ID

875

Descrizione

SOUTHWEST ONCOLOGY GROUP BASELINE TUMOR ASSESSMENT FORM (S0226) S0226 Anastrozole With or Without Fulvestrant as First-Line Therapy in Postmenopausal Women With Metastatic Breast Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=C322202A-32BF-25B7-E034-0003BA12F5E7

collegamento

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=C322202A-32BF-25B7-E034-0003BA12F5E7

Keywords

versioni (3)
  1. 26/08/12 26/08/12 -
  2. 09/01/15 09/01/15 - Martin Dugas
  3. 25/03/15 25/03/15 - Martin Dugas
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26 agosto 2012

DOI

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Creative Commons BY-NC 3.0 Legacy
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    Breast Cancer NCT00075764 Pre-Study - SOUTHWEST ONCOLOGY GROUP BASELINE TUMOR ASSESSMENT FORM (S0226) - 2173571v3.0

    Inglese

    No Instruction available.

    1 moduli  
    1. StudyEvent: SOUTHWEST ONCOLOGY GROUP BASELINE TUMOR ASSESSMENT FORM (S0226)
      1. No Instruction available.
    Unnamed1
    Descrizione

    Unnamed1

    SWOG Patient ID
    Descrizione

    PatientSouthwestOncologyGroupIdentifierNumber

    Tipo di dati

    double

    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
    C25699
    UMLS 2011AA Property
    C1519429
    SWOG Study No.
    Descrizione

    ProtocolSWOGIdentifierNumber

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS 2011AA ValueDomain
    C0237753
    NCI Thesaurus ObjectClass
    C25320
    UMLS 2011AA ObjectClass
    C1507394
    NCI Thesaurus Property
    C25364
    UMLS 2011AA Property
    C0600091
    NCI Thesaurus Property
    C25699
    UMLS 2011AA Property
    C1519429
    Registration Step
    Descrizione

    RegistrationStepNumber

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS 2011AA ValueDomain
    C0237753
    NCI Thesaurus ObjectClass
    C25646
    UMLS 2011AA ObjectClass
    C1514821
    NCI Thesaurus Property
    C16154
    UMLS 2011AA Property
    C1704379
    NCI Thesaurus ValueDomain
    C16154
    UMLS 2011AA ValueDomain
    C1704379
    Patient Initials (L, F M)
    Descrizione

    PatientInitialsName

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS 2011AA ValueDomain
    C1547383
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C25536
    UMLS 2011AA Property
    C1555582
    Institution/Affiliate
    Descrizione

    CombinedInstitutionName

    Tipo di dati

    text

    Alias
    NCI Thesaurus ObjectClass
    C25454
    UMLS 2011AA ObjectClass
    C0205195
    NCI Thesaurus ObjectClass
    C21541
    UMLS 2011AA ObjectClass
    C0018704
    NCI Thesaurus Property
    C25364
    UMLS 2011AA Property
    C0600091
    NCI Thesaurus ValueDomain
    C25191
    UMLS 2011AA ValueDomain
    C1547383
    NCI Thesaurus ValueDomain
    C21541
    UMLS 2011AA ValueDomain
    C0018704
    Physician (Groups Other than SWOG)
    Descrizione

    RegisteredInvestigatorName

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS 2011AA ValueDomain
    C1547383
    NCI Thesaurus Property
    C25364
    UMLS 2011AA Property
    C0600091
    NCI Thesaurus ObjectClass
    C17089
    UMLS 2011AA ObjectClass
    C0035173
    NCI Thesaurus ObjectClass
    C25644
    Group Name
    Descrizione

    ParticipatingGroupName

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS 2011AA ValueDomain
    C1547383
    NCI Thesaurus ObjectClass
    C25608
    UMLS 2011AA ObjectClass
    C0679823
    NCI Thesaurus ObjectClass
    C17005
    UMLS 2011AA ObjectClass
    C1257890
    NCI Thesaurus Property
    C25364
    UMLS 2011AA Property
    C0600091
    Study No.
    Descrizione

    ProtocolParticipatingIdentifierNumber

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS 2011AA ValueDomain
    C0237753
    NCI Thesaurus ObjectClass
    C25320
    UMLS 2011AA ObjectClass
    C1507394
    NCI Thesaurus Property
    C25608
    UMLS 2011AA Property
    C0679823
    NCI Thesaurus Property
    C25364
    UMLS 2011AA Property
    C0600091
    Pt. ID (Instructions: Record the requested information for all target lesions and all sites of other disease. Please refer to section 10.0 of the protocol for definitions. Choose all measurable lesions up to a maximum of 5 lesions per organ and 10 lesions in total to follow as target lesions. Record any remaining measurable lesions and all non-measurable lesions as non-terget lesions.)
    Descrizione

    PatientParticipatingIdentifierNumber

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS 2011AA ValueDomain
    C0237753
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C25608
    UMLS 2011AA Property
    C0679823
    NCI Thesaurus Property
    C25364
    UMLS 2011AA Property
    C0600091
    Target Lesions
    Descrizione

    Target Lesions

    Lesion Number
    Descrizione

    LesionSiteNumber

    Tipo di dati

    double

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS 2011AA ValueDomain
    C0237753
    NCI Thesaurus ObjectClass
    C3824
    UMLS 2011AA ObjectClass
    C0221198
    NCI Thesaurus Property
    C25341
    UMLS 2011AA Property
    C0450429
    Target Lesion Site
    Descrizione

    LesionTargetSite

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C13717
    UMLS 2011AA ValueDomain
    C1515974
    NCI Thesaurus ObjectClass
    C3824
    UMLS 2011AA ObjectClass
    C0221198
    NCI Thesaurus Property
    C25341
    UMLS 2011AA Property
    C0450429
    NCI Thesaurus Property
    C25702
    UMLS 2011AA Property
    C1521840
    Longest Diameter (cm)
    Descrizione

    LesionLongestDiameterMeasurement

    Tipo di dati

    double

    Unità di misura
    • cm
    Alias
    NCI Thesaurus ObjectClass
    C3824
    UMLS 2011AA ObjectClass
    C0221198
    NCI Thesaurus Property
    C25285
    UMLS 2011AA Property
    C1301886
    NCI Thesaurus Property
    C25558
    UMLS 2011AA Property
    C1522425
    NCI Thesaurus ValueDomain
    C25209
    UMLS 2011AA ValueDomain
    C0242485
    NCI Thesaurus ValueDomain
    C25285
    UMLS 2011AA ValueDomain
    C1301886
    cm
    Assessment Date
    Descrizione

    AssessmentDate

    Tipo di dati

    date

    Assessment Type
    Descrizione

    AssessmentMethodType

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25284
    UMLS 2011AA ValueDomain
    C0332307
    NCI Thesaurus ObjectClass
    C20989
    UMLS 2011AA ObjectClass
    C0031809
    NCI Thesaurus Property
    C16847
    UMLS 2011AA Property
    C0449851
    Non-target Disease
    Descrizione

    Non-target Disease

    Lesion Number
    Descrizione

    Lesion,ReferenceNumber

    Tipo di dati

    double

    Assessment Date
    Descrizione

    AssessmentDate

    Tipo di dati

    date

    Assessment Type
    Descrizione

    AssessmentType

    Tipo di dati

    text

    Unnamed5 (Lesion site)
    Descrizione

    Unnamed5(Lesionsite)

    Tipo di dati

    text

    Extent
    Descrizione

    Extent

    Tipo di dati

    text

    Unnamed6
    Descrizione

    Unnamed6

    Tests/studies
    Descrizione

    Tests/studies

    Tipo di dati

    text

    Assessment Date
    Descrizione

    AssessmentDate

    Tipo di dati

    date

    Comments
    Descrizione

    Comments

    Comments
    Descrizione

    Comments

    Tipo di dati

    text

    Ccrr Module For Southwest Oncology Group Baseline Tumor Assessment Form (s0226)
    Descrizione

    Ccrr Module For Southwest Oncology Group Baseline Tumor Assessment Form (s0226)

    Ritorna all'inizio della pagina

    Similar models

    No Instruction available.

    1 moduli
    1. StudyEvent: SOUTHWEST ONCOLOGY GROUP BASELINE TUMOR ASSESSMENT FORM (S0226)
      1. No Instruction available.
    Name
    genere
    Description | Question | Decode (Coded Value)
    Tipo di dati
    Alias
    Item Group
    Unnamed1
    PatientSouthwestOncologyGroupIdentifierNumber
    Item
    SWOG Patient ID
    double
    C25337 (NCI Thesaurus ValueDomain)
    C0237753 (UMLS 2011AA ValueDomain)
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C25364 (NCI Thesaurus Property)
    C0600091 (UMLS 2011AA Property)
    C25699 (NCI Thesaurus Property)
    C1519429 (UMLS 2011AA Property)
    ProtocolSWOGIdentifierNumber
    Item
    SWOG Study No.
    text
    C25337 (NCI Thesaurus ValueDomain)
    C0237753 (UMLS 2011AA ValueDomain)
    C25320 (NCI Thesaurus ObjectClass)
    C1507394 (UMLS 2011AA ObjectClass)
    C25364 (NCI Thesaurus Property)
    C0600091 (UMLS 2011AA Property)
    C25699 (NCI Thesaurus Property)
    C1519429 (UMLS 2011AA Property)
    RegistrationStepNumber
    Item
    Registration Step
    text
    C25337 (NCI Thesaurus ValueDomain)
    C0237753 (UMLS 2011AA ValueDomain)
    C25646 (NCI Thesaurus ObjectClass)
    C1514821 (UMLS 2011AA ObjectClass)
    C16154 (NCI Thesaurus Property)
    C1704379 (UMLS 2011AA Property)
    C16154 (NCI Thesaurus ValueDomain)
    C1704379 (UMLS 2011AA ValueDomain)
    PatientInitialsName
    Item
    Patient Initials (L, F M)
    text
    C25191 (NCI Thesaurus ValueDomain)
    C1547383 (UMLS 2011AA ValueDomain)
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C25536 (NCI Thesaurus Property)
    C1555582 (UMLS 2011AA Property)
    CombinedInstitutionName
    Item
    Institution/Affiliate
    text
    C25454 (NCI Thesaurus ObjectClass)
    C0205195 (UMLS 2011AA ObjectClass)
    C21541 (NCI Thesaurus ObjectClass)
    C0018704 (UMLS 2011AA ObjectClass)
    C25364 (NCI Thesaurus Property)
    C0600091 (UMLS 2011AA Property)
    C25191 (NCI Thesaurus ValueDomain)
    C1547383 (UMLS 2011AA ValueDomain)
    C21541 (NCI Thesaurus ValueDomain)
    C0018704 (UMLS 2011AA ValueDomain)
    RegisteredInvestigatorName
    Item
    Physician (Groups Other than SWOG)
    text
    C25191 (NCI Thesaurus ValueDomain)
    C1547383 (UMLS 2011AA ValueDomain)
    C25364 (NCI Thesaurus Property)
    C0600091 (UMLS 2011AA Property)
    C17089 (NCI Thesaurus ObjectClass)
    C0035173 (UMLS 2011AA ObjectClass)
    C25644 (NCI Thesaurus ObjectClass)
    ParticipatingGroupName
    Item
    Group Name
    text
    C25191 (NCI Thesaurus ValueDomain)
    C1547383 (UMLS 2011AA ValueDomain)
    C25608 (NCI Thesaurus ObjectClass)
    C0679823 (UMLS 2011AA ObjectClass)
    C17005 (NCI Thesaurus ObjectClass)
    C1257890 (UMLS 2011AA ObjectClass)
    C25364 (NCI Thesaurus Property)
    C0600091 (UMLS 2011AA Property)
    ProtocolParticipatingIdentifierNumber
    Item
    Study No.
    text
    C25337 (NCI Thesaurus ValueDomain)
    C0237753 (UMLS 2011AA ValueDomain)
    C25320 (NCI Thesaurus ObjectClass)
    C1507394 (UMLS 2011AA ObjectClass)
    C25608 (NCI Thesaurus Property)
    C0679823 (UMLS 2011AA Property)
    C25364 (NCI Thesaurus Property)
    C0600091 (UMLS 2011AA Property)
    PatientParticipatingIdentifierNumber
    Item
    Pt. ID (Instructions: Record the requested information for all target lesions and all sites of other disease. Please refer to section 10.0 of the protocol for definitions. Choose all measurable lesions up to a maximum of 5 lesions per organ and 10 lesions in total to follow as target lesions. Record any remaining measurable lesions and all non-measurable lesions as non-terget lesions.)
    text
    C25337 (NCI Thesaurus ValueDomain)
    C0237753 (UMLS 2011AA ValueDomain)
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C25608 (NCI Thesaurus Property)
    C0679823 (UMLS 2011AA Property)
    C25364 (NCI Thesaurus Property)
    C0600091 (UMLS 2011AA Property)
    Item Group
    Target Lesions
    LesionSiteNumber
    Item
    Lesion Number
    double
    C25337 (NCI Thesaurus ValueDomain)
    C0237753 (UMLS 2011AA ValueDomain)
    C3824 (NCI Thesaurus ObjectClass)
    C0221198 (UMLS 2011AA ObjectClass)
    C25341 (NCI Thesaurus Property)
    C0450429 (UMLS 2011AA Property)
    LesionTargetSite
    Item
    Target Lesion Site
    text
    C13717 (NCI Thesaurus ValueDomain)
    C1515974 (UMLS 2011AA ValueDomain)
    C3824 (NCI Thesaurus ObjectClass)
    C0221198 (UMLS 2011AA ObjectClass)
    C25341 (NCI Thesaurus Property)
    C0450429 (UMLS 2011AA Property)
    C25702 (NCI Thesaurus Property)
    C1521840 (UMLS 2011AA Property)
    LesionLongestDiameterMeasurement
    Item
    Longest Diameter (cm)
    double
    C3824 (NCI Thesaurus ObjectClass)
    C0221198 (UMLS 2011AA ObjectClass)
    C25285 (NCI Thesaurus Property)
    C1301886 (UMLS 2011AA Property)
    C25558 (NCI Thesaurus Property)
    C1522425 (UMLS 2011AA Property)
    C25209 (NCI Thesaurus ValueDomain)
    C0242485 (UMLS 2011AA ValueDomain)
    C25285 (NCI Thesaurus ValueDomain)
    C1301886 (UMLS 2011AA ValueDomain)
    AssessmentDate
    Item
    Assessment Date
    date
    Item
    Assessment Type
    text
    C25284 (NCI Thesaurus ValueDomain)
    C0332307 (UMLS 2011AA ValueDomain)
    C20989 (NCI Thesaurus ObjectClass)
    C0031809 (UMLS 2011AA ObjectClass)
    C16847 (NCI Thesaurus Property)
    C0449851 (UMLS 2011AA Property)
    CL.1
    Code List
    Assessment Type
    CL Item
    Palpation (Palpation)
    CL Item
    Visualization (Visualization)
    CL Item
    Colposcopy (Colposcopy)
    CL Item
    Endoscopy (Endoscopy)
    CL Item
    Plain film/X-ray without contrast (Plain film/X-ray without contrast)
    CL Item
    Plain film/X-ray with contrast (Plain film/X-ray with contrast)
    CL Item
    Ct Scan (CT scan)
    CL Item
    Mri (MRI scan)
    CL Item
    Radioisotope scan (Radioisotope scan)
    CL Item
    Ultrasound (Ultrasound)
    C64384 (NCI Thesaurus)
    C1456803 (UMLS 2011AA)
    CL Item
    PET scan (PET scan)
    CL Item
    Spiral Ct Scan (Spiral CT scan)
    CL Item
    Cystoscopy (Cystoscopy)
    C16482 (NCI Thesaurus)
    C0010702 (UMLS 2011AA)
    CL Item
    Histology (Histologic confirmation)
    C16681 (NCI Thesaurus)
    C0019638 (UMLS 2011AA)
    CL Item
    Cytology (Cytologic confirmation)
    C16491 (NCI Thesaurus)
    C0010819 (UMLS 2011AA)
    CL Item
    Other (Other)
    C17649 (NCI Thesaurus)
    C0205394 (UMLS 2011AA)
    Item Group
    Non-target Disease
    Lesion,ReferenceNumber
    Item
    Lesion Number
    double
    AssessmentDate
    Item
    Assessment Date
    date
    Item
    Assessment Type
    text
    CL.2
    Code List
    Assessment Type
    CL Item
    Palpation (Palpation)
    CL Item
    Visualization (Visualization)
    CL Item
    Colposcopy (Colposcopy)
    CL Item
    Endoscopy (Endoscopy)
    CL Item
    Plain film/X-ray without contrast (Plain film/X-ray without contrast)
    CL Item
    Plain film/X-ray with contrast (Plain film/X-ray with contrast)
    CL Item
    CT scan (CT scan)
    CL Item
    MRI scan (MRI scan)
    CL Item
    Radioisotope scan (Radioisotope scan)
    CL Item
    Ultrasound (Ultrasound)
    CL Item
    PET scan (PET scan)
    CL Item
    Spiral CT scan (Spiral CT scan)
    CL Item
    Cytoscopy (Cytoscopy)
    CL Item
    Histologic confirmation (Histologic confirmation)
    CL Item
    Cytologic confirmation (Cytologic confirmation)
    CL Item
    Other (Other)
    Unnamed5(Lesionsite)
    Item
    Unnamed5 (Lesion site)
    text
    Extent
    Item
    Extent
    text
    Item Group
    Unnamed6
    Tests/studies
    Item
    Tests/studies
    text
    AssessmentDate
    Item
    Assessment Date
    date
    Item Group
    Comments
    Comments
    Item
    Comments
    text
    Item Group
    Ccrr Module For Southwest Oncology Group Baseline Tumor Assessment Form (s0226)
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