ID
8164
Description
NCIC MA.32 Death Report Form A Phase III Randomized Trial of Metformin vs Placebo in Early Stage Breast Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=805B03D5-89D0-F93C-E040-BB89AD433826
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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Breast Cancer NCT01101438 Off Treatment - NCIC MA.32 Death Report Form - 3017307v1.0
The aim of the "Death Report" Folder is to collect death information. The "Death Report" Folder should be completed at the time of death. It should be submitted electronically within 8 weeks of the patient's death.
Description
Autopsy
Description
AutopsyPerformedInd-3
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
- NCI Thesaurus ObjectClass
- C25153
- UMLS 2011AA ObjectClass
- C0004398
- NCI Thesaurus Property
- C38000
- UMLS 2011AA Property
- C0884358
Description
AutopsyFindingPatientDeathReason
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25638
- UMLS 2011AA ValueDomain
- C0392360
- NCI Thesaurus ObjectClass
- C25153
- UMLS 2011AA ObjectClass
- C0004398
- NCI Thesaurus Property
- C3367
- UMLS 2011AA Property
- C0037088
Description
AutopsyFindingSpecify
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
- NCI Thesaurus ObjectClass
- C25153
- UMLS 2011AA ObjectClass
- C0004398
- NCI Thesaurus Property
- C3367
- UMLS 2011AA Property
- C0037088
Description
Adverse Events - Death Report
Description
DiabetesMellitusNewInd-3
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
- NCI Thesaurus Property
- C25586
- UMLS 2011AA Property
- C0205314
- NCI Thesaurus ObjectClass
- C2985
- UMLS 2011AA ObjectClass
- C0011849
- NCI Thesaurus Property-2
- C15220
- UMLS 2011AA Property-2
- C0011900
Description
AdverseEventCommonTerminologyforAdverseEventsVersion4TermName
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C41331
- UMLS 2011AA ObjectClass
- C0877248
- NCI Thesaurus Property
- C49704
- UMLS 2011AA Property
- C1516728
- NCI Thesaurus Property-2
- C45559
- UMLS 2011AA Property-2
- C1705313
- NCI Thesaurus ValueDomain
- C45255
- UMLS 2011AA ValueDomain
- C1708523
- NCI Thesaurus ValueDomain-2
- C49704
- UMLS 2011AA ValueDomain-2
- C1516728
- NCI Thesaurus ValueDomain-3
- C42614
- UMLS 2011AA ValueDomain-3
- C0027365
- NCI Thesaurus ValueDomain-4
- C45559
- UMLS 2011AA ValueDomain-4
- C1705313
- NCI Thesaurus ValueDomain-5
- C25714
- UMLS 2011AA ValueDomain-5
- C0333052
Description
CommonToxicityCriteriaAdverseEventReportingGrade
Data type
float
Alias
- NCI Thesaurus ObjectClass
- C49704
- UMLS 2011AA ObjectClass
- C1516728
- NCI Thesaurus Property
- C25651
- UMLS 2011AA Property
- C0700287
- NCI Thesaurus ValueDomain
- C18000
- UMLS 2011AA ValueDomain
- C0919553
- NCI Thesaurus Property-2
- C25365
- UMLS 2011AA Property-2
- C0678257
Description
CTC Adverse Event Attribution Category
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS CUI-1
- C1706735
- NCI Thesaurus ObjectClass
- C49704
- NCI Thesaurus Property
- C25358
Description
AdverseEventSeriousnessAttributionScale
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS 2011AA ValueDomain
- C0349674
- NCI Thesaurus ObjectClass
- C41331
- UMLS 2011AA ObjectClass
- C0877248
- NCI Thesaurus Property
- C25358
- UMLS 2011AA Property
- C0596130
Description
Cardiovascular Mobidity
Description
CardiacDiseaseAssessmentType
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Thesaurus ObjectClass
- C13306
- UMLS 2011AA ObjectClass
- C1522601
- NCI Thesaurus ObjectClass-2
- C2991
- UMLS 2011AA ObjectClass-2
- C0012634
Description
CardiacDiseaseAssessmentSpecify
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Thesaurus ObjectClass
- C13306
- UMLS 2011AA ObjectClass
- C1522601
- NCI Thesaurus ObjectClass-2
- C2991
- UMLS 2011AA ObjectClass-2
- C0012634
Description
HospitalAdmissionDate
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C16696
- UMLS 2011AA ObjectClass
- C0019994
- NCI Thesaurus Property
- C25385
- UMLS 2011AA Property
- C0809949
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The aim of the "Death Report" Folder is to collect death information. The "Death Report" Folder should be completed at the time of death. It should be submitted electronically within 8 weeks of the patient's death.
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C1516728 (UMLS 2011AA ValueDomain-2)
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C0038454 (UMLS 2011AA-4)
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C1522601 (UMLS 2011AA ObjectClass)
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