item
RT Total Dose
float
Item
RT Interruptions Ind
text
CL.4
Code List
RT Interruptions Ind
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes, For Other Reasons, Specify (Yes, for other reasons, specify)
CL Item
Yes, Due To Toxicity (Yes, due to toxicity)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
RTInterruptionsReason
Item
RT Interruptions Reason
text
Item Group
Gi: Treatment Cycle Information - Systemic Therapy
Item
Protocol Treatment, Systemic Therapy Ind
text
CL.5
Code List
Protocol Treatment, Systemic Therapy Ind
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
TotalCourseNumber
Item
Total Course Number
float
FirstTreatmentStartDate
Item
First Treatment Start Date
date
LastTreatmentDate
Item
Last Treatment Date
date
Item
Systemic Therapy Type
text
CL.6
Code List
Systemic Therapy Type
CL Item
Chemotherapy (Chemotherapy)
C15632 (NCI Thesaurus)
C0392920 (UMLS 2011AA)
CL Item
Other Specify (Other, specify)
CL Item
Immunotherapy (Immunotherapy)
C15262 (NCI Thesaurus)
C0021083 (UMLS 2011AA)
SystemicTherapyType,Other
Item
Systemic Therapy Type, Other
text
AgentName
Item
Agent Name
text
AgentTotalDose(percourse)
Item
Agent Total Dose (per course)
float
Item
Agent Dose Units
text
CL.7
Code List
Agent Dose Units
CL Item
Curie (Ci)
C0700085 (NCI Metathesaurus)
CL Item
Unit (unit)
C44278 (NCI Thesaurus)
C0439148 (UMLS 2011AA)
CL Item
Hertz (Hz)
CL Item
International Unit (IU)
C28255 (NCI Thesaurus)
CL Item
Joules Per Centimeter Square (JCM2)
CL Item
Liter (L)
CL Item
Megahertz (MHz)
CL Item
Milligrams Per Milliliter Per Minute (MMM)
CL Item
Million Electron Volts (MeV)
CL Item
Megarad (Mrad)
CL Item
Not Applicable (N/A)
C48660 (NCI Thesaurus)
C1272460 (UMLS 2011AA)
CL Item
Osmole (Osmol)
CL Item
Pascal (Pa)
C42547 (NCI Thesaurus)
C0439473 (UMLS 2011AA)
CL Item
Viral Particles (VP)
CL Item
Centimeter (cm)
C49668 (NCI Thesaurus)
C0475210 (UMLS 2011AA)
CL Item
Deciliter (dL)
CL Item
Decimeter (dm)
CL Item
Gram (g)
C0439208 (NCI Metathesaurus)
CL Item
Gravity (in Centrifugation) (gravity)
CL Item
Kilohertz (kHz)
CL Item
Kilopascal (kPa)
CL Item
Kilo-electron Volt (keV)
CL Item
Kilogram (kg)
C28252 (NCI Thesaurus)
C0439209 (UMLS 2011AA)
CL Item
Meter (m)
C0475209 (NCI Metathesaurus)
CL Item
Millicurie (mCi)
CL Item
Milliequivalent (mEq)
CL Item
Milliliter (mL)
C28254 (NCI Thesaurus)
C0439242 (UMLS 2011AA)
CL Item
Milliosmole (mOsmol)
CL Item
Million Unit (mU)
CL Item
Millivolt (mV)
C0456691 (NCI Metathesaurus)
CL Item
Microcurie (mcCi)
CL Item
Microliter (mcL)
CL Item
Microgram (mcg)
CL Item
Micrometer (mcm)
CL Item
Milligram (mg)
C28253 (NCI Thesaurus)
C0439210 (UMLS 2011AA)
CL Item
Milliunit (milliunit)
CL Item
Millimeter (mm)
C28251 (NCI Thesaurus)
C0439200 (UMLS 2011AA)
CL Item
Millimole (mmol)
CL Item
Gram-molecular Weight (mole) (mol)
CL Item
Nanocurie (nCi)
C0560007 (NCI Metathesaurus)
CL Item
Nanogram (ng)
CL Item
Nanometer (nm)
C0439202 (NCI Metathesaurus)
CL Item
Nanometers Of Light (nm light)
CL Item
Plaque Forming Unit (pfu)
CL Item
Picogram (pg)
C0439213 (NCI Metathesaurus)
CL Item
Pounds Per Square Inch (psi)
C0439472 (NCI Metathesaurus)
CL Item
Gram-equivalent Weight (Eq)
Item
Dose Modification (Change)
text
CL.8
Code List
Dose Modification (Change)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
(i.e., The Treatment Change Was Not Part Of Protocol Guidelines) (Yes, unplanned)
CL Item
(i.e., The Treatment Was Changed According To Protocol Guidelines) (Yes, planned)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
TherapyModificationName
Item
Therapy Modification Name
text
TherapyModificationReason
Item
Therapy Modification Reason
text
Item Group
Allows Documentation Of Any Additional Cooments
Comments
Item
Comments
text
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