ID
8649
Beskrivning
GOG-0262: Medical History Form (Form MEDH) Paclitaxel and Carboplatin With or Without Bevacizumab in Treating Patients With Stage II, Stage III, or Stage IV Ovarian Epithelial Cancer, Primary Peritoneal Cancer, or Fallopian Tube Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=6E5EB14F-2030-D8EE-E040-BB89AD4349C7
Länk
Nyckelord
Versioner (4)
- 2012-09-19 2012-09-19 -
- 2014-08-11 2014-08-11 - Martin Dugas
- 2014-08-11 2014-08-11 - Martin Dugas
- 2015-01-09 2015-01-09 - Martin Dugas
Uppladdad den
9 januari 2015
DOI
För en begäran logga in.
Licens
Creative Commons BY-NC 3.0 Legacy
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Fallopian Tube Cancer NCT01167712 Pre-Study - GOG-0262: Medical History Form (Form MEDH) - 2917582v1.0
No Instruction available.
- StudyEvent: GOG-0262: Medical History Form (Form MEDH)
Beskrivning
Ovarian: Disease Description
Beskrivning
PersonHypertensionTherapeuticProcedurePersonalMedicalHistoryIndicator
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus Property
- C3117
- UMLS 2011AA Property
- C0020538
- NCI Thesaurus Property-2
- C49236
- UMLS 2011AA Property-2
- C0087111
- NCI Thesaurus Property-3
- C18772
- UMLS 2011AA Property-3
- C0262926
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Beskrivning
HistoryofPeripheralVascularDiseasePresentInd-3
Datatyp
boolean
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
- NCI Thesaurus Property
- C25626
- UMLS 2011AA Property
- C0150312
- NCI Thesaurus ObjectClass
- C66923
- UMLS 2011AA ObjectClass
- C1881056
Beskrivning
PatientCerebrovascularAccidentMyocardialInfarctionPersonalMedicalHistoryInd-3
Datatyp
boolean
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C27996
- UMLS 2011AA Property
- C0027051
- NCI Thesaurus Property-2
- C3390
- UMLS 2011AA Property-2
- C0038454
- NCI Thesaurus Property-3
- C18772
- UMLS 2011AA Property-3
- C0262926
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
Beskrivning
Current Smoker
Datatyp
boolean
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS CUI-1
- C3241966
- NCI Thesaurus Property
- C25471
- NCI Thesaurus ObjectClass
- C17934
- NCI Metathesaurus Property
- C0449865
Beskrivning
CigaretteAverageDailyPackUseCount
Datatyp
float
Alias
- NCI Thesaurus ObjectClass
- C1802
- UMLS 2011AA ObjectClass
- C0677453
- NCI Thesaurus Property
- C25473
- UMLS 2011AA Property
- C0332173
- NCI Thesaurus Property-2
- C62653
- UMLS 2011AA Property-2
- C2825051
- NCI Thesaurus Property-3
- C37917
- UMLS 2011AA Property-3
- C1510992
- NCI Thesaurus Property-4
- C25340
- UMLS 2011AA Property-4
- C0457083
- NCI Thesaurus ValueDomain
- C25463
- UMLS 2011AA ValueDomain
- C0750480
Beskrivning
CigarAverageDailyUseCount
Datatyp
float
Alias
- NCI Thesaurus ObjectClass
- C1813
- UMLS 2011AA ObjectClass
- C0182504
- NCI Thesaurus Property
- C25473
- UMLS 2011AA Property
- C0332173
- NCI Thesaurus Property-2
- C37917
- UMLS 2011AA Property-2
- C1510992
- NCI Thesaurus Property-3
- C25340
- UMLS 2011AA Property-3
- C0457083
- NCI Thesaurus ValueDomain
- C25463
- UMLS 2011AA ValueDomain
- C0750480
Beskrivning
Smoking Duration
Datatyp
float
Alias
- NCI Thesaurus ValueDomain
- C25463
- UMLS CUI-1
- C3694955
- NCI Thesaurus ObjectClass
- C17934
- NCI Thesaurus Property
- C25330
Beskrivning
PersonDiabetesMellitusTherapeuticProcedurePersonalMedicalHistoryIndicator
Datatyp
text
Alias
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus Property
- C2985
- UMLS 2011AA Property
- C0011849
- NCI Thesaurus Property-2
- C49236
- UMLS 2011AA Property-2
- C0087111
- NCI Thesaurus Property-3
- C18772
- UMLS 2011AA Property-3
- C0262926
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Beskrivning
Ovarian: Findings From Primary Surgery
Beskrivning
DiseasesandDisordersPatientSelf-ReportAutoimmuneDiseaseDiagnosisInd-3
Datatyp
boolean
Alias
- NCI Thesaurus ObjectClass
- C2991
- UMLS 2011AA ObjectClass
- C0012634
- NCI Thesaurus Property
- C15220
- UMLS 2011AA Property
- C0011900
- NCI Thesaurus Property-2
- C2889
- UMLS 2011AA Property-2
- C0004364
- NCI Thesaurus Property-3
- C21089
- UMLS 2011AA Property-3
- C0681906
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
Beskrivning
Ovarian: Post-operative Findings Following Primary Surgery
Beskrivning
PatientUlcerationPersonalMedicalHistoryInd-3
Datatyp
boolean
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C18772
- UMLS 2011AA Property
- C0262926
- NCI Thesaurus Property-2
- C25757
- UMLS 2011AA Property-2
- C0041582
Beskrivning
TumorIntestinalObstructionInd-3
Datatyp
boolean
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
- NCI Thesaurus ObjectClass
- C3262
- UMLS 2011AA ObjectClass
- C0027651
- NCI Thesaurus Property
- C25266
- UMLS 2011AA Property
- C0021853
- NCI Thesaurus Property-2
- C3284
- UMLS 2011AA Property-2
- C0028778
Beskrivning
PatientInflammatoryBowelDiseasePersonalMedicalHistoryIndicator
Datatyp
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C3138
- UMLS 2011AA Property
- C0021390
- NCI Thesaurus Property-2
- C18772
- UMLS 2011AA Property-2
- C0262926
Beskrivning
PatientInflammatoryBowelDiseaseTreatmentPersonalMedicalHistoryInd-2
Datatyp
boolean
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C15368
- NCI Thesaurus Property-2
- C3138
- UMLS 2011AA Property
- C0021390
- NCI Thesaurus Property-3
- C18772
- UMLS 2011AA Property-2
- C0262926
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Beskrivning
PatientDiverticulitisTreatmentPersonalMedicalHistoryInd-2
Datatyp
boolean
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C15368
- NCI Thesaurus Property-2
- C18772
- UMLS 2011AA Property
- C0262926
- NCI Thesaurus Property-3
- C26752
- UMLS 2011AA Property-2
- C0012813
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Beskrivning
PatientC.DifficileColitisPersonalMedicalHistoryInd-2
Datatyp
boolean
Alias
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C18772
- UMLS 2011AA Property
- C0262926
- NCI Thesaurus Property-2
- C35286
- UMLS 2011AA Property-2
- C0238106
Beskrivning
PatientSmallIntestineExcisionAnastomosisPersonalMedicalHistoryInd-2
Datatyp
boolean
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C12386
- UMLS 2011AA Property
- C0021852
- NCI Thesaurus Property-2
- C15609
- UMLS 2011AA Property-2
- C0677554
- NCI Thesaurus Property-3
- C15232
- UMLS 2011AA Property-3
- C0728940
- NCI Thesaurus Property-4
- C18772
- UMLS 2011AA Property-4
- C0262926
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Beskrivning
PatientSmallBowelExcisionAnastomosisDebulkingPersonalMedicalHistoryInd-2
Datatyp
boolean
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C12386
- UMLS 2011AA Property
- C0021852
- NCI Thesaurus Property-2
- C15609
- UMLS 2011AA Property-2
- C0677554
- NCI Thesaurus Property-3
- C15232
- UMLS 2011AA Property-3
- C0728940
- NCI Thesaurus Property-4
- C18772
- UMLS 2011AA Property-4
- C0262926
- NCI Thesaurus Property-5
- C15749
- UMLS 2011AA Property-5
- C0439805
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Beskrivning
PatientLargeIntestineExcisionAnastomosisPersonalMedicalHistoryInd-2
Datatyp
boolean
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C15609
- UMLS 2011AA Property
- C0677554
- NCI Thesaurus Property-2
- C12379
- UMLS 2011AA Property-2
- C0021851
- NCI Thesaurus Property-3
- C15232
- UMLS 2011AA Property-3
- C0728940
- NCI Thesaurus Property-4
- C18772
- UMLS 2011AA Property-4
- C0262926
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Beskrivning
PatientLargeIntestineExcisionAnastomosisDebulkingPersonalMedicalHistoryInd-2
Datatyp
boolean
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C15609
- UMLS 2011AA Property
- C0677554
- NCI Thesaurus Property-2
- C12379
- UMLS 2011AA Property-2
- C0021851
- NCI Thesaurus Property-3
- C15232
- UMLS 2011AA Property-3
- C0728940
- NCI Thesaurus Property-4
- C18772
- UMLS 2011AA Property-4
- C0262926
- NCI Thesaurus Property-5
- C15749
- UMLS 2011AA Property-5
- C0439805
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Beskrivning
Footer Module
Beskrivning
PatientCorticosteroidUsePersonalMedicalHistoryInd-2
Datatyp
boolean
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C2322
- UMLS 2011AA Property
- C0001617
- NCI Thesaurus Property-2
- C18772
- UMLS 2011AA Property-2
- C0262926
- NCI Thesaurus Property-3
- C25340
- UMLS 2011AA Property-3
- C0457083
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Beskrivning
PatientNonsteroidalAntiinflammatoryDrugRegularUsePersonalMedicalHistoryInd-2
Datatyp
boolean
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C18772
- UMLS 2011AA Property
- C0262926
- NCI Thesaurus Property-2
- C257
- UMLS 2011AA Property-2
- C0003211
- NCI Thesaurus Property-3
- C25340
- UMLS 2011AA Property-3
- C0457083
- NCI Thesaurus Property-4
- C25647
- UMLS 2011AA Property-4
- C0205272
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Beskrivning
Comments
Similar models
No Instruction available.
- StudyEvent: GOG-0262: Medical History Form (Form MEDH)
C1549507 (UMLS CUI-1)
C25250 (NCI Thesaurus Property)
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C25164 (NCI Thesaurus ValueDomain)
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C0020538 (UMLS 2011AA Property)
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C0262926 (UMLS 2011AA Property-3)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C3241966 (UMLS CUI-1)
C25471 (NCI Thesaurus Property)
C17934 (NCI Thesaurus ObjectClass)
C0449865 (NCI Metathesaurus Property)
C0677453 (UMLS 2011AA ObjectClass)
C25473 (NCI Thesaurus Property)
C0332173 (UMLS 2011AA Property)
C62653 (NCI Thesaurus Property-2)
C2825051 (UMLS 2011AA Property-2)
C37917 (NCI Thesaurus Property-3)
C1510992 (UMLS 2011AA Property-3)
C25340 (NCI Thesaurus Property-4)
C0457083 (UMLS 2011AA Property-4)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
C0182504 (UMLS 2011AA ObjectClass)
C25473 (NCI Thesaurus Property)
C0332173 (UMLS 2011AA Property)
C37917 (NCI Thesaurus Property-2)
C1510992 (UMLS 2011AA Property-2)
C25340 (NCI Thesaurus Property-3)
C0457083 (UMLS 2011AA Property-3)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
C3694955 (UMLS CUI-1)
C17934 (NCI Thesaurus ObjectClass)
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C0027361 (UMLS 2011AA ObjectClass)
C2985 (NCI Thesaurus Property)
C0011849 (UMLS 2011AA Property)
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C0087111 (UMLS 2011AA Property-2)
C18772 (NCI Thesaurus Property-3)
C0262926 (UMLS 2011AA Property-3)
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C1298908 (UMLS 2011AA)
C0012634 (UMLS 2011AA ObjectClass)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)
C2889 (NCI Thesaurus Property-2)
C0004364 (UMLS 2011AA Property-2)
C21089 (NCI Thesaurus Property-3)
C0681906 (UMLS 2011AA Property-3)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C18772 (NCI Thesaurus Property)
C0262926 (UMLS 2011AA Property)
C25757 (NCI Thesaurus Property-2)
C0041582 (UMLS 2011AA Property-2)
C1512699 (UMLS 2011AA ValueDomain)
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C25266 (NCI Thesaurus Property)
C0021853 (UMLS 2011AA Property)
C3284 (NCI Thesaurus Property-2)
C0028778 (UMLS 2011AA Property-2)
C1522602 (UMLS 2011AA ValueDomain)
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C0030705 (UMLS 2011AA ObjectClass)
C3138 (NCI Thesaurus Property)
C0021390 (UMLS 2011AA Property)
C18772 (NCI Thesaurus Property-2)
C0262926 (UMLS 2011AA Property-2)
C1298908 (UMLS 2011AA)
C0030705 (UMLS 2011AA ObjectClass)
C15368 (NCI Thesaurus Property)
C3138 (NCI Thesaurus Property-2)
C0021390 (UMLS 2011AA Property)
C18772 (NCI Thesaurus Property-3)
C0262926 (UMLS 2011AA Property-2)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C0030705 (UMLS 2011AA ObjectClass)
C15368 (NCI Thesaurus Property)
C18772 (NCI Thesaurus Property-2)
C0262926 (UMLS 2011AA Property)
C26752 (NCI Thesaurus Property-3)
C0012813 (UMLS 2011AA Property-2)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C18772 (NCI Thesaurus Property)
C0262926 (UMLS 2011AA Property)
C35286 (NCI Thesaurus Property-2)
C0238106 (UMLS 2011AA Property-2)
C0030705 (UMLS 2011AA ObjectClass)
C12386 (NCI Thesaurus Property)
C0021852 (UMLS 2011AA Property)
C15609 (NCI Thesaurus Property-2)
C0677554 (UMLS 2011AA Property-2)
C15232 (NCI Thesaurus Property-3)
C0728940 (UMLS 2011AA Property-3)
C18772 (NCI Thesaurus Property-4)
C0262926 (UMLS 2011AA Property-4)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C0030705 (UMLS 2011AA ObjectClass)
C12386 (NCI Thesaurus Property)
C0021852 (UMLS 2011AA Property)
C15609 (NCI Thesaurus Property-2)
C0677554 (UMLS 2011AA Property-2)
C15232 (NCI Thesaurus Property-3)
C0728940 (UMLS 2011AA Property-3)
C18772 (NCI Thesaurus Property-4)
C0262926 (UMLS 2011AA Property-4)
C15749 (NCI Thesaurus Property-5)
C0439805 (UMLS 2011AA Property-5)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C0030705 (UMLS 2011AA ObjectClass)
C15609 (NCI Thesaurus Property)
C0677554 (UMLS 2011AA Property)
C12379 (NCI Thesaurus Property-2)
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C15232 (NCI Thesaurus Property-3)
C0728940 (UMLS 2011AA Property-3)
C18772 (NCI Thesaurus Property-4)
C0262926 (UMLS 2011AA Property-4)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C0030705 (UMLS 2011AA ObjectClass)
C15609 (NCI Thesaurus Property)
C0677554 (UMLS 2011AA Property)
C12379 (NCI Thesaurus Property-2)
C0021851 (UMLS 2011AA Property-2)
C15232 (NCI Thesaurus Property-3)
C0728940 (UMLS 2011AA Property-3)
C18772 (NCI Thesaurus Property-4)
C0262926 (UMLS 2011AA Property-4)
C15749 (NCI Thesaurus Property-5)
C0439805 (UMLS 2011AA Property-5)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C0030705 (UMLS 2011AA ObjectClass)
C2322 (NCI Thesaurus Property)
C0001617 (UMLS 2011AA Property)
C18772 (NCI Thesaurus Property-2)
C0262926 (UMLS 2011AA Property-2)
C25340 (NCI Thesaurus Property-3)
C0457083 (UMLS 2011AA Property-3)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C0030705 (UMLS 2011AA ObjectClass)
C18772 (NCI Thesaurus Property)
C0262926 (UMLS 2011AA Property)
C257 (NCI Thesaurus Property-2)
C0003211 (UMLS 2011AA Property-2)
C25340 (NCI Thesaurus Property-3)
C0457083 (UMLS 2011AA Property-3)
C25647 (NCI Thesaurus Property-4)
C0205272 (UMLS 2011AA Property-4)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)