0 Evaluaciones
ID

6901

Descripción

Esophageal Cancer - Adjuvant On-Study Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=99CD59C5-A9A2-3FA4-E034-080020C9C0E0

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=99CD59C5-A9A2-3FA4-E034-080020C9C0E0

Palabras clave

Versiones (2)
  1. 19/9/12 19/9/12 -
  2. 8/1/15 8/1/15 - Martin Dugas
Subido en

8 de enero de 2015

DOI

Para solicitar uno, por favor iniciar sesión.

Licencia

Creative Commons BY-NC 3.0 Legacy
Comentarios del modelo :

Puede comentar sobre el modelo de datos aquí. A través de las burbujas de diálogo en los grupos de elementos y elementos, puede agregar comentarios específicos.

Volver a los comentarios del modelo
Comentarios de grupo de elementos para :

Comentarios del elemento para :

  • El más nuevo
  • Más antiguo
  • Popular
  • El más nuevo
    • El más nuevo
    • Más antiguo
    • Popular

    Sin comentarios

    Para descargar modelos de datos, debe haber iniciado sesión. Por favor iniciar sesión o Registrate gratis.

    On-Study - Esophageal Cancer - Adjuvant On-Study Form - 2020201v2.31

    Inglés

    No Instruction available.

    1 formularios  
    1. StudyEvent: Esophageal Cancer - Adjuvant On-Study Form
      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 (undefined)
    UMLS 2011AA ValueDomain
    C0805701 (Code)
    Protocol Title
    Descripción

    Protocol Title

    Tipo de datos

    text

    Alias
    NCI Thesaurus ObjectClass
    C25320 (undefined)
    UMLS CUI-1
    C2986303 (Study Protocol Document Version Public Title)
    NCI Thesaurus Property
    C42774 (undefined)
    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

    Esophageal: Form Administration
    Descripción

    Esophageal: Form Administration

    Person Completing Form, Last Name
    Descripción

    PersonCompletingForm,LastName

    Tipo de datos

    text

    Person Completing Form, First Name
    Descripción

    PersonCompletingForm,FirstName

    Tipo de datos

    text

    Alias
    NCI Thesaurus ObjectClass
    C25190 (undefined)
    UMLS 2011AA ObjectClass
    C0027361 (Persons)
    SNOMED
    125676002
    NCI Thesaurus Property
    C25364 (undefined)
    UMLS 2011AA Property
    C0600091 (Identifier)
    SNOMED
    118522005
    LOINC
    LP31795-5
    Amended Data Ind
    Descripción

    AmendedDataInd

    Tipo de datos

    text

    Alias
    NCI Thesaurus ObjectClass
    C25474 (undefined)
    UMLS 2011AA ObjectClass
    C1511726 (Data)
    NCI Thesaurus Property
    C25416 (undefined)
    UMLS 2011AA Property
    C1691222 (Amended)
    Esophageal: Adjuvant Disease Description
    Descripción

    Esophageal: Adjuvant Disease Description

    Primary Site
    Descripción

    PrimarySite

    Tipo de datos

    text

    Primary Site, Other
    Descripción

    PrimarySite,Other

    Tipo de datos

    text

    Disease Involvement Site
    Descripción

    DiseaseInvolvementSite

    Tipo de datos

    text

    Disease Involvement Site, Adjacent Specify
    Descripción

    DiseaseInvolvementSite,AdjacentSpecify

    Tipo de datos

    text

    Disease Involvement Site, Other
    Descripción

    DiseaseInvolvementSite,Other

    Tipo de datos

    text

    Histologic Type
    Descripción

    HistologicType

    Tipo de datos

    text

    Histologic Type, Other Name
    Descripción

    HistologicType,OtherName

    Tipo de datos

    text

    Histologic Grade
    Descripción

    HistologicGrade

    Tipo de datos

    text

    T Stage, Pathologic
    Descripción

    TStage,Pathologic

    Tipo de datos

    text

    N Stage, Pathologic
    Descripción

    NStage,Pathologic

    Tipo de datos

    text

    M Stage, Pathologic
    Descripción

    MStage,Pathologic

    Tipo de datos

    text

    Esophageal: Adjuvant Prior Treatment
    Descripción

    Esophageal: Adjuvant Prior Treatment

    Prior Surgery Ind
    Descripción

    PriorSurgeryInd

    Tipo de datos

    text

    Volver a la parte superior de la página

    Similar models

    No Instruction available.

    1 formularios
    1. StudyEvent: Esophageal Cancer - Adjuvant On-Study Form
      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
    Esophageal: Form Administration
    PersonCompletingForm,LastName
    Item
    Person Completing Form, Last Name
    text
    PersonCompletingForm,FirstName
    Item
    Person Completing Form, First Name
    text
    C25190 (NCI Thesaurus ObjectClass)
    C0027361 (UMLS 2011AA ObjectClass)
    C25364 (NCI Thesaurus Property)
    C0600091 (UMLS 2011AA Property)
    Item
    Amended Data Ind
    text
    C25474 (NCI Thesaurus ObjectClass)
    C1511726 (UMLS 2011AA ObjectClass)
    C25416 (NCI Thesaurus Property)
    C1691222 (UMLS 2011AA Property)
    CL.2
    Code List
    Amended Data Ind
    CL Item
    Yes (YES)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    Unknown (UNKNOWN)
    C17998 (NCI Thesaurus)
    C0439673 (UMLS 2011AA)
    CL Item
    No (NO)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item Group
    Esophageal: Adjuvant Disease Description
    Item
    Primary Site
    text
    CL.3
    Code List
    Primary Site
    CL Item
    Antrum (Antrum)
    CL Item
    Upper Thoracic Esophagus (Upper thoracic esophagus)
    CL Item
    Cardia (Cardia)
    C0007144 (NCI Metathesaurus)
    CL Item
    Cervical Esophagus (Cervical esophagus)
    C12250 (NCI Thesaurus)
    C0227186 (UMLS 2011AA)
    CL Item
    Diffuse (Diffuse)
    C14175 (NCI Thesaurus)
    C0205219 (UMLS 2011AA)
    CL Item
    Esophagus, Not Otherwise Specified (Esophagus, NOS)
    CL Item
    Fundus (Fundus)
    C13378 (NCI Thesaurus)
    C0740422 (UMLS 2011AA)
    CL Item
    Gastro-esophageal Junction (Gastro-esophageal junction)
    CL Item
    Head Of Pancreas (Head of pancreas)
    C0227579 (NCI Metathesaurus)
    CL Item
    Linitus Plastica (Linitus plastica)
    CL Item
    Lower Thoracic Esophagus, Excluding The Gastro-esophageal Junction (Lower thoracic esophagus (excludes G-E junction))
    CL Item
    Mid-thoracic Esophagus (Mid-thoracic esophagus)
    CL Item
    Other, Specify (Other, specify)
    CL Item
    Pancreas, Not Otherwise Specified (Pancreas, NOS)
    CL Item
    Pylorus/pyloric Channel (Pylorus/Pyloric channel)
    CL Item
    Stomach, Not Otherwise Specified (Stomach, NOS)
    CL Item
    Tail Of Pancreas (Tail of pancreas)
    C0227590 (NCI Metathesaurus)
    CL Item
    Uncinate Process (Uncinate process)
    CL Item
    Body Of Pancreas (Body of pancreas)
    C0227582 (NCI Metathesaurus)
    PrimarySite,Other
    Item
    Primary Site, Other
    text
    Item
    Disease Involvement Site
    text
    CL.4
    Code List
    Disease Involvement Site
    CL Item
    Adjacent Structures, Specify (Adjacent structures, specify)
    CL Item
    Adjacent Viscera (Adjacent viscera)
    CL Item
    Adjacent Viscera/vessels (Adjacent viscera/vessels)
    CL Item
    Bone (Bone)
    C12366 (NCI Thesaurus)
    C0262950 (UMLS 2011AA)
    CL Item
    Distant Lymph Nodes (Distant lymph nodes)
    CL Item
    Liver (Liver)
    C12392 (NCI Thesaurus)
    C0023884 (UMLS 2011AA)
    CL Item
    Regional Lymph Nodes (Regional lymph nodes)
    CL Item
    Other, Specify (Other, specify)
    CL Item
    Peritoneal Disease (Peritoneal disease)
    CL Item
    Peritoneum (Peritoneum)
    C12770 (NCI Thesaurus)
    C0031153 (UMLS 2011AA)
    CL Item
    Primary Tumor/esophagus (Primary tumor/esophagus)
    CL Item
    Primary Tumor/pancreas (Primary tumor/pancreas)
    CL Item
    Primary Tumor/stomach (Primary tumor/stomach)
    CL Item
    Lung (Lung)
    C12468 (NCI Thesaurus)
    C0024109 (UMLS 2011AA)
    DiseaseInvolvementSite,AdjacentSpecify
    Item
    Disease Involvement Site, Adjacent Specify
    text
    DiseaseInvolvementSite,Other
    Item
    Disease Involvement Site, Other
    text
    Item
    Histologic Type
    text
    CL.5
    Code List
    Histologic Type
    CL Item
    Acinar Cell Carcinoma (Acinar cell carcinoma)
    C3768 (NCI Thesaurus)
    C0206685 (UMLS 2011AA)
    CL Item
    Unknown (Unknown)
    C17998 (NCI Thesaurus)
    C0439673 (UMLS 2011AA)
    CL Item
    Adenosquamous Carcinoma (Adenosquamous carcinoma)
    C3727 (NCI Thesaurus)
    C0206623 (UMLS 2011AA)
    CL Item
    Ductal Adenocarcinoma (Ductal adenocarcinoma)
    CL Item
    Mixed-type (ductal-endocrine Or Acinar-endocrine) (Mixed-type (ductal-endocrine or acinar-endocrine))
    CL Item
    Mucinous Adenocarcinoma (Mucinous adenocarcinoma)
    C26712 (NCI Thesaurus)
    C0007130 (UMLS 2011AA)
    CL Item
    Mucinous Noncystic Carcinoma (Mucinous noncystic carcinoma)
    CL Item
    Neuroendocrine Carcinoma (Neuroendocrine carcinoma)
    C3773 (NCI Thesaurus)
    C0206695 (UMLS 2011AA)
    CL Item
    Other, Specify (Other, specify)
    CL Item
    Signet Ring Cell Carcinoma (Signet ring cell carcinoma)
    C3774 (NCI Thesaurus)
    C0206696 (UMLS 2011AA)
    CL Item
    Small Cell Carcinoma (Small cell carcinoma)
    C3915 (NCI Thesaurus)
    C0262584 (UMLS 2011AA)
    CL Item
    Squamous Cell Carcinoma (Squamous cell carcinoma)
    C2929 (NCI Thesaurus)
    C0007137 (UMLS 2011AA)
    CL Item
    Tubular Adenocarcinoma (Tubular adenocarcinoma)
    C3682 (NCI Thesaurus)
    C1883403 (UMLS 2011AA)
    CL Item
    Undifferentiated (anaplastic) Carcinoma (Undifferentiated (anaplastic) carcinoma)
    CL Item
    Undifferentiated Carcinoma With Osteoclast-like Giant Cells (Undifferentiated carcinoma with osteoclast-like giant cells)
    CL Item
    Adenocarcinoma (Adenocarcinoma)
    C2852 (NCI Thesaurus)
    C0001418 (UMLS 2011AA)
    HistologicType,OtherName
    Item
    Histologic Type, Other Name
    text
    Item
    Histologic Grade
    text
    CL.6
    Code List
    Histologic Grade
    CL Item
    Tumor Is Moderately Differentiated According To Who Grading System (Moderately differentiated (Grade II))
    CL Item
    Tumor Is Poorly Differentiated According To Who Grading System (Poorly differentiated (Grade III))
    CL Item
    Tumor Is Well Differentiated According To Who Grading System (Well differentiated (Grade I))
    CL Item
    Unknown (Unknown)
    C17998 (NCI Thesaurus)
    C0439673 (UMLS 2011AA)
    CL Item
    Tumor Is Undifferentiated According To Who Grading System (Undifferentiated (Grade IV))
    Item
    T Stage, Pathologic
    text
    CL.7
    Code List
    T Stage, Pathologic
    CL Item
    T0, According To Ajcc Criteria (T0)
    CL Item
    T1, According To Ajcc Criteria (T1)
    CL Item
    T2, According To Ajcc Criteria (T2)
    CL Item
    Tis, According To Ajcc Criteria (Tis)
    CL Item
    T4, According To Ajcc Criteria (T4)
    CL Item
    Tx, According To Ajcc Criteria (TX)
    CL Item
    T3, According To Ajcc Criteria (T3)
    Item
    N Stage, Pathologic
    text
    CL.8
    Code List
    N Stage, Pathologic
    CL Item
    No Lymph Node Involvement According To Ajcc Guidelines (use For Esophageal, Gastric, And Pancreatic) (N0)
    CL Item
    N1, According To Ajcc Criteria (N1)
    CL Item
    Lymph Node Involvement Cannot Be Assessed According To Ajcc Guidelines (use For Esophageal, Gastric, And Pancreatic) (NX)
    CL Item
    N3, According To Ajcc Criteria (N3)
    CL Item
    N2, According To Ajcc Criteria (N2)
    Item
    M Stage, Pathologic
    text
    CL.9
    Code List
    M Stage, Pathologic
    CL Item
    No Distant Metastases According To Ajcc Guidelines (M0)
    CL Item
    Distant Metastases Presence Or Absence Cannot Be Assessed According To Ajcc Guidelines (MX)
    CL Item
    Distant Metastases Present According To Ajcc Guidelines (M1)
    Item Group
    Esophageal: Adjuvant Prior Treatment
    Item
    Prior Surgery Ind
    text
    CL.10
    Code List
    Prior Surgery Ind
    CL Item
    Yes (YES)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    Unknown (UNKNOWN)
    C17998 (NCI Thesaurus)
    C0439673 (UMLS 2011AA)
    CL Item
    No (NO)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Volver a la parte superior de la página 

    Ayuda

    Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

    Watch Tutorial