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ID

7032

Beschrijving

North Central Cancer Treatment Group N0577 Pretreatment 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=4C0A4D9C-15EE-0D5E-E044-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=4C0A4D9C-15EE-0D5E-E044-0003BA3F9857

Trefwoorden

Versies (2)
  1. 26/08/2012 26/08/2012 -
  2. 08/01/2015 08/01/2015 - Martin Dugas
Geüploaded op

8 janvier 2015

DOI

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Licentie

Creative Commons BY-NC 3.0 Legacy
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    Brain and Central Nervous System Tumors NCT00887146 Treatment - North Central Cancer Treatment Group N0577 Pretreatment Measurement Form - 2746048v1.0

    Engels

    ALL ITEMS MUST BE COMPLETED

    1 Formulieren  
    1. StudyEvent: North Central Cancer Treatment Group N0577 Pretreatment Measurement Form
      1. ALL ITEMS MUST BE COMPLETED
    Header
    Beschrijving

    Header

    Protocol Number
    Beschrijving

    Protocol ID NCCTG

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337 (undefined)
    UMLS CUI-1
    C3274381 (Clinical Trial Registry Identifier)
    NCI Thesaurus ObjectClass
    C25320 (undefined)
    UMLS CUI-2
    C1518419 (North Central Cancer Treatment Group)
    NCI Thesaurus Property
    C25364 (undefined)
    NCI Thesaurus Property-2
    C25581 (undefined)
    Patient ID
    Beschrijving

    PatientNorthCentralCancerTreatmentGroupIdentifierNumber

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337 (undefined)
    UMLS 2011AA ValueDomain
    C0237753 (Numbers)
    SNOMED
    260299005
    LOINC
    LP6841-3
    NCI Thesaurus ObjectClass
    C16960 (undefined)
    UMLS 2011AA ObjectClass
    C0030705 (Patients)
    SNOMED
    116154003
    NCI Thesaurus Property
    C25364 (undefined)
    UMLS 2011AA Property
    C0600091 (Identifier)
    SNOMED
    118522005
    LOINC
    LP31795-5
    NCI Thesaurus Property-2
    C25581 (undefined)
    UMLS 2011AA Property-2
    C1518419 (North Central Cancer Treatment Group)
    Patient Initials (L F M)
    Beschrijving

    Patient Initials

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191 (undefined)
    UMLS CUI-1
    C2986440 (Person Initials)
    NCI Thesaurus ObjectClass
    C16960 (undefined)
    NCI Thesaurus Property
    C25536 (undefined)
    Institution Number
    Beschrijving

    Institution Number

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337 (undefined)
    UMLS CUI-1
    C1301943 (Institution name)
    SNOMED
    398321007
    NCI Thesaurus ObjectClass
    C21541 (undefined)
    UMLS CUI-2
    C0805701 (Code)
    NCI Thesaurus Property
    C25364 (undefined)
    Institution
    Beschrijving

    Institution Name

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191 (undefined)
    UMLS CUI-1
    C1301943 (Institution name)
    SNOMED
    398321007
    NCI Thesaurus ObjectClass
    C21541 (undefined)
    NCI Thesaurus ValueDomain-2
    C21541 (undefined)
    NCI Thesaurus Property
    C25364 (undefined)
    Are data amended (If yes, highlight amended areas)
    Beschrijving

    Data amended

    Datatype

    boolean

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

    Header

    Assessment Date (mm/dd/yyyy)
    Beschrijving

    LesionAssessmentDate

    Datatype

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164 (undefined)
    UMLS 2011AA ValueDomain
    C0011008 (Date in time)
    SNOMED
    410671006
    NCI Thesaurus ObjectClass
    C3824 (undefined)
    UMLS 2011AA ObjectClass
    C0221198 (Lesion)
    SNOMED
    52988006
    NCI Thesaurus Property
    C20989 (undefined)
    UMLS 2011AA Property
    C0031809 (Physical Examination)
    SNOMED
    5880005
    LOINC
    MTHU028014
    NCI Thesaurus ValueDomain-2
    C25367 (undefined)
    Method of Evaluation
    Beschrijving

    Evaluation method

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C25284 (undefined)
    UMLS CUI-1
    C2911685 (Evaluation Method)
    NCI Thesaurus ObjectClass
    C20989 (undefined)
    NCI Thesaurus Property
    C16847 (undefined)
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    Similar models

    ALL ITEMS MUST BE COMPLETED

    1 Formulieren
    1. StudyEvent: North Central Cancer Treatment Group N0577 Pretreatment Measurement Form
      1. ALL ITEMS MUST BE COMPLETED
    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
    LesionAssessmentDate
    Item
    Assessment Date (mm/dd/yyyy)
    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)
    CL.2
    Code List
    Method of Evaluation
    CL Item
    Ct Scan (CT scan)
    CL Item
    Mri Scan (MRI scan)
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