ID

7871

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

Lien

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=F97FF9CE-553B-2533-E034-0003BA3F9857

Mots-clés

Versions (3)
  1. 20/09/2012 20/09/2012 -
  2. 09/01/2015 09/01/2015 - Martin Dugas
  3. 16/06/2015 16/06/2015 -
Téléchargé le

9 janvier 2015

DOI

Pour une demande vous connecter.

Licence

Creative Commons BY-NC 3.0 Legacy
Modèle Commentaires :

Ici, vous pouvez faire des commentaires sur le modèle. À partir des bulles de texte, vous pouvez laisser des commentaires spécifiques sur les groupes Item et les Item.

Retour au modèle Commentaires
Groupe Item commentaires pour :

Item commentaires pour :

Vous devez être connecté pour pouvoir télécharger des formulaires. Veuillez vous connecter ou s’inscrire gratuitement.

Prostate Cancer NCT00309985 Follow-Up - E3805 Hormone Refractory Disease Form - 2234044v1.0

Anglais

No Instruction available.

1 Formulaires  
  1. StudyEvent: E3805 Hormone Refractory Disease Form
    1. No Instruction available.
Header
Description

Header

ECOG Protocol Number
Description

Protocol Number ECOG

Type de données

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
ECOG Patient ID
Description

Patient ID ECOG

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C2348585
NCI Thesaurus ObjectClass
C16960
UMLS CUI-2
C1512162
NCI Thesaurus Property
C25364
NCI Thesaurus Property-2
C25491
DCI Name
Description

Generic drug form

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C3242750
NCI Thesaurus Property
C19464
NCI Thesaurus ObjectClass
C25474
NCI Thesaurus ObjectClass-2
C25452
Registration Step
Description

Registration Number

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C1514821
NCI Thesaurus ObjectClass
C25646
UMLS CUI-2
C0237753
NCI Thesaurus Property
C16154
NCI Thesaurus ValueDomain-2
C16154
Reporting Period (Select one)
Description

Clinical Trial Period

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS CUI-1
C2347804
NCI Thesaurus ObjectClass
C25214
NCI Thesaurus Property
C25616
NCI Thesaurus ObjectClass-2
C25651
Unnamed2
Description

Unnamed2

ECOG Protocol Number
Description

Protocol Number ECOG

Type de données

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
ECOG Patient ID
Description

Patient ID ECOG

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C2348585
NCI Thesaurus ObjectClass
C16960
UMLS CUI-2
C1512162
NCI Thesaurus Property
C25364
NCI Thesaurus Property-2
C25491
Patient Initials
Description

Patient Initials

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C2986440
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25536
Participating Group Protocol Number
Description

Study Number Participating Group

Type de données

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
Institution/Affiliate
Description

Institution Name

Type de données

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
Participating Group Patient ID
Description

Trial subject ID Participating Group

Type de données

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
Unnamed3
Description

Unnamed3

Please mark an 'X' if data have been amended.
Description

Data amended

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS CUI-1
C0680532
NCI Thesaurus ObjectClass
C25474
NCI Thesaurus Property
C25416
Date data amended
Description

Data amended date

Type de données

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
Diagnosis Of Hormone Refractory Disease
Description

Diagnosis Of Hormone Refractory Disease

Increasing PSA level per protocol (Note: Two consecutive increases must be documented with each measurement obtained at least 2 weeks apart)
Description

HormoneRefractoryProstateCarcinomaElevatedProstate-SpecificAntigenDiagnosisInd-2

Type de données

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
Date of first PSA progression
Description

PSAProgressionFirstOccurrenceDate

Type de données

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
Radiographic Progression per RECIST criteria
Description

ResponseEvaluationCriteriainSolidTumorsGroupDiseaseProgressionMedicalImagingDocumentedInd-2

Type de données

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
Date of First Clinical Progression
Description

ClinicalProgressionFirstDate

Type de données

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
Testosterone level at progression (ng/dl)
Description

LaboratoryProcedureTestosteroneDiseaseProgressionOutcomeSpecifiedValue

Type de données

float

Unités de mesure
  • 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
ng/dl
Testosterone level at progression (ng/dl)
Description

LaboratoryProcedureTestosteroneDiseaseProgressionOutcomeSpecifiedValue

Type de données

float

Unités de mesure
  • 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
ng/dl
Mark an 'X' if not assessed
Description

DataUnknownText

Type de données

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
Mark an 'X' if not assessed
Description

DataUnknownText

Type de données

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
New lesions (If yes, Basis of progression per RECIST please answer yes or no for each of the following 1=no, 2=yes)
Description

ResponseEvaluationCriteriainSolidTumorsGroupDiseaseProgressionMedicalImagingNewNeoplasmDocumentedInd-2

Type de données

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
Progression in existing measurable sites
Description

ResponseEvaluationCriteriainSolidTumorsGroupDiseaseProgressionMedicalImagingMeasurableDiseaseDocumentedInd-2

Type de données

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
Progression in existing non-measurable sites (including bone)
Description

ResponseEvaluationCriteriainSolidTumorsGroupDiseaseProgressionMedicalImagingNon-MeasurableDocumentedInd-2

Type de données

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
Other
Description

HormoneRefractoryProstateCarcinomaOtherDiagnosisInd-2

Type de données

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
Other, specify
Description

HormoneRefractoryProstateCarcinomaOtherDiagnosisSpecify

Type de données

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
Comments
Description

Comments

Comments
Description

Research Comments

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS CUI-1
C0947611
NCI Thesaurus ObjectClass
C15319
NCI Thesaurus Property
C25393
Investigator Signature
Description

Investigator Signature

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS CUI-1
C2346576
NCI Thesaurus Property
C25678
NCI Thesaurus ObjectClass
C17089
Investigator Signature Date
Description

Investigator Signature Date

Type de données

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
Retour au début de la page

Similar models

No Instruction available.

1 Formulaires
  1. StudyEvent: E3805 Hormone Refractory Disease Form
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Type de données
Alias
Item Group
Header
Protocol Number ECOG
Item
ECOG Protocol Number
text
C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1512162 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25491 (NCI Thesaurus Property-2)
Patient ID ECOG
Item
ECOG Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1512162 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25491 (NCI Thesaurus Property-2)
Generic drug form
Item
DCI Name
text
C25191 (NCI Thesaurus ValueDomain)
C3242750 (UMLS CUI-1)
C19464 (NCI Thesaurus Property)
C25474 (NCI Thesaurus ObjectClass)
C25452 (NCI Thesaurus ObjectClass-2)
Registration Number
Item
Registration Step
text
C25337 (NCI Thesaurus ValueDomain)
C1514821 (UMLS CUI-1)
C25646 (NCI Thesaurus ObjectClass)
C0237753 (UMLS CUI-2)
C16154 (NCI Thesaurus Property)
C16154 (NCI Thesaurus ValueDomain-2)
Item
Reporting Period (Select one)
text
C25284 (NCI Thesaurus ValueDomain)
C2347804 (UMLS CUI-1)
C25214 (NCI Thesaurus ObjectClass)
C25616 (NCI Thesaurus Property)
C25651 (NCI Thesaurus ObjectClass-2)
CL.1
Code List
Reporting Period (Select one)
CL Item
Hormone Refractory Disease (Hormone refractory disease)
Item Group
Unnamed2
Protocol Number ECOG
Item
ECOG Protocol Number
text
C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1512162 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25491 (NCI Thesaurus Property-2)
Patient ID ECOG
Item
ECOG Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1512162 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25491 (NCI Thesaurus Property-2)
Patient Initials
Item
Patient Initials
text
C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
Study Number Participating Group
Item
Participating Group Protocol Number
text
C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
Institution Name
Item
Institution/Affiliate
text
C25454 (NCI Thesaurus ObjectClass)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C25191 (NCI Thesaurus ValueDomain)
C21541 (NCI Thesaurus ValueDomain-2)
Trial subject ID Participating Group
Item
Participating Group Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
Item Group
Unnamed3
Data amended
Item
Please mark an 'X' if data have been amended.
text
C25704 (NCI Thesaurus ValueDomain)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
Data amended date
Item
Date data amended
date
C25164 (NCI Thesaurus ValueDomain)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C0011008 (UMLS CUI-2)
C25416 (NCI Thesaurus Property)
C25367 (NCI Thesaurus ValueDomain-2)
Item Group
Diagnosis Of Hormone Refractory Disease
HormoneRefractoryProstateCarcinomaElevatedProstate-SpecificAntigenDiagnosisInd-2
Item
Increasing PSA level per protocol (Note: Two consecutive increases must be documented with each measurement obtained at least 2 weeks apart)
boolean
C38014 (NCI Thesaurus ObjectClass)
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)
PSAProgressionFirstOccurrenceDate
Item
Date of first PSA progression
date
C17525 (NCI Thesaurus ObjectClass)
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)
ResponseEvaluationCriteriainSolidTumorsGroupDiseaseProgressionMedicalImagingDocumentedInd-2
Item
Radiographic Progression per RECIST criteria
boolean
C17747 (NCI Thesaurus ObjectClass)
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)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
ClinicalProgressionFirstDate
Item
Date of First Clinical Progression
date
C25398 (NCI Thesaurus ObjectClass)
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)
LaboratoryProcedureTestosteroneDiseaseProgressionOutcomeSpecifiedValue
Item
Testosterone level at progression (ng/dl)
float
C25294 (NCI Thesaurus ObjectClass)
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)
LaboratoryProcedureTestosteroneDiseaseProgressionOutcomeSpecifiedValue
Item
Testosterone level at progression (ng/dl)
float
C25294 (NCI Thesaurus ObjectClass)
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)
DataUnknownText
Item
Mark an 'X' if not assessed
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C25474 (NCI Thesaurus ObjectClass)
C1511726 (UMLS 2011AA ObjectClass)
C17998 (NCI Thesaurus Property)
C0439673 (UMLS 2011AA Property)
DataUnknownText
Item
Mark an 'X' if not assessed
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C25474 (NCI Thesaurus ObjectClass)
C1511726 (UMLS 2011AA ObjectClass)
C17998 (NCI Thesaurus Property)
C0439673 (UMLS 2011AA Property)
ResponseEvaluationCriteriainSolidTumorsGroupDiseaseProgressionMedicalImagingNewNeoplasmDocumentedInd-2
Item
New lesions (If yes, Basis of progression per RECIST please answer yes or no for each of the following 1=no, 2=yes)
boolean
C17747 (NCI Thesaurus ObjectClass)
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)
ResponseEvaluationCriteriainSolidTumorsGroupDiseaseProgressionMedicalImagingMeasurableDiseaseDocumentedInd-2
Item
Progression in existing measurable sites
boolean
C17747 (NCI Thesaurus ObjectClass)
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)
ResponseEvaluationCriteriainSolidTumorsGroupDiseaseProgressionMedicalImagingNon-MeasurableDocumentedInd-2
Item
Progression in existing non-measurable sites (including bone)
boolean
C17747 (NCI Thesaurus ObjectClass)
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)
HormoneRefractoryProstateCarcinomaOtherDiagnosisInd-2
Item
Other
boolean
C38014 (NCI Thesaurus ObjectClass)
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)
HormoneRefractoryProstateCarcinomaOtherDiagnosisSpecify
Item
Other, specify
text
C38014 (NCI Thesaurus ObjectClass)
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)
Item Group
Comments
Research Comments
Item
Comments
text
C25704 (NCI Thesaurus ValueDomain)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
Investigator Signature
Item
Investigator Signature
text
C25704 (NCI Thesaurus ValueDomain)
C2346576 (UMLS CUI-1)
C25678 (NCI Thesaurus Property)
C17089 (NCI Thesaurus ObjectClass)
Investigator Signature Date
Item
Investigator Signature Date
date
C25164 (NCI Thesaurus ValueDomain)
C2346576 (UMLS CUI-1)
C25678 (NCI Thesaurus Property)
C0011008 (UMLS CUI-2)
C25367 (NCI Thesaurus ValueDomain-2)
C17089 (NCI Thesaurus ObjectClass)
Retour au début de la page 

Contact

Utilisez ce formulaire pour les retours, les questions et les améliorations suggérées.

Les champs marqués d’un * sont obligatoires.

Aide

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