ID
7384
Beschreibung
CALGB: 30610 On-Study Form Three Different Radiation Therapy Regimens in Treating Patients With Limited-Stage Small Cell Lung Cancer Receiving Cisplatin and Etoposide Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=3C26256D-03C2-01FC-E044-0003BA3F9857
Link
Stichworte
Versionen (2)
- 19.09.12 19.09.12 -
- 09.01.15 09.01.15 - Martin Dugas
Hochgeladen am
9. Januar 2015
DOI
Für eine Beantragung loggen Sie sich ein.
Lizenz
Creative Commons BY-NC 3.0 Legacy
Modell Kommentare :
Hier können Sie das Modell kommentieren. Über die Sprechblasen an den Itemgruppen und Items können Sie diese spezifisch kommentieren.
Itemgroup Kommentare für :
Item Kommentare für :
Um Formulare herunterzuladen müssen Sie angemeldet sein. Bitte loggen Sie sich ein oder registrieren Sie sich kostenlos.
Lung Cancer NCT00632853 On-Study - CALGB: 30610 On-Study Form - 2688471v1.0
INSTRUCTIONS: Complete and submit this form as required by the protocol. Information in the upper right box must be completed for this form to be accepted.
- StudyEvent: CALGB: 30610 On-Study Form
Beschreibung
Disease Information
Beschreibung
CancerInitialDiagnosisDate
Datentyp
date
Alias
- NCI Thesaurus ObjectClass
- C9305
- UMLS 2011AA ObjectClass
- C0006826
- NCI Thesaurus Property
- C25509
- UMLS 2011AA Property
- C1279901
- NCI Thesaurus Property-2
- C15220
- UMLS 2011AA Property-2
- C0011900
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ValueDomain-2
- C25367
Beschreibung
MedDRACode
Datentyp
float
Alias
- NCI Thesaurus ValueDomain
- C25162
- UMLS 2011AA ValueDomain
- C0805701
- NCI Thesaurus Property
- C25364
- UMLS 2011AA Property
- C0600091
- NCI Metathesaurus ObjectClass
- CL104089
Beschreibung
LungCarcinomaInvolvementAnatomicSite
Datentyp
text
Alias
- NCI Thesaurus ValueDomain
- C13717
- UMLS 2011AA ValueDomain
- C1515974
- NCI Thesaurus ObjectClass
- C4878
- UMLS 2011AA ObjectClass
- C0684249
- NCI Thesaurus Property
- C25548
- UMLS 2011AA Property
- C1314939
Beschreibung
LungCarcinomaInvolvementSpecify
Datentyp
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
- NCI Thesaurus ObjectClass
- C4878
- UMLS 2011AA ObjectClass
- C0684249
- NCI Thesaurus Property
- C25548
- UMLS 2011AA Property
- C1314939
Beschreibung
Extent of disease
Datentyp
text
Alias
- NCI Thesaurus ObjectClass
- C4917
- UMLS CUI-1
- C0449279
- NCI Thesaurus ValueDomain
- C25688
- NCI Thesaurus Property
- C20625
Beschreibung
Pleural Effusion
Datentyp
boolean
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS CUI-1
- C0032227
- NCI Thesaurus ObjectClass
- C12468
- NCI Thesaurus Property
- C3003
- NCI Thesaurus Property-2
- C25223
Beschreibung
MalignantPleuralEffusionMalignantPericardialEffusionPresentInd-2
Datentyp
boolean
Alias
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
- NCI Thesaurus Property
- C25626
- UMLS 2011AA Property
- C0150312
- NCI Thesaurus ObjectClass
- C7717
- UMLS 2011AA ObjectClass
- C0220655
- NCI Thesaurus ObjectClass-2
- C9432
- UMLS 2011AA ObjectClass-2
- C0080032
Beschreibung
Prior Treatment
Beschreibung
PriorChemotherapyRadiationTherapySmallCellLungCarcinomaAdministeredInd-2
Datentyp
boolean
Alias
- NCI Thesaurus ObjectClass
- C15632
- UMLS 2011AA ObjectClass
- C0392920
- NCI Thesaurus ObjectClass-2
- C15313
- UMLS 2011AA ObjectClass-2
- C1522449
- NCI Thesaurus ObjectClass-3
- C25629
- UMLS 2011AA ObjectClass-3
- C0332152
- NCI Thesaurus Property
- C4917
- UMLS 2011AA Property
- C0149925
- NCI Thesaurus Property-2
- C25382
- UMLS 2011AA Property-2
- C1521801
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Beschreibung
RadiationTherapyPriorThoraxAdministeredInd-2
Datentyp
boolean
Alias
- NCI Thesaurus ObjectClass
- C15313
- UMLS 2011AA ObjectClass
- C1522449
- NCI Thesaurus Property
- C25629
- UMLS 2011AA Property
- C0332152
- NCI Thesaurus Property-2
- C12799
- UMLS 2011AA Property-2
- C0817096
- NCI Thesaurus Property-3
- C25382
- UMLS 2011AA Property-3
- C1521801
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Beschreibung
Lab Values
Beschreibung
Neutrophil count
Datentyp
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS CUI-1
- C0200633
- NCI Thesaurus Property
- C12533
- NCI Thesaurus Property-2
- C20200
- NCI Thesaurus ValueDomain
- C25304
- NCI Thesaurus ValueDomain-2
- C25712
Beschreibung
Platelets
Datentyp
float
Maßeinheiten
- 1000/uL
Alias
- NCI Thesaurus Property
- C20200
- UMLS CUI-1
- C0005821
- NCI Thesaurus Property-2
- C12520
- NCI Thesaurus ObjectClass
- C25294
- NCI Thesaurus ValueDomain
- C25712
Beschreibung
HepaticBilirubinLabValue
Datentyp
float
Maßeinheiten
- mg/dL
Alias
- NCI Thesaurus Property
- C20200
- UMLS 2011AA Property
- C1274040
- NCI Thesaurus Property-2
- C305
- UMLS 2011AA Property-2
- C0005437
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
Beschreibung
HepaticBilirubinLabUpperLimitNormalValue
Datentyp
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C20200
- UMLS 2011AA Property
- C1274040
- NCI Thesaurus Property-2
- C305
- UMLS 2011AA Property-2
- C0005437
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
- NCI Thesaurus ValueDomain-2
- C25706
- UMLS 2011AA ValueDomain-2
- C1519815
Beschreibung
SGOT (AST)
Datentyp
float
Maßeinheiten
- U/L
Alias
- NCI Thesaurus Property
- C25202
- UMLS CUI-1
- C0201899
- NCI Thesaurus Property-2
- C20200
- NCI Thesaurus ObjectClass
- C25294
- NCI Thesaurus ValueDomain
- C25712
Beschreibung
LaboratoryProcedureSerumGlutamicOxaloaceticTransferaseResultUnspecifiedUpperLimitofNormalValue
Datentyp
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C25202
- UMLS 2011AA Property
- C0242192
- NCI Thesaurus Property-2
- C20200
- UMLS 2011AA Property-2
- C1274040
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
- NCI Thesaurus ValueDomain-2
- C25706
- UMLS 2011AA ValueDomain-2
- C1519815
Beschreibung
Creatinine, Serum
Datentyp
float
Maßeinheiten
- mg/dL
Alias
- NCI Thesaurus Property
- C20200
- UMLS CUI-1
- C0201976
- NCI Thesaurus Property-2
- C399
- NCI Thesaurus ObjectClass
- C25294
- NCI Thesaurus ValueDomain
- C25712
Beschreibung
Creatinine, serum ULN
Datentyp
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS CUI-1
- C0201976
- NCI Thesaurus Property
- C20200
- UMLS CUI-2
- C1519815
- NCI Thesaurus Property-2
- C399
- NCI Thesaurus ValueDomain
- C25712
- NCI Thesaurus ValueDomain-2
- C25706
Beschreibung
Creatinine Clearance
Datentyp
float
Alias
- NCI Thesaurus Property
- C20200
- UMLS CUI-1
- C0373595
- NCI Thesaurus Property-2
- C25747
- NCI Thesaurus ObjectClass
- C25294
- NCI Thesaurus ValueDomain
- C25712
Beschreibung
Footer
Beschreibung
Person Completing Form
Datentyp
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS CUI-1
- C1550483
- NCI Thesaurus ObjectClass
- C25657
- NCI Thesaurus Property
- C25364
Beschreibung
Form Completion Date
Datentyp
date
Alias
- NCI Thesaurus ObjectClass
- C19464
- UMLS CUI-1
- C1549507
- NCI Thesaurus Property
- C25250
- NCI Thesaurus Property-2
- C25604
- NCI Thesaurus ValueDomain
- C25164
- NCI Thesaurus ValueDomain-2
- C25367
Ähnliche Modelle
INSTRUCTIONS: Complete and submit this form as required by the protocol. Information in the upper right box must be completed for this form to be accepted.
- StudyEvent: CALGB: 30610 On-Study Form
C3262252 (UMLS CUI-1)
C19464 (NCI Thesaurus ObjectClass)
C1516238 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25442 (NCI Thesaurus ObjectClass-2)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1516238 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25442 (NCI Thesaurus Property-2)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1516238 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25442 (NCI Thesaurus Property-2)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C1301894 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25261 (NCI Thesaurus Property)
C25198 (NCI Thesaurus Property-2)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C25191 (NCI Thesaurus ValueDomain)
C21541 (NCI Thesaurus ValueDomain-2)
C2347449 (UMLS CUI-1)
C25608 (NCI Thesaurus ObjectClass)
C17005 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
C0006826 (UMLS 2011AA ObjectClass)
C25509 (NCI Thesaurus Property)
C1279901 (UMLS 2011AA Property)
C15220 (NCI Thesaurus Property-2)
C0011900 (UMLS 2011AA Property-2)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
C0805701 (UMLS 2011AA ValueDomain)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
CL104089 (NCI Metathesaurus ObjectClass)
C1515974 (UMLS 2011AA ValueDomain)
C4878 (NCI Thesaurus ObjectClass)
C0684249 (UMLS 2011AA ObjectClass)
C25548 (NCI Thesaurus Property)
C1314939 (UMLS 2011AA Property)
C0588055 (UMLS 2011AA)
C0205394 (UMLS 2011AA)
C1521902 (UMLS 2011AA ValueDomain)
C4878 (NCI Thesaurus ObjectClass)
C0684249 (UMLS 2011AA ObjectClass)
C25548 (NCI Thesaurus Property)
C1314939 (UMLS 2011AA Property)
C0449279 (UMLS CUI-1)
C25688 (NCI Thesaurus ValueDomain)
C20625 (NCI Thesaurus Property)
C0205231 (UMLS 2011AA)
C0032227 (UMLS CUI-1)
C12468 (NCI Thesaurus ObjectClass)
C3003 (NCI Thesaurus Property)
C25223 (NCI Thesaurus Property-2)
C1512698 (UMLS 2011AA ValueDomain)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C7717 (NCI Thesaurus ObjectClass)
C0220655 (UMLS 2011AA ObjectClass)
C9432 (NCI Thesaurus ObjectClass-2)
C0080032 (UMLS 2011AA ObjectClass-2)
C0392920 (UMLS 2011AA ObjectClass)
C15313 (NCI Thesaurus ObjectClass-2)
C1522449 (UMLS 2011AA ObjectClass-2)
C25629 (NCI Thesaurus ObjectClass-3)
C0332152 (UMLS 2011AA ObjectClass-3)
C4917 (NCI Thesaurus Property)
C0149925 (UMLS 2011AA Property)
C25382 (NCI Thesaurus Property-2)
C1521801 (UMLS 2011AA Property-2)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C1522449 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus Property)
C0332152 (UMLS 2011AA Property)
C12799 (NCI Thesaurus Property-2)
C0817096 (UMLS 2011AA Property-2)
C25382 (NCI Thesaurus Property-3)
C1521801 (UMLS 2011AA Property-3)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C0200633 (UMLS CUI-1)
C12533 (NCI Thesaurus Property)
C20200 (NCI Thesaurus Property-2)
C25304 (NCI Thesaurus ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)
C0005821 (UMLS CUI-1)
C12520 (NCI Thesaurus Property-2)
C25294 (NCI Thesaurus ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C1274040 (UMLS 2011AA Property)
C305 (NCI Thesaurus Property-2)
C0005437 (UMLS 2011AA Property-2)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C305 (NCI Thesaurus Property-2)
C0005437 (UMLS 2011AA Property-2)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25706 (NCI Thesaurus ValueDomain-2)
C1519815 (UMLS 2011AA ValueDomain-2)
C0201899 (UMLS CUI-1)
C20200 (NCI Thesaurus Property-2)
C25294 (NCI Thesaurus ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C0022885 (UMLS 2011AA ObjectClass)
C25202 (NCI Thesaurus Property)
C0242192 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property-2)
C1274040 (UMLS 2011AA Property-2)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25706 (NCI Thesaurus ValueDomain-2)
C1519815 (UMLS 2011AA ValueDomain-2)
C0201976 (UMLS CUI-1)
C399 (NCI Thesaurus Property-2)
C25294 (NCI Thesaurus ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C0201976 (UMLS CUI-1)
C20200 (NCI Thesaurus Property)
C1519815 (UMLS CUI-2)
C399 (NCI Thesaurus Property-2)
C25712 (NCI Thesaurus ValueDomain)
C25706 (NCI Thesaurus ValueDomain-2)
C0373595 (UMLS CUI-1)
C25747 (NCI Thesaurus Property-2)
C25294 (NCI Thesaurus ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C1550483 (UMLS CUI-1)
C25657 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)
C1549507 (UMLS CUI-1)
C25250 (NCI Thesaurus Property)
C25604 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
Keine Kommentare