ID
8402
Description
USMCI 8214/Z6091: Crossover Form Standard Therapy With or Without Surgery and Mitomycin C in Treating Patients With Advanced Limited Peritoneal Dissemination of Colon Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=86892E20-76ED-E852-E040-BB89AD43495E
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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Colorectal Cancer NCT01167725 Follow-Up - USMCI 8214/Z6091: Crossover Form - 3086267v1.0
No Instruction available.
- StudyEvent: USMCI 8214/Z6091: Crossover Form
Description
Header
Description
LastDoseDate
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164 (undefined)
- UMLS 2011AA ValueDomain
- C0011008 (Date in time)
- SNOMED
- 410671006
- NCI Thesaurus ObjectClass
- C25488 (undefined)
- UMLS 2011AA ObjectClass
- C0178602 (Dosage)
- SNOMED
- 260911001
- LOINC
- LP7180-5
- NCI Thesaurus ObjectClass-2
- C25551 (undefined)
- UMLS 2011AA ObjectClass-2
- C1517741 (Last)
- LOINC
- LP200101-6
- NCI Thesaurus Property
- C25275 (undefined)
- UMLS 2011AA Property
- C2745955 (Occurrence)
- SNOMED
- 246454002
Description
PatientCrossoverStudyInd-2
Data type
boolean
Alias
- NCI Thesaurus ValueDomain
- C38147 (undefined)
- UMLS 2011AA ValueDomain
- C1512698 (Yes or No Response)
- NCI Thesaurus ObjectClass
- C16960 (undefined)
- UMLS 2011AA ObjectClass
- C0030705 (Patients)
- SNOMED
- 116154003
- NCI Thesaurus Property
- C82637 (undefined)
- UMLS 2011AA Property
- C0150097 (Cross-Over Studies)
Description
DiseaseProgressionDate
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164 (undefined)
- UMLS 2011AA ValueDomain
- C0011008 (Date in time)
- SNOMED
- 410671006
- NCI Thesaurus ValueDomain-2
- C25367 (undefined)
- NCI Thesaurus Property
- C25331 (undefined)
- NCI Thesaurus ObjectClass
- C2991 (undefined)
- UMLS 2011AA ObjectClass
- C0012634 (Disease)
- SNOMED
- 64572001
- LOINC
- LP21006-9
Description
PatientNegationCrossoverStudyReason
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25638 (undefined)
- UMLS 2011AA ValueDomain
- C0392360 (Indication of (contextual qualifier))
- SNOMED
- 230165009
- LOINC
- MTHU008319
- NCI Thesaurus ObjectClass
- C16960 (undefined)
- UMLS 2011AA ObjectClass
- C0030705 (Patients)
- SNOMED
- 116154003
- NCI Thesaurus Property
- C25594 (undefined)
- UMLS 2011AA Property
- C1518422 (Negation)
- LOINC
- LA21291-2
- NCI Thesaurus Property-2
- C82637 (undefined)
- UMLS 2011AA Property-2
- C0150097 (Cross-Over Studies)
Description
PatientNegationCrossoverStudySpecify
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25685 (undefined)
- UMLS 2011AA ValueDomain
- C1521902 (To specify)
- NCI Thesaurus ObjectClass
- C16960 (undefined)
- UMLS 2011AA ObjectClass
- C0030705 (Patients)
- SNOMED
- 116154003
- NCI Thesaurus Property
- C25594 (undefined)
- UMLS 2011AA Property
- C1518422 (Negation)
- LOINC
- LA21291-2
- NCI Thesaurus Property-2
- C82637 (undefined)
- UMLS 2011AA Property-2
- C0150097 (Cross-Over Studies)
Description
Footer Module
Description
Person Completing Form
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25191 (undefined)
- UMLS CUI-1
- C1550483 (data entry person)
- NCI Thesaurus ObjectClass
- C25657 (undefined)
- NCI Thesaurus Property
- C25364 (undefined)
Description
Date Form Completed
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164 (undefined)
- UMLS CUI-1
- C1115437 (Date form completed)
- LOINC
- MTHU014518
- NCI Thesaurus ObjectClass
- C40988 (undefined)
- NCI Thesaurus Property
- C25250 (undefined)
- NCI Thesaurus ValueDomain-2
- C25367 (undefined)
Similar models
No Instruction available.
- StudyEvent: USMCI 8214/Z6091: Crossover Form
C0332307 (UMLS 2011AA ValueDomain)
C25616 (NCI Thesaurus Property)
C1948053 (UMLS 2011AA Property)
C19712 (NCI Thesaurus ObjectClass)
C1515944 (UMLS 2011AA ObjectClass)
C25716 (NCI Thesaurus ObjectClass-2)
C0545082 (UMLS 2011AA ObjectClass-2)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25462 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C0805701 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C21541 (NCI Thesaurus ValueDomain-2)
C25364 (NCI Thesaurus Property)
C0011008 (UMLS 2011AA ValueDomain)
C25488 (NCI Thesaurus ObjectClass)
C0178602 (UMLS 2011AA ObjectClass)
C25551 (NCI Thesaurus ObjectClass-2)
C1517741 (UMLS 2011AA ObjectClass-2)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
C1512698 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C82637 (NCI Thesaurus Property)
C0150097 (UMLS 2011AA Property)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
C25331 (NCI Thesaurus Property)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C0392360 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25594 (NCI Thesaurus Property)
C1518422 (UMLS 2011AA Property)
C82637 (NCI Thesaurus Property-2)
C0150097 (UMLS 2011AA Property-2)
C0205394 (UMLS 2011AA)
C1521902 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25594 (NCI Thesaurus Property)
C1518422 (UMLS 2011AA Property)
C82637 (NCI Thesaurus Property-2)
C0150097 (UMLS 2011AA Property-2)
C1550483 (UMLS CUI-1)
C25657 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)
C1115437 (UMLS CUI-1)
C40988 (NCI Thesaurus ObjectClass)
C25250 (NCI Thesaurus Property)
C25367 (NCI Thesaurus ValueDomain-2)
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