ID

8436

Descripción

Pediatric Soft Tissue Sarcoma - On-Study Form Newly Diagnosed Patients Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=E4051BFF-CFA4-2D00-E034-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=E4051BFF-CFA4-2D00-E034-0003BA3F9857

Palabras clave

Versiones (3)
  1. 19/9/12 19/9/12 -
  2. 9/1/15 9/1/15 - Martin Dugas
  3. 9/1/15 9/1/15 - Martin Dugas
Subido en

9 de enero de 2015

DOI

Para solicitar uno, por favor iniciar sesión.

Licencia

Creative Commons BY-NC 3.0 Legacy
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On-Study - Pediatric Soft Tissue Sarcoma - On-Study Form Newly Diagnosed Patients - 2292713v3.0

Inglés

No Instruction available.

1 formularios  
  1. StudyEvent: Pediatric Soft Tissue Sarcoma - On-Study Form Newly Diagnosed Patients
    1. No Instruction available.
Crf Header
Descripción

Crf Header

Coordinating Group Protocol No.
Descripción

Protocol ID Coordinating Group

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C3274381
NCI Thesaurus ObjectClass
C25320
UMLS CUI-2
C1711341
NCI Thesaurus Property
C25462
NCI Thesaurus Property-2
C25364
Coordinating Group Code
Descripción

Coordinating Group Code

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25162
UMLS CUI-1
C1711341
NCI Thesaurus ObjectClass
C17005
UMLS CUI-2
C0805701
NCI Thesaurus ObjectClass-2
C25462
NCI Thesaurus Property
C25364
Protocol Title
Descripción

Protocol Title

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C2986303
NCI Thesaurus ObjectClass
C25320
NCI Thesaurus Property
C42774
Patient Study ID
Descripción

Patient Study ID

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C2348585
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25462
NCI Thesaurus Property-2
C25364
Institution/Affiliate
Descripción

Institution Name

Tipo de datos

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
Other Patient ID
Descripción

Trial subject ID Participating Group

Tipo de datos

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
Participating Group Code
Descripción

ParticipatingGroupIdentifierCode

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25162
UMLS 2011AA ValueDomain
C0805701
NCI Thesaurus ObjectClass
C25608
UMLS 2011AA ObjectClass
C0679823
NCI Thesaurus ObjectClass-2
C17005
UMLS 2011AA ObjectClass-2
C1257890
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Patient Name (initials acceptable)
Descripción

Patient Name

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C1299487
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25364
Sarcoma: Form Administration
Descripción

Sarcoma: Form Administration

Person Completing Form
Descripción

Person Completing Form

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C1550483
NCI Thesaurus ObjectClass
C25657
NCI Thesaurus Property
C25364
Are data amended (If data are amended, please circle in red when using paper form)
Descripción

Data amended

Tipo de datos

boolean

Alias
NCI Thesaurus ValueDomain
C38148
UMLS CUI-1
C0680532
NCI Thesaurus ObjectClass
C25474
NCI Thesaurus Property
C25416
Pediatric Soft Tissue Sarcoma: Disease Description
Descripción

Pediatric Soft Tissue Sarcoma: Disease Description

Date of Initial Pathologic Diagnosis (MM DD YYYY)
Descripción

CancerInitialDiagnosisDate

Tipo de datos

date

Alias
NCI Thesaurus ObjectClass
C9305
UMLS 2011AA ObjectClass
C0006826
NCI Thesaurus Property
C25509
UMLS 2011AA Property
C1279901
NCI Thesaurus Property-2
C15220
UMLS 2011AA Property-2
C0011900
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ValueDomain-2
C25367
Biopsy Type
Descripción

BiopsyProcedure

Tipo de datos

text

Alias
NCI Thesaurus ObjectClass
C15189
UMLS 2011AA ObjectClass
C0005558
NCI Thesaurus Property
C15368
NCI Thesaurus ValueDomain
C25218
UMLS 2011AA ValueDomain
C1948041
Other specify
Descripción

BiopsyDescriptionSpecify

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ObjectClass
C15189
UMLS 2011AA ObjectClass
C0005558
NCI Thesaurus Property
C25365
UMLS 2011AA Property
C0678257
Primary Site
Descripción

PediatricSoftTissueSarcomaPrimarySite

Tipo de datos

text

Alias
NCI Thesaurus ObjectClass
C9306
UMLS 2011AA ObjectClass
C1261473
NCI Thesaurus ObjectClass-2
C39299
UMLS 2011AA ObjectClass-2
C0231335
NCI Thesaurus Property
C25341
UMLS 2011AA Property
C0450429
NCI Thesaurus Property-2
C25251
UMLS 2011AA Property-2
C0205225
NCI Thesaurus ValueDomain
C13717
UMLS 2011AA ValueDomain
C1515974
Other specify
Descripción

Primary Disease Site

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS CUI-1
C0449695
NCI Thesaurus Property
C25341
NCI Thesaurus ObjectClass
C25251
NCI Thesaurus ObjectClass-2
C2991
Tumor Location, Side
Descripción

SarcomaTumorOrganSideType

Tipo de datos

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass-2
C9118
UMLS 2011AA ObjectClass-2
C1261473
NCI Thesaurus Property
C13018
UMLS 2011AA Property
C0178784
NCI Thesaurus Property-2
C25306
UMLS 2011AA Property-2
C0441987
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Intracranial Tumor Extension (check all that apply)
Descripción

IntracranialTumorExtensionType

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus Property
C25270
UMLS 2011AA Property
C0231448
NCI Thesaurus ObjectClass-2
C38236
UMLS 2011AA ObjectClass-2
C1522213
Other specify
Descripción

IntracranialTumorExtensionSpecify

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus Property
C25270
UMLS 2011AA Property
C0231448
NCI Thesaurus ObjectClass-2
C38236
UMLS 2011AA ObjectClass-2
C1522213
Metastatic Site (s - For high risk/advanced studies, - check all that apply)
Descripción

SarcomaMalignantNeoplasmMetastaticInvolvementSite

Tipo de datos

text

Alias
NCI Thesaurus ObjectClass
C9305
UMLS 2011AA ObjectClass
C0006826
NCI Thesaurus ObjectClass-2
C9118
UMLS 2011AA ObjectClass-2
C1261473
NCI Thesaurus Property
C14174
UMLS 2011AA Property
C0036525
NCI Thesaurus Property-2
C25548
UMLS 2011AA Property-2
C1314939
NCI Thesaurus ValueDomain
C13717
UMLS 2011AA ValueDomain
C1515974
Distant nodes specify
Descripción

MalignantNeoplasmDistantLymphNodeMetastaticInvolvementSpecify

Tipo de datos

text

Alias
NCI Thesaurus ObjectClass
C9305
UMLS 2011AA ObjectClass
C0006826
NCI Thesaurus Property
C14174
UMLS 2011AA Property
C0036525
NCI Thesaurus Property-2
C12745
UMLS 2011AA Property-2
C0024204
NCI Thesaurus Property-3
C25321
UMLS 2011AA Property-3
C0443203
NCI Thesaurus Property-4
C25548
UMLS 2011AA Property-4
C1314939
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
Other specify
Descripción

Metastatic Sites, other

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS CUI-1
C0280457
NCI Thesaurus Property
C14174
UMLS CUI-2
C3844311
NCI Thesaurus ObjectClass
C9305
NCI Thesaurus Property-2
C25548
Number of Regional Lymph Nodes Examined
Descripción

RegionalLymphNodeExaminedCount

Tipo de datos

float

Alias
NCI Thesaurus Property
C25500
UMLS 2011AA Property
C0332128
NCI Thesaurus ObjectClass
C12745
UMLS 2011AA ObjectClass
C0024204
NCI Thesaurus ObjectClass-2
C25643
UMLS 2011AA ObjectClass-2
C0205147
NCI Thesaurus ValueDomain
C25463
UMLS 2011AA ValueDomain
C0750480
Number of Positive Lymph Nodes
Descripción

LymphNodePositiveCount

Tipo de datos

float

Alias
NCI Thesaurus Property
C25246
UMLS 2011AA Property
C1446409
NCI Thesaurus ObjectClass
C12745
UMLS 2011AA ObjectClass
C0024204
NCI Thesaurus ValueDomain
C25463
UMLS 2011AA ValueDomain
C0750480
Dimension 1 (Longest)
Descripción

TumorLargestDimensionMeasurement

Tipo de datos

float

Unidades de medida
  • cm
Alias
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus Property
C25550
UMLS 2011AA Property
C0443228
NCI Thesaurus Property-2
C25483
UMLS 2011AA Property-2
C0439534
cm
Dimension 2 (cm)
Descripción

TumorSecondDimensionMeasurement

Tipo de datos

float

Unidades de medida
  • cm
Alias
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus Property
C25666
UMLS 2011AA Property
C0205436
NCI Thesaurus Property-2
C25483
UMLS 2011AA Property-2
C0439534
cm
Dimension 3 (cm)
Descripción

TumorThirdDimensionMeasurement

Tipo de datos

float

Unidades de medida
  • cm
Alias
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus Property
C25260
UMLS 2011AA Property
C0205437
NCI Thesaurus Property-2
C25483
UMLS 2011AA Property-2
C0439534
cm
Status of Primary Tumor
Descripción

Resection type primary tumor

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS CUI-1
C0449522
NCI Thesaurus ObjectClass
C3262
UMLS CUI-2
C0677930
NCI Thesaurus ObjectClass-2
C25251
NCI Thesaurus Property
C15232
Histologic Type (check all that apply)
Descripción

SarcomaHistologicCategory

Tipo de datos

text

Alias
NCI Thesaurus ObjectClass
C9118
UMLS 2011AA ObjectClass
C1261473
NCI Thesaurus Property
C25526
UMLS 2011AA Property
C0205462
NCI Thesaurus Property-2
C25161
UMLS 2011AA Property-2
C0008902
NCI Thesaurus ValueDomain
C25372
UMLS 2011AA ValueDomain
C0683312
NCI Thesaurus ValueDomain-2
C25526
UMLS 2011AA ValueDomain-2
C0205462
Other specify
Descripción

Histologic Type, other

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS CUI-1
C1299220
NCI Thesaurus ObjectClass
C3262
NCI Thesaurus Property
C25526
NCI Thesaurus Property-2
C25161
Histologic Subtype (specify)
Descripción

SarcomaHistologicSubcategorySpecify

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ObjectClass
C9118
UMLS 2011AA ObjectClass
C1261473
NCI Thesaurus Property
C25526
UMLS 2011AA Property
C0205462
NCI Thesaurus Property-2
C25692
UMLS 2011AA Property-2
C1515010
Histologic Grade, French System (check highest grade)
Descripción

SarcomaTumorFrenchClassificationHistologicGrade

Tipo de datos

text

Alias
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass-2
C9118
UMLS 2011AA ObjectClass-2
C1261473
NCI Thesaurus Property
C43854
UMLS 2011AA Property
C1556084
NCI Thesaurus Property-2
C25161
UMLS 2011AA Property-2
C0008902
NCI Thesaurus ValueDomain
C25526
UMLS 2011AA ValueDomain
C0205462
NCI Thesaurus ValueDomain-2
C18000
UMLS 2011AA ValueDomain-2
C0919553
Pathologic T Stage
Descripción

SarcomaPathologicTStage

Tipo de datos

text

Alias
NCI Thesaurus Property
C25610
UMLS 2011AA Property
C1521733
NCI Thesaurus ObjectClass
C9118
UMLS 2011AA ObjectClass
C1261473
NCI Thesaurus ValueDomain
C16899
UMLS 2011AA ValueDomain
C1300072
NCI Thesaurus Property-2
C25728
UMLS 2011AA Property-2
C0475455
Pathologic N Stage
Descripción

SarcomaPathologicNStage

Tipo de datos

text

Alias
NCI Thesaurus Property
C25610
UMLS 2011AA Property
C1521733
NCI Thesaurus ObjectClass
C9118
UMLS 2011AA ObjectClass
C1261473
NCI Thesaurus ValueDomain
C16899
UMLS 2011AA ValueDomain
C1300072
NCI Thesaurus Property-2
C25580
UMLS 2011AA Property-2
C0456532
Pathologic M Stage
Descripción

SarcomaPathologicMStage

Tipo de datos

text

Alias
NCI Thesaurus Property
C25610
UMLS 2011AA Property
C1521733
NCI Thesaurus ObjectClass
C9118
UMLS 2011AA ObjectClass
C1261473
NCI Thesaurus ValueDomain
C16899
UMLS 2011AA ValueDomain
C1300072
NCI Thesaurus Property-2
C25727
UMLS 2011AA Property-2
C0456533
Clinical T Stage
Descripción

SarcomaClinicalTStage

Tipo de datos

text

Alias
NCI Thesaurus Property
C25398
UMLS 2011AA Property
C0205210
NCI Thesaurus ObjectClass
C9118
UMLS 2011AA ObjectClass
C1261473
NCI Thesaurus ValueDomain
C16899
UMLS 2011AA ValueDomain
C1300072
NCI Thesaurus Property-2
C25728
UMLS 2011AA Property-2
C0475455
Clinical N Stage
Descripción

SarcomaClinicalNStage

Tipo de datos

text

Alias
NCI Thesaurus Property
C25398
UMLS 2011AA Property
C0205210
NCI Thesaurus ObjectClass
C9118
UMLS 2011AA ObjectClass
C1261473
NCI Thesaurus ValueDomain
C16899
UMLS 2011AA ValueDomain
C1300072
NCI Thesaurus Property-2
C25580
UMLS 2011AA Property-2
C0456532
Clinical M Stage
Descripción

SarcomaClinicalMStage

Tipo de datos

text

Alias
NCI Thesaurus Property
C25398
UMLS 2011AA Property
C0205210
NCI Thesaurus ObjectClass
C9118
UMLS 2011AA ObjectClass
C1261473
NCI Thesaurus ValueDomain
C16899
UMLS 2011AA ValueDomain
C1300072
NCI Thesaurus Property-2
C25727
UMLS 2011AA Property-2
C0456533
Depth (cm)
Descripción

InvasiveTumorDepthMeasurement

Tipo de datos

float

Unidades de medida
  • cm
Alias
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
NCI Thesaurus ObjectClass
C3262
UMLS 2011AA ObjectClass
C0027651
NCI Thesaurus ObjectClass-2
C14159
UMLS 2011AA ObjectClass-2
C0205281
NCI Thesaurus Property
C25333
UMLS 2011AA Property
C0205125
cm
Pediatric Soft Tissue Sarcoma: Prior Health History
Descripción

Pediatric Soft Tissue Sarcoma: Prior Health History

Does the patient have a chronic disease associated with this cancer?
Descripción

ChronicDiseaseDiagnosisInd-3

Tipo de datos

boolean

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C2991
UMLS 2011AA ObjectClass
C0012634
NCI Thesaurus Property
C15220
UMLS 2011AA Property
C0011900
NCI Thesaurus ObjectClass-2
C14141
UMLS 2011AA ObjectClass-2
C0205191
Current Medical Conditions (currently symptomatic or on medications for)
Descripción

PatientMedicalConditionCurrentType

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25261
UMLS 2011AA Property
C0205476
NCI Thesaurus Property-2
C25457
UMLS 2011AA Property-2
C0348080
Other malignancies specify
Descripción

MalignantDiseaseOtherPresentSpecify

Tipo de datos

text

Alias
NCI Thesaurus ObjectClass
C14143
UMLS 2011AA ObjectClass
C0205282
NCI Thesaurus ObjectClass-2
C2991
UMLS 2011AA ObjectClass-2
C0012634
NCI Thesaurus Property
C17649
UMLS 2011AA Property
C0205394
NCI Thesaurus Property-2
C25626
UMLS 2011AA Property-2
C0150312
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
Other specify
Descripción

PatientMedicalConditionCurrentSpecify

Tipo de datos

text

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25261
UMLS 2011AA Property
C0205476
NCI Thesaurus Property-2
C25457
UMLS 2011AA Property-2
C0348080
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ValueDomain-2
C25471
UMLS 2011AA ValueDomain-2
C0521116
Congenital abnormalities
Descripción

PatientCongenitalAbnormalityType

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C2849
UMLS 2011AA Property
C0000768
Other specify
Descripción

PatientCongenitalAbnormalitySpecify

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C2849
UMLS 2011AA Property
C0000768
Family history of neurofibromatosis?
Descripción

NeurofibromatosisFamilyMedicalHistoryInd-3

Tipo de datos

boolean

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C6727
UMLS 2011AA ObjectClass
C0162678
NCI Thesaurus Property
C17726
UMLS 2011AA Property
C0241889
Comments
Descripción

Comments

Comments
Descripción

Research Comments

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS CUI-1
C0947611
NCI Thesaurus ObjectClass
C15319
NCI Thesaurus Property
C25393
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1 formularios
  1. StudyEvent: Pediatric Soft Tissue Sarcoma - On-Study Form Newly Diagnosed Patients
    1. No Instruction available.
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
Crf Header
Protocol ID Coordinating Group
Item
Coordinating Group Protocol No.
text
C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1711341 (UMLS CUI-2)
C25462 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
Coordinating Group Code
Item
Coordinating Group Code
text
C25162 (NCI Thesaurus ValueDomain)
C1711341 (UMLS CUI-1)
C17005 (NCI Thesaurus ObjectClass)
C0805701 (UMLS CUI-2)
C25462 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
Protocol Title
Item
Protocol Title
text
C25191 (NCI Thesaurus ValueDomain)
C2986303 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C42774 (NCI Thesaurus Property)
Patient Study ID
Item
Patient Study ID
text
C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25462 (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
Other 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)
ParticipatingGroupIdentifierCode
Item
Participating Group Code
text
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
C25608 (NCI Thesaurus ObjectClass)
C0679823 (UMLS 2011AA ObjectClass)
C17005 (NCI Thesaurus ObjectClass-2)
C1257890 (UMLS 2011AA ObjectClass-2)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
Patient Name
Item
Patient Name (initials acceptable)
text
C25191 (NCI Thesaurus ValueDomain)
C1299487 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)
Item Group
Sarcoma: Form Administration
Person Completing Form
Item
Person Completing Form
text
C25191 (NCI Thesaurus ValueDomain)
C1550483 (UMLS CUI-1)
C25657 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)
Data amended
Item
Are data amended (If data are amended, please circle in red when using paper form)
boolean
C38148 (NCI Thesaurus ValueDomain)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
Item Group
Pediatric Soft Tissue Sarcoma: Disease Description
CancerInitialDiagnosisDate
Item
Date of Initial Pathologic Diagnosis (MM DD YYYY)
date
C9305 (NCI Thesaurus ObjectClass)
C0006826 (UMLS 2011AA ObjectClass)
C25509 (NCI Thesaurus Property)
C1279901 (UMLS 2011AA Property)
C15220 (NCI Thesaurus Property-2)
C0011900 (UMLS 2011AA Property-2)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
Item
Biopsy Type
text
C15189 (NCI Thesaurus ObjectClass)
C0005558 (UMLS 2011AA ObjectClass)
C15368 (NCI Thesaurus Property)
C25218 (NCI Thesaurus ValueDomain)
C1948041 (UMLS 2011AA ValueDomain)
CL.2
Code List
Biopsy Type
CL Item
Incisional (Incisional)
CL Item
Excisional (Excisional)
CL Item
Trucut Needle (TruCut needle)
CL Item
Large Bore Needle (Large bore needle)
CL Item
Other, Specify (Other specify)
BiopsyDescriptionSpecify
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C15189 (NCI Thesaurus ObjectClass)
C0005558 (UMLS 2011AA ObjectClass)
C25365 (NCI Thesaurus Property)
C0678257 (UMLS 2011AA Property)
Item
Primary Site
text
C9306 (NCI Thesaurus ObjectClass)
C1261473 (UMLS 2011AA ObjectClass)
C39299 (NCI Thesaurus ObjectClass-2)
C0231335 (UMLS 2011AA ObjectClass-2)
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
C25251 (NCI Thesaurus Property-2)
C0205225 (UMLS 2011AA Property-2)
C13717 (NCI Thesaurus ValueDomain)
C1515974 (UMLS 2011AA ValueDomain)
CL.3
Code List
Primary Site
CL Item
Eye And Orbit (Eye and orbit)
CL Item
Parameningeal (Parameningeal)
CL Item
Non-parameningeal Head And Neck (Non-parameningeal head and neck)
CL Item
Thorax (Thorax)
C12799 (NCI Thesaurus)
C0817096 (UMLS 2011AA)
CL Item
Trunk (Trunk)
C33816 (NCI Thesaurus)
C0460005 (UMLS 2011AA)
CL Item
Perineum/anus (Perineum/anus)
CL Item
Retroperitoneum (Retroperitoneum)
C12298 (NCI Thesaurus)
C0035359 (UMLS 2011AA)
CL Item
Intra-abdominal, Nos (Intra-abdominal)
CL Item
Bladder (Bladder)
C12414 (NCI Thesaurus)
C0005682 (UMLS 2011AA)
CL Item
Prostate (Prostate)
C12410 (NCI Thesaurus)
C0033572 (UMLS 2011AA)
CL Item
Genitourinary, Nos (Genitourinary NOS)
CL Item
Upper Extremity (Upper extremity)
C12671 (NCI Thesaurus)
C1140618 (UMLS 2011AA)
CL Item
Lower Extremity (Lower extremity)
C12742 (NCI Thesaurus)
C0023216 (UMLS 2011AA)
CL Item
Other Specify (Other)
Primary Disease Site
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C0449695 (UMLS CUI-1)
C25341 (NCI Thesaurus Property)
C25251 (NCI Thesaurus ObjectClass)
C2991 (NCI Thesaurus ObjectClass-2)
Item
Tumor Location, Side
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C9118 (NCI Thesaurus ObjectClass-2)
C1261473 (UMLS 2011AA ObjectClass-2)
C13018 (NCI Thesaurus Property)
C0178784 (UMLS 2011AA Property)
C25306 (NCI Thesaurus Property-2)
C0441987 (UMLS 2011AA Property-2)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.4
Code List
Tumor Location, Side
CL Item
Left (Left)
C25229 (NCI Thesaurus)
C0205091 (UMLS 2011AA)
CL Item
Right (Right)
C25228 (NCI Thesaurus)
C0205090 (UMLS 2011AA)
CL Item
Both (Both)
C49636 (NCI Thesaurus)
C1706086 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Intracranial Tumor Extension (check all that apply)
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C25270 (NCI Thesaurus Property)
C0231448 (UMLS 2011AA Property)
C38236 (NCI Thesaurus ObjectClass-2)
C1522213 (UMLS 2011AA ObjectClass-2)
CL.5
Code List
Intracranial Tumor Extension (check all that apply)
CL Item
Intracranial Extension (Intracranial extension)
CL Item
Cranial Nerve Palsy (Cranial nerve palsy)
CL Item
Base Of Skull Erosion (Base of skull erosion)
CL Item
Other, Specify (Other specify)
IntracranialTumorExtensionSpecify
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C25270 (NCI Thesaurus Property)
C0231448 (UMLS 2011AA Property)
C38236 (NCI Thesaurus ObjectClass-2)
C1522213 (UMLS 2011AA ObjectClass-2)
Item
Metastatic Site (s - For high risk/advanced studies, - check all that apply)
text
C9305 (NCI Thesaurus ObjectClass)
C0006826 (UMLS 2011AA ObjectClass)
C9118 (NCI Thesaurus ObjectClass-2)
C1261473 (UMLS 2011AA ObjectClass-2)
C14174 (NCI Thesaurus Property)
C0036525 (UMLS 2011AA Property)
C25548 (NCI Thesaurus Property-2)
C1314939 (UMLS 2011AA Property-2)
C13717 (NCI Thesaurus ValueDomain)
C1515974 (UMLS 2011AA ValueDomain)
CL.6
Code List
Metastatic Site (s - For high risk/advanced studies, - check all that apply)
CL Item
Bone (Bone)
C12366 (NCI Thesaurus)
C0262950 (UMLS 2011AA)
CL Item
Bone Marrow (Bone marrow)
C12431 (NCI Thesaurus)
C0005953 (UMLS 2011AA)
CL Item
Cns/brain (CNS/Brain)
CL Item
Liver (Liver)
C12392 (NCI Thesaurus)
C0023884 (UMLS 2011AA)
CL Item
Lung (Lung)
C12468 (NCI Thesaurus)
C0024109 (UMLS 2011AA)
CL Item
Pleural Nodules (Pleural nodules)
CL Item
Peritoneal Nodules (Peritoneal nodules)
CL Item
Soft Tissue (Soft tissue)
C12471 (NCI Thesaurus)
C0225317 (UMLS 2011AA)
CL Item
Pleural Effusion (Pleural effusion)
C3331 (NCI Thesaurus)
C0021071 (UMLS 2011AA)
CL Item
Ascites (Ascites)
C2885 (NCI Thesaurus)
C0003962 (UMLS 2011AA)
CL Item
Cerebrospinal Fluid (csf) (Cerebrospinal fluid (CSF))
CL Item
Distant Nodes, Specify (Distant Nodes)
CL Item
Other Specify (Other)
MalignantNeoplasmDistantLymphNodeMetastaticInvolvementSpecify
Item
Distant nodes specify
text
C9305 (NCI Thesaurus ObjectClass)
C0006826 (UMLS 2011AA ObjectClass)
C14174 (NCI Thesaurus Property)
C0036525 (UMLS 2011AA Property)
C12745 (NCI Thesaurus Property-2)
C0024204 (UMLS 2011AA Property-2)
C25321 (NCI Thesaurus Property-3)
C0443203 (UMLS 2011AA Property-3)
C25548 (NCI Thesaurus Property-4)
C1314939 (UMLS 2011AA Property-4)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
Metastatic Sites, other
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C0280457 (UMLS CUI-1)
C14174 (NCI Thesaurus Property)
C3844311 (UMLS CUI-2)
C9305 (NCI Thesaurus ObjectClass)
C25548 (NCI Thesaurus Property-2)
RegionalLymphNodeExaminedCount
Item
Number of Regional Lymph Nodes Examined
float
C25500 (NCI Thesaurus Property)
C0332128 (UMLS 2011AA Property)
C12745 (NCI Thesaurus ObjectClass)
C0024204 (UMLS 2011AA ObjectClass)
C25643 (NCI Thesaurus ObjectClass-2)
C0205147 (UMLS 2011AA ObjectClass-2)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
LymphNodePositiveCount
Item
Number of Positive Lymph Nodes
float
C25246 (NCI Thesaurus Property)
C1446409 (UMLS 2011AA Property)
C12745 (NCI Thesaurus ObjectClass)
C0024204 (UMLS 2011AA ObjectClass)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
TumorLargestDimensionMeasurement
Item
Dimension 1 (Longest)
float
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C25550 (NCI Thesaurus Property)
C0443228 (UMLS 2011AA Property)
C25483 (NCI Thesaurus Property-2)
C0439534 (UMLS 2011AA Property-2)
TumorSecondDimensionMeasurement
Item
Dimension 2 (cm)
float
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C25666 (NCI Thesaurus Property)
C0205436 (UMLS 2011AA Property)
C25483 (NCI Thesaurus Property-2)
C0439534 (UMLS 2011AA Property-2)
TumorThirdDimensionMeasurement
Item
Dimension 3 (cm)
float
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C25260 (NCI Thesaurus Property)
C0205437 (UMLS 2011AA Property)
C25483 (NCI Thesaurus Property-2)
C0439534 (UMLS 2011AA Property-2)
Item
Status of Primary Tumor
text
C25284 (NCI Thesaurus ValueDomain)
C0449522 (UMLS CUI-1)
C3262 (NCI Thesaurus ObjectClass)
C0677930 (UMLS CUI-2)
C25251 (NCI Thesaurus ObjectClass-2)
C15232 (NCI Thesaurus Property)
CL.7
Code List
Status of Primary Tumor
CL Item
Unresected (Unresected)
CL Item
Not Recurrent, Resected, No Residual Tumor (Not recurrent, resected, no residual tumor)
CL Item
Not Recurrent, Resected, Residual Tumor (Not recurrent, resected, residual tumor)
CL Item
Recurrent (Recurrent)
C14173 (NCI Thesaurus)
C2945760 (UMLS 2011AA)
Item
Histologic Type (check all that apply)
text
C9118 (NCI Thesaurus ObjectClass)
C1261473 (UMLS 2011AA ObjectClass)
C25526 (NCI Thesaurus Property)
C0205462 (UMLS 2011AA Property)
C25161 (NCI Thesaurus Property-2)
C0008902 (UMLS 2011AA Property-2)
C25372 (NCI Thesaurus ValueDomain)
C0683312 (UMLS 2011AA ValueDomain)
C25526 (NCI Thesaurus ValueDomain-2)
C0205462 (UMLS 2011AA ValueDomain-2)
CL.8
Code List
Histologic Type (check all that apply)
CL Item
Embryonal Rhabdomyosarcoma (Embryonal rhabdomyosarcoma)
CL Item
Botryoid Rhabdomyosarcoma (Botryoid rhabdomyosarcoma)
CL Item
Spindle Cell Rhabdomyosarcoma (Spindle cell rhabdomyosarcoma)
CL Item
Alveolar Rhabdomyosarcoma (Alveolar rhabdomyosarcoma)
CL Item
Pleomorphic Rhabdomyosarcoma (Pleomorphic rhabdomyosarcoma)
CL Item
Rhabdomyosarcoma Nos (Rhabdomyosarcoma NOS)
CL Item
Extraskeletal Ewing's/pnet (Extraskeletal Ewing's/PNET)
CL Item
Synovial Sarcoma (Synovial sarcoma)
C3400 (NCI Thesaurus)
C0039101 (UMLS 2011AA)
CL Item
Maligant Peripheral Nerve Sheath Tumor (Malignant peripheral nerve sheath tumor)
CL Item
Infantile Fibrosarcoma (Infantile fibrosarcoma)
CL Item
Fibrosacoma, Nos (Fibrosacoma NOS)
CL Item
Dermatofibrosarcoma Protuberans (Dermatofibrosarcoma protuberans)
CL Item
Myxofibrosarcoma (Myxofibrosarcoma)
CL Item
Solitary Fibrous Tumor/hemangiopericytoma (Solitary fibrous tumor/hemangiopericytoma)
CL Item
Undifferentiated Pleomorphic Sarcoma/"mfh" (Undifferentiated pleomorphic sarcoma/"MFH")
CL Item
Well Differentiated Liposarcoma (Well differentiated liposarcoma)
CL Item
Dedifferentiated Liposarcoma (Dedifferentiated liposarcoma)
CL Item
Myxoid Liposarcoma (Myxoid liposarcoma)
CL Item
Pleomorphic Liposarcoma (Pleomorphic liposarcoma)
CL Item
Liposarcoma Nos (Liposarcoma NOS)
CL Item
Leiomyosarcoma (Leiomyosarcoma)
C3158 (NCI Thesaurus)
C0023269 (UMLS 2011AA)
CL Item
Gastrointestinal Stromal Tumor (gist) (Gastrointestinal stromal tumor (GIST))
CL Item
Extraskeletal Myxoid Chondrosarcoma (Extraskeletal myxoid chondrosarcoma)
CL Item
Extraskeletal Mesenchymal Chondrosarcoma (Extraskeletal mesenchymal chondrosarcoma)
CL Item
Extraskeletal Osteosarcoma (Extraskeletal osteosarcoma)
CL Item
Angiosarcoma (Angiosarcoma)
C3088 (NCI Thesaurus)
C0018923 (UMLS 2011AA)
CL Item
Kaposi Sarcoma (Kaposi sarcoma)
C9087 (NCI Thesaurus)
C0036220 (UMLS 2011AA)
CL Item
Epithelioid Sarcoma (Epithelioid sarcoma)
CL Item
Alveolar Soft Part Sarcoma (Alveolar soft part sarcoma)
CL Item
Clear Cell Sarcoma (mmsp) (Clear cell sarcoma (MMSP))
CL Item
Desmoplastic Small Cell Tumor (Desmoplastic small cell tumor)
CL Item
Malignant Mesenchymoma (Malignant mesenchymoma)
CL Item
Soft Tissue Sarcoma Nos (Soft tissue sarcoma NOS)
CL Item
Endometrial Stromal Sarcoma (Endometrial stromal sarcoma)
C8973 (NCI Thesaurus)
C0206630 (UMLS 2011AA)
CL Item
Uterine Leiomyosarcoma (Uterine leiomyosarcoma)
CL Item
Uterine Carcinosarcoma (mixed Mesodermal Sarcoma) (Uterine carcinosarcoma (mixed mesodermal sarcoma))
CL Item
Uterine Sarcoma Nos (Uterine sarcoma NOS)
CL Item
Undifferentiated Sarcoma (Undifferentiated sarcoma)
CL Item
Other Specify (Other specify)
Histologic Type, other
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1299220 (UMLS CUI-1)
C3262 (NCI Thesaurus ObjectClass)
C25526 (NCI Thesaurus Property)
C25161 (NCI Thesaurus Property-2)
SarcomaHistologicSubcategorySpecify
Item
Histologic Subtype (specify)
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C9118 (NCI Thesaurus ObjectClass)
C1261473 (UMLS 2011AA ObjectClass)
C25526 (NCI Thesaurus Property)
C0205462 (UMLS 2011AA Property)
C25692 (NCI Thesaurus Property-2)
C1515010 (UMLS 2011AA Property-2)
Item
Histologic Grade, French System (check highest grade)
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C9118 (NCI Thesaurus ObjectClass-2)
C1261473 (UMLS 2011AA ObjectClass-2)
C43854 (NCI Thesaurus Property)
C1556084 (UMLS 2011AA Property)
C25161 (NCI Thesaurus Property-2)
C0008902 (UMLS 2011AA Property-2)
C25526 (NCI Thesaurus ValueDomain)
C0205462 (UMLS 2011AA ValueDomain)
C18000 (NCI Thesaurus ValueDomain-2)
C0919553 (UMLS 2011AA ValueDomain-2)
CL.9
Code List
Histologic Grade, French System (check highest grade)
CL Item
Grade I (Grade I)
CL Item
Grade Ii (Grade II)
CL Item
Grade Iii (Grade III)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Pathologic T Stage
text
C25610 (NCI Thesaurus Property)
C1521733 (UMLS 2011AA Property)
C9118 (NCI Thesaurus ObjectClass)
C1261473 (UMLS 2011AA ObjectClass)
C16899 (NCI Thesaurus ValueDomain)
C1300072 (UMLS 2011AA ValueDomain)
C25728 (NCI Thesaurus Property-2)
C0475455 (UMLS 2011AA Property-2)
CL.10
Code List
Pathologic T Stage
CL Item
Pt0 (pT0)
CL Item
Pt1 (pT1)
CL Item
Pt2 (pT2)
CL Item
Pt3 (pT3)
CL Item
Pt4 (pT4)
CL Item
Ptx (pTX)
Item
Pathologic N Stage
text
C25610 (NCI Thesaurus Property)
C1521733 (UMLS 2011AA Property)
C9118 (NCI Thesaurus ObjectClass)
C1261473 (UMLS 2011AA ObjectClass)
C16899 (NCI Thesaurus ValueDomain)
C1300072 (UMLS 2011AA ValueDomain)
C25580 (NCI Thesaurus Property-2)
C0456532 (UMLS 2011AA Property-2)
CL.11
Code List
Pathologic N Stage
CL Item
Pn0 (pN0)
CL Item
Pn1 (pN1)
CL Item
Pn2 (pN2)
CL Item
Pn3 (pN3)
CL Item
Pnx (pNX)
Item
Pathologic M Stage
text
C25610 (NCI Thesaurus Property)
C1521733 (UMLS 2011AA Property)
C9118 (NCI Thesaurus ObjectClass)
C1261473 (UMLS 2011AA ObjectClass)
C16899 (NCI Thesaurus ValueDomain)
C1300072 (UMLS 2011AA ValueDomain)
C25727 (NCI Thesaurus Property-2)
C0456533 (UMLS 2011AA Property-2)
CL.12
Code List
Pathologic M Stage
CL Item
Pm0 (pM0)
CL Item
Pm1 (pM1)
CL Item
Pmx (pMX)
Item
Clinical T Stage
text
C25398 (NCI Thesaurus Property)
C0205210 (UMLS 2011AA Property)
C9118 (NCI Thesaurus ObjectClass)
C1261473 (UMLS 2011AA ObjectClass)
C16899 (NCI Thesaurus ValueDomain)
C1300072 (UMLS 2011AA ValueDomain)
C25728 (NCI Thesaurus Property-2)
C0475455 (UMLS 2011AA Property-2)
CL.13
Code List
Clinical T Stage
CL Item
T0 (T0)
CL Item
T1 (T1)
C1179687 (NCI Metathesaurus)
CL Item
T2 (T2)
CL Item
T3 (T3)
CL Item
T4 (T4)
CL Item
Tx (TX)
Item
Clinical N Stage
text
C25398 (NCI Thesaurus Property)
C0205210 (UMLS 2011AA Property)
C9118 (NCI Thesaurus ObjectClass)
C1261473 (UMLS 2011AA ObjectClass)
C16899 (NCI Thesaurus ValueDomain)
C1300072 (UMLS 2011AA ValueDomain)
C25580 (NCI Thesaurus Property-2)
C0456532 (UMLS 2011AA Property-2)
CL.14
Code List
Clinical N Stage
CL Item
N0 (N0)
CL Item
N1 (N1)
CL Item
N2 (N2)
CL Item
N3 (N3)
CL Item
Nx (NX)
Item
Clinical M Stage
text
C25398 (NCI Thesaurus Property)
C0205210 (UMLS 2011AA Property)
C9118 (NCI Thesaurus ObjectClass)
C1261473 (UMLS 2011AA ObjectClass)
C16899 (NCI Thesaurus ValueDomain)
C1300072 (UMLS 2011AA ValueDomain)
C25727 (NCI Thesaurus Property-2)
C0456533 (UMLS 2011AA Property-2)
CL.15
Code List
Clinical M Stage
CL Item
M0 (M0)
CL Item
M1 (M1)
CL Item
Mx (MX)
InvasiveTumorDepthMeasurement
Item
Depth (cm)
float
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C14159 (NCI Thesaurus ObjectClass-2)
C0205281 (UMLS 2011AA ObjectClass-2)
C25333 (NCI Thesaurus Property)
C0205125 (UMLS 2011AA Property)
Item Group
Pediatric Soft Tissue Sarcoma: Prior Health History
ChronicDiseaseDiagnosisInd-3
Item
Does the patient have a chronic disease associated with this cancer?
boolean
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)
C14141 (NCI Thesaurus ObjectClass-2)
C0205191 (UMLS 2011AA ObjectClass-2)
Item
Current Medical Conditions (currently symptomatic or on medications for)
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25261 (NCI Thesaurus Property)
C0205476 (UMLS 2011AA Property)
C25457 (NCI Thesaurus Property-2)
C0348080 (UMLS 2011AA Property-2)
CL.17
Code List
Current Medical Conditions (currently symptomatic or on medications for)
CL Item
Cerebrovascular Disease (Cerebrovascular disease)
CL Item
Cardiac Disease (Cardiac disease)
CL Item
High Blood Pressure (High blood pressure)
CL Item
Deep Vein Thrombosis (Deep vein thrombosis)
CL Item
Peripheral Vascular Disease (Peripheral vascular disease)
CL Item
Gastrointestinal Disease (Gastrointestinal disease)
CL Item
Diabetes (Diabetes)
CL Item
Neurologic Disease (Neurologic disease)
CL Item
Respiratory Problems (Respiratory problems)
CL Item
Other Malignancies, Specify (Other malignancies specify)
CL Item
Other, Specify (Other specify)
MalignantDiseaseOtherPresentSpecify
Item
Other malignancies specify
text
C14143 (NCI Thesaurus ObjectClass)
C0205282 (UMLS 2011AA ObjectClass)
C2991 (NCI Thesaurus ObjectClass-2)
C0012634 (UMLS 2011AA ObjectClass-2)
C17649 (NCI Thesaurus Property)
C0205394 (UMLS 2011AA Property)
C25626 (NCI Thesaurus Property-2)
C0150312 (UMLS 2011AA Property-2)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
PatientMedicalConditionCurrentSpecify
Item
Other specify
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25261 (NCI Thesaurus Property)
C0205476 (UMLS 2011AA Property)
C25457 (NCI Thesaurus Property-2)
C0348080 (UMLS 2011AA Property-2)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C25471 (NCI Thesaurus ValueDomain-2)
C0521116 (UMLS 2011AA ValueDomain-2)
Item
Congenital abnormalities
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C2849 (NCI Thesaurus Property)
C0000768 (UMLS 2011AA Property)
CL.18
Code List
Congenital abnormalities
CL Item
None (None)
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
Downs Syndrome (Downs syndrome)
CL Item
Neurofibromatosis (Neurofibromatosis)
CL Item
Li-fraumeni Syndrome (Li-Fraumeni syndrome)
CL Item
Hemihypertrophy (Hemihypertrophy)
CL Item
Other, Specify (Other specify)
PatientCongenitalAbnormalitySpecify
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C2849 (NCI Thesaurus Property)
C0000768 (UMLS 2011AA Property)
NeurofibromatosisFamilyMedicalHistoryInd-3
Item
Family history of neurofibromatosis?
boolean
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C6727 (NCI Thesaurus ObjectClass)
C0162678 (UMLS 2011AA ObjectClass)
C17726 (NCI Thesaurus Property)
C0241889 (UMLS 2011AA Property)
Item Group
Comments
Research Comments
Item
Comments
text
C25704 (NCI Thesaurus ValueDomain)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
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