ID
7603
Beschrijving
CALGB: 90401 Medications Supplement Form Docetaxel and Prednisone With or Without Bevacizumab in Treating Patients With Prostate Cancer That Did Not Respond to Hormone Therapy Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=359FF873-CDE9-6CE9-E044-0003BA3F9857
Link
Trefwoorden
Versies (4)
- 20-09-12 20-09-12 -
- 09-01-15 09-01-15 - Martin Dugas
- 16-06-15 16-06-15 -
- 20-09-21 20-09-21 -
Geüploaded op
9 januari 2015
DOI
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Licentie
Creative Commons BY-NC 3.0 Legacy
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Prostate Cancer NCT00110214 Treatment - CALGB: 90401 Medications Supplement Form - 2664914v1.0
If submitting electronically, click the Send button when you have completed the form.
- StudyEvent: CALGB: 90401 Medications Supplement Form
Beschrijving
Unnamed2
Beschrijving
Patient Initials
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS CUI-1
- C2986440
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25536
Beschrijving
Medical Record Number
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C1301894
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25261
- NCI Thesaurus Property-2
- C25198
Beschrijving
Institution Name
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C25454
- UMLS CUI-1
- C1301943
- NCI Thesaurus ObjectClass-2
- C21541
- NCI Thesaurus Property
- C25364
- NCI Thesaurus ValueDomain
- C25191
- NCI Thesaurus ValueDomain-2
- C21541
Beschrijving
Participating Group
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS CUI-1
- C2347449
- NCI Thesaurus ObjectClass
- C25608
- NCI Thesaurus ObjectClass-2
- C17005
- NCI Thesaurus Property
- C25364
Beschrijving
Study Number Participating Group
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C3274381
- NCI Thesaurus ObjectClass
- C25320
- UMLS CUI-2
- C2347449
- NCI Thesaurus Property
- C25608
- NCI Thesaurus Property-2
- C25364
Beschrijving
Trial subject ID Participating Group
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C2348585
- NCI Thesaurus ObjectClass
- C16960
- UMLS CUI-2
- C2347449
- NCI Thesaurus Property
- C25608
- NCI Thesaurus Property-2
- C25364
Beschrijving
Unnamed Module 2
Beschrijving
CardiovascularAgentPriorYearReceivedInd-2
Datatype
boolean
Alias
- NCI Thesaurus ObjectClass
- C2079
- UMLS 2011AA ObjectClass
- C0007209
- NCI Thesaurus Property
- C25629
- UMLS 2011AA Property
- C0332152
- NCI Thesaurus Property-2
- C29848
- UMLS 2011AA Property-2
- C0439234
- NCI Thesaurus Property-3
- C25639
- UMLS 2011AA Property-3
- C1514756
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Beschrijving
CardiovascularAgentPriorYearReceivedType
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C2079
- UMLS 2011AA ObjectClass
- C0007209
- NCI Thesaurus Property
- C25629
- UMLS 2011AA Property
- C0332152
- NCI Thesaurus Property-2
- C29848
- UMLS 2011AA Property-2
- C0439234
- NCI Thesaurus Property-3
- C25639
- UMLS 2011AA Property-3
- C1514756
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
Beschrijving
Agent
Datatype
text
Alias
- NCI Thesaurus Property
- C25364
- UMLS CUI-1
- C1521826
- NCI Thesaurus ObjectClass
- C1708
- NCI Thesaurus ValueDomain
- C1708
- NCI Thesaurus ValueDomain-2
- C42614
Beschrijving
DiabetesMellitusCurrentTherapeuticProcedureInd-2
Datatype
boolean
Alias
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
- NCI Thesaurus Property
- C25471
- UMLS 2011AA Property
- C0521116
- NCI Thesaurus ObjectClass
- C2985
- UMLS 2011AA ObjectClass
- C0011849
- NCI Thesaurus Property-2
- C49236
- UMLS 2011AA Property-2
- C0087111
Beschrijving
DiabetesMellitusCurrentTherapeuticProcedureType
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus Property
- C25471
- UMLS 2011AA Property
- C0521116
- NCI Thesaurus ObjectClass
- C2985
- UMLS 2011AA ObjectClass
- C0011849
- NCI Thesaurus Property-2
- C49236
- UMLS 2011AA Property-2
- C0087111
Beschrijving
PatientPre-ExistingConditionInd-3
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Metathesaurus Property
- CL232826
Beschrijving
PatientPre-ExistingConditionText
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Metathesaurus Property
- CL232826
Beschrijving
PatientPre-ExistingConditionMostRecentDate
Datatype
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus ValueDomain-2
- C25577
- UMLS 2011AA ValueDomain-2
- C1513491
- NCI Metathesaurus Property
- CL232826
Beschrijving
PatientGastrointestinalTractPerforationPre-ExistingConditionText
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C34082
- UMLS 2011AA Property
- C0017189
- NCI Metathesaurus Property
- CL232826
- NCI Thesaurus Property-2
- C4080
- UMLS 2011AA Property-2
- C0549099
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
Beschrijving
PatientGenitourinaryPerforationPre-ExistingConditionText
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25350
- UMLS 2011AA Property
- C2709259
- NCI Metathesaurus Property
- CL232826
- NCI Thesaurus Property-2
- C4080
- UMLS 2011AA Property-2
- C0549099
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
Beschrijving
PatientHemorrhagePre-ExistingConditionText
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C26791
- UMLS 2011AA Property
- C0019080
- NCI Metathesaurus Property
- CL232826
Beschrijving
Footer
Beschrijving
Research Comments
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C0947611
- NCI Thesaurus ObjectClass
- C15319
- NCI Thesaurus Property
- C25393
Beschrijving
Person Completing Form
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS CUI-1
- C1550483
- NCI Thesaurus ObjectClass
- C25657
- NCI Thesaurus Property
- C25364
Beschrijving
Form Completion Date
Datatype
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
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If submitting electronically, click the Send button when you have completed the form.
- StudyEvent: CALGB: 90401 Medications Supplement Form
C3262252 (UMLS CUI-1)
C19464 (NCI Thesaurus ObjectClass)
C1516238 (UMLS CUI-2)
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C42614 (NCI Thesaurus ValueDomain-2)
C1512698 (UMLS 2011AA ValueDomain)
C25471 (NCI Thesaurus Property)
C0521116 (UMLS 2011AA Property)
C2985 (NCI Thesaurus ObjectClass)
C0011849 (UMLS 2011AA ObjectClass)
C49236 (NCI Thesaurus Property-2)
C0087111 (UMLS 2011AA Property-2)
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C25471 (NCI Thesaurus Property)
C0521116 (UMLS 2011AA Property)
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C0439673 (UMLS 2011AA)
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CL232826 (NCI Metathesaurus Property)
C0011008 (UMLS 2011AA ValueDomain)
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C0030705 (UMLS 2011AA ObjectClass)
C25577 (NCI Thesaurus ValueDomain-2)
C1513491 (UMLS 2011AA ValueDomain-2)
CL232826 (NCI Metathesaurus Property)
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C34082 (NCI Thesaurus Property)
C0017189 (UMLS 2011AA Property)
CL232826 (NCI Metathesaurus Property)
C4080 (NCI Thesaurus Property-2)
C0549099 (UMLS 2011AA Property-2)
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C1527021 (UMLS 2011AA ValueDomain)
C0030705 (UMLS 2011AA ObjectClass)
C25350 (NCI Thesaurus Property)
C2709259 (UMLS 2011AA Property)
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C4080 (NCI Thesaurus Property-2)
C0549099 (UMLS 2011AA Property-2)
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CL232826 (NCI Metathesaurus Property)
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