ID
8328
Description
RTOG-1005 T7: Radiation Therapy Oncology Group Phase III Whole Breast Irradiation for Early Stage Breast Cancer Photograph Submission Notification Form Higher-Dose Radiation Therapy or Standard Radiation Therapy in Treating Patients With Early-Stage Breast Cancer That Was Removed by Surgery Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=9E3CC0E2-B278-1265-E040-BB89AD430CE0
Lien
Mots-clés
Versions (2)
- 18/12/2014 18/12/2014 - Martin Dugas
- 09/01/2015 09/01/2015 - Martin Dugas
Téléchargé le
9 janvier 2015
DOI
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Creative Commons BY-NC 3.0 Legacy
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NCT01349322 Quality of Life - RTOG-1005 T7: Radiation Therapy Oncology Group Phase III Whole Breast Irradiation for Early Stage Breast Cancer Photograph Submission Notification Form - 3202750v1.0
This form is completed by the investigator (rater) and submitted at each time point specified by the protocol, whether or not any of the patient assessment items (Q's 6,7,8) are answered
- StudyEvent: RTOG-1005 T7: Radiation Therapy Oncology Group Phase III Whole Breast Irradiation for Early Stage Breast Cancer Photograph Submission Notification Form
Description
Unamed Module 2
Description
PhotographBreastReconstructionSubmissionInd-3
Type de données
boolean
Alias
- NCI Thesaurus ObjectClass
- C86035
- UMLS 2011AA ObjectClass
- C0441468
- NCI Thesaurus Property
- C12971
- UMLS 2011AA Property
- C0006141
- NCI Thesaurus Property-2
- C25694
- UMLS 2011AA Property-2
- C1515022
- NCI Thesaurus Property-3
- C25351
- UMLS 2011AA Property-3
- C0524865
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
Description
AssessmentPeriodType
Type de données
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
Description
PhotographBreastReconstructionTakenDate
Type de données
date
Alias
- NCI Thesaurus ObjectClass
- C86035
- UMLS 2011AA ObjectClass
- C0441468
- NCI Thesaurus Property
- C12971
- UMLS 2011AA Property
- C0006141
- NCI Thesaurus Property-2
- C25351
- UMLS 2011AA Property-2
- C0524865
- NCI Thesaurus Property-3
- C25701
- UMLS 2011AA Property-3
- C1883727
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
Description
PhotographBreastReconstructionSubmissionDate
Type de données
date
Alias
- NCI Thesaurus ObjectClass
- C86035
- UMLS 2011AA ObjectClass
- C0441468
- NCI Thesaurus Property
- C12971
- UMLS 2011AA Property
- C0006141
- NCI Thesaurus Property-2
- C25694
- UMLS 2011AA Property-2
- C1515022
- NCI Thesaurus Property-3
- C25351
- UMLS 2011AA Property-3
- C0524865
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
Description
PhotographBreastReconstructionNoSubmissionReason
Type de données
text
Alias
- NCI Thesaurus ObjectClass
- C86035
- UMLS 2011AA ObjectClass
- C0441468
- NCI Thesaurus Property
- C49487
- UMLS 2011AA Property
- C1298908
- NCI Thesaurus Property-2
- C12971
- UMLS 2011AA Property-2
- C0006141
- NCI Thesaurus Property-3
- C25694
- UMLS 2011AA Property-3
- C1515022
- NCI Thesaurus Property-4
- C25351
- UMLS 2011AA Property-4
- C0524865
- NCI Thesaurus ValueDomain
- C25638
- UMLS 2011AA ValueDomain
- C0392360
Description
PhotographBreastReconstructionNoSubmissionSpecify
Type de données
text
Alias
- NCI Thesaurus ObjectClass
- C86035
- UMLS 2011AA ObjectClass
- C0441468
- NCI Thesaurus Property
- C49487
- UMLS 2011AA Property
- C1298908
- NCI Thesaurus Property-2
- C12971
- UMLS 2011AA Property-2
- C0006141
- NCI Thesaurus Property-3
- C25694
- UMLS 2011AA Property-3
- C1515022
- NCI Thesaurus Property-4
- C25351
- UMLS 2011AA Property-4
- C0524865
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
- NCI Thesaurus ValueDomain-2
- C15368
Description
Responsible Person Signature
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C1550483
- NCI Thesaurus ObjectClass
- C25190
- NCI Thesaurus ObjectClass-2
- C25657
- NCI Thesaurus Property
- C25678
Description
Date Form Completed
Type de données
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C1115437
- NCI Thesaurus ObjectClass
- C40988
- NCI Thesaurus Property
- C25250
- NCI Thesaurus ValueDomain-2
- C25367
Similar models
This form is completed by the investigator (rater) and submitted at each time point specified by the protocol, whether or not any of the patient assessment items (Q's 6,7,8) are answered
- StudyEvent: RTOG-1005 T7: Radiation Therapy Oncology Group Phase III Whole Breast Irradiation for Early Stage Breast Cancer Photograph Submission Notification Form
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1514695 (UMLS CUI-2)
C19778 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
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)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C21541 (NCI Thesaurus ValueDomain-2)
C25364 (NCI Thesaurus Property)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C0805701 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1514695 (UMLS CUI-2)
C19778 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
C0441468 (UMLS 2011AA ObjectClass)
C12971 (NCI Thesaurus Property)
C0006141 (UMLS 2011AA Property)
C25694 (NCI Thesaurus Property-2)
C1515022 (UMLS 2011AA Property-2)
C25351 (NCI Thesaurus Property-3)
C0524865 (UMLS 2011AA Property-3)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25616 (NCI Thesaurus Property)
C1948053 (UMLS 2011AA Property)
C1442488 (UMLS 2011AA)
C0441468 (UMLS 2011AA ObjectClass)
C12971 (NCI Thesaurus Property)
C0006141 (UMLS 2011AA Property)
C25351 (NCI Thesaurus Property-2)
C0524865 (UMLS 2011AA Property-2)
C25701 (NCI Thesaurus Property-3)
C1883727 (UMLS 2011AA Property-3)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C0441468 (UMLS 2011AA ObjectClass)
C12971 (NCI Thesaurus Property)
C0006141 (UMLS 2011AA Property)
C25694 (NCI Thesaurus Property-2)
C1515022 (UMLS 2011AA Property-2)
C25351 (NCI Thesaurus Property-3)
C0524865 (UMLS 2011AA Property-3)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C0441468 (UMLS 2011AA ObjectClass)
C49487 (NCI Thesaurus Property)
C1298908 (UMLS 2011AA Property)
C12971 (NCI Thesaurus Property-2)
C0006141 (UMLS 2011AA Property-2)
C25694 (NCI Thesaurus Property-3)
C1515022 (UMLS 2011AA Property-3)
C25351 (NCI Thesaurus Property-4)
C0524865 (UMLS 2011AA Property-4)
C25638 (NCI Thesaurus ValueDomain)
C0392360 (UMLS 2011AA ValueDomain)
C0441468 (UMLS 2011AA ObjectClass)
C49487 (NCI Thesaurus Property)
C1298908 (UMLS 2011AA Property)
C12971 (NCI Thesaurus Property-2)
C0006141 (UMLS 2011AA Property-2)
C25694 (NCI Thesaurus Property-3)
C1515022 (UMLS 2011AA Property-3)
C25351 (NCI Thesaurus Property-4)
C0524865 (UMLS 2011AA Property-4)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C15368 (NCI Thesaurus ValueDomain-2)
C1550483 (UMLS CUI-1)
C25190 (NCI Thesaurus ObjectClass)
C25657 (NCI Thesaurus ObjectClass-2)
C25678 (NCI Thesaurus Property)
C1115437 (UMLS CUI-1)
C40988 (NCI Thesaurus ObjectClass)
C25250 (NCI Thesaurus Property)
C25367 (NCI Thesaurus ValueDomain-2)