ID

6919

Descrizione

Gynecologic Cancer - Toxicity Form- copy 2 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=13996779-2A06-0B29-E044-0003BA3F9857

collegamento

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=13996779-2A06-0B29-E044-0003BA3F9857

Keywords

versioni (2)
  1. 19/09/12 19/09/12 -
  2. 08/01/15 08/01/15 - Martin Dugas
Caricato su

8 gennaio 2015

DOI

Per favore, per richiedere un accesso.

Licenza

Creative Commons BY-NC 3.0 Legacy
Commenti del modello :

Puoi commentare il modello dati qui. Tramite i fumetti nei gruppi di articoli e articoli è possibile aggiungere commenti a quelli in modo specifico.

Torna ai commenti del modello
Commenti del gruppo di articoli per :

Commenti dell'articolo per :

  • i più nuovi
  • i più vecchi
  • Popolare
  • i più nuovi
    • i più nuovi
    • i più vecchi
    • Popolare

Non ci sono commenti

Per scaricare i modelli di dati devi essere registrato. Per favore accesso o registrati GRATIS.

Toxicity - Gynecologic Cancer - Toxicity Form- copy 2 - 2481262v1.0

Inglese

No Instruction available.

1 moduli  
  1. StudyEvent: Gynecologic Cancer - Toxicity Form- copy 2
    1. No Instruction available.
Crf Header
Descrizione

Crf Header

Coordinating Group Protocol Number
Descrizione

CoordinatingGroupProtocolNumber

Tipo di dati

text

Coordinating Group Code
Descrizione

CoordinatingGroupCode

Tipo di dati

text

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

Protocol Title

Tipo di dati

text

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

PatientStudyID,CoordinatingGroup

Tipo di dati

text

Patient Study ID, Participating Group
Descrizione

PatientStudyID,ParticipatingGroup

Tipo di dati

text

Participating Group Code
Descrizione

ParticipatingGroupCode

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C25162
UMLS 2011AA ValueDomain
C0805701
Institution Name
Descrizione

InstitutionName

Tipo di dati

text

Affiliate Name
Descrizione

AffiliateName

Tipo di dati

text

Patient Name, Last
Descrizione

PatientName,Last

Tipo di dati

text

Patient Name, First
Descrizione

PatientName,First

Tipo di dati

text

Patient Name, Middle
Descrizione

PatientName,Middle

Tipo di dati

text

Gyn: Form Administration
Descrizione

Gyn: Form Administration

Person Completing Form, First Name
Descrizione

PersonCompletingForm,FirstName

Tipo di dati

text

Alias
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Amended Data Ind
Descrizione

AmendedDataInd

Tipo di dati

text

Alias
NCI Thesaurus ObjectClass
C25474
UMLS 2011AA ObjectClass
C1511726
NCI Thesaurus Property
C25416
UMLS 2011AA Property
C1691222
Interval Report From Date
Descrizione

IntervalReportFromDate

Tipo di dati

date

Interval Report To Date
Descrizione

IntervalReportToDate

Tipo di dati

date

Responsible Person Last Name
Descrizione

Person Completing Form Last Name

Tipo di dati

text

Alias
NCI Thesaurus ObjectClass
C25190
UMLS CUI-1
C1550483
NCI Thesaurus ObjectClass-2
C25657
UMLS CUI-2
C1301584
NCI Thesaurus Property
C25364
NCI Thesaurus Property-2
C25551
NCI Thesaurus ValueDomain
C25191
Responsible Person Last Name
Descrizione

Person Completing Form Last Name

Tipo di dati

text

Alias
NCI Thesaurus ObjectClass
C25190
UMLS CUI-1
C1550483
NCI Thesaurus ObjectClass-2
C25657
UMLS CUI-2
C1301584
NCI Thesaurus Property
C25364
NCI Thesaurus Property-2
C25551
NCI Thesaurus ValueDomain
C25191
Responsible Person Last Name
Descrizione

ResponsiblePersonLastName

Tipo di dati

text

Gyn: Adverse Events
Descrizione

Gyn: Adverse Events

CTC Adverse Event Report Begin Date
Descrizione

CTCAdverseEventReportBeginDate

Tipo di dati

date

CTC Adverse Event Report End Date
Descrizione

CTCAdverseEventReportEndDate

Tipo di dati

date

CTC Adverse Event Term
Descrizione

CTCAdverseEventTerm

Tipo di dati

text

CTC Adverse Event Grade
Descrizione

CTCAdverseEventGrade

Tipo di dati

text

CTC Adverse Event Attribution Code
Descrizione

CTCAdverseEventAttributionCode

Tipo di dati

text

CTC Adverse Event Term, Other
Descrizione

CTCAdverseEventTerm,Other

Tipo di dati

text

Allows Documentation Of Any Additional Cooments
Descrizione

Allows Documentation Of Any Additional Cooments

Comments
Descrizione

Comments

Tipo di dati

text

Ritorna all'inizio della pagina

Similar models

No Instruction available.

1 moduli
  1. StudyEvent: Gynecologic Cancer - Toxicity Form- copy 2
    1. No Instruction available.
Name
genere
Description | Question | Decode (Coded Value)
Tipo di dati
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
ParticipatingGroupCode
Item
Participating Group Code
text
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
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
Gyn: Form Administration
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.1
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)
IntervalReportFromDate
Item
Interval Report From Date
date
IntervalReportToDate
Item
Interval Report To Date
date
Person Completing Form Last Name
Item
Responsible Person Last Name
text
C25190 (NCI Thesaurus ObjectClass)
C1550483 (UMLS CUI-1)
C25657 (NCI Thesaurus ObjectClass-2)
C1301584 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25551 (NCI Thesaurus Property-2)
C25191 (NCI Thesaurus ValueDomain)
Person Completing Form Last Name
Item
Responsible Person Last Name
text
C25190 (NCI Thesaurus ObjectClass)
C1550483 (UMLS CUI-1)
C25657 (NCI Thesaurus ObjectClass-2)
C1301584 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25551 (NCI Thesaurus Property-2)
C25191 (NCI Thesaurus ValueDomain)
ResponsiblePersonLastName
Item
Responsible Person Last Name
text
Item Group
Gyn: Adverse Events
CTCAdverseEventReportBeginDate
Item
CTC Adverse Event Report Begin Date
date
CTCAdverseEventReportEndDate
Item
CTC Adverse Event Report End Date
date
Item
CTC Adverse Event Term
text
CL.2
Code List
CTC Adverse Event Term
CL Item
Ctep.info.nih.gov/ctc3/ctc.htm (http://ctep.info.nih.gov/CTC3/ctc.htm)
Item
CTC Adverse Event Grade
text
CL.3
Code List
CTC Adverse Event Grade
CL Item
Ctep.info.nih.gov/ctc3/ctc.htm (http://ctep.info.nih.gov/CTC3/ctc.htm)
Item
CTC Adverse Event Attribution Code
text
CL.4
Code List
CTC Adverse Event Attribution Code
CL Item
Definitely (Definitely)
CL Item
Possibly (Possibly)
CL Item
Unrelated (Unrelated)
C25328 (NCI Thesaurus)
C0445356 (UMLS 2011AA)
CL Item
Unlikely (Unlikely)
CL Item
Probably (Probably)
CTCAdverseEventTerm,Other
Item
CTC Adverse Event Term, Other
text
Item Group
Allows Documentation Of Any Additional Cooments
Comments
Item
Comments
text
Ritorna all'inizio della pagina 

Contatto

Si prega di utilizzare questo modulo per feedback, domande e suggerimenti per miglioramenti.

I campi contrassegnati da * sono obbligatori.

Aiuto

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