0 Beoordelingen

ID

7014

Beschrijving

North Central Cancer Treatment Group N0577 Active Monitoring Measurement Form Radiation Therapy or Radiation Therapy and Temozolomide or Temozolomide Alone in Treating Patients With Newly Diagnosed Anaplastic Glioma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=4CD2A079-1EF5-2B7D-E044-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=4CD2A079-1EF5-2B7D-E044-0003BA3F9857

Trefwoorden

  1. 26-08-12 26-08-12 -
  2. 08-01-15 08-01-15 - Martin Dugas
Geüploaded op

8 januari 2015

DOI

Voor een aanvraag inloggen.

Licentie

Creative Commons BY-NC 3.0 Legacy

Model Commentaren :

Hier kunt u commentaar leveren op het model. U kunt de tekstballonnen bij de itemgroepen en items gebruiken om er specifiek commentaar op te geven.

Itemgroep Commentaren voor :

Item Commentaren voor :


    Geen commentaren

    U moet ingelogd zijn om formulieren te downloaden. AUB inloggen of schrijf u gratis in.

    Brain and Central Nervous System Tumors NCT00887146 On-Study - North Central Cancer Treatment Group N0577 Active Monitoring Measurement Form - 2748630v1.0

    1. Record the target lesions in the same order as recorded at pretreatment (refer to Section 11 of the protocol). 2. Measure target lesions in cm. using longest diameter (one dimension only). 3. Record measurements at scheduled evaluations and progression

    Header
    Beschrijving

    Header

    Protocol Number
    Beschrijving

    Protocol ID NCCTG

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C3274381
    NCI Thesaurus ObjectClass
    C25320
    UMLS CUI-2
    C1518419
    NCI Thesaurus Property
    C25364
    NCI Thesaurus Property-2
    C25581
    Patient ID
    Beschrijving

    PatientNorthCentralCancerTreatmentGroupIdentifierNumber

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS 2011AA ValueDomain
    C0237753
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C25364
    UMLS 2011AA Property
    C0600091
    NCI Thesaurus Property-2
    C25581
    UMLS 2011AA Property-2
    C1518419
    Patient Initials (L F M)
    Beschrijving

    Patient Initials

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS CUI-1
    C2986440
    NCI Thesaurus ObjectClass
    C16960
    NCI Thesaurus Property
    C25536
    Institution Number
    Beschrijving

    Institution Number

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C1301943
    NCI Thesaurus ObjectClass
    C21541
    UMLS CUI-2
    C0805701
    NCI Thesaurus Property
    C25364
    Institution
    Beschrijving

    Institution Name

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS CUI-1
    C1301943
    NCI Thesaurus ObjectClass
    C21541
    NCI Thesaurus ValueDomain-2
    C21541
    NCI Thesaurus Property
    C25364
    Are data amended (If yes, highlight amended areas)
    Beschrijving

    Data amended

    Datatype

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38148
    UMLS CUI-1
    C0680532
    NCI Thesaurus ObjectClass
    C25474
    NCI Thesaurus Property
    C25416
    Header
    Beschrijving

    Header

    Current Cycle Number
    Beschrijving

    Cycle Number Chemotherapeutics

    Datatype

    integer

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C2045829
    NCI Thesaurus Property
    C25471
    NCI Thesaurus ObjectClass
    C15368
    NCI Thesaurus Property-2
    C25379
    Assessment Date
    Beschrijving

    LesionAssessmentDate

    Datatype

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ObjectClass
    C3824
    UMLS 2011AA ObjectClass
    C0221198
    NCI Thesaurus Property
    C20989
    UMLS 2011AA Property
    C0031809
    NCI Thesaurus ValueDomain-2
    C25367
    Method of Evaluation
    Beschrijving

    Evaluation method

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C25284
    UMLS CUI-1
    C2911685
    NCI Thesaurus ObjectClass
    C20989
    NCI Thesaurus Property
    C16847
    Primary Indicator Lesion Site
    Beschrijving

    Primary Indicator Lesion Site

    CT/MRI Scan Score
    Beschrijving

    BrainTumorComputedTomographyMagneticResonanceImagingResponseType

    Datatype

    text

    Alias
    NCI Thesaurus ObjectClass
    C3262
    UMLS 2011AA ObjectClass
    C0027651
    NCI Thesaurus ObjectClass-2
    C12439
    UMLS 2011AA ObjectClass-2
    C0006104
    NCI Thesaurus Property
    C25755
    UMLS 2011AA Property
    C0871261
    NCI Thesaurus Property-2
    C17204
    UMLS 2011AA Property-2
    C0040405
    NCI Thesaurus Property-3
    C16809
    UMLS 2011AA Property-3
    C0024485
    NCI Thesaurus ValueDomain
    C25284
    UMLS 2011AA ValueDomain
    C0332307
    Neurologic Exam Score
    Beschrijving

    NeurologicalBrainExamScore

    Datatype

    text

    Alias
    NCI Thesaurus ObjectClass
    C12439
    UMLS 2011AA ObjectClass
    C0006104
    NCI Thesaurus ObjectClass-2
    C25262
    UMLS 2011AA ObjectClass-2
    C0205494
    NCI Thesaurus Property
    C25305
    UMLS 2011AA Property
    C0582103
    NCI Thesaurus ValueDomain
    C25338
    UMLS 2011AA ValueDomain
    C0449820
    Overall Response Status
    Beschrijving

    BrainTumorResponseType

    Datatype

    text

    Alias
    NCI Thesaurus ObjectClass
    C3262
    UMLS 2011AA ObjectClass
    C0027651
    NCI Thesaurus Property
    C25755
    UMLS 2011AA Property
    C0871261
    NCI Thesaurus ObjectClass-2
    C12439
    UMLS 2011AA ObjectClass-2
    C0006104
    NCI Thesaurus ValueDomain
    C25688
    UMLS 2011AA ValueDomain
    C0449438

    Similar models

    1. Record the target lesions in the same order as recorded at pretreatment (refer to Section 11 of the protocol). 2. Measure target lesions in cm. using longest diameter (one dimension only). 3. Record measurements at scheduled evaluations and progression

    Name
    Type
    Description | Question | Decode (Coded Value)
    Datatype
    Alias
    Item Group
    Header
    Protocol ID NCCTG
    Item
    Protocol Number
    text
    C25337 (NCI Thesaurus ValueDomain)
    C3274381 (UMLS CUI-1)
    C25320 (NCI Thesaurus ObjectClass)
    C1518419 (UMLS CUI-2)
    C25364 (NCI Thesaurus Property)
    C25581 (NCI Thesaurus Property-2)
    PatientNorthCentralCancerTreatmentGroupIdentifierNumber
    Item
    Patient ID
    text
    C25337 (NCI Thesaurus ValueDomain)
    C0237753 (UMLS 2011AA ValueDomain)
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C25364 (NCI Thesaurus Property)
    C0600091 (UMLS 2011AA Property)
    C25581 (NCI Thesaurus Property-2)
    C1518419 (UMLS 2011AA Property-2)
    Patient Initials
    Item
    Patient Initials (L F M)
    text
    C25191 (NCI Thesaurus ValueDomain)
    C2986440 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C25536 (NCI Thesaurus Property)
    Institution Number
    Item
    Institution Number
    text
    C25337 (NCI Thesaurus ValueDomain)
    C1301943 (UMLS CUI-1)
    C21541 (NCI Thesaurus ObjectClass)
    C0805701 (UMLS CUI-2)
    C25364 (NCI Thesaurus Property)
    Institution Name
    Item
    Institution
    text
    C25191 (NCI Thesaurus ValueDomain)
    C1301943 (UMLS CUI-1)
    C21541 (NCI Thesaurus ObjectClass)
    C21541 (NCI Thesaurus ValueDomain-2)
    C25364 (NCI Thesaurus Property)
    Data amended
    Item
    Are data amended (If yes, highlight amended areas)
    boolean
    C38148 (NCI Thesaurus ValueDomain)
    C0680532 (UMLS CUI-1)
    C25474 (NCI Thesaurus ObjectClass)
    C25416 (NCI Thesaurus Property)
    Item Group
    Header
    Cycle Number Chemotherapeutics
    Item
    Current Cycle Number
    integer
    C25337 (NCI Thesaurus ValueDomain)
    C2045829 (UMLS CUI-1)
    C25471 (NCI Thesaurus Property)
    C15368 (NCI Thesaurus ObjectClass)
    C25379 (NCI Thesaurus Property-2)
    LesionAssessmentDate
    Item
    Assessment Date
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C3824 (NCI Thesaurus ObjectClass)
    C0221198 (UMLS 2011AA ObjectClass)
    C20989 (NCI Thesaurus Property)
    C0031809 (UMLS 2011AA Property)
    C25367 (NCI Thesaurus ValueDomain-2)
    Item
    Method of Evaluation
    text
    C25284 (NCI Thesaurus ValueDomain)
    C2911685 (UMLS CUI-1)
    C20989 (NCI Thesaurus ObjectClass)
    C16847 (NCI Thesaurus Property)
    Code List
    Method of Evaluation
    CL Item
    Ct Scan (CT scan)
    CL Item
    Mri Scan (MRI scan)
    Item Group
    Primary Indicator Lesion Site
    Item
    CT/MRI Scan Score
    text
    C3262 (NCI Thesaurus ObjectClass)
    C0027651 (UMLS 2011AA ObjectClass)
    C12439 (NCI Thesaurus ObjectClass-2)
    C0006104 (UMLS 2011AA ObjectClass-2)
    C25755 (NCI Thesaurus Property)
    C0871261 (UMLS 2011AA Property)
    C17204 (NCI Thesaurus Property-2)
    C0040405 (UMLS 2011AA Property-2)
    C16809 (NCI Thesaurus Property-3)
    C0024485 (UMLS 2011AA Property-3)
    C25284 (NCI Thesaurus ValueDomain)
    C0332307 (UMLS 2011AA ValueDomain)
    Code List
    CT/MRI Scan Score
    CL Item
    Complete Response (CR)
    CL Item
    Ned (NED)
    CL Item
    Not Done (Not Done)
    CL Item
    Progressive Disease (PD)
    C35571 (NCI Thesaurus)
    C1335499 (UMLS 2011AA)
    CL Item
    Partial Response (PR)
    C18212 (NCI Thesaurus)
    CL Item
    Regression (REGR)
    C18243 (NCI Thesaurus)
    C0684320 (UMLS 2011AA)
    CL Item
    Stable Disease (SD)
    C18213 (NCI Thesaurus)
    C0677946 (UMLS 2011AA)
    Item
    Neurologic Exam Score
    text
    C12439 (NCI Thesaurus ObjectClass)
    C0006104 (UMLS 2011AA ObjectClass)
    C25262 (NCI Thesaurus ObjectClass-2)
    C0205494 (UMLS 2011AA ObjectClass-2)
    C25305 (NCI Thesaurus Property)
    C0582103 (UMLS 2011AA Property)
    C25338 (NCI Thesaurus ValueDomain)
    C0449820 (UMLS 2011AA ValueDomain)
    Code List
    Neurologic Exam Score
    CL Item
    Better (better)
    CL Item
    Not Done (not done)
    CL281691 (NCI Metathesaurus)
    CL Item
    Same (same)
    CL Item
    Worse (worse)
    C71686 (NCI Thesaurus)
    C1457868 (UMLS 2011AA)
    Item
    Overall Response Status
    text
    C3262 (NCI Thesaurus ObjectClass)
    C0027651 (UMLS 2011AA ObjectClass)
    C25755 (NCI Thesaurus Property)
    C0871261 (UMLS 2011AA Property)
    C12439 (NCI Thesaurus ObjectClass-2)
    C0006104 (UMLS 2011AA ObjectClass-2)
    C25688 (NCI Thesaurus ValueDomain)
    C0449438 (UMLS 2011AA ValueDomain)
    Code List
    Overall Response Status
    CL Item
    No Evidence Of Disease (NED)
    CL Item
    Complete Response (CR)
    CL Item
    Partial Response (PR)
    C18212 (NCI Thesaurus)
    CL Item
    Regr (REGR)
    CL Item
    Stable Disease (SD)
    C18213 (NCI Thesaurus)
    C0677946 (UMLS 2011AA)
    CL Item
    Progressive Disease (PD)
    C35571 (NCI Thesaurus)
    C1335499 (UMLS 2011AA)
    CL Item
    Unknown (Unknown)
    C17998 (NCI Thesaurus)
    C0439673 (UMLS 2011AA)

    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