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ID
8962
Description
E4203 Registration Worksheet (step 2) Bevacizumab and Oxaliplatin Combined With Irinotecan or Leucovorin and Fluorouracil in Treating Patients With Metastatic or Recurrent Colorectal Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=8A2D12C3-C08C-3EF0-E040-BB89AD436C14
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Versions (2)
- 8/27/12 8/27/12 -
- 1/9/15 1/9/15 - Martin Dugas
Uploaded on
January 9, 2015
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License
Creative Commons BY-NC 3.0 Legacy
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Colorectal Cancer NCT00098787 Eligibility - E4203 Registration Worksheet (step 2) - 3115210v1.0
No Instruction available.
- StudyEvent: E4203 Registration Worksheet (step 2)
Similar models
No Instruction available.
- StudyEvent: E4203 Registration Worksheet (step 2)
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
EligibilityDeterminationChecklistCompleteEligibilityInd-2
Item
Has the eligibility checklist been completed
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C25171 (NCI Thesaurus ObjectClass)
C0013893 (UMLS 2011AA ObjectClass)
C49073 (NCI Thesaurus Property-2)
C1707357 (UMLS 2011AA Property-2)
C1512698 (UMLS 2011AA ValueDomain)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C25171 (NCI Thesaurus ObjectClass)
C0013893 (UMLS 2011AA ObjectClass)
C49073 (NCI Thesaurus Property-2)
C1707357 (UMLS 2011AA Property-2)
Eligibility for trial
Item
In the opinion of the investigator, is the patient eligible?
boolean
C38148 (NCI Thesaurus ValueDomain)
C1302261 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25171 (NCI Thesaurus Property)
C1302261 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25171 (NCI Thesaurus Property)
Item
Indicate the level/status that was determined centrally and reported to you.
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25171 (NCI Thesaurus Property)
C0013893 (UMLS 2011AA Property)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
C17199 (NCI Thesaurus Property-2)
C0040085 (UMLS 2011AA Property-2)
C0030705 (UMLS 2011AA ObjectClass)
C25171 (NCI Thesaurus Property)
C0013893 (UMLS 2011AA Property)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
C17199 (NCI Thesaurus Property-2)
C0040085 (UMLS 2011AA Property-2)
CL Item
1 - High Ts Expression Status - Score Of 2 Or 3 (1 - High TS expression status - score of 2 or 3)
CL Item
2 - Low Ts Expression - Score Of 0 Or 1 (2 - Low TS expression - score of 0 or 1)
CL Item
3 - Indeterminate Ts Expression Status (3 - Indeterminate TS expression status)