ID
7069
Description
The Division of Cancer Prevention's screening case report form (CRF) template. Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=516F6F73-F6A7-27F0-E044-0003BA3F9857
Link
Keywords
Versions (2)
- 8/27/12 8/27/12 -
- 1/9/15 1/9/15 - Martin Dugas
Uploaded on
January 9, 2015
DOI
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License
Creative Commons BY-NC 3.0 Legacy
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Eligibility - Screening - 2762748v1.0
No Instruction available.
- StudyEvent: Screening
Description
Screening
Description
ScreeningInformedConsentSignedDate
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C48261
- UMLS 2011AA ObjectClass
- C1710032
- NCI Thesaurus ObjectClass-2
- C16735
- UMLS 2011AA ObjectClass-2
- C0021430
- NCI Thesaurus Property
- C25679
Description
NotObtainedIndicator
Data type
text
Alias
- NCI Thesaurus Property
- C25180
- UMLS 2011AA Property
- C1522602
- NCI Metathesaurus ObjectClass
- CL310460
- NCI Metathesaurus ObjectClass-2
- CL052458
- NCI Metathesaurus ValueDomain
- C0021212
Description
NotObtainedIndicator
Data type
text
Alias
- NCI Thesaurus Property
- C25180
- UMLS 2011AA Property
- C1522602
- NCI Metathesaurus ObjectClass
- CL310460
- NCI Metathesaurus ObjectClass-2
- CL052458
- NCI Metathesaurus ValueDomain
- C0021212
Description
ScreenDate
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus Property
- C48261
- UMLS 2011AA Property
- C1710032
- NCI Thesaurus ObjectClass
- C15207
Description
ProtocolScreenIndicator
Data type
boolean
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
- NCI Thesaurus Property
- C48261
- UMLS 2011AA Property
- C1710032
- NCI Thesaurus ObjectClass
- C15207
Description
ProtocolScreenFailureReasonType
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus ValueDomain-2
- C25638
- UMLS 2011AA ValueDomain-2
- C0392360
- NCI Thesaurus Property
- C48261
- UMLS 2011AA Property
- C1710032
- NCI Thesaurus ObjectClass
- C15207
Description
OtherSpecifyText
Data type
text
Alias
- NCI Thesaurus Property
- C25685
- UMLS 2011AA Property
- C1521902
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus ObjectClass
- C17649
- UMLS 2011AA ObjectClass
- C0205394
- NCI Thesaurus Property-2
- C25638
- UMLS 2011AA Property-2
- C0392360
Description
Research Comments
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C0947611
- NCI Thesaurus ObjectClass
- C15319
- NCI Thesaurus Property
- C25393
Description
PatientReferralSourceName
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25683
- UMLS 2011AA Property
- C0449416
- NCI Thesaurus Property-2
- C52582
- UMLS 2011AA Property-2
- C0034927
- NCI Thesaurus ValueDomain
- C25683
- UMLS 2011AA ValueDomain
- C0449416
- NCI Thesaurus ValueDomain-2
- C42614
- UMLS 2011AA ValueDomain-2
- C0027365
- NCI Thesaurus ValueDomain-3
- C52582
- UMLS 2011AA ValueDomain-3
- C0034927
Description
PatientReferralSourceOtherSpecify
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25683
- UMLS 2011AA Property
- C0449416
- NCI Thesaurus Property-2
- C52582
- UMLS 2011AA Property-2
- C0034927
Description
ParticipantDiscoverStudySourceName
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C29867
- UMLS 2011AA ObjectClass
- C0679646
- NCI Thesaurus Property
- C63536
- UMLS 2011AA Property
- C2603343
- NCI Thesaurus Property-2
- C62262
- UMLS 2011AA Property-2
- C1880355
- NCI Thesaurus ValueDomain
- C25683
- UMLS 2011AA ValueDomain
- C0449416
- NCI Thesaurus ValueDomain-2
- C42614
- UMLS 2011AA ValueDomain-2
- C0027365
- NCI Thesaurus ValueDomain-3
- C62262
- UMLS 2011AA ValueDomain-3
- C1880355
Description
ParticipantDiscoverStudyOtherSpecify
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus ObjectClass
- C29867
- UMLS 2011AA ObjectClass
- C0679646
- NCI Thesaurus Property
- C63536
- UMLS 2011AA Property
- C2603343
- NCI Thesaurus Property-2
- C62262
- UMLS 2011AA Property-2
- C1880355
Description
Dcp Template Footer
Description
Protocol Title
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS CUI-1
- C2986303
- NCI Thesaurus ObjectClass
- C25320
- NCI Thesaurus Property
- C42774
Description
Protocol Version
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C2985700
- NCI Thesaurus ObjectClass
- C25320
- NCI Thesaurus Property
- C25364
Description
Protocol Version
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C2985700
- NCI Thesaurus ObjectClass
- C25320
- NCI Thesaurus Property
- C25364
Description
Protocol Version Date
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C2985700
- NCI Thesaurus ObjectClass
- C25320
- UMLS CUI-2
- C0011008
- NCI Thesaurus Property
- C25364
- NCI Thesaurus ValueDomain-2
- C25367
Description
PageNumber
Data type
float
Alias
- NCI Thesaurus Property
- C25337
- UMLS 2011AA Property
- C0237753
- NCI Thesaurus ValueDomain
- C25337
- UMLS 2011AA ValueDomain
- C0237753
- NCI Metathesaurus ObjectClass
- C0439643
Description
CaseReportFormTotalPageNumber
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C40988
- UMLS 2011AA ObjectClass
- C1516308
- NCI Thesaurus Property
- C25337
- UMLS 2011AA Property
- C0237753
- NCI Thesaurus Property-2
- C25304
- UMLS 2011AA Property-2
- C0439810
- NCI Thesaurus Property-3
- C42783
- UMLS 2011AA Property-3
- C1704732
- NCI Thesaurus ValueDomain
- C25337
- UMLS 2011AA ValueDomain
- C0237753
Description
DCPTemplateVersionText
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Metathesaurus ObjectClass
- C0728990
- NCI Thesaurus Property
- C25714
- UMLS 2011AA Property
- C0333052
Similar models
No Instruction available.
- StudyEvent: Screening
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1513882 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C19202 (NCI Thesaurus Property-2)
C0805701 (UMLS 2011AA ValueDomain)
C21541 (NCI Thesaurus ObjectClass)
C0018704 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C0030705 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C25364 (NCI Thesaurus ValueDomain)
C0600091 (UMLS 2011AA ValueDomain)
C0332307 (UMLS 2011AA Property)
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C25716 (NCI Thesaurus ObjectClass)
C0545082 (UMLS 2011AA ObjectClass)
C0011008 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
C25716 (NCI Thesaurus ObjectClass)
C0545082 (UMLS 2011AA ObjectClass)
C0011008 (UMLS 2011AA ValueDomain)
C48261 (NCI Thesaurus ObjectClass)
C1710032 (UMLS 2011AA ObjectClass)
C16735 (NCI Thesaurus ObjectClass-2)
C0021430 (UMLS 2011AA ObjectClass-2)
C25679 (NCI Thesaurus Property)
C1522602 (UMLS 2011AA Property)
CL310460 (NCI Metathesaurus ObjectClass)
CL052458 (NCI Metathesaurus ObjectClass-2)
C0021212 (NCI Metathesaurus ValueDomain)
C1272460 (UMLS 2011AA)
C1522602 (UMLS 2011AA Property)
CL310460 (NCI Metathesaurus ObjectClass)
CL052458 (NCI Metathesaurus ObjectClass-2)
C0021212 (NCI Metathesaurus ValueDomain)
C1272460 (UMLS 2011AA)
C0011008 (UMLS 2011AA ValueDomain)
C48261 (NCI Thesaurus Property)
C1710032 (UMLS 2011AA Property)
C15207 (NCI Thesaurus ObjectClass)
C1522602 (UMLS 2011AA ValueDomain)
C48261 (NCI Thesaurus Property)
C1710032 (UMLS 2011AA Property)
C15207 (NCI Thesaurus ObjectClass)
C0332307 (UMLS 2011AA ValueDomain)
C25638 (NCI Thesaurus ValueDomain-2)
C0392360 (UMLS 2011AA ValueDomain-2)
C48261 (NCI Thesaurus Property)
C1710032 (UMLS 2011AA Property)
C15207 (NCI Thesaurus ObjectClass)
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)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C0030705 (UMLS 2011AA ObjectClass)
C25683 (NCI Thesaurus Property)
C0449416 (UMLS 2011AA Property)
C52582 (NCI Thesaurus Property-2)
C0034927 (UMLS 2011AA Property-2)
C25683 (NCI Thesaurus ValueDomain)
C0449416 (UMLS 2011AA ValueDomain)
C42614 (NCI Thesaurus ValueDomain-2)
C0027365 (UMLS 2011AA ValueDomain-2)
C52582 (NCI Thesaurus ValueDomain-3)
C0034927 (UMLS 2011AA ValueDomain-3)
C0031831 (UMLS 2011AA)
C0018724 (UMLS 2011AA)
C0015576 (UMLS 2011AA)
C72884 (NCI Thesaurus-3)
C0079382 (UMLS 2011AA-4)
C0036588 (UMLS 2011AA)
C0205394 (UMLS 2011AA)
C1527021 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25683 (NCI Thesaurus Property)
C0449416 (UMLS 2011AA Property)
C52582 (NCI Thesaurus Property-2)
C0034927 (UMLS 2011AA Property-2)
C0679646 (UMLS 2011AA ObjectClass)
C63536 (NCI Thesaurus Property)
C2603343 (UMLS 2011AA Property)
C62262 (NCI Thesaurus Property-2)
C1880355 (UMLS 2011AA Property-2)
C25683 (NCI Thesaurus ValueDomain)
C0449416 (UMLS 2011AA ValueDomain)
C42614 (NCI Thesaurus ValueDomain-2)
C0027365 (UMLS 2011AA ValueDomain-2)
C62262 (NCI Thesaurus ValueDomain-3)
C1880355 (UMLS 2011AA ValueDomain-3)
C0031831 (UMLS 2011AA)
C0028661 (UMLS 2011AA)
C0015576 (UMLS 2011AA)
C72884 (NCI Thesaurus-3)
C0079382 (UMLS 2011AA-4)
C1513882 (UMLS 2011AA)
C67518 (NCI Thesaurus-3)
C2349146 (UMLS 2011AA-4)
C0439673 (UMLS 2011AA)
C1521902 (UMLS 2011AA)
C17649 (NCI Thesaurus-3)
C0205394 (UMLS 2011AA-4)
C1527021 (UMLS 2011AA ValueDomain)
C29867 (NCI Thesaurus ObjectClass)
C0679646 (UMLS 2011AA ObjectClass)
C63536 (NCI Thesaurus Property)
C2603343 (UMLS 2011AA Property)
C62262 (NCI Thesaurus Property-2)
C1880355 (UMLS 2011AA Property-2)
C2986303 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C42774 (NCI Thesaurus Property)
C2985700 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)
C2985700 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)
C2985700 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C0011008 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25367 (NCI Thesaurus ValueDomain-2)
C0237753 (UMLS 2011AA Property)
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C0439643 (NCI Metathesaurus 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)
C1527021 (UMLS 2011AA ValueDomain)
C0728990 (NCI Metathesaurus ObjectClass)
C25714 (NCI Thesaurus Property)
C0333052 (UMLS 2011AA Property)