ID

8649

Beschreibung

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

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=6E5EB14F-2030-D8EE-E040-BB89AD4349C7

Stichworte

Versionen (4)
  1. 19.09.12 19.09.12 -
  2. 11.08.14 11.08.14 - Martin Dugas
  3. 11.08.14 11.08.14 - Martin Dugas
  4. 09.01.15 09.01.15 - Martin Dugas
Hochgeladen am

9. Januar 2015

DOI

Für eine Beantragung loggen Sie sich ein.

Lizenz

Creative Commons BY-NC 3.0 Legacy
Modell Kommentare :

Hier können Sie das Modell kommentieren. Über die Sprechblasen an den Itemgruppen und Items können Sie diese spezifisch kommentieren.

Zurück zu Modell Kommentaren
Itemgroup Kommentare für :

Item Kommentare für :

Um Formulare herunterzuladen müssen Sie angemeldet sein. Bitte loggen Sie sich ein oder registrieren Sie sich kostenlos.

Fallopian Tube Cancer NCT01167712 Pre-Study - GOG-0262: Medical History Form (Form MEDH) - 2917582v1.0

Englisch

No Instruction available.

1 Formulare  
  1. StudyEvent: GOG-0262: Medical History Form (Form MEDH)
    1. No Instruction available.
Header Module
Beschreibung

Header Module

Date form originally completed
Beschreibung

Form Completion Date

Datentyp

date

Alias
NCI Thesaurus ObjectClass
C19464
UMLS CUI-1
C1549507
NCI Thesaurus Property
C25250
NCI Thesaurus Property-2
C25604
NCI Thesaurus ValueDomain
C25164
NCI Thesaurus ValueDomain-2
C25367
Date form amended
Beschreibung

Amendment date

Datentyp

date

Alias
NCI Thesaurus ObjectClass
C19464
UMLS CUI-1
C0680532
NCI Thesaurus Property
C25250
UMLS CUI-2
C0011008
NCI Thesaurus Property-2
C25416
NCI Thesaurus ValueDomain
C25164
NCI Thesaurus ValueDomain-2
C25367
Person amending form, last name
Beschreibung

Person Amending Form

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C0680532
NCI Thesaurus ObjectClass
C25190
UMLS CUI-2
C1547383
NCI Thesaurus Property
C25364
Patient Initials
Beschreibung

Patient Initials

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C2986440
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25536
Patient Study ID
Beschreibung

Patient Study ID

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C2348585
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25462
NCI Thesaurus Property-2
C25364
Person Completing Form, Last Name
Beschreibung

Person Completing Form Last Name

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C25190
UMLS CUI-1
C1550483
NCI Thesaurus ObjectClass-2
C25657
UMLS CUI-2
C1301584
NCI Thesaurus Property
C25364
NCI Thesaurus Property-2
C25551
NCI Thesaurus ValueDomain
C25191
Ovarian: Disease Description
Beschreibung

Ovarian: Disease Description

Have you ever been treated for hypertension that required medication
Beschreibung

PersonHypertensionTherapeuticProcedurePersonalMedicalHistoryIndicator

Datentyp

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
Peripheral vascular disease with claudication
Beschreibung

HistoryofPeripheralVascularDiseasePresentInd-3

Datentyp

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
Myocardial infarction or cerebrovascular accident
Beschreibung

PatientCerebrovascularAccidentMyocardialInfarctionPersonalMedicalHistoryInd-3

Datentyp

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
Have you smoked during the past year
Beschreibung

Current Smoker

Datentyp

boolean

Alias
NCI Thesaurus ValueDomain
C38148
UMLS CUI-1
C3241966
NCI Thesaurus Property
C25471
NCI Thesaurus ObjectClass
C17934
NCI Metathesaurus Property
C0449865
If you smoke, how many packs of cigarettes do you average per day
Beschreibung

CigaretteAverageDailyPackUseCount

Datentyp

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
How many cigars/pipes do you average per day
Beschreibung

CigarAverageDailyUseCount

Datentyp

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
How many years have you smoked
Beschreibung

Smoking Duration

Datentyp

float

Alias
NCI Thesaurus ValueDomain
C25463
UMLS CUI-1
C3694955
NCI Thesaurus ObjectClass
C17934
NCI Thesaurus Property
C25330
Do you currently take medication for diabetes
Beschreibung

PersonDiabetesMellitusTherapeuticProcedurePersonalMedicalHistoryIndicator

Datentyp

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
Ovarian: Findings From Primary Surgery
Beschreibung

Ovarian: Findings From Primary Surgery

Have you ever been diagnosed with an autoimmune disease
Beschreibung

DiseasesandDisordersPatientSelf-ReportAutoimmuneDiseaseDiagnosisInd-3

Datentyp

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
Ovarian: Post-operative Findings Following Primary Surgery
Beschreibung

Ovarian: Post-operative Findings Following Primary Surgery

Have you ever had peptic ulcer disease, documented by endoscopy
Beschreibung

PatientUlcerationPersonalMedicalHistoryInd-3

Datentyp

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
Have you ever had an intestinal obstruction, documented radiographically
Beschreibung

TumorIntestinalObstructionInd-3

Datentyp

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
Have you ever had inflammatory bowel disease
Beschreibung

PatientInflammatoryBowelDiseasePersonalMedicalHistoryIndicator

Datentyp

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
If you have had inflammatory bowel disease, did you require medication and/or surgery
Beschreibung

PatientInflammatoryBowelDiseaseTreatmentPersonalMedicalHistoryInd-2

Datentyp

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
Have you ever had diverticulitis that required hospitalization or outpatient antibiotics and dietary modification
Beschreibung

PatientDiverticulitisTreatmentPersonalMedicalHistoryInd-2

Datentyp

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
Have you ever had C. difficile colitis
Beschreibung

PatientC.DifficileColitisPersonalMedicalHistoryInd-2

Datentyp

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
Have you ever had small bowel resection with anastomosis
Beschreibung

PatientSmallIntestineExcisionAnastomosisPersonalMedicalHistoryInd-2

Datentyp

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
At primary debulking surgery
Beschreibung

PatientSmallBowelExcisionAnastomosisDebulkingPersonalMedicalHistoryInd-2

Datentyp

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
Have you ever had large bowel resection with anastomosis
Beschreibung

PatientLargeIntestineExcisionAnastomosisPersonalMedicalHistoryInd-2

Datentyp

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
At primary debulking surgery
Beschreibung

PatientLargeIntestineExcisionAnastomosisDebulkingPersonalMedicalHistoryInd-2

Datentyp

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
Footer Module
Beschreibung

Footer Module

Do you use corticosteroids for a chronic condition
Beschreibung

PatientCorticosteroidUsePersonalMedicalHistoryInd-2

Datentyp

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
Do you use NSAID chronically
Beschreibung

PatientNonsteroidalAntiinflammatoryDrugRegularUsePersonalMedicalHistoryInd-2

Datentyp

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
Comments
Beschreibung

Comments

COMMENTS
Beschreibung

Research Comments

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS CUI-1
C0947611
NCI Thesaurus ObjectClass
C15319
NCI Thesaurus Property
C25393
Zum Seitenanfang zurückkehren

Ähnliche Modelle

No Instruction available.

1 Formulare
  1. StudyEvent: GOG-0262: Medical History Form (Form MEDH)
    1. No Instruction available.
Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
Alias
Item Group
Header Module
Form Completion Date
Item
Date form originally completed
date
C19464 (NCI Thesaurus ObjectClass)
C1549507 (UMLS CUI-1)
C25250 (NCI Thesaurus Property)
C25604 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
Amendment date
Item
Date form amended
date
C19464 (NCI Thesaurus ObjectClass)
C0680532 (UMLS CUI-1)
C25250 (NCI Thesaurus Property)
C0011008 (UMLS CUI-2)
C25416 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
Person Amending Form
Item
Person amending form, last name
text
C25191 (NCI Thesaurus ValueDomain)
C0680532 (UMLS CUI-1)
C25190 (NCI Thesaurus ObjectClass)
C1547383 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
Patient Initials
Item
Patient Initials
text
C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (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)
Person Completing Form Last Name
Item
Person Completing Form, Last Name
text
C25190 (NCI Thesaurus ObjectClass)
C1550483 (UMLS CUI-1)
C25657 (NCI Thesaurus ObjectClass-2)
C1301584 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25551 (NCI Thesaurus Property-2)
C25191 (NCI Thesaurus ValueDomain)
Item Group
Ovarian: Disease Description
Item
Have you ever been treated for hypertension that required medication
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C3117 (NCI Thesaurus Property)
C0020538 (UMLS 2011AA Property)
C49236 (NCI Thesaurus Property-2)
C0087111 (UMLS 2011AA Property-2)
C18772 (NCI Thesaurus Property-3)
C0262926 (UMLS 2011AA Property-3)
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
CL.1
Code List
Have you ever been treated for hypertension that required medication
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes, Currently (Yes, currently)
CL Item
Yes, In The Past (Yes, in the past)
HistoryofPeripheralVascularDiseasePresentInd-3
Item
Peripheral vascular disease with claudication
boolean
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C66923 (NCI Thesaurus ObjectClass)
C1881056 (UMLS 2011AA ObjectClass)
PatientCerebrovascularAccidentMyocardialInfarctionPersonalMedicalHistoryInd-3
Item
Myocardial infarction or cerebrovascular accident
boolean
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C27996 (NCI Thesaurus Property)
C0027051 (UMLS 2011AA Property)
C3390 (NCI Thesaurus Property-2)
C0038454 (UMLS 2011AA Property-2)
C18772 (NCI Thesaurus Property-3)
C0262926 (UMLS 2011AA Property-3)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
Current Smoker
Item
Have you smoked during the past year
boolean
C38148 (NCI Thesaurus ValueDomain)
C3241966 (UMLS CUI-1)
C25471 (NCI Thesaurus Property)
C17934 (NCI Thesaurus ObjectClass)
C0449865 (NCI Metathesaurus Property)
CigaretteAverageDailyPackUseCount
Item
If you smoke, how many packs of cigarettes do you average per day
float
C1802 (NCI Thesaurus ObjectClass)
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)
CigarAverageDailyUseCount
Item
How many cigars/pipes do you average per day
float
C1813 (NCI Thesaurus ObjectClass)
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)
Smoking Duration
Item
How many years have you smoked
float
C25463 (NCI Thesaurus ValueDomain)
C3694955 (UMLS CUI-1)
C17934 (NCI Thesaurus ObjectClass)
C25330 (NCI Thesaurus Property)
Item
Do you currently take medication for diabetes
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C2985 (NCI Thesaurus Property)
C0011849 (UMLS 2011AA Property)
C49236 (NCI Thesaurus Property-2)
C0087111 (UMLS 2011AA Property-2)
C18772 (NCI Thesaurus Property-3)
C0262926 (UMLS 2011AA Property-3)
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
CL.5
Code List
Do you currently take medication for diabetes
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes - Insulin (Yes - Insulin)
CL Item
Yes - Oral Hypoglycemics (Yes - Oral hypoglycemics)
Item Group
Ovarian: Findings From Primary Surgery
DiseasesandDisordersPatientSelf-ReportAutoimmuneDiseaseDiagnosisInd-3
Item
Have you ever been diagnosed with an autoimmune disease
boolean
C2991 (NCI Thesaurus ObjectClass)
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)
Item Group
Ovarian: Post-operative Findings Following Primary Surgery
PatientUlcerationPersonalMedicalHistoryInd-3
Item
Have you ever had peptic ulcer disease, documented by endoscopy
boolean
C38148 (NCI Thesaurus 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)
TumorIntestinalObstructionInd-3
Item
Have you ever had an intestinal obstruction, documented radiographically
boolean
C38148 (NCI Thesaurus ValueDomain)
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)
Item
Have you ever had inflammatory bowel disease
text
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C3138 (NCI Thesaurus Property)
C0021390 (UMLS 2011AA Property)
C18772 (NCI Thesaurus Property-2)
C0262926 (UMLS 2011AA Property-2)
CL.9
Code List
Have you ever had inflammatory bowel disease
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes - Crohn's Disease (Yes - Crohn's disease)
CL Item
Yes - Ulcerative Colitis (Yes - Ulcerative colitis)
PatientInflammatoryBowelDiseaseTreatmentPersonalMedicalHistoryInd-2
Item
If you have had inflammatory bowel disease, did you require medication and/or surgery
boolean
C16960 (NCI Thesaurus ObjectClass)
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)
PatientDiverticulitisTreatmentPersonalMedicalHistoryInd-2
Item
Have you ever had diverticulitis that required hospitalization or outpatient antibiotics and dietary modification
boolean
C16960 (NCI Thesaurus ObjectClass)
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)
PatientC.DifficileColitisPersonalMedicalHistoryInd-2
Item
Have you ever had C. difficile colitis
boolean
C38147 (NCI Thesaurus 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)
PatientSmallIntestineExcisionAnastomosisPersonalMedicalHistoryInd-2
Item
Have you ever had small bowel resection with anastomosis
boolean
C16960 (NCI Thesaurus ObjectClass)
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)
PatientSmallBowelExcisionAnastomosisDebulkingPersonalMedicalHistoryInd-2
Item
At primary debulking surgery
boolean
C16960 (NCI Thesaurus ObjectClass)
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)
PatientLargeIntestineExcisionAnastomosisPersonalMedicalHistoryInd-2
Item
Have you ever had large bowel resection with anastomosis
boolean
C16960 (NCI Thesaurus ObjectClass)
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)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
PatientLargeIntestineExcisionAnastomosisDebulkingPersonalMedicalHistoryInd-2
Item
At primary debulking surgery
boolean
C16960 (NCI Thesaurus ObjectClass)
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)
Item Group
Footer Module
PatientCorticosteroidUsePersonalMedicalHistoryInd-2
Item
Do you use corticosteroids for a chronic condition
boolean
C16960 (NCI Thesaurus ObjectClass)
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)
PatientNonsteroidalAntiinflammatoryDrugRegularUsePersonalMedicalHistoryInd-2
Item
Do you use NSAID chronically
boolean
C16960 (NCI Thesaurus ObjectClass)
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)
Item Group
Comments
Research Comments
Item
COMMENTS
text
C25704 (NCI Thesaurus ValueDomain)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
Zum Seitenanfang zurückkehren 

Kontakt

Benutzen Sie dieses Formular für Rückmeldungen, Fragen und Verbesserungsvorschläge.

Mit * gekennzeichnete Felder sind notwendig.

Hilfe

Benötigen Sie Hilfe bei der Suche? Um mehr Details zu erfahren und die Suche effektiver nutzen zu können schauen Sie sich doch das entsprechende Video auf unserer Tutorial Seite an.

Zum Video