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ID

8548

Beschrijving

North Central Cancer Treatment Group N0723 Event Monitoring Form Pemetrexed or Erlotinib as Second-Line Therapy in Treating Patients With Advanced Non-Small Cell Lung Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=46FB8C2F-3D9F-1548-E044-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=46FB8C2F-3D9F-1548-E044-0003BA3F9857

Trefwoorden

  1. 19-09-12 19-09-12 -
  2. 08-01-15 08-01-15 - Martin Dugas
  3. 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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    Lung Cancer NCT00738881 Follow-Up - North Central Cancer Treatment Group N0723 Event Monitoring Form - 2731425v1.0

    No Instruction available.

    1. StudyEvent: North Central Cancer Treatment Group N0723 Event Monitoring Form
      1. No Instruction available.
    Header
    Beschrijving

    Header

    Protocol Number
    Beschrijving

    Protocol ID NCCTG

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C3274381
    NCI Thesaurus ObjectClass
    C25320
    UMLS CUI-2
    C1518419
    NCI Thesaurus Property
    C25364
    NCI Thesaurus Property-2
    C25581
    Patient ID
    Beschrijving

    PatientNorthCentralCancerTreatmentGroupIdentifierNumber

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS 2011AA ValueDomain
    C0237753
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C25364
    UMLS 2011AA Property
    C0600091
    NCI Thesaurus Property-2
    C25581
    UMLS 2011AA Property-2
    C1518419
    Patient Initials (L F M)
    Beschrijving

    Patient Initials

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS CUI-1
    C2986440
    NCI Thesaurus ObjectClass
    C16960
    NCI Thesaurus Property
    C25536
    Institution Number
    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
    Institution
    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
    Are data amended (If yes, highlight amended areas)
    Beschrijving

    Data amended

    Datatype

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38148
    UMLS CUI-1
    C0680532
    NCI Thesaurus ObjectClass
    C25474
    NCI Thesaurus Property
    C25416
    Unnamed Module
    Beschrijving

    Unnamed Module

    Were you able to obtain any information about the patient since the last report (If this is the first event monitoring form check yes, enter assessment date and complete the rest of the form.)
    Beschrijving

    PatientInformationCurrentFollow-upCollectedInd-2

    Datatype

    boolean

    Alias
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus ObjectClass-2
    C48191
    UMLS 2011AA ObjectClass-2
    C1533716
    NCI Thesaurus Property
    C25471
    UMLS 2011AA Property
    C0521116
    NCI Thesaurus Property-2
    C16033
    UMLS 2011AA Property-2
    C1522577
    NCI Thesaurus Property-3
    C25452
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    Date of last attempt to contact patient (If No, mm/dd/yyyy)
    Beschrijving

    PatientLastAttemptContactDate

    Datatype

    date

    Alias
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C25461
    UMLS 2011AA Property
    C0337611
    NCI Thesaurus Property-2
    C25551
    UMLS 2011AA Property-2
    C1517741
    NCI Thesaurus Property-3
    C39769
    UMLS 2011AA Property-3
    C1516084
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    Vital Status
    Beschrijving

    Vital Status

    Vital Status
    Beschrijving

    Patient Status

    Datatype

    text

    Alias
    NCI Thesaurus ObjectClass
    C16960
    UMLS CUI-1
    C3846084
    NCI Thesaurus ValueDomain
    C18003
    NCI Thesaurus ValueDomain-2
    C25688
    NCI Thesaurus Property
    C25717
    Date of Last Contact or Death (mm/dd/yyyy)
    Beschrijving

    Date last contact

    Datatype

    date

    Alias
    NCI Thesaurus ObjectClass
    C16960
    UMLS CUI-1
    C0805839
    NCI Thesaurus Property
    C25461
    NCI Thesaurus Property-2
    C25551
    NCI Thesaurus ValueDomain
    C25164
    NCI Thesaurus ValueDomain-2
    C25367
    Primary Cause of Death
    Beschrijving

    Primary Cause of Death

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C25638
    UMLS CUI-1
    C0007465
    NCI Thesaurus ObjectClass
    C16960
    NCI Thesaurus Property
    C28554
    NCI Thesaurus ValueDomain-2
    C25251
    Due to other cause, specify
    Beschrijving

    Primary Cause of Death, specify

    Datatype

    text

    Alias
    NCI Thesaurus ObjectClass
    C16960
    UMLS CUI-1
    C0007465
    NCI Thesaurus ObjectClass-2
    C25251
    NCI Metathesaurus ObjectClass
    C0007465
    NCI Thesaurus Property
    C17649
    NCI Thesaurus Property-2
    C25365
    NCI Thesaurus ValueDomain
    C25685
    Disease Follow-up Status
    Beschrijving

    Disease Follow-up Status

    Has the patient had a documented clinical assessment for this cancer? (since submission of the last event monitoring form)
    Beschrijving

    Documented clinical assessment for this cancer

    Datatype

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38148
    UMLS CUI-1
    C1522577
    NCI Thesaurus Property
    C16033
    UMLS CUI-2
    C0006826
    NCI Thesaurus ObjectClass
    C9305
    NCI Thesaurus Property-2
    C25365
    Cancer Follow-up Status Date (If yes,)
    Beschrijving

    Follow-Up Date

    Datatype

    date

    Alias
    NCI Thesaurus ObjectClass
    C9305
    UMLS CUI-1
    C3694716
    NCI Thesaurus Property
    C16033
    NCI Thesaurus Property-2
    C25365
    NCI Thesaurus ValueDomain
    C25164
    NCI Thesaurus ValueDomain-2
    C25367
    Notice Of First Relapse/progression In The Event Monitoring Phase
    Beschrijving

    Notice Of First Relapse/progression In The Event Monitoring Phase

    Has the patient developed a first relapse or progression that has not been previously reported
    Beschrijving

    DiseaseRelapseProgressionInd-3

    Datatype

    boolean

    Alias
    NCI Thesaurus ObjectClass
    C2991
    UMLS 2011AA ObjectClass
    C0012634
    NCI Thesaurus Property
    C38155
    UMLS 2011AA Property
    C0277556
    NCI Thesaurus Property-2
    C15220
    UMLS 2011AA Property-2
    C0011900
    NCI Thesaurus Property-3
    C19987
    UMLS 2011AA Property-3
    C0242656
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    Date of Relapse or Progression (If yes,)
    Beschrijving

    DiseaseRecurrentDiseaseCancerProgressionDiagnosisDate

    Datatype

    date

    Alias
    NCI Thesaurus ObjectClass
    C2991
    UMLS 2011AA ObjectClass
    C0012634
    NCI Thesaurus Property
    C38155
    UMLS 2011AA Property
    C0277556
    NCI Thesaurus Property-2
    C15220
    UMLS 2011AA Property-2
    C0011900
    NCI Thesaurus Property-3
    C19987
    UMLS 2011AA Property-3
    C0242656
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    Notice Of First Subsequent Treatment
    Beschrijving

    Notice Of First Subsequent Treatment

    Has the patient received subsequent treatment for this cancer that has not been previously reported
    Beschrijving

    AdditionalTreatmentProgressionInd-3

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    NCI Thesaurus Property
    C25331
    NCI Thesaurus ObjectClass
    C15368
    NCI Thesaurus ObjectClass-2
    C25406
    UMLS 2011AA ObjectClass
    C1524062
    Date of Subsequent Treatment (If yes mm/dd/yyyy)
    Beschrijving

    AdditionalTreatmentProgressionDate

    Datatype

    date

    Alias
    NCI Thesaurus ObjectClass
    C15368
    NCI Thesaurus ObjectClass-2
    C25406
    UMLS 2011AA ObjectClass
    C1524062
    NCI Thesaurus Property
    C25331
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ValueDomain-2
    C25367
    Subsequent Treatment Type
    Beschrijving

    AdditionalTreatmentProgressionText

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704
    UMLS 2011AA ValueDomain
    C1527021
    NCI Thesaurus Property
    C25331
    NCI Thesaurus ObjectClass
    C15368
    NCI Thesaurus ObjectClass-2
    C25406
    UMLS 2011AA ObjectClass
    C1524062
    Notice Of New Primary
    Beschrijving

    Notice Of New Primary

    Has a new primary cancer or MDS been diagnosed that has not been previously reported? (myelodyplastic syndrome)
    Beschrijving

    NewCancerDiagnosisInd-3

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    NCI Thesaurus ObjectClass
    C25586
    UMLS 2011AA ObjectClass
    C0205314
    NCI Thesaurus ObjectClass-2
    C9305
    UMLS 2011AA ObjectClass-2
    C0006826
    NCI Thesaurus Property
    C15220
    UMLS 2011AA Property
    C0011900
    New Primary Cancer Date (If yes,)
    Beschrijving

    NewCancerDiagnosisDate

    Datatype

    date

    Alias
    NCI Thesaurus ObjectClass
    C25586
    UMLS 2011AA ObjectClass
    C0205314
    NCI Thesaurus ObjectClass-2
    C9305
    UMLS 2011AA ObjectClass-2
    C0006826
    NCI Thesaurus Property
    C15220
    UMLS 2011AA Property
    C0011900
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ValueDomain-2
    C25367
    Site of New Primary
    Beschrijving

    NewCancerSiteText

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704
    UMLS 2011AA ValueDomain
    C1527021
    NCI Thesaurus ObjectClass
    C25586
    UMLS 2011AA ObjectClass
    C0205314
    NCI Thesaurus Property
    C25341
    UMLS 2011AA Property
    C0450429
    NCI Thesaurus ObjectClass-2
    C9305
    UMLS 2011AA ObjectClass-2
    C0006826
    Late Adverse Event
    Beschrijving

    Late Adverse Event

    Has the patient experienced (prior to treatment for progression or relapse or a second primary, and prior to non-protocol treatment) any severe (grade >=3) long term toxicity that has not been previously reported?
    Beschrijving

    AdverseEventPriorCancerProgressionRecurrentNeoplasmPresentInd-3

    Datatype

    text

    Alias
    NCI Thesaurus ObjectClass
    C41331
    UMLS 2011AA ObjectClass
    C0877248
    NCI Thesaurus Property
    C25626
    UMLS 2011AA Property
    C0150312
    NCI Thesaurus Property-2
    C25629
    UMLS 2011AA Property-2
    C0332152
    NCI Thesaurus Property-3
    C19987
    UMLS 2011AA Property-3
    C0242656
    NCI Thesaurus Property-4
    C4798
    UMLS 2011AA Property-4
    C0521158
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    Description Of Primary Disease
    Beschrijving

    Description Of Primary Disease

    CTC Adverse Event Term
    Beschrijving

    CTC Adverse Event Term

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C25284
    UMLS CUI-1
    C1516728
    NCI Thesaurus ObjectClass
    C49704
    UMLS CUI-2
    C2826934
    NCI Thesaurus Property
    C45559
    MedDRA Code (primary tumor site: Metastases to brain parenchyma)
    Beschrijving

    MedDRACode

    Datatype

    float

    Alias
    NCI Thesaurus ValueDomain
    C25162
    UMLS 2011AA ValueDomain
    C0805701
    NCI Thesaurus Property
    C25364
    UMLS 2011AA Property
    C0600091
    NCI Metathesaurus ObjectClass
    CL104089
    CTC Adverse Event Grade (Highest Grade)
    Beschrijving

    CTC Adverse Event Grade

    Datatype

    float

    Alias
    NCI Thesaurus ObjectClass
    C49704
    UMLS CUI-1
    C2985911
    NCI Thesaurus ValueDomain
    C18000
    NCI Thesaurus Property
    C25365
    CTC AE Attribution Code
    Beschrijving

    CTC Adverse Event Attribution Category

    Datatype

    text

    Alias
    NCI Thesaurus ValueDomain
    C25664
    UMLS CUI-1
    C1706735
    NCI Thesaurus ObjectClass
    C49704
    NCI Thesaurus Property
    C25358
    Late Adverse Event Onset Date (mm/dd/yyyy)
    Beschrijving

    LateAdverseEventOnsetDate

    Datatype

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ValueDomain-2
    C25367
    NCI Thesaurus ObjectClass
    C41331
    UMLS 2011AA ObjectClass
    C0877248
    NCI Thesaurus Property
    C25279
    UMLS 2011AA Property
    C0332162

    Similar models

    No Instruction available.

    1. StudyEvent: North Central Cancer Treatment Group N0723 Event Monitoring Form
      1. No Instruction available.
    Name
    Type
    Description | Question | Decode (Coded Value)
    Datatype
    Alias
    Item Group
    Header
    Protocol ID NCCTG
    Item
    Protocol Number
    text
    C25337 (NCI Thesaurus ValueDomain)
    C3274381 (UMLS CUI-1)
    C25320 (NCI Thesaurus ObjectClass)
    C1518419 (UMLS CUI-2)
    C25364 (NCI Thesaurus Property)
    C25581 (NCI Thesaurus Property-2)
    PatientNorthCentralCancerTreatmentGroupIdentifierNumber
    Item
    Patient ID
    text
    C25337 (NCI Thesaurus ValueDomain)
    C0237753 (UMLS 2011AA ValueDomain)
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C25364 (NCI Thesaurus Property)
    C0600091 (UMLS 2011AA Property)
    C25581 (NCI Thesaurus Property-2)
    C1518419 (UMLS 2011AA Property-2)
    Patient Initials
    Item
    Patient Initials (L F M)
    text
    C25191 (NCI Thesaurus ValueDomain)
    C2986440 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C25536 (NCI Thesaurus Property)
    Institution Number
    Item
    Institution Number
    text
    C25337 (NCI Thesaurus ValueDomain)
    C1301943 (UMLS CUI-1)
    C21541 (NCI Thesaurus ObjectClass)
    C0805701 (UMLS CUI-2)
    C25364 (NCI Thesaurus Property)
    Institution Name
    Item
    Institution
    text
    C25191 (NCI Thesaurus ValueDomain)
    C1301943 (UMLS CUI-1)
    C21541 (NCI Thesaurus ObjectClass)
    C21541 (NCI Thesaurus ValueDomain-2)
    C25364 (NCI Thesaurus Property)
    Data amended
    Item
    Are data amended (If yes, highlight amended areas)
    boolean
    C38148 (NCI Thesaurus ValueDomain)
    C0680532 (UMLS CUI-1)
    C25474 (NCI Thesaurus ObjectClass)
    C25416 (NCI Thesaurus Property)
    Item Group
    Unnamed Module
    PatientInformationCurrentFollow-upCollectedInd-2
    Item
    Were you able to obtain any information about the patient since the last report (If this is the first event monitoring form check yes, enter assessment date and complete the rest of the form.)
    boolean
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C48191 (NCI Thesaurus ObjectClass-2)
    C1533716 (UMLS 2011AA ObjectClass-2)
    C25471 (NCI Thesaurus Property)
    C0521116 (UMLS 2011AA Property)
    C16033 (NCI Thesaurus Property-2)
    C1522577 (UMLS 2011AA Property-2)
    C25452 (NCI Thesaurus Property-3)
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    PatientLastAttemptContactDate
    Item
    Date of last attempt to contact patient (If No, mm/dd/yyyy)
    date
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C25461 (NCI Thesaurus Property)
    C0337611 (UMLS 2011AA Property)
    C25551 (NCI Thesaurus Property-2)
    C1517741 (UMLS 2011AA Property-2)
    C39769 (NCI Thesaurus Property-3)
    C1516084 (UMLS 2011AA Property-3)
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    Item Group
    Vital Status
    Item
    Vital Status
    text
    C16960 (NCI Thesaurus ObjectClass)
    C3846084 (UMLS CUI-1)
    C18003 (NCI Thesaurus ValueDomain)
    C25688 (NCI Thesaurus ValueDomain-2)
    C25717 (NCI Thesaurus Property)
    Code List
    Vital Status
    CL Item
    Alive (Alive)
    CL Item
    Dead (Dead)
    Date last contact
    Item
    Date of Last Contact or Death (mm/dd/yyyy)
    date
    C16960 (NCI Thesaurus ObjectClass)
    C0805839 (UMLS CUI-1)
    C25461 (NCI Thesaurus Property)
    C25551 (NCI Thesaurus Property-2)
    C25164 (NCI Thesaurus ValueDomain)
    C25367 (NCI Thesaurus ValueDomain-2)
    Item
    Primary Cause of Death
    text
    C25638 (NCI Thesaurus ValueDomain)
    C0007465 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C28554 (NCI Thesaurus Property)
    C25251 (NCI Thesaurus ValueDomain-2)
    Code List
    Primary Cause of Death
    CL Item
    Due To Protocol Treatment (Due to protocol treatment)
    CL Item
    Due To This Disease (Due to this disease)
    CL Item
    Due To Other Cause (Due to other cause)
    Primary Cause of Death, specify
    Item
    Due to other cause, specify
    text
    C16960 (NCI Thesaurus ObjectClass)
    C0007465 (UMLS CUI-1)
    C25251 (NCI Thesaurus ObjectClass-2)
    C0007465 (NCI Metathesaurus ObjectClass)
    C17649 (NCI Thesaurus Property)
    C25365 (NCI Thesaurus Property-2)
    C25685 (NCI Thesaurus ValueDomain)
    Item Group
    Disease Follow-up Status
    Documented clinical assessment for this cancer
    Item
    Has the patient had a documented clinical assessment for this cancer? (since submission of the last event monitoring form)
    boolean
    C38148 (NCI Thesaurus ValueDomain)
    C1522577 (UMLS CUI-1)
    C16033 (NCI Thesaurus Property)
    C0006826 (UMLS CUI-2)
    C9305 (NCI Thesaurus ObjectClass)
    C25365 (NCI Thesaurus Property-2)
    Follow-Up Date
    Item
    Cancer Follow-up Status Date (If yes,)
    date
    C9305 (NCI Thesaurus ObjectClass)
    C3694716 (UMLS CUI-1)
    C16033 (NCI Thesaurus Property)
    C25365 (NCI Thesaurus Property-2)
    C25164 (NCI Thesaurus ValueDomain)
    C25367 (NCI Thesaurus ValueDomain-2)
    Item Group
    Notice Of First Relapse/progression In The Event Monitoring Phase
    DiseaseRelapseProgressionInd-3
    Item
    Has the patient developed a first relapse or progression that has not been previously reported
    boolean
    C2991 (NCI Thesaurus ObjectClass)
    C0012634 (UMLS 2011AA ObjectClass)
    C38155 (NCI Thesaurus Property)
    C0277556 (UMLS 2011AA Property)
    C15220 (NCI Thesaurus Property-2)
    C0011900 (UMLS 2011AA Property-2)
    C19987 (NCI Thesaurus Property-3)
    C0242656 (UMLS 2011AA Property-3)
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    DiseaseRecurrentDiseaseCancerProgressionDiagnosisDate
    Item
    Date of Relapse or Progression (If yes,)
    date
    C2991 (NCI Thesaurus ObjectClass)
    C0012634 (UMLS 2011AA ObjectClass)
    C38155 (NCI Thesaurus Property)
    C0277556 (UMLS 2011AA Property)
    C15220 (NCI Thesaurus Property-2)
    C0011900 (UMLS 2011AA Property-2)
    C19987 (NCI Thesaurus Property-3)
    C0242656 (UMLS 2011AA Property-3)
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    Item Group
    Notice Of First Subsequent Treatment
    Item
    Has the patient received subsequent treatment for this cancer that has not been previously reported
    text
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    C25331 (NCI Thesaurus Property)
    C15368 (NCI Thesaurus ObjectClass)
    C25406 (NCI Thesaurus ObjectClass-2)
    C1524062 (UMLS 2011AA ObjectClass)
    Code List
    Has the patient received subsequent treatment for this cancer that has not been previously reported
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    CL Item
    Unknown (Unknown)
    C17998 (NCI Thesaurus)
    C0439673 (UMLS 2011AA)
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    AdditionalTreatmentProgressionDate
    Item
    Date of Subsequent Treatment (If yes mm/dd/yyyy)
    date
    C15368 (NCI Thesaurus ObjectClass)
    C25406 (NCI Thesaurus ObjectClass-2)
    C1524062 (UMLS 2011AA ObjectClass)
    C25331 (NCI Thesaurus Property)
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C25367 (NCI Thesaurus ValueDomain-2)
    AdditionalTreatmentProgressionText
    Item
    Subsequent Treatment Type
    text
    C25704 (NCI Thesaurus ValueDomain)
    C1527021 (UMLS 2011AA ValueDomain)
    C25331 (NCI Thesaurus Property)
    C15368 (NCI Thesaurus ObjectClass)
    C25406 (NCI Thesaurus ObjectClass-2)
    C1524062 (UMLS 2011AA ObjectClass)
    Item Group
    Notice Of New Primary
    Item
    Has a new primary cancer or MDS been diagnosed that has not been previously reported? (myelodyplastic syndrome)
    text
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    C25586 (NCI Thesaurus ObjectClass)
    C0205314 (UMLS 2011AA ObjectClass)
    C9305 (NCI Thesaurus ObjectClass-2)
    C0006826 (UMLS 2011AA ObjectClass-2)
    C15220 (NCI Thesaurus Property)
    C0011900 (UMLS 2011AA Property)
    Code List
    Has a new primary cancer or MDS been diagnosed that has not been previously reported? (myelodyplastic syndrome)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    CL Item
    Unknown (Unknown)
    C17998 (NCI Thesaurus)
    C0439673 (UMLS 2011AA)
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    NewCancerDiagnosisDate
    Item
    New Primary Cancer Date (If yes,)
    date
    C25586 (NCI Thesaurus ObjectClass)
    C0205314 (UMLS 2011AA ObjectClass)
    C9305 (NCI Thesaurus ObjectClass-2)
    C0006826 (UMLS 2011AA ObjectClass-2)
    C15220 (NCI Thesaurus Property)
    C0011900 (UMLS 2011AA Property)
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C25367 (NCI Thesaurus ValueDomain-2)
    NewCancerSiteText
    Item
    Site of New Primary
    text
    C25704 (NCI Thesaurus ValueDomain)
    C1527021 (UMLS 2011AA ValueDomain)
    C25586 (NCI Thesaurus ObjectClass)
    C0205314 (UMLS 2011AA ObjectClass)
    C25341 (NCI Thesaurus Property)
    C0450429 (UMLS 2011AA Property)
    C9305 (NCI Thesaurus ObjectClass-2)
    C0006826 (UMLS 2011AA ObjectClass-2)
    Item Group
    Late Adverse Event
    Item
    Has the patient experienced (prior to treatment for progression or relapse or a second primary, and prior to non-protocol treatment) any severe (grade >=3) long term toxicity that has not been previously reported?
    text
    C41331 (NCI Thesaurus ObjectClass)
    C0877248 (UMLS 2011AA ObjectClass)
    C25626 (NCI Thesaurus Property)
    C0150312 (UMLS 2011AA Property)
    C25629 (NCI Thesaurus Property-2)
    C0332152 (UMLS 2011AA Property-2)
    C19987 (NCI Thesaurus Property-3)
    C0242656 (UMLS 2011AA Property-3)
    C4798 (NCI Thesaurus Property-4)
    C0521158 (UMLS 2011AA Property-4)
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    Code List
    Has the patient experienced (prior to treatment for progression or relapse or a second primary, and prior to non-protocol treatment) any severe (grade >=3) long term toxicity that has not been previously reported?
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    CL Item
    Unknown (Unknown)
    C17998 (NCI Thesaurus)
    C0439673 (UMLS 2011AA)
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    Item Group
    Description Of Primary Disease
    CTC Adverse Event Term
    Item
    CTC Adverse Event Term
    text
    C25284 (NCI Thesaurus ValueDomain)
    C1516728 (UMLS CUI-1)
    C49704 (NCI Thesaurus ObjectClass)
    C2826934 (UMLS CUI-2)
    C45559 (NCI Thesaurus Property)
    MedDRACode
    Item
    MedDRA Code (primary tumor site: Metastases to brain parenchyma)
    float
    C25162 (NCI Thesaurus ValueDomain)
    C0805701 (UMLS 2011AA ValueDomain)
    C25364 (NCI Thesaurus Property)
    C0600091 (UMLS 2011AA Property)
    CL104089 (NCI Metathesaurus ObjectClass)
    CTC Adverse Event Grade
    Item
    CTC Adverse Event Grade (Highest Grade)
    float
    C49704 (NCI Thesaurus ObjectClass)
    C2985911 (UMLS CUI-1)
    C18000 (NCI Thesaurus ValueDomain)
    C25365 (NCI Thesaurus Property)
    Item
    CTC AE Attribution Code
    text
    C25664 (NCI Thesaurus ValueDomain)
    C1706735 (UMLS CUI-1)
    C49704 (NCI Thesaurus ObjectClass)
    C25358 (NCI Thesaurus Property)
    Code List
    CTC AE Attribution Code
    CL Item
    Definite (Definite)
    CL209464 (NCI Metathesaurus)
    CL Item
    Possible (Possible)
    C0332149 (NCI Metathesaurus)
    CL Item
    Probable (Probable)
    C0332148 (NCI Metathesaurus)
    CL Item
    Unlikely (Unlikely)
    CL Item
    Unrelated (Unrelated)
    C25328 (NCI Thesaurus)
    C0445356 (UMLS 2011AA)
    LateAdverseEventOnsetDate
    Item
    Late Adverse Event Onset Date (mm/dd/yyyy)
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C25367 (NCI Thesaurus ValueDomain-2)
    C41331 (NCI Thesaurus ObjectClass)
    C0877248 (UMLS 2011AA ObjectClass)
    C25279 (NCI Thesaurus Property)
    C0332162 (UMLS 2011AA Property)

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