0 Valutazioni

ID

7068

Descrizione

The Division of Cancer Prevention's death report case report form (CRF) template. Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=51746AB3-F58D-0C29-E044-0003BA3F9857

collegamento

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=51746AB3-F58D-0C29-E044-0003BA3F9857

Keywords

  1. 27/08/12 27/08/12 -
  2. 09/01/15 09/01/15 - Martin Dugas
Caricato su

9 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.

Commenti del gruppo di articoli per :

Commenti dell'articolo per :


    Non ci sono commenti

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

    Death Report - 2762971v1.0

    No Instruction available.

    1. StudyEvent: Death Report
      1. No Instruction available.
    Screening
    Descrizione

    Screening

    DCP Protocol #
    Descrizione

    Protocol ID NCI

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337 (undefined)
    UMLS CUI-1
    C3274381 (Clinical Trial Registry Identifier)
    NCI Thesaurus ObjectClass
    C25320 (undefined)
    UMLS CUI-2
    C1513882 (National Cancer Institute)
    LOINC
    LA4524-0
    NCI Thesaurus Property
    C25364 (undefined)
    NCI Thesaurus Property-2
    C19202 (undefined)
    Institution Code
    Descrizione

    NationalCancerInstituteInstituteCode

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25162 (undefined)
    UMLS 2011AA ValueDomain
    C0805701 (Code)
    NCI Thesaurus ObjectClass
    C21541 (undefined)
    UMLS 2011AA ObjectClass
    C0018704 (Health care facility)
    SNOMED
    257622000
    LOINC
    LA30302-6
    NCI Thesaurus Property
    C25364 (undefined)
    UMLS 2011AA Property
    C0600091 (Identifier)
    SNOMED
    118522005
    LOINC
    LP31795-5
    Participant ID
    Descrizione

    ParticipantIdentifier

    Tipo di dati

    text

    Alias
    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 ValueDomain
    C25364 (undefined)
    UMLS 2011AA ValueDomain
    C0600091 (Identifier)
    SNOMED
    118522005
    LOINC
    LP31795-5
    Form Date
    Descrizione

    FormCompletionDate

    Tipo di dati

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164 (undefined)
    UMLS 2011AA ValueDomain
    C0011008 (Date in time)
    SNOMED
    410671006
    NCI Thesaurus ObjectClass
    C40988 (undefined)
    UMLS 2011AA ObjectClass
    C1516308 (Case Report Form)
    NCI Thesaurus Property
    C25250 (undefined)
    UMLS 2011AA Property
    C0205197 (Complete)
    SNOMED
    255594003
    LOINC
    LA13937-0
    Death Report
    Descrizione

    Death Report

    Date of Death (MM/DD/YYYY)
    Descrizione

    DeathDate

    Tipo di dati

    date

    Alias
    NCI Thesaurus Property
    C25164 (undefined)
    UMLS 2011AA Property
    C0011008 (Date in time)
    SNOMED
    410671006
    NCI Thesaurus ValueDomain
    C25164 (undefined)
    UMLS 2011AA ValueDomain
    C0011008 (Date in time)
    SNOMED
    410671006
    NCI Thesaurus ObjectClass
    C28554 (undefined)
    UMLS 2011AA ObjectClass
    C0011065 (Cessation of life)
    SNOMED
    419620001
    Place of Death
    Descrizione

    PlaceofDeathName

    Tipo di dati

    text

    Alias
    NCI Thesaurus ObjectClass
    C28554 (undefined)
    UMLS 2011AA ObjectClass
    C0011065 (Cessation of life)
    SNOMED
    419620001
    NCI Thesaurus ValueDomain
    C42614 (undefined)
    UMLS 2011AA ValueDomain
    C0027365 (Name)
    SNOMED
    703503000
    LOINC
    LP72974-6
    NCI Thesaurus Property
    C25319 (undefined)
    UMLS 2011AA Property
    C0442504 (Place)
    SNOMED
    246297005
    Other, Specify
    Descrizione

    OtherSpecifyText

    Tipo di dati

    text

    Alias
    NCI Thesaurus Property
    C25685 (undefined)
    UMLS 2011AA Property
    C1521902 (To specify)
    NCI Thesaurus ValueDomain
    C25704 (undefined)
    UMLS 2011AA ValueDomain
    C1527021 (Text)
    LOINC
    LP6885-0
    NCI Thesaurus ObjectClass
    C17649 (undefined)
    UMLS 2011AA ObjectClass
    C0205394 (Other)
    SNOMED
    74964007
    LOINC
    LP21049-9
    NCI Thesaurus Property-2
    C25638 (undefined)
    UMLS 2011AA Property-2
    C0392360 (Indication of (contextual qualifier))
    SNOMED
    230165009
    LOINC
    MTHU008319
    Cause of Death
    Descrizione

    DeathCauseName

    Tipo di dati

    text

    Alias
    NCI Thesaurus Property
    C25638 (undefined)
    UMLS 2011AA Property
    C0392360 (Indication of (contextual qualifier))
    SNOMED
    230165009
    LOINC
    MTHU008319
    NCI Thesaurus ObjectClass
    C28554 (undefined)
    UMLS 2011AA ObjectClass
    C0011065 (Cessation of life)
    SNOMED
    419620001
    NCI Thesaurus Property-2
    C25251 (undefined)
    UMLS 2011AA Property-2
    C0205225 (Primary)
    SNOMED
    63161005
    LOINC
    LA21208-6
    NCI Thesaurus ValueDomain
    C42614 (undefined)
    UMLS 2011AA ValueDomain
    C0027365 (Name)
    SNOMED
    703503000
    LOINC
    LP72974-6
    Cause of Death other, specify
    Descrizione

    PatientCauseofDeathText

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704 (undefined)
    UMLS 2011AA ValueDomain
    C1527021 (Text)
    LOINC
    LP6885-0
    NCI Thesaurus Property
    C25638 (undefined)
    UMLS 2011AA Property
    C0392360 (Indication of (contextual qualifier))
    SNOMED
    230165009
    LOINC
    MTHU008319
    NCI Thesaurus ObjectClass
    C28554 (undefined)
    UMLS 2011AA ObjectClass
    C0011065 (Cessation of life)
    SNOMED
    419620001
    NCI Thesaurus Property-2
    C25251 (undefined)
    UMLS 2011AA Property-2
    C0205225 (Primary)
    SNOMED
    63161005
    LOINC
    LA21208-6
    Autopsy performed?
    Descrizione

    ParticipantAutopsyPerformedIndicator

    Tipo di dati

    text

    Alias
    NCI Thesaurus Property
    C25180 (undefined)
    UMLS 2011AA Property
    C1522602 (Indicator)
    NCI Thesaurus ObjectClass
    C25153 (undefined)
    UMLS 2011AA ObjectClass
    C0004398 (Autopsy)
    SNOMED
    29240004
    LOINC
    LA20097-4
    NCI Thesaurus Property-2
    C38000 (undefined)
    UMLS 2011AA Property-2
    C0884358 (Performed)
    SNOMED
    398166005
    LOINC
    LA19974-7
    NCI Metathesaurus ValueDomain
    C0021212 (Indicators)
    Dcp Template Footer
    Descrizione

    Dcp Template Footer

    Protocol Title
    Descrizione

    Protocol Title

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191 (undefined)
    UMLS CUI-1
    C2986303 (Study Protocol Document Version Public Title)
    NCI Thesaurus ObjectClass
    C25320 (undefined)
    NCI Thesaurus Property
    C42774 (undefined)
    Protocol Version
    Descrizione

    Protocol Version

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704 (undefined)
    UMLS CUI-1
    C2985700 (Study Protocol Version)
    NCI Thesaurus ObjectClass
    C25320 (undefined)
    NCI Thesaurus Property
    C25364 (undefined)
    Protocol Date
    Descrizione

    Protocol Version Date

    Tipo di dati

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164 (undefined)
    UMLS CUI-1
    C2985700 (Study Protocol Version)
    NCI Thesaurus ObjectClass
    C25320 (undefined)
    UMLS CUI-2
    C0011008 (Date in time)
    SNOMED
    410671006
    NCI Thesaurus Property
    C25364 (undefined)
    NCI Thesaurus ValueDomain-2
    C25367 (undefined)
    Page #
    Descrizione

    PageNumber

    Tipo di dati

    float

    Alias
    NCI Thesaurus Property
    C25337 (undefined)
    UMLS 2011AA Property
    C0237753 (Numbers)
    SNOMED
    260299005
    LOINC
    LP6841-3
    NCI Thesaurus ValueDomain
    C25337 (undefined)
    UMLS 2011AA ValueDomain
    C0237753 (Numbers)
    SNOMED
    260299005
    LOINC
    LP6841-3
    NCI Metathesaurus ObjectClass
    C0439643 (Sheets (formation))
    SNOMED
    255292000
    Total Page Number
    Descrizione

    CaseReportFormTotalPageNumber

    Tipo di dati

    text

    Alias
    NCI Thesaurus ObjectClass
    C40988 (undefined)
    UMLS 2011AA ObjectClass
    C1516308 (Case Report Form)
    NCI Thesaurus Property
    C25337 (undefined)
    UMLS 2011AA Property
    C0237753 (Numbers)
    SNOMED
    260299005
    LOINC
    LP6841-3
    NCI Thesaurus Property-2
    C25304 (undefined)
    UMLS 2011AA Property-2
    C0439810 (Total)
    SNOMED
    255619001
    LOINC
    LP21089-5
    NCI Thesaurus Property-3
    C42783 (undefined)
    UMLS 2011AA Property-3
    C1704732 (Page (document))
    NCI Thesaurus ValueDomain
    C25337 (undefined)
    UMLS 2011AA ValueDomain
    C0237753 (Numbers)
    SNOMED
    260299005
    LOINC
    LP6841-3
    DCP Template Version
    Descrizione

    DCPTemplateVersionText

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704 (undefined)
    UMLS 2011AA ValueDomain
    C1527021 (Text)
    LOINC
    LP6885-0
    NCI Metathesaurus ObjectClass
    C0728990 (Clinical Use Template)
    NCI Thesaurus Property
    C25714 (undefined)
    UMLS 2011AA Property
    C0333052 (Version)
    LOINC
    MTHU010265

    Similar models

    No Instruction available.

    1. StudyEvent: Death Report
      1. No Instruction available.
    Name
    genere
    Description | Question | Decode (Coded Value)
    Tipo di dati
    Alias
    Item Group
    Screening
    Protocol ID NCI
    Item
    DCP Protocol #
    text
    C25337 (NCI Thesaurus ValueDomain)
    C3274381 (UMLS CUI-1)
    C25320 (NCI Thesaurus ObjectClass)
    C1513882 (UMLS CUI-2)
    C25364 (NCI Thesaurus Property)
    C19202 (NCI Thesaurus Property-2)
    NationalCancerInstituteInstituteCode
    Item
    Institution Code
    text
    C25162 (NCI Thesaurus ValueDomain)
    C0805701 (UMLS 2011AA ValueDomain)
    C21541 (NCI Thesaurus ObjectClass)
    C0018704 (UMLS 2011AA ObjectClass)
    C25364 (NCI Thesaurus Property)
    C0600091 (UMLS 2011AA Property)
    ParticipantIdentifier
    Item
    Participant ID
    text
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C25364 (NCI Thesaurus Property)
    C0600091 (UMLS 2011AA Property)
    C25364 (NCI Thesaurus ValueDomain)
    C0600091 (UMLS 2011AA ValueDomain)
    FormCompletionDate
    Item
    Form Date
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C40988 (NCI Thesaurus ObjectClass)
    C1516308 (UMLS 2011AA ObjectClass)
    C25250 (NCI Thesaurus Property)
    C0205197 (UMLS 2011AA Property)
    Item Group
    Death Report
    DeathDate
    Item
    Date of Death (MM/DD/YYYY)
    date
    C25164 (NCI Thesaurus Property)
    C0011008 (UMLS 2011AA Property)
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C28554 (NCI Thesaurus ObjectClass)
    C0011065 (UMLS 2011AA ObjectClass)
    Item
    Place of Death
    text
    C28554 (NCI Thesaurus ObjectClass)
    C0011065 (UMLS 2011AA ObjectClass)
    C42614 (NCI Thesaurus ValueDomain)
    C0027365 (UMLS 2011AA ValueDomain)
    C25319 (NCI Thesaurus Property)
    C0442504 (UMLS 2011AA Property)
    Code List
    Place of Death
    CL Item
    Hospital (Hospital)
    CL Item
    Other, Specify (Other, specify)
    CL Item
    Unknown (Unknown)
    C17998 (NCI Thesaurus)
    C0439673 (UMLS 2011AA)
    OtherSpecifyText
    Item
    Other, Specify
    text
    C25685 (NCI Thesaurus Property)
    C1521902 (UMLS 2011AA Property)
    C25704 (NCI Thesaurus ValueDomain)
    C1527021 (UMLS 2011AA ValueDomain)
    C17649 (NCI Thesaurus ObjectClass)
    C0205394 (UMLS 2011AA ObjectClass)
    C25638 (NCI Thesaurus Property-2)
    C0392360 (UMLS 2011AA Property-2)
    Item
    Cause of Death
    text
    C25638 (NCI Thesaurus Property)
    C0392360 (UMLS 2011AA Property)
    C28554 (NCI Thesaurus ObjectClass)
    C0011065 (UMLS 2011AA ObjectClass)
    C25251 (NCI Thesaurus Property-2)
    C0205225 (UMLS 2011AA Property-2)
    C42614 (NCI Thesaurus ValueDomain)
    C0027365 (UMLS 2011AA ValueDomain)
    Code List
    Cause of Death
    CL Item
    Adverse Event/serious Adverse Event (AE/SAE)
    CL Item
    Other, Specify (Other, specify)
    CL Item
    Unknown (Unknown)
    C17998 (NCI Thesaurus)
    C0439673 (UMLS 2011AA)
    PatientCauseofDeathText
    Item
    Cause of Death other, specify
    text
    C25704 (NCI Thesaurus ValueDomain)
    C1527021 (UMLS 2011AA ValueDomain)
    C25638 (NCI Thesaurus Property)
    C0392360 (UMLS 2011AA Property)
    C28554 (NCI Thesaurus ObjectClass)
    C0011065 (UMLS 2011AA ObjectClass)
    C25251 (NCI Thesaurus Property-2)
    C0205225 (UMLS 2011AA Property-2)
    Item
    Autopsy performed?
    text
    C25180 (NCI Thesaurus Property)
    C1522602 (UMLS 2011AA Property)
    C25153 (NCI Thesaurus ObjectClass)
    C0004398 (UMLS 2011AA ObjectClass)
    C38000 (NCI Thesaurus Property-2)
    C0884358 (UMLS 2011AA Property-2)
    C0021212 (NCI Metathesaurus ValueDomain)
    Code List
    Autopsy performed?
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    CL Item
    Unknown (Unknown)
    C17998 (NCI Thesaurus)
    C0439673 (UMLS 2011AA)
    Item Group
    Dcp Template Footer
    Protocol Title
    Item
    Protocol Title
    text
    C25191 (NCI Thesaurus ValueDomain)
    C2986303 (UMLS CUI-1)
    C25320 (NCI Thesaurus ObjectClass)
    C42774 (NCI Thesaurus Property)
    Protocol Version
    Item
    Protocol Version
    text
    C25704 (NCI Thesaurus ValueDomain)
    C2985700 (UMLS CUI-1)
    C25320 (NCI Thesaurus ObjectClass)
    C25364 (NCI Thesaurus Property)
    Protocol Version Date
    Item
    Protocol Date
    date
    C25164 (NCI Thesaurus ValueDomain)
    C2985700 (UMLS CUI-1)
    C25320 (NCI Thesaurus ObjectClass)
    C0011008 (UMLS CUI-2)
    C25364 (NCI Thesaurus Property)
    C25367 (NCI Thesaurus ValueDomain-2)
    PageNumber
    Item
    Page #
    float
    C25337 (NCI Thesaurus Property)
    C0237753 (UMLS 2011AA Property)
    C25337 (NCI Thesaurus ValueDomain)
    C0237753 (UMLS 2011AA ValueDomain)
    C0439643 (NCI Metathesaurus ObjectClass)
    CaseReportFormTotalPageNumber
    Item
    Total Page Number
    text
    C40988 (NCI Thesaurus ObjectClass)
    C1516308 (UMLS 2011AA ObjectClass)
    C25337 (NCI Thesaurus Property)
    C0237753 (UMLS 2011AA Property)
    C25304 (NCI Thesaurus Property-2)
    C0439810 (UMLS 2011AA Property-2)
    C42783 (NCI Thesaurus Property-3)
    C1704732 (UMLS 2011AA Property-3)
    C25337 (NCI Thesaurus ValueDomain)
    C0237753 (UMLS 2011AA ValueDomain)
    DCPTemplateVersionText
    Item
    DCP Template Version
    text
    C25704 (NCI Thesaurus ValueDomain)
    C1527021 (UMLS 2011AA ValueDomain)
    C0728990 (NCI Metathesaurus ObjectClass)
    C25714 (NCI Thesaurus Property)
    C0333052 (UMLS 2011AA Property)

    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