ID

8298

Beschrijving

RTOG 0825 Phase III GBM Neurocognitive Evaluation Summary Form (CS) Temozolomide and Radiation Therapy With or Without Bevacizumab in Treating Patients With Newly Diagnosed Glioblastoma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=5BE60D36-11E5-00FF-E044-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=5BE60D36-11E5-00FF-E044-0003BA3F9857

Trefwoorden

  1. 18-12-14 18-12-14 - Martin Dugas
  2. 09-01-15 09-01-15 - Martin Dugas
Geüploaded op

9 januari 2015

DOI

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Licentie

Creative Commons BY-NC 3.0 Legacy

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GBM Neurocognitive Evaluation Summary Form (CS) RTOG 0825 Phase III

INSTRUCTIONS: This sheet represents a summary of results for the Hopkins Verbal Learning Test - Revised (HVLT-R) Controlled Oral Word Association (COWA), and Trail Making Test Parts A and B

Header Module
Beschrijving

Header Module

Alias
UMLS CUI-1
C1320722
RTOG Study No.
Beschrijving

Protocol ID RTOG

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C3274381
NCI Thesaurus ObjectClass
C25320
UMLS CUI-2
C1514695
NCI Thesaurus Property
C19778
NCI Thesaurus Property-2
C25364
Case #
Beschrijving

RadiationTherapyOncologyGroupPatientCaseIdentifierNumber

Datatype

text

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus ObjectClass-2
C19778
UMLS 2011AA ObjectClass-2
C1514695
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus Property-2
C49152
UMLS 2011AA Property-2
C1706256
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
Institution Name
Beschrijving

Institution Name

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C1301943
NCI Thesaurus ObjectClass
C21541
NCI Thesaurus ValueDomain-2
C21541
NCI Thesaurus Property
C25364
Institution No.
Beschrijving

Institution Number

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C1301943
NCI Thesaurus ObjectClass
C21541
UMLS CUI-2
C0805701
NCI Thesaurus Property
C25364
Patient Initials
Beschrijving

Patient Initials

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C2986440
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25536
RTOG Patient ID
Beschrijving

Trial subject ID RTOG

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C2348585
NCI Thesaurus ObjectClass
C16960
UMLS CUI-2
C1514695
NCI Thesaurus Property
C19778
NCI Thesaurus Property-2
C25364
Amended Data
Beschrijving

Data amended

Datatype

boolean

Alias
NCI Thesaurus ValueDomain
C38148
UMLS CUI-1
C0680532
NCI Thesaurus ObjectClass
C25474
NCI Thesaurus Property
C25416
Time point of this assessment
Beschrijving

AssessmentPeriodType

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus Property
C25616
UMLS 2011AA Property
C1948053
Date of evaluation (MM DD YYYY)
Beschrijving

Assessment Date

Datatype

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS CUI-1
C2985720
NCI Thesaurus ObjectClass
C25367
NCI Thesaurus ValueDomain-2
C25367
NCI Thesaurus Property
C38000
Hopkins Verbal Learning Test - Revised Administration
Beschrijving

Hopkins Verbal Learning Test - Revised Administration

HVLT-R reason not completed
Beschrijving

NeurologicCognitiveAssessmentLearningNegationCompleteStatus

Datatype

text

Alias
NCI Thesaurus ObjectClass
C25217
UMLS 2011AA ObjectClass
C1516048
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus ObjectClass-3
C37926
UMLS 2011AA ObjectClass-3
C1516691
NCI Thesaurus Property
C25250
UMLS 2011AA Property
C0205197
NCI Thesaurus Property-2
C25594
UMLS 2011AA Property-2
C1518422
NCI Thesaurus Property-3
C19369
UMLS 2011AA Property-3
C0023185
NCI Thesaurus ValueDomain
C25688
UMLS 2011AA ValueDomain
C0449438
Not tested, other reason specify
Beschrijving

NeurologicCognitiveAssessmentLearningNegationCompleteSpecify

Datatype

text

Alias
NCI Thesaurus ObjectClass
C25217
UMLS 2011AA ObjectClass
C1516048
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus ObjectClass-3
C37926
UMLS 2011AA ObjectClass-3
C1516691
NCI Thesaurus Property
C25250
UMLS 2011AA Property
C0205197
NCI Thesaurus Property-2
C25594
UMLS 2011AA Property-2
C1518422
NCI Thesaurus Property-3
C19369
UMLS 2011AA Property-3
C0023185
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
Discontinued, other reason specify
Beschrijving

NeurologicCognitiveAssessmentLearningDiscontinueSpecify

Datatype

text

Alias
NCI Thesaurus ObjectClass
C25217
UMLS 2011AA ObjectClass
C1516048
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus ObjectClass-3
C37926
UMLS 2011AA ObjectClass-3
C1516691
NCI Thesaurus Property
C25484
UMLS 2011AA Property
C1444662
NCI Thesaurus Property-2
C19369
UMLS 2011AA Property-2
C0023185
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
Free Recall (Trial #3)
Beschrijving

NeurologicCognitiveAssessmentLearningCompleteRecallValue

Datatype

float

Alias
NCI Thesaurus ObjectClass
C25217
UMLS 2011AA ObjectClass
C1516048
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus ObjectClass-3
C37926
UMLS 2011AA ObjectClass-3
C1516691
NCI Thesaurus Property
C25250
UMLS 2011AA Property
C0205197
NCI Thesaurus Property-2
C19369
UMLS 2011AA Property-2
C0023185
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
Free Recall (Trial #3)
Beschrijving

NeurologicCognitiveAssessmentLearningCompleteRecallValue

Datatype

float

Alias
NCI Thesaurus ObjectClass
C25217
UMLS 2011AA ObjectClass
C1516048
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus ObjectClass-3
C37926
UMLS 2011AA ObjectClass-3
C1516691
NCI Thesaurus Property
C25250
UMLS 2011AA Property
C0205197
NCI Thesaurus Property-2
C19369
UMLS 2011AA Property-2
C0023185
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
Free Recall (Trial #3)
Beschrijving

NeurologicCognitiveAssessmentLearningCompleteRecallValue

Datatype

float

Alias
NCI Thesaurus ObjectClass
C25217
UMLS 2011AA ObjectClass
C1516048
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus ObjectClass-3
C37926
UMLS 2011AA ObjectClass-3
C1516691
NCI Thesaurus Property
C25250
UMLS 2011AA Property
C0205197
NCI Thesaurus Property-2
C19369
UMLS 2011AA Property-2
C0023185
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
Free Recall Total Score
Beschrijving

NeurologicCognitiveAssessmentLearningCompleteRecallTotalValue

Datatype

float

Alias
NCI Thesaurus ObjectClass
C25217
UMLS 2011AA ObjectClass
C1516048
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus ObjectClass-3
C37926
UMLS 2011AA ObjectClass-3
C1516691
NCI Thesaurus Property
C25250
UMLS 2011AA Property
C0205197
NCI Thesaurus Property-2
C19369
UMLS 2011AA Property-2
C0023185
NCI Thesaurus ValueDomain
C25304
UMLS 2011AA ValueDomain
C0439810
NCI Thesaurus ValueDomain-2
C25712
UMLS 2011AA ValueDomain-2
C1522609
Free Recall Stop Time
Beschrijving

NeurologicCognitiveAssessmentLearningCompleteFreeRecallStopTime

Datatype

time

Alias
NCI Thesaurus ObjectClass
C25217
UMLS 2011AA ObjectClass
C1516048
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus ObjectClass-3
C37926
UMLS 2011AA ObjectClass-3
C1516691
NCI Thesaurus Property
C25250
UMLS 2011AA Property
C0205197
NCI Thesaurus Property-2
C19369
UMLS 2011AA Property-2
C0023185
NCI Thesaurus ValueDomain
C25207
UMLS 2011AA ValueDomain
C0040223
NCI Thesaurus ValueDomain-2
C65125
UMLS 2011AA ValueDomain-2
C1947925
Delayed Recall Start Time
Beschrijving

NeurologicCognitiveAssessmentLearningCompleteDelayedRecallBeginTime

Datatype

time

Alias
NCI Thesaurus ObjectClass
C25217
UMLS 2011AA ObjectClass
C1516048
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus ObjectClass-3
C37926
UMLS 2011AA ObjectClass-3
C1516691
NCI Thesaurus Property
C25250
UMLS 2011AA Property
C0205197
NCI Thesaurus Property-2
C19369
UMLS 2011AA Property-2
C0023185
NCI Thesaurus ValueDomain
C25431
UMLS 2011AA ValueDomain
C0439659
NCI Thesaurus ValueDomain-2
C25207
UMLS 2011AA ValueDomain-2
C0040223
Delayed Recall Total Score
Beschrijving

NeurologicCognitiveAssessmentLearningCompleteDelayedRecallTotalValue

Datatype

float

Alias
NCI Thesaurus ObjectClass
C25217
UMLS 2011AA ObjectClass
C1516048
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus ObjectClass-3
C37926
UMLS 2011AA ObjectClass-3
C1516691
NCI Thesaurus Property
C25250
UMLS 2011AA Property
C0205197
NCI Thesaurus Property-2
C19369
UMLS 2011AA Property-2
C0023185
NCI Thesaurus ValueDomain
C25304
UMLS 2011AA ValueDomain
C0439810
NCI Thesaurus ValueDomain-2
C25712
UMLS 2011AA ValueDomain-2
C1522609
Delayed Recognition Total Score
Beschrijving

NeurologicCognitiveAssessmentLearningCompleteDelayedRecognitionTotalValue

Datatype

text

Alias
NCI Thesaurus ObjectClass
C25217
UMLS 2011AA ObjectClass
C1516048
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus ObjectClass-3
C37926
UMLS 2011AA ObjectClass-3
C1516691
NCI Thesaurus Property
C25250
UMLS 2011AA Property
C0205197
NCI Thesaurus Property-2
C19369
UMLS 2011AA Property-2
C0023185
NCI Thesaurus ValueDomain
C25304
UMLS 2011AA ValueDomain
C0439810
NCI Thesaurus ValueDomain-2
C25712
UMLS 2011AA ValueDomain-2
C1522609
Trail Making Test Part A
Beschrijving

Trail Making Test Part A

Sample A completed
Beschrijving

NeurologicCognitiveAssessmentNumberExampleCompleteInd-2

Datatype

boolean

Alias
NCI Thesaurus ObjectClass
C25217
UMLS 2011AA ObjectClass
C1516048
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus ObjectClass-3
C37926
UMLS 2011AA ObjectClass-3
C1516691
NCI Thesaurus Property
C25337
UMLS 2011AA Property
C0237753
NCI Thesaurus Property-2
C25250
UMLS 2011AA Property-2
C0205197
NCI Thesaurus Property-3
C48175
UMLS 2011AA Property-3
C1707959
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
Trail Making Test A reason not complete
Beschrijving

NeurologicCognitiveAssessmentNumberNegationCompleteStatus

Datatype

text

Alias
NCI Thesaurus ObjectClass
C25217
UMLS 2011AA ObjectClass
C1516048
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus ObjectClass-3
C37926
UMLS 2011AA ObjectClass-3
C1516691
NCI Thesaurus Property
C25337
UMLS 2011AA Property
C0237753
NCI Thesaurus Property-2
C25250
UMLS 2011AA Property-2
C0205197
NCI Thesaurus Property-3
C25594
UMLS 2011AA Property-3
C1518422
NCI Thesaurus ValueDomain
C25688
UMLS 2011AA ValueDomain
C0449438
Not tested, other reason specify
Beschrijving

NeurologicCognitiveAssessmentNumberNegationCompleteSpecify

Datatype

text

Alias
NCI Thesaurus ObjectClass
C25217
UMLS 2011AA ObjectClass
C1516048
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus ObjectClass-3
C37926
UMLS 2011AA ObjectClass-3
C1516691
NCI Thesaurus Property
C25337
UMLS 2011AA Property
C0237753
NCI Thesaurus Property-2
C25250
UMLS 2011AA Property-2
C0205197
NCI Thesaurus Property-3
C25594
UMLS 2011AA Property-3
C1518422
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
Discontinued, other reason specify
Beschrijving

NeurologicCognitiveAssessmentNumberDiscontinueSpecify

Datatype

text

Alias
NCI Thesaurus ObjectClass
C25217
UMLS 2011AA ObjectClass
C1516048
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus ObjectClass-3
C37926
UMLS 2011AA ObjectClass-3
C1516691
NCI Thesaurus Property
C25337
UMLS 2011AA Property
C0237753
NCI Thesaurus Property-2
C25484
UMLS 2011AA Property-2
C1444662
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
Total time to completion (Part A)
Beschrijving

NeurologicCognitiveAssessmentNumberCompleteTotalTime

Datatype

time

Alias
NCI Thesaurus ObjectClass
C25217
UMLS 2011AA ObjectClass
C1516048
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus ObjectClass-3
C37926
UMLS 2011AA ObjectClass-3
C1516691
NCI Thesaurus Property
C25337
UMLS 2011AA Property
C0237753
NCI Thesaurus Property-2
C25250
UMLS 2011AA Property-2
C0205197
NCI Thesaurus ValueDomain
C25304
UMLS 2011AA ValueDomain
C0439810
NCI Thesaurus ValueDomain-2
C25207
UMLS 2011AA ValueDomain-2
C0040223
Trail Making Test Part A
Beschrijving

Trail Making Test Part A

Sample B completed
Beschrijving

NeurologicCognitiveAssessmentNumberExampleSecondCompleteInd-2

Datatype

boolean

Alias
NCI Thesaurus ObjectClass
C25217
UMLS 2011AA ObjectClass
C1516048
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus ObjectClass-3
C37926
UMLS 2011AA ObjectClass-3
C1516691
NCI Thesaurus Property
C25337
UMLS 2011AA Property
C0237753
NCI Thesaurus Property-2
C25250
UMLS 2011AA Property-2
C0205197
NCI Thesaurus Property-3
C25666
UMLS 2011AA Property-3
C0205436
NCI Thesaurus Property-4
C48175
UMLS 2011AA Property-4
C1707959
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
Trail Making Test B reason not completed
Beschrijving

NeurologicCognitiveAssessmentNumberNegationSecondCompleteStatus

Datatype

text

Alias
NCI Thesaurus ObjectClass
C25217
UMLS 2011AA ObjectClass
C1516048
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus ObjectClass-3
C37926
UMLS 2011AA ObjectClass-3
C1516691
NCI Thesaurus Property
C25337
UMLS 2011AA Property
C0237753
NCI Thesaurus Property-2
C25250
UMLS 2011AA Property-2
C0205197
NCI Thesaurus Property-3
C25594
UMLS 2011AA Property-3
C1518422
NCI Thesaurus Property-4
C25666
UMLS 2011AA Property-4
C0205436
NCI Thesaurus ValueDomain
C25688
UMLS 2011AA ValueDomain
C0449438
Not tested, other reason specify
Beschrijving

NeurologicCognitiveAssessmentNumberNegationSecondCompleteSpecify

Datatype

text

Alias
NCI Thesaurus ObjectClass
C25217
UMLS 2011AA ObjectClass
C1516048
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus ObjectClass-3
C37926
UMLS 2011AA ObjectClass-3
C1516691
NCI Thesaurus Property
C25337
UMLS 2011AA Property
C0237753
NCI Thesaurus Property-2
C25250
UMLS 2011AA Property-2
C0205197
NCI Thesaurus Property-3
C25594
UMLS 2011AA Property-3
C1518422
NCI Thesaurus Property-4
C25666
UMLS 2011AA Property-4
C0205436
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
Discontinued, other reason specify
Beschrijving

NeurologicCognitiveAssessmentNumberSecondDiscontinuedSpecify

Datatype

text

Alias
NCI Thesaurus ObjectClass
C25217
UMLS 2011AA ObjectClass
C1516048
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus ObjectClass-3
C37926
UMLS 2011AA ObjectClass-3
C1516691
NCI Thesaurus Property
C25337
UMLS 2011AA Property
C0237753
NCI Thesaurus Property-2
C25666
UMLS 2011AA Property-2
C0205436
NCI Thesaurus Property-3
C25484
UMLS 2011AA Property-3
C1444662
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
Total time to completion (Part A)
Beschrijving

NeurologicCognitiveAssessmentNumberCompleteTotalTime

Datatype

time

Alias
NCI Thesaurus ObjectClass
C25217
UMLS 2011AA ObjectClass
C1516048
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus ObjectClass-3
C37926
UMLS 2011AA ObjectClass-3
C1516691
NCI Thesaurus Property
C25337
UMLS 2011AA Property
C0237753
NCI Thesaurus Property-2
C25250
UMLS 2011AA Property-2
C0205197
NCI Thesaurus ValueDomain
C25304
UMLS 2011AA ValueDomain
C0439810
NCI Thesaurus ValueDomain-2
C25207
UMLS 2011AA ValueDomain-2
C0040223
Contolled Oral Word Association (cowa)
Beschrijving

Contolled Oral Word Association (cowa)

COWA reason not completed
Beschrijving

NeurologicCognitiveAssessmentWordRelationshipNegationCompleteStatus

Datatype

text

Alias
NCI Thesaurus ObjectClass
C25217
UMLS 2011AA ObjectClass
C1516048
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus ObjectClass-3
C37926
UMLS 2011AA ObjectClass-3
C1516691
NCI Thesaurus Property
C25250
UMLS 2011AA Property
C0205197
NCI Thesaurus Property-2
C25648
UMLS 2011AA Property-2
C0439849
NCI Thesaurus Property-3
C25594
UMLS 2011AA Property-3
C1518422
NCI Thesaurus ValueDomain
C25688
UMLS 2011AA ValueDomain
C0449438
Not tested, other reason specify
Beschrijving

NeurologicCognitiveAssessmentWordRelationshipNegationCompleteSpecify

Datatype

text

Alias
NCI Thesaurus ObjectClass
C25217
UMLS 2011AA ObjectClass
C1516048
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus ObjectClass-3
C37926
UMLS 2011AA ObjectClass-3
C1516691
NCI Thesaurus Property
C25250
UMLS 2011AA Property
C0205197
NCI Thesaurus Property-2
C25648
UMLS 2011AA Property-2
C0439849
NCI Thesaurus Property-3
C25594
UMLS 2011AA Property-3
C1518422
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
Discontinued, other reason specify
Beschrijving

NeurologicCognitiveAssessmentWordRelationshipDiscontinueSpecify

Datatype

text

Alias
NCI Thesaurus ObjectClass
C25217
UMLS 2011AA ObjectClass
C1516048
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus ObjectClass-3
C37926
UMLS 2011AA ObjectClass-3
C1516691
NCI Thesaurus Property
C25648
UMLS 2011AA Property
C0439849
NCI Thesaurus Property-2
C25484
UMLS 2011AA Property-2
C1444662
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
First letter column (COWA Results)
Beschrijving

NeurologicCognitiveAssessmentWordRelationshipFirstColumnCompleteTotalCount

Datatype

float

Alias
NCI Thesaurus ObjectClass
C25217
UMLS 2011AA ObjectClass
C1516048
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus ObjectClass-3
C37926
UMLS 2011AA ObjectClass-3
C1516691
NCI Thesaurus Property
C25250
UMLS 2011AA Property
C0205197
NCI Thesaurus Property-2
C25648
UMLS 2011AA Property-2
C0439849
NCI Thesaurus Property-3
C25509
UMLS 2011AA Property-3
C1279901
NCI Thesaurus Property-4
C43379
UMLS 2011AA Property-4
C1706132
NCI Thesaurus ValueDomain
C25304
UMLS 2011AA ValueDomain
C0439810
NCI Thesaurus ValueDomain-2
C25463
UMLS 2011AA ValueDomain-2
C0750480
Second letter column (COWA Results)
Beschrijving

NeurologicCognitiveAssessmentWordRelationshipSecondColumnCompleteTotalCount

Datatype

float

Alias
NCI Thesaurus ObjectClass
C25217
UMLS 2011AA ObjectClass
C1516048
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus ObjectClass-3
C37926
UMLS 2011AA ObjectClass-3
C1516691
NCI Thesaurus Property
C25250
UMLS 2011AA Property
C0205197
NCI Thesaurus Property-2
C25648
UMLS 2011AA Property-2
C0439849
NCI Thesaurus Property-3
C25666
UMLS 2011AA Property-3
C0205436
NCI Thesaurus Property-4
C45559
UMLS 2011AA Property-4
C1705313
NCI Thesaurus Property-5
C43379
UMLS 2011AA Property-5
C1706132
NCI Thesaurus ValueDomain
C25304
UMLS 2011AA ValueDomain
C0439810
NCI Thesaurus ValueDomain-2
C25463
UMLS 2011AA ValueDomain-2
C0750480
Third letter column (COWA Results)
Beschrijving

NeurologicCognitiveAssessmentWordRelationshipThirdColumnCompleteTotalCount

Datatype

float

Alias
NCI Thesaurus ObjectClass
C25217
UMLS 2011AA ObjectClass
C1516048
NCI Thesaurus ObjectClass-2
C25262
UMLS 2011AA ObjectClass-2
C0205494
NCI Thesaurus ObjectClass-3
C37926
UMLS 2011AA ObjectClass-3
C1516691
NCI Thesaurus Property
C25250
UMLS 2011AA Property
C0205197
NCI Thesaurus Property-2
C25648
UMLS 2011AA Property-2
C0439849
NCI Thesaurus Property-3
C25260
UMLS 2011AA Property-3
C0205437
NCI Thesaurus Property-4
C45559
UMLS 2011AA Property-4
C1705313
NCI Thesaurus Property-5
C43379
UMLS 2011AA Property-5
C1706132
NCI Thesaurus ValueDomain
C25304
UMLS 2011AA ValueDomain
C0439810
NCI Thesaurus ValueDomain-2
C25463
UMLS 2011AA ValueDomain-2
C0750480
Footer
Beschrijving

Footer

Comments
Beschrijving

Research Comments

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS CUI-1
C0947611
NCI Thesaurus ObjectClass
C15319
NCI Thesaurus Property
C25393
Signature of Person Completing This Form
Beschrijving

Responsible Person Signature

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS CUI-1
C1550483
NCI Thesaurus ObjectClass
C25190
NCI Thesaurus ObjectClass-2
C25657
NCI Thesaurus Property
C25678
Date Form Originally Completed
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

Similar models

INSTRUCTIONS: This sheet represents a summary of results for the Hopkins Verbal Learning Test - Revised (HVLT-R) Controlled Oral Word Association (COWA), and Trail Making Test Parts A and B

Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
Header Module
C1320722 (UMLS CUI-1)
Protocol ID RTOG
Item
RTOG Study No.
text
C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1514695 (UMLS CUI-2)
C19778 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
RadiationTherapyOncologyGroupPatientCaseIdentifierNumber
Item
Case #
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C19778 (NCI Thesaurus ObjectClass-2)
C1514695 (UMLS 2011AA ObjectClass-2)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C49152 (NCI Thesaurus Property-2)
C1706256 (UMLS 2011AA Property-2)
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
Institution Name
Item
Institution Name
text
C25191 (NCI Thesaurus ValueDomain)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C21541 (NCI Thesaurus ValueDomain-2)
C25364 (NCI Thesaurus Property)
Institution Number
Item
Institution No.
text
C25337 (NCI Thesaurus ValueDomain)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C0805701 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
Patient Initials
Item
Patient Initials
text
C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
Trial subject ID RTOG
Item
RTOG Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1514695 (UMLS CUI-2)
C19778 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
Data amended
Item
Amended Data
boolean
C38148 (NCI Thesaurus ValueDomain)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
Item
Time point of this assessment
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25616 (NCI Thesaurus Property)
C1948053 (UMLS 2011AA Property)
Code List
Time point of this assessment
CL Item
Registration (Registration)
C25646 (NCI Thesaurus)
C1514821 (UMLS 2011AA)
CL Item
Week 6 (week 6)
CL Item
Week 10 (Week 10)
CL Item
Week 22 (Week 22)
CL Item
Week 34 (Week 34)
CL Item
Week 46 (Week 46)
CL Item
Week 62 (Week 62)
CL Item
Other Followup (Other follow-ups)
Assessment Date
Item
Date of evaluation (MM DD YYYY)
date
C25164 (NCI Thesaurus ValueDomain)
C2985720 (UMLS CUI-1)
C25367 (NCI Thesaurus ObjectClass)
C25367 (NCI Thesaurus ValueDomain-2)
C38000 (NCI Thesaurus Property)
Item Group
Hopkins Verbal Learning Test - Revised Administration
Item
HVLT-R reason not completed
text
C25217 (NCI Thesaurus ObjectClass)
C1516048 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C37926 (NCI Thesaurus ObjectClass-3)
C1516691 (UMLS 2011AA ObjectClass-3)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C25594 (NCI Thesaurus Property-2)
C1518422 (UMLS 2011AA Property-2)
C19369 (NCI Thesaurus Property-3)
C0023185 (UMLS 2011AA Property-3)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
Code List
HVLT-R reason not completed
CL Item
Discontinue Due To Disability (Discontinued due to disability)
CL Item
Discontinue, Other Reason (Discontinued, other reason)
CL Item
Not Applicable (Not Applicable)
C48660 (NCI Thesaurus)
C1272460 (UMLS 2011AA)
CL Item
Not Tested Due To Disability (Not tested due to disability)
CL Item
Not Tested, Other Reason (Not tested, other reason)
CL Item
Reason Unknown (Reason unknown)
NeurologicCognitiveAssessmentLearningNegationCompleteSpecify
Item
Not tested, other reason specify
text
C25217 (NCI Thesaurus ObjectClass)
C1516048 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C37926 (NCI Thesaurus ObjectClass-3)
C1516691 (UMLS 2011AA ObjectClass-3)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C25594 (NCI Thesaurus Property-2)
C1518422 (UMLS 2011AA Property-2)
C19369 (NCI Thesaurus Property-3)
C0023185 (UMLS 2011AA Property-3)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
NeurologicCognitiveAssessmentLearningDiscontinueSpecify
Item
Discontinued, other reason specify
text
C25217 (NCI Thesaurus ObjectClass)
C1516048 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C37926 (NCI Thesaurus ObjectClass-3)
C1516691 (UMLS 2011AA ObjectClass-3)
C25484 (NCI Thesaurus Property)
C1444662 (UMLS 2011AA Property)
C19369 (NCI Thesaurus Property-2)
C0023185 (UMLS 2011AA Property-2)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
NeurologicCognitiveAssessmentLearningCompleteRecallValue
Item
Free Recall (Trial #3)
float
C25217 (NCI Thesaurus ObjectClass)
C1516048 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C37926 (NCI Thesaurus ObjectClass-3)
C1516691 (UMLS 2011AA ObjectClass-3)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C19369 (NCI Thesaurus Property-2)
C0023185 (UMLS 2011AA Property-2)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
NeurologicCognitiveAssessmentLearningCompleteRecallValue
Item
Free Recall (Trial #3)
float
C25217 (NCI Thesaurus ObjectClass)
C1516048 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C37926 (NCI Thesaurus ObjectClass-3)
C1516691 (UMLS 2011AA ObjectClass-3)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C19369 (NCI Thesaurus Property-2)
C0023185 (UMLS 2011AA Property-2)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
NeurologicCognitiveAssessmentLearningCompleteRecallValue
Item
Free Recall (Trial #3)
float
C25217 (NCI Thesaurus ObjectClass)
C1516048 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C37926 (NCI Thesaurus ObjectClass-3)
C1516691 (UMLS 2011AA ObjectClass-3)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C19369 (NCI Thesaurus Property-2)
C0023185 (UMLS 2011AA Property-2)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
NeurologicCognitiveAssessmentLearningCompleteRecallTotalValue
Item
Free Recall Total Score
float
C25217 (NCI Thesaurus ObjectClass)
C1516048 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C37926 (NCI Thesaurus ObjectClass-3)
C1516691 (UMLS 2011AA ObjectClass-3)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C19369 (NCI Thesaurus Property-2)
C0023185 (UMLS 2011AA Property-2)
C25304 (NCI Thesaurus ValueDomain)
C0439810 (UMLS 2011AA ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)
C1522609 (UMLS 2011AA ValueDomain-2)
NeurologicCognitiveAssessmentLearningCompleteFreeRecallStopTime
Item
Free Recall Stop Time
time
C25217 (NCI Thesaurus ObjectClass)
C1516048 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C37926 (NCI Thesaurus ObjectClass-3)
C1516691 (UMLS 2011AA ObjectClass-3)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C19369 (NCI Thesaurus Property-2)
C0023185 (UMLS 2011AA Property-2)
C25207 (NCI Thesaurus ValueDomain)
C0040223 (UMLS 2011AA ValueDomain)
C65125 (NCI Thesaurus ValueDomain-2)
C1947925 (UMLS 2011AA ValueDomain-2)
NeurologicCognitiveAssessmentLearningCompleteDelayedRecallBeginTime
Item
Delayed Recall Start Time
time
C25217 (NCI Thesaurus ObjectClass)
C1516048 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C37926 (NCI Thesaurus ObjectClass-3)
C1516691 (UMLS 2011AA ObjectClass-3)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C19369 (NCI Thesaurus Property-2)
C0023185 (UMLS 2011AA Property-2)
C25431 (NCI Thesaurus ValueDomain)
C0439659 (UMLS 2011AA ValueDomain)
C25207 (NCI Thesaurus ValueDomain-2)
C0040223 (UMLS 2011AA ValueDomain-2)
NeurologicCognitiveAssessmentLearningCompleteDelayedRecallTotalValue
Item
Delayed Recall Total Score
float
C25217 (NCI Thesaurus ObjectClass)
C1516048 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C37926 (NCI Thesaurus ObjectClass-3)
C1516691 (UMLS 2011AA ObjectClass-3)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C19369 (NCI Thesaurus Property-2)
C0023185 (UMLS 2011AA Property-2)
C25304 (NCI Thesaurus ValueDomain)
C0439810 (UMLS 2011AA ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)
C1522609 (UMLS 2011AA ValueDomain-2)
NeurologicCognitiveAssessmentLearningCompleteDelayedRecognitionTotalValue
Item
Delayed Recognition Total Score
text
C25217 (NCI Thesaurus ObjectClass)
C1516048 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C37926 (NCI Thesaurus ObjectClass-3)
C1516691 (UMLS 2011AA ObjectClass-3)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C19369 (NCI Thesaurus Property-2)
C0023185 (UMLS 2011AA Property-2)
C25304 (NCI Thesaurus ValueDomain)
C0439810 (UMLS 2011AA ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)
C1522609 (UMLS 2011AA ValueDomain-2)
Item Group
Trail Making Test Part A
NeurologicCognitiveAssessmentNumberExampleCompleteInd-2
Item
Sample A completed
boolean
C25217 (NCI Thesaurus ObjectClass)
C1516048 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C37926 (NCI Thesaurus ObjectClass-3)
C1516691 (UMLS 2011AA ObjectClass-3)
C25337 (NCI Thesaurus Property)
C0237753 (UMLS 2011AA Property)
C25250 (NCI Thesaurus Property-2)
C0205197 (UMLS 2011AA Property-2)
C48175 (NCI Thesaurus Property-3)
C1707959 (UMLS 2011AA Property-3)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
Item
Trail Making Test A reason not complete
text
C25217 (NCI Thesaurus ObjectClass)
C1516048 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C37926 (NCI Thesaurus ObjectClass-3)
C1516691 (UMLS 2011AA ObjectClass-3)
C25337 (NCI Thesaurus Property)
C0237753 (UMLS 2011AA Property)
C25250 (NCI Thesaurus Property-2)
C0205197 (UMLS 2011AA Property-2)
C25594 (NCI Thesaurus Property-3)
C1518422 (UMLS 2011AA Property-3)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
Code List
Trail Making Test A reason not complete
CL Item
Discontinue Due To Disability (Discontinued due to disability)
CL Item
Discontinue, Other Reason (Discontinued, other reason)
CL Item
Not Applicable (Not Applicable)
C48660 (NCI Thesaurus)
C1272460 (UMLS 2011AA)
CL Item
Not Tested Due To Disability (Not tested due to disability)
CL Item
Not Tested, Other Reason (Not tested, other reason)
CL Item
Reason Unknown (Reason unknown)
NeurologicCognitiveAssessmentNumberNegationCompleteSpecify
Item
Not tested, other reason specify
text
C25217 (NCI Thesaurus ObjectClass)
C1516048 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C37926 (NCI Thesaurus ObjectClass-3)
C1516691 (UMLS 2011AA ObjectClass-3)
C25337 (NCI Thesaurus Property)
C0237753 (UMLS 2011AA Property)
C25250 (NCI Thesaurus Property-2)
C0205197 (UMLS 2011AA Property-2)
C25594 (NCI Thesaurus Property-3)
C1518422 (UMLS 2011AA Property-3)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
NeurologicCognitiveAssessmentNumberDiscontinueSpecify
Item
Discontinued, other reason specify
text
C25217 (NCI Thesaurus ObjectClass)
C1516048 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C37926 (NCI Thesaurus ObjectClass-3)
C1516691 (UMLS 2011AA ObjectClass-3)
C25337 (NCI Thesaurus Property)
C0237753 (UMLS 2011AA Property)
C25484 (NCI Thesaurus Property-2)
C1444662 (UMLS 2011AA Property-2)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
NeurologicCognitiveAssessmentNumberCompleteTotalTime
Item
Total time to completion (Part A)
time
C25217 (NCI Thesaurus ObjectClass)
C1516048 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C37926 (NCI Thesaurus ObjectClass-3)
C1516691 (UMLS 2011AA ObjectClass-3)
C25337 (NCI Thesaurus Property)
C0237753 (UMLS 2011AA Property)
C25250 (NCI Thesaurus Property-2)
C0205197 (UMLS 2011AA Property-2)
C25304 (NCI Thesaurus ValueDomain)
C0439810 (UMLS 2011AA ValueDomain)
C25207 (NCI Thesaurus ValueDomain-2)
C0040223 (UMLS 2011AA ValueDomain-2)
Item Group
Trail Making Test Part A
NeurologicCognitiveAssessmentNumberExampleSecondCompleteInd-2
Item
Sample B completed
boolean
C25217 (NCI Thesaurus ObjectClass)
C1516048 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C37926 (NCI Thesaurus ObjectClass-3)
C1516691 (UMLS 2011AA ObjectClass-3)
C25337 (NCI Thesaurus Property)
C0237753 (UMLS 2011AA Property)
C25250 (NCI Thesaurus Property-2)
C0205197 (UMLS 2011AA Property-2)
C25666 (NCI Thesaurus Property-3)
C0205436 (UMLS 2011AA Property-3)
C48175 (NCI Thesaurus Property-4)
C1707959 (UMLS 2011AA Property-4)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
Item
Trail Making Test B reason not completed
text
C25217 (NCI Thesaurus ObjectClass)
C1516048 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C37926 (NCI Thesaurus ObjectClass-3)
C1516691 (UMLS 2011AA ObjectClass-3)
C25337 (NCI Thesaurus Property)
C0237753 (UMLS 2011AA Property)
C25250 (NCI Thesaurus Property-2)
C0205197 (UMLS 2011AA Property-2)
C25594 (NCI Thesaurus Property-3)
C1518422 (UMLS 2011AA Property-3)
C25666 (NCI Thesaurus Property-4)
C0205436 (UMLS 2011AA Property-4)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
Code List
Trail Making Test B reason not completed
CL Item
Discontinue Due To Disability (Discontinued due to disability)
CL Item
Discontinue, Other Reason (Discontinued, other reason)
CL Item
Not Applicable (Not Applicable)
C48660 (NCI Thesaurus)
C1272460 (UMLS 2011AA)
CL Item
Not Tested Due To Disability (Not tested due to disability)
CL Item
Not Tested, Other Reason (Not tested, other reason)
CL Item
Reason Unknown (Reason unknown)
NeurologicCognitiveAssessmentNumberNegationSecondCompleteSpecify
Item
Not tested, other reason specify
text
C25217 (NCI Thesaurus ObjectClass)
C1516048 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C37926 (NCI Thesaurus ObjectClass-3)
C1516691 (UMLS 2011AA ObjectClass-3)
C25337 (NCI Thesaurus Property)
C0237753 (UMLS 2011AA Property)
C25250 (NCI Thesaurus Property-2)
C0205197 (UMLS 2011AA Property-2)
C25594 (NCI Thesaurus Property-3)
C1518422 (UMLS 2011AA Property-3)
C25666 (NCI Thesaurus Property-4)
C0205436 (UMLS 2011AA Property-4)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
NeurologicCognitiveAssessmentNumberSecondDiscontinuedSpecify
Item
Discontinued, other reason specify
text
C25217 (NCI Thesaurus ObjectClass)
C1516048 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C37926 (NCI Thesaurus ObjectClass-3)
C1516691 (UMLS 2011AA ObjectClass-3)
C25337 (NCI Thesaurus Property)
C0237753 (UMLS 2011AA Property)
C25666 (NCI Thesaurus Property-2)
C0205436 (UMLS 2011AA Property-2)
C25484 (NCI Thesaurus Property-3)
C1444662 (UMLS 2011AA Property-3)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
NeurologicCognitiveAssessmentNumberCompleteTotalTime
Item
Total time to completion (Part A)
time
C25217 (NCI Thesaurus ObjectClass)
C1516048 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C37926 (NCI Thesaurus ObjectClass-3)
C1516691 (UMLS 2011AA ObjectClass-3)
C25337 (NCI Thesaurus Property)
C0237753 (UMLS 2011AA Property)
C25250 (NCI Thesaurus Property-2)
C0205197 (UMLS 2011AA Property-2)
C25304 (NCI Thesaurus ValueDomain)
C0439810 (UMLS 2011AA ValueDomain)
C25207 (NCI Thesaurus ValueDomain-2)
C0040223 (UMLS 2011AA ValueDomain-2)
Item Group
Contolled Oral Word Association (cowa)
Item
COWA reason not completed
text
C25217 (NCI Thesaurus ObjectClass)
C1516048 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C37926 (NCI Thesaurus ObjectClass-3)
C1516691 (UMLS 2011AA ObjectClass-3)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C25648 (NCI Thesaurus Property-2)
C0439849 (UMLS 2011AA Property-2)
C25594 (NCI Thesaurus Property-3)
C1518422 (UMLS 2011AA Property-3)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
Code List
COWA reason not completed
CL Item
Discontinue Due To Disability (Discontinued due to disability)
CL Item
Discontinue, Other Reason (Discontinued, other reason)
CL Item
Not Applicable (Not Applicable)
C48660 (NCI Thesaurus)
C1272460 (UMLS 2011AA)
CL Item
Not Tested Due To Disability (Not tested due to disability)
CL Item
Not Tested, Other Reason (Not tested, other reason)
CL Item
Reason Unknown (Reason unknown)
NeurologicCognitiveAssessmentWordRelationshipNegationCompleteSpecify
Item
Not tested, other reason specify
text
C25217 (NCI Thesaurus ObjectClass)
C1516048 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C37926 (NCI Thesaurus ObjectClass-3)
C1516691 (UMLS 2011AA ObjectClass-3)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C25648 (NCI Thesaurus Property-2)
C0439849 (UMLS 2011AA Property-2)
C25594 (NCI Thesaurus Property-3)
C1518422 (UMLS 2011AA Property-3)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
NeurologicCognitiveAssessmentWordRelationshipDiscontinueSpecify
Item
Discontinued, other reason specify
text
C25217 (NCI Thesaurus ObjectClass)
C1516048 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C37926 (NCI Thesaurus ObjectClass-3)
C1516691 (UMLS 2011AA ObjectClass-3)
C25648 (NCI Thesaurus Property)
C0439849 (UMLS 2011AA Property)
C25484 (NCI Thesaurus Property-2)
C1444662 (UMLS 2011AA Property-2)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
NeurologicCognitiveAssessmentWordRelationshipFirstColumnCompleteTotalCount
Item
First letter column (COWA Results)
float
C25217 (NCI Thesaurus ObjectClass)
C1516048 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C37926 (NCI Thesaurus ObjectClass-3)
C1516691 (UMLS 2011AA ObjectClass-3)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C25648 (NCI Thesaurus Property-2)
C0439849 (UMLS 2011AA Property-2)
C25509 (NCI Thesaurus Property-3)
C1279901 (UMLS 2011AA Property-3)
C43379 (NCI Thesaurus Property-4)
C1706132 (UMLS 2011AA Property-4)
C25304 (NCI Thesaurus ValueDomain)
C0439810 (UMLS 2011AA ValueDomain)
C25463 (NCI Thesaurus ValueDomain-2)
C0750480 (UMLS 2011AA ValueDomain-2)
NeurologicCognitiveAssessmentWordRelationshipSecondColumnCompleteTotalCount
Item
Second letter column (COWA Results)
float
C25217 (NCI Thesaurus ObjectClass)
C1516048 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C37926 (NCI Thesaurus ObjectClass-3)
C1516691 (UMLS 2011AA ObjectClass-3)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C25648 (NCI Thesaurus Property-2)
C0439849 (UMLS 2011AA Property-2)
C25666 (NCI Thesaurus Property-3)
C0205436 (UMLS 2011AA Property-3)
C45559 (NCI Thesaurus Property-4)
C1705313 (UMLS 2011AA Property-4)
C43379 (NCI Thesaurus Property-5)
C1706132 (UMLS 2011AA Property-5)
C25304 (NCI Thesaurus ValueDomain)
C0439810 (UMLS 2011AA ValueDomain)
C25463 (NCI Thesaurus ValueDomain-2)
C0750480 (UMLS 2011AA ValueDomain-2)
NeurologicCognitiveAssessmentWordRelationshipThirdColumnCompleteTotalCount
Item
Third letter column (COWA Results)
float
C25217 (NCI Thesaurus ObjectClass)
C1516048 (UMLS 2011AA ObjectClass)
C25262 (NCI Thesaurus ObjectClass-2)
C0205494 (UMLS 2011AA ObjectClass-2)
C37926 (NCI Thesaurus ObjectClass-3)
C1516691 (UMLS 2011AA ObjectClass-3)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C25648 (NCI Thesaurus Property-2)
C0439849 (UMLS 2011AA Property-2)
C25260 (NCI Thesaurus Property-3)
C0205437 (UMLS 2011AA Property-3)
C45559 (NCI Thesaurus Property-4)
C1705313 (UMLS 2011AA Property-4)
C43379 (NCI Thesaurus Property-5)
C1706132 (UMLS 2011AA Property-5)
C25304 (NCI Thesaurus ValueDomain)
C0439810 (UMLS 2011AA ValueDomain)
C25463 (NCI Thesaurus ValueDomain-2)
C0750480 (UMLS 2011AA ValueDomain-2)
Item Group
Footer
Research Comments
Item
Comments
text
C25704 (NCI Thesaurus ValueDomain)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
Responsible Person Signature
Item
Signature of Person Completing This Form
text
C25704 (NCI Thesaurus ValueDomain)
C1550483 (UMLS CUI-1)
C25190 (NCI Thesaurus ObjectClass)
C25657 (NCI Thesaurus ObjectClass-2)
C25678 (NCI Thesaurus Property)
Form Completion Date
Item
Date Form Originally Completed
date
C19464 (NCI Thesaurus ObjectClass)
C1549507 (UMLS CUI-1)
C25250 (NCI Thesaurus Property)
C25604 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)

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