ID
11050
Description
E3805 Hormone Refractory Disease Form Androgen Ablation Therapy With or Without Chemotherapy in Treating Patients With Metastatic Prostate Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=F97FF9CE-553B-2533-E034-0003BA3F9857
Link
Keywords
Versions (3)
- 9/20/12 9/20/12 -
- 1/9/15 1/9/15 - Martin Dugas
- 6/16/15 6/16/15 -
Uploaded on
June 16, 2015
DOI
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License
Creative Commons BY-NC 3.0 Legacy
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E3805 Hormone Refractory Disease Form
No Instruction available.
- StudyEvent: E3805 Hormone Refractory Disease Form
Description
Patient demographics
Description
Protocol Number ECOG
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C3274381
- NCI Thesaurus ObjectClass
- C25320
- UMLS CUI-2
- C1512162
- NCI Thesaurus Property
- C25364
- NCI Thesaurus Property-2
- C25491
Description
Patient Initials
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS CUI-1
- C2986440
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25536
Description
Study Number Participating Group
Data type
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
Description
Institution Name
Data type
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
Description
Trial subject ID Participating Group
Data type
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
Description
Data amendment
Description
Data amended
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C0680532
- NCI Thesaurus ObjectClass
- C25474
- NCI Thesaurus Property
- C25416
Description
Data amended date
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C0680532
- NCI Thesaurus ObjectClass
- C25474
- UMLS CUI-2
- C0011008
- NCI Thesaurus Property
- C25416
- NCI Thesaurus ValueDomain-2
- C25367
Description
Diagnosis Of Hormone Refractory Disease
Description
HormoneRefractoryProstateCarcinomaElevatedProstate-SpecificAntigenDiagnosisInd-2
Data type
boolean
Alias
- NCI Thesaurus ObjectClass
- C38014
- UMLS 2011AA ObjectClass
- C0205269
- NCI Thesaurus ObjectClass-2
- C4863
- UMLS 2011AA ObjectClass-2
- C0600139
- NCI Thesaurus ObjectClass-3
- C2315
- UMLS 2011AA ObjectClass-3
- C0019932
- NCI Thesaurus Property
- C17525
- UMLS 2011AA Property
- C0138741
- NCI Thesaurus Property-2
- C25493
- UMLS 2011AA Property-2
- C0205250
- NCI Thesaurus Property-3
- C15220
- UMLS 2011AA Property-3
- C0011900
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Description
PSAProgressionFirstOccurrenceDate
Data type
date
Alias
- NCI Thesaurus ObjectClass
- C17525
- UMLS 2011AA ObjectClass
- C0138741
- NCI Thesaurus ObjectClass-2
- C25331
- NCI Thesaurus Property
- C25509
- UMLS 2011AA Property
- C1279901
- NCI Thesaurus Property-2
- C25275
- UMLS 2011AA Property-2
- C2745955
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ValueDomain-2
- C25509
- UMLS 2011AA ValueDomain-2
- C1279901
Description
ResponseEvaluationCriteriainSolidTumorsGroupDiseaseProgressionMedicalImagingDocumentedInd-2
Data type
boolean
Alias
- NCI Thesaurus ObjectClass
- C17747
- UMLS 2011AA ObjectClass
- C0242656
- NCI Thesaurus ObjectClass-2
- C49164
- UMLS 2011AA ObjectClass-2
- C1709926
- NCI Thesaurus Property
- C16831
- NCI Thesaurus Property-2
- C25356
- UMLS 2011AA Property
- C1301725
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Description
ClinicalProgressionFirstDate
Data type
date
Alias
- NCI Thesaurus ObjectClass
- C25398
- UMLS 2011AA ObjectClass
- C0205210
- NCI Thesaurus ObjectClass-2
- C25331
- NCI Thesaurus Property
- C25509
- UMLS 2011AA Property
- C1279901
- NCI Thesaurus Property-2
- C25275
- UMLS 2011AA Property-2
- C2745955
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ValueDomain-2
- C25509
- UMLS 2011AA ValueDomain-2
- C1279901
Description
LaboratoryProcedureTestosteroneDiseaseProgressionOutcomeSpecifiedValue
Data type
float
Measurement units
- ng/dl
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C17747
- UMLS 2011AA Property
- C0242656
- NCI Thesaurus Property-2
- C20200
- UMLS 2011AA Property-2
- C1274040
- NCI Thesaurus Property-3
- C2299
- UMLS 2011AA Property-3
- C0039601
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
Description
LaboratoryProcedureTestosteroneDiseaseProgressionOutcomeSpecifiedValue
Data type
float
Measurement units
- ng/dl
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C17747
- UMLS 2011AA Property
- C0242656
- NCI Thesaurus Property-2
- C20200
- UMLS 2011AA Property-2
- C1274040
- NCI Thesaurus Property-3
- C2299
- UMLS 2011AA Property-3
- C0039601
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
Description
DataUnknownText
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus ObjectClass
- C25474
- UMLS 2011AA ObjectClass
- C1511726
- NCI Thesaurus Property
- C17998
- UMLS 2011AA Property
- C0439673
Description
DataUnknownText
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus ObjectClass
- C25474
- UMLS 2011AA ObjectClass
- C1511726
- NCI Thesaurus Property
- C17998
- UMLS 2011AA Property
- C0439673
Description
ResponseEvaluationCriteriainSolidTumorsGroupDiseaseProgressionMedicalImagingNewNeoplasmDocumentedInd-2
Data type
boolean
Alias
- NCI Thesaurus ObjectClass
- C17747
- UMLS 2011AA ObjectClass
- C0242656
- NCI Thesaurus ObjectClass-2
- C49164
- UMLS 2011AA ObjectClass-2
- C1709926
- NCI Thesaurus Property
- C25586
- UMLS 2011AA Property
- C0205314
- NCI Thesaurus Property-2
- C16831
- NCI Thesaurus Property-3
- C25356
- UMLS 2011AA Property-2
- C1301725
- NCI Metathesaurus Property
- CL053268
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Description
ResponseEvaluationCriteriainSolidTumorsGroupDiseaseProgressionMedicalImagingMeasurableDiseaseDocumentedInd-2
Data type
boolean
Alias
- NCI Thesaurus ObjectClass
- C17747
- UMLS 2011AA ObjectClass
- C0242656
- NCI Thesaurus ObjectClass-2
- C49164
- UMLS 2011AA ObjectClass-2
- C1709926
- NCI Thesaurus Property
- C8507
- UMLS 2011AA Property
- C1513041
- NCI Thesaurus Property-2
- C16831
- NCI Thesaurus Property-3
- C25356
- UMLS 2011AA Property-2
- C1301725
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Description
ResponseEvaluationCriteriainSolidTumorsGroupDiseaseProgressionMedicalImagingNon-MeasurableDocumentedInd-2
Data type
boolean
Alias
- NCI Thesaurus ObjectClass
- C17747
- UMLS 2011AA ObjectClass
- C0242656
- NCI Thesaurus ObjectClass-2
- C49164
- UMLS 2011AA ObjectClass-2
- C1709926
- NCI Thesaurus Property
- C25589
- UMLS 2011AA Property
- C1518373
- NCI Thesaurus Property-2
- C16831
- NCI Thesaurus Property-3
- C25356
- UMLS 2011AA Property-2
- C1301725
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Description
HormoneRefractoryProstateCarcinomaOtherDiagnosisInd-2
Data type
boolean
Alias
- NCI Thesaurus ObjectClass
- C38014
- UMLS 2011AA ObjectClass
- C0205269
- NCI Thesaurus ObjectClass-2
- C4863
- UMLS 2011AA ObjectClass-2
- C0600139
- NCI Thesaurus ObjectClass-3
- C2315
- UMLS 2011AA ObjectClass-3
- C0019932
- NCI Thesaurus Property
- C17649
- UMLS 2011AA Property
- C0205394
- NCI Thesaurus Property-2
- C15220
- UMLS 2011AA Property-2
- C0011900
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Description
HormoneRefractoryProstateCarcinomaOtherDiagnosisSpecify
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C38014
- UMLS 2011AA ObjectClass
- C0205269
- NCI Thesaurus ObjectClass-2
- C4863
- UMLS 2011AA ObjectClass-2
- C0600139
- NCI Thesaurus ObjectClass-3
- C2315
- UMLS 2011AA ObjectClass-3
- C0019932
- NCI Thesaurus Property
- C17649
- UMLS 2011AA Property
- C0205394
- NCI Thesaurus Property-2
- C15220
- UMLS 2011AA Property-2
- C0011900
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
Description
Comments
Description
Research Comments
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C0947611
- NCI Thesaurus ObjectClass
- C15319
- NCI Thesaurus Property
- C25393
Description
Investigator Signature
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C2346576
- NCI Thesaurus Property
- C25678
- NCI Thesaurus ObjectClass
- C17089
Description
Investigator Signature Date
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C2346576
- NCI Thesaurus Property
- C25678
- UMLS CUI-2
- C0011008
- NCI Thesaurus ValueDomain-2
- C25367
- NCI Thesaurus ObjectClass
- C17089
Similar models
No Instruction available.
- StudyEvent: E3805 Hormone Refractory Disease Form
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1512162 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25491 (NCI Thesaurus Property-2)
C3242750 (UMLS CUI-1)
C19464 (NCI Thesaurus Property)
C25474 (NCI Thesaurus ObjectClass)
C25452 (NCI Thesaurus ObjectClass-2)
C1514821 (UMLS CUI-1)
C25646 (NCI Thesaurus ObjectClass)
C0237753 (UMLS CUI-2)
C16154 (NCI Thesaurus Property)
C16154 (NCI Thesaurus ValueDomain-2)
C2347804 (UMLS CUI-1)
C25214 (NCI Thesaurus ObjectClass)
C25616 (NCI Thesaurus Property)
C25651 (NCI Thesaurus ObjectClass-2)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1512162 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25491 (NCI Thesaurus Property-2)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (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)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C0011008 (UMLS CUI-2)
C25416 (NCI Thesaurus Property)
C25367 (NCI Thesaurus ValueDomain-2)
C0205269 (UMLS 2011AA ObjectClass)
C4863 (NCI Thesaurus ObjectClass-2)
C0600139 (UMLS 2011AA ObjectClass-2)
C2315 (NCI Thesaurus ObjectClass-3)
C0019932 (UMLS 2011AA ObjectClass-3)
C17525 (NCI Thesaurus Property)
C0138741 (UMLS 2011AA Property)
C25493 (NCI Thesaurus Property-2)
C0205250 (UMLS 2011AA Property-2)
C15220 (NCI Thesaurus Property-3)
C0011900 (UMLS 2011AA Property-3)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C0138741 (UMLS 2011AA ObjectClass)
C25331 (NCI Thesaurus ObjectClass-2)
C25509 (NCI Thesaurus Property)
C1279901 (UMLS 2011AA Property)
C25275 (NCI Thesaurus Property-2)
C2745955 (UMLS 2011AA Property-2)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25509 (NCI Thesaurus ValueDomain-2)
C1279901 (UMLS 2011AA ValueDomain-2)
C0242656 (UMLS 2011AA ObjectClass)
C49164 (NCI Thesaurus ObjectClass-2)
C1709926 (UMLS 2011AA ObjectClass-2)
C16831 (NCI Thesaurus Property)
C25356 (NCI Thesaurus Property-2)
C1301725 (UMLS 2011AA Property)
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C1512698 (UMLS 2011AA ValueDomain)
C0205210 (UMLS 2011AA ObjectClass)
C25331 (NCI Thesaurus ObjectClass-2)
C25509 (NCI Thesaurus Property)
C1279901 (UMLS 2011AA Property)
C25275 (NCI Thesaurus Property-2)
C2745955 (UMLS 2011AA Property-2)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25509 (NCI Thesaurus ValueDomain-2)
C1279901 (UMLS 2011AA ValueDomain-2)
C0022885 (UMLS 2011AA ObjectClass)
C17747 (NCI Thesaurus Property)
C0242656 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property-2)
C1274040 (UMLS 2011AA Property-2)
C2299 (NCI Thesaurus Property-3)
C0039601 (UMLS 2011AA Property-3)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C0022885 (UMLS 2011AA ObjectClass)
C17747 (NCI Thesaurus Property)
C0242656 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property-2)
C1274040 (UMLS 2011AA Property-2)
C2299 (NCI Thesaurus Property-3)
C0039601 (UMLS 2011AA Property-3)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C25474 (NCI Thesaurus ObjectClass)
C1511726 (UMLS 2011AA ObjectClass)
C17998 (NCI Thesaurus Property)
C0439673 (UMLS 2011AA Property)
C1527021 (UMLS 2011AA ValueDomain)
C25474 (NCI Thesaurus ObjectClass)
C1511726 (UMLS 2011AA ObjectClass)
C17998 (NCI Thesaurus Property)
C0439673 (UMLS 2011AA Property)
C0242656 (UMLS 2011AA ObjectClass)
C49164 (NCI Thesaurus ObjectClass-2)
C1709926 (UMLS 2011AA ObjectClass-2)
C25586 (NCI Thesaurus Property)
C0205314 (UMLS 2011AA Property)
C16831 (NCI Thesaurus Property-2)
C25356 (NCI Thesaurus Property-3)
C1301725 (UMLS 2011AA Property-2)
CL053268 (NCI Metathesaurus Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C0242656 (UMLS 2011AA ObjectClass)
C49164 (NCI Thesaurus ObjectClass-2)
C1709926 (UMLS 2011AA ObjectClass-2)
C8507 (NCI Thesaurus Property)
C1513041 (UMLS 2011AA Property)
C16831 (NCI Thesaurus Property-2)
C25356 (NCI Thesaurus Property-3)
C1301725 (UMLS 2011AA Property-2)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C0242656 (UMLS 2011AA ObjectClass)
C49164 (NCI Thesaurus ObjectClass-2)
C1709926 (UMLS 2011AA ObjectClass-2)
C25589 (NCI Thesaurus Property)
C1518373 (UMLS 2011AA Property)
C16831 (NCI Thesaurus Property-2)
C25356 (NCI Thesaurus Property-3)
C1301725 (UMLS 2011AA Property-2)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C0205269 (UMLS 2011AA ObjectClass)
C4863 (NCI Thesaurus ObjectClass-2)
C0600139 (UMLS 2011AA ObjectClass-2)
C2315 (NCI Thesaurus ObjectClass-3)
C0019932 (UMLS 2011AA ObjectClass-3)
C17649 (NCI Thesaurus Property)
C0205394 (UMLS 2011AA Property)
C15220 (NCI Thesaurus Property-2)
C0011900 (UMLS 2011AA Property-2)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C0205269 (UMLS 2011AA ObjectClass)
C4863 (NCI Thesaurus ObjectClass-2)
C0600139 (UMLS 2011AA ObjectClass-2)
C2315 (NCI Thesaurus ObjectClass-3)
C0019932 (UMLS 2011AA ObjectClass-3)
C17649 (NCI Thesaurus Property)
C0205394 (UMLS 2011AA Property)
C15220 (NCI Thesaurus Property-2)
C0011900 (UMLS 2011AA Property-2)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C2346576 (UMLS CUI-1)
C25678 (NCI Thesaurus Property)
C17089 (NCI Thesaurus ObjectClass)
C2346576 (UMLS CUI-1)
C25678 (NCI Thesaurus Property)
C0011008 (UMLS CUI-2)
C25367 (NCI Thesaurus ValueDomain-2)
C17089 (NCI Thesaurus ObjectClass)