ID
9208
Descripción
Form 1 - Eligibility Checklist and Initial Evaluation Gefitinib in Treating Patients With Non-Small Cell Lung Cancer That Has Been Surgically Removed Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A7422C05-78BD-5678-E034-0003BA0B1A09
Link
Palabras clave
Versiones (4)
- 19/9/12 19/9/12 -
- 9/1/15 9/1/15 - Martin Dugas
- 22/3/15 22/3/15 - Martin Dugas
- 20/9/21 20/9/21 -
Subido en
9 de enero de 2015
DOI
Para solicitar uno, por favor iniciar sesión.
Licencia
Creative Commons BY-NC 3.0 Legacy
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Lung Cancer NCT00049543 On-Study - Form 1 - Eligibility Checklist and Initial Evaluation - 2055363v3.0
No Instruction available.
- StudyEvent: Form 1 - Eligibility Checklist and Initial Evaluation
Descripción
Ncic Ctg Use Only
Descripción
LoggedEntryInitials
Tipo de datos
text
Descripción
LoggedEntryDate
Tipo de datos
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
Descripción
RegulatoryAffairsReviewInitials
Tipo de datos
text
Descripción
RegulatoryAffairsReviewDate
Tipo de datos
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
Descripción
CoordinatorReviewInitials
Tipo de datos
text
Descripción
CoordinatorReviewDate
Tipo de datos
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
Descripción
PhysicianReviewInitials
Tipo de datos
text
Descripción
DataEntryInitials
Tipo de datos
text
Descripción
DataVerificationInitials
Tipo de datos
text
Descripción
Header
Descripción
Eligibility Checklist
Descripción
LungCancerProofInd
Tipo de datos
text
Descripción
HistologicType
Tipo de datos
text
Descripción
PathologicStagePostoperativeInd
Tipo de datos
text
Descripción
StageGrouping
Tipo de datos
text
Descripción
LymphNodeAdequateSamplingInd
Tipo de datos
text
Descripción
LymphNodeSamplingExtent
Tipo de datos
text
Descripción
LymphNodeSamplingExtentLargeSite
Tipo de datos
text
Descripción
LymphNodeSamplingOtherExtent
Tipo de datos
text
Descripción
LungCarcinomaSurgicalProcedureTherapyInd-3
Tipo de datos
text
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
- NCI Thesaurus Property
- C15329
- UMLS 2011AA Property
- C0543467
- NCI Thesaurus ObjectClass
- C4878
- UMLS 2011AA ObjectClass
- C0684249
Descripción
GrossDiseaseRemovedInd
Tipo de datos
text
Descripción
SurgicalResectionNegativeMarginIndicator
Tipo de datos
text
Descripción
MaximumTimePostSurgeryIndicator
Tipo de datos
text
Descripción
SurgeryDate
Tipo de datos
date
Descripción
TumorBlocksSentIndicator
Tipo de datos
text
Descripción
MinimumPerformanceStatusIndicator
Tipo de datos
text
Descripción
RequiredHematology14DaysIndicator
Tipo de datos
text
Descripción
Lab,Hematology,SampleCollectionDate
Tipo de datos
date
Descripción
Lab,Hematology,WBC
Tipo de datos
float
Descripción
Lab,Hematology,NeutrophilCount
Tipo de datos
float
Descripción
Lab,Hematology,Platelets
Tipo de datos
float
Descripción
Lab,UnitsofMeasure
Tipo de datos
text
Descripción
Ncic Ctg Use Only
Descripción
PatientGender
Tipo de datos
text
Alias
- NCI Thesaurus ValueDomain
- C25372
- UMLS 2011AA ValueDomain
- C0683312
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C17357
- UMLS 2011AA Property
- C0079399
Descripción
HistologicType
Tipo de datos
text
Descripción
StageGrouping
Tipo de datos
text
Descripción
Unnamed2
Descripción
Eligibility Checklist Continued
Descripción
SpecimenCollectionDate
Tipo de datos
date
Descripción
RequiredBiochemistry14DaysIndicator
Tipo de datos
text
Descripción
Lab,Hepatic,Bilirubin
Tipo de datos
float
Descripción
HepaticBilirubinLabUpperLimitNormalValue
Tipo de datos
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C20200
- UMLS 2011AA Property
- C1274040
- NCI Thesaurus Property-2
- C305
- UMLS 2011AA Property-2
- C0005437
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
- NCI Thesaurus ValueDomain-2
- C25706
- UMLS 2011AA ValueDomain-2
- C1519815
Descripción
AdjuvantRTEndDate
Tipo de datos
date
Descripción
Lab,Hepatic,SGOT
Tipo de datos
float
Descripción
SGOTLabUpperLimitNormalValue
Tipo de datos
float
Alias
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
- NCI Thesaurus ValueDomain-2
- C25706
- UMLS 2011AA ValueDomain-2
- C1519815
Descripción
Lab,Hepatic,SGPT
Tipo de datos
float
Descripción
SGPTLabUpperLimitNormalValue
Tipo de datos
float
Alias
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
- NCI Thesaurus ValueDomain-2
- C25706
- UMLS 2011AA ValueDomain-2
- C1519815
Descripción
Lab,Hepatic,AlkalinePhosphatase
Tipo de datos
float
Descripción
Alkaline Phosphatase ULN
Tipo de datos
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS CUI-1
- C0151420
- NCI Thesaurus Property
- C20200
- NCI Thesaurus Property-2
- C16276
- NCI Thesaurus ValueDomain
- C25712
- NCI Thesaurus ValueDomain-2
- C25706
Descripción
Lab,Renal,Creatinine
Tipo de datos
float
Descripción
Creatinine, serum ULN
Tipo de datos
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS CUI-1
- C0201976
- NCI Thesaurus Property
- C20200
- UMLS CUI-2
- C1519815
- NCI Thesaurus Property-2
- C399
- NCI Thesaurus ValueDomain
- C25712
- NCI Thesaurus ValueDomain-2
- C25706
Descripción
PatientAge18YearsIndicator
Tipo de datos
text
Alias
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Descripción
PrestudyChestX-RayIndicator
Tipo de datos
text
Descripción
ChestX-RayAssessmentDate
Tipo de datos
date
Descripción
PrestudyChestCTIndicator
Tipo de datos
text
Descripción
ChestComputedTomographyMagneticResonanceImagingDiagnosticImagingPerformedDate
Tipo de datos
date
Alias
- NCI Thesaurus ObjectClass
- C16502
- UMLS 2011AA ObjectClass
- C0011923
- NCI Thesaurus ObjectClass-2
- C17204
- UMLS 2011AA ObjectClass-2
- C0040405
- NCI Thesaurus ObjectClass-3
- C25389
- UMLS 2011AA ObjectClass-3
- C0817096
- NCI Thesaurus ObjectClass-4
- C16809
- UMLS 2011AA ObjectClass-4
- C0024485
- NCI Thesaurus Property
- C38000
- UMLS 2011AA Property
- C0884358
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
Descripción
PrestudyEKGIndicator
Tipo de datos
text
Descripción
DiagnosticElectrocardiogramPerformedDate
Tipo de datos
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus Property
- C38000
- UMLS 2011AA Property
- C0884358
- NCI Thesaurus ObjectClass
- C25482
- UMLS 2011AA ObjectClass
- C0348026
- NCI Metathesaurus ObjectClass
- C0013798
Descripción
Lab,UnitsofMeasure
Tipo de datos
text
Descripción
EligibilityContraceptionIndicator
Tipo de datos
text
Descripción
PrestudyPostoperativeRadiationTherapyIndicator
Tipo de datos
boolean
Descripción
PrestudyRadiationTherapyCompleteIndicator
Tipo de datos
text
Descripción
RadiationTherapyToxicityRecoveryIndicator
Tipo de datos
text
Descripción
PatientConsentSignedIndicator
Tipo de datos
text
Descripción
InformedConsentDateSigned
Tipo de datos
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
Descripción
PatientTherapeuticProcedureFollow-upEligibilityDeterminationInd-2
Tipo de datos
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C16033
- UMLS 2011AA Property
- C1522577
- NCI Thesaurus Property-2
- C49236
- UMLS 2011AA Property-2
- C0087111
- NCI Thesaurus Property-3
- C25171
- UMLS 2011AA Property-3
- C0013893
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Descripción
TreatmentRequirementBeginIndicator
Tipo de datos
text
Descripción
Ncic Ctg Use Only2
Descripción
Unnamed3
Descripción
Eligibility Checklist Continued2
Descripción
NoOtherMalignancyIndicator
Tipo de datos
text
Descripción
NoCombinationLungCancerIndicator
Tipo de datos
text
Descripción
OneDiscretePrimaryCancerIndicator
Tipo de datos
text
Descripción
NoOphthalmologicGastrointestinalDiseaseIndicator
Tipo de datos
text
Descripción
NoPathologicRiskConditionIndicator
Tipo de datos
text
Descripción
NoPsychiatricImpairmentHistoryIndicator
Tipo de datos
text
Descripción
FemalePatientNotPregnantIndicator
Tipo de datos
text
Descripción
NoPriorLungChemotherapyIndicator
Tipo de datos
text
Descripción
NoAgentAllergyHistoryIndicator
Tipo de datos
text
Descripción
NoCYP3A4EnzymeMedicationsIndicator
Tipo de datos
text
Descripción
AdequateSurgicalHealingIndicator
Tipo de datos
text
Descripción
Randomization
Descripción
RandomizationDate
Tipo de datos
date
Descripción
InvestigatorSignature
Tipo de datos
text
Alias
- NCI Thesaurus Property
- C25678
- UMLS 2011AA Property
- C1519316
- NCI Thesaurus ObjectClass
- C17089
- UMLS 2011AA ObjectClass
- C0035173
Descripción
PersonCompletingForm,LastName
Tipo de datos
text
Descripción
InvestigatorSignatureDate
Tipo de datos
date
Descripción
PersonCompletingForm,FirstName
Tipo de datos
text
Alias
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus Property
- C25364
- UMLS 2011AA Property
- C0600091
Descripción
FormCompletionDate,Original
Tipo de datos
date
Descripción
Unnamed4
Descripción
History And Physical Exam
Descripción
PatientCurrentSmokerIndicator
Tipo de datos
text
Descripción
AssessmentDate
Tipo de datos
date
Descripción
PatientPreviousSmokerIndicator
Tipo de datos
text
Descripción
PerformanceStatus
Tipo de datos
text
Descripción
PatientHeight
Tipo de datos
float
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25347
- UMLS 2011AA Property
- C0489786
Descripción
PatientWeight
Tipo de datos
float
Descripción
Investigations
Descripción
DiagnosticImagingAnatomicSite
Tipo de datos
text
Alias
- NCI Thesaurus ValueDomain
- C13717
- UMLS 2011AA ValueDomain
- C1515974
- NCI Thesaurus Property
- C25341
- UMLS 2011AA Property
- C0450429
- NCI Thesaurus ObjectClass
- C16502
- UMLS 2011AA ObjectClass
- C0011923
- NCI Thesaurus Property-2
- C25421
- UMLS 2011AA Property-2
- C0002808
Descripción
AssessmentType
Tipo de datos
text
Descripción
AssessmentDate
Tipo de datos
date
Descripción
PregnancyTestResult
Tipo de datos
text
Descripción
Unnamed5
Descripción
Baseline Hematology/biochemistry Values
Descripción
Lab,Hematology,Hemoglobin
Tipo de datos
float
Descripción
Lab,Hematology,Neutrophils,CellPercentage
Tipo de datos
float
Descripción
Lab,Hematology,SampleCollectionDate
Tipo de datos
date
Descripción
Lab,Hematology,WBC
Tipo de datos
float
Descripción
Lab,Hematology,Platelets
Tipo de datos
float
Descripción
Lab,UnitsofMeasure
Tipo de datos
text
Descripción
Biochemistry
Descripción
SpecimenCollectionDate
Tipo de datos
date
Descripción
Lab,Hepatic,Bilirubin
Tipo de datos
float
Descripción
HepaticBilirubinLabUpperLimitNormalValue
Tipo de datos
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C20200
- UMLS 2011AA Property
- C1274040
- NCI Thesaurus Property-2
- C305
- UMLS 2011AA Property-2
- C0005437
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
- NCI Thesaurus ValueDomain-2
- C25706
- UMLS 2011AA ValueDomain-2
- C1519815
Descripción
Lab,Hepatic,SGOT
Tipo de datos
float
Descripción
SGOTLabUpperLimitNormalValue
Tipo de datos
float
Alias
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
- NCI Thesaurus ValueDomain-2
- C25706
- UMLS 2011AA ValueDomain-2
- C1519815
Descripción
Lab,Hepatic,SGPT
Tipo de datos
float
Descripción
SGPTLabUpperLimitNormalValue
Tipo de datos
float
Alias
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
- NCI Thesaurus ValueDomain-2
- C25706
- UMLS 2011AA ValueDomain-2
- C1519815
Descripción
Lab,Hepatic,AlkalinePhosphatase
Tipo de datos
float
Descripción
Alkaline Phosphatase ULN
Tipo de datos
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS CUI-1
- C0151420
- NCI Thesaurus Property
- C20200
- NCI Thesaurus Property-2
- C16276
- NCI Thesaurus ValueDomain
- C25712
- NCI Thesaurus ValueDomain-2
- C25706
Descripción
Lab,Chemistry,LactateDehydrogenase
Tipo de datos
float
Descripción
Lab,Chemistry,LactateDehydrogenase,ULN
Tipo de datos
float
Descripción
Lab,Renal,Creatinine
Tipo de datos
float
Descripción
Creatinine, serum ULN
Tipo de datos
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS CUI-1
- C0201976
- NCI Thesaurus Property
- C20200
- UMLS CUI-2
- C1519815
- NCI Thesaurus Property-2
- C399
- NCI Thesaurus ValueDomain
- C25712
- NCI Thesaurus ValueDomain-2
- C25706
Descripción
Lab,Renal,BUN
Tipo de datos
float
Descripción
LaboratoryProcedureBloodUreaNitrogenResultUpperLimitNormalValue
Tipo de datos
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C20200
- UMLS 2011AA Property
- C1274040
- NCI Thesaurus Property-2
- C61019
- UMLS 2011AA Property-2
- C0005845
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
- NCI Thesaurus ValueDomain-2
- C25706
- UMLS 2011AA ValueDomain-2
- C1519815
Descripción
Lab,Electrolytes,Potassium
Tipo de datos
float
Descripción
LaboratoryProcedurePotassiumElectrolytesOutcomeLowerLimitNormalValue
Tipo de datos
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C20200
- UMLS 2011AA Property
- C1274040
- NCI Thesaurus Property-2
- C464
- UMLS 2011AA Property-2
- C0013832
- NCI Thesaurus Property-3
- C765
- UMLS 2011AA Property-3
- C0032821
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
- NCI Thesaurus ValueDomain-2
- C25555
- UMLS 2011AA ValueDomain-2
- C1518030
Descripción
LaboratoryProcedurePotassiumElectrolytesOutcomeUpperLimitNormalValue
Tipo de datos
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C20200
- UMLS 2011AA Property
- C1274040
- NCI Thesaurus Property-2
- C464
- UMLS 2011AA Property-2
- C0013832
- NCI Thesaurus Property-3
- C765
- UMLS 2011AA Property-3
- C0032821
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
- NCI Thesaurus ValueDomain-2
- C25706
- UMLS 2011AA ValueDomain-2
- C1519815
Descripción
Lab,Electrolytes,Sodium
Tipo de datos
float
Descripción
LaboratoryProcedureSodiumElectrolytesOutcomeLowerLimitofNormalValue
Tipo de datos
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C20200
- UMLS 2011AA Property
- C1274040
- NCI Thesaurus Property-2
- C830
- UMLS 2011AA Property-2
- C0037473
- NCI Thesaurus Property-3
- C464
- UMLS 2011AA Property-3
- C0013832
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
- NCI Thesaurus ValueDomain-2
- C25555
- UMLS 2011AA ValueDomain-2
- C1518030
Descripción
Lab,UnitsofMeasure
Tipo de datos
text
Descripción
LaboratoryProcedureSodiumElectrolytesOutcomeUpperLimitofNormalValue
Tipo de datos
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C20200
- UMLS 2011AA Property
- C1274040
- NCI Thesaurus Property-2
- C830
- UMLS 2011AA Property-2
- C0037473
- NCI Thesaurus Property-3
- C464
- UMLS 2011AA Property-3
- C0013832
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
- NCI Thesaurus ValueDomain-2
- C25706
- UMLS 2011AA ValueDomain-2
- C1519815
Descripción
Lab,Electrolytes,Chloride
Tipo de datos
float
Descripción
LaboratoryProcedureChlorideIonElectrolytesOutcomeLowerLimitofNormalValue
Tipo de datos
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C20200
- UMLS 2011AA Property
- C1274040
- NCI Thesaurus Property-2
- C464
- UMLS 2011AA Property-2
- C0013832
- NCI Thesaurus Property-3
- C1741
- UMLS 2011AA Property-3
- C0596019
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
- NCI Thesaurus ValueDomain-2
- C25555
- UMLS 2011AA ValueDomain-2
- C1518030
Descripción
LaboratoryProcedureChlorideIonElectrolytesOutcomeUpperLimitofNormalValue
Tipo de datos
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C20200
- UMLS 2011AA Property
- C1274040
- NCI Thesaurus Property-2
- C464
- UMLS 2011AA Property-2
- C0013832
- NCI Thesaurus Property-3
- C1741
- UMLS 2011AA Property-3
- C0596019
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
- NCI Thesaurus ValueDomain-2
- C25706
- UMLS 2011AA ValueDomain-2
- C1519815
Descripción
Lab,Electrolytes,Calcium
Tipo de datos
float
Descripción
LaboratoryProcedureCalciumElectrolytesOutcomeLowerLimitofNormalValue
Tipo de datos
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C331
- UMLS 2011AA Property
- C0006675
- NCI Thesaurus Property-2
- C20200
- UMLS 2011AA Property-2
- C1274040
- NCI Thesaurus Property-3
- C464
- UMLS 2011AA Property-3
- C0013832
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
- NCI Thesaurus ValueDomain-2
- C25555
- UMLS 2011AA ValueDomain-2
- C1518030
Descripción
LaboratoryProcedureCalciumElectrolytesOutcomeUpperLimitofNormalValue
Tipo de datos
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C331
- UMLS 2011AA Property
- C0006675
- NCI Thesaurus Property-2
- C20200
- UMLS 2011AA Property-2
- C1274040
- NCI Thesaurus Property-3
- C464
- UMLS 2011AA Property-3
- C0013832
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
- NCI Thesaurus ValueDomain-2
- C25706
- UMLS 2011AA ValueDomain-2
- C1519815
Descripción
Chemistry,BloodAlbumin
Tipo de datos
float
Descripción
LaboratoryProcedureAlbuminResultLowerLimitofNormalValue
Tipo de datos
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C20200
- UMLS 2011AA Property
- C1274040
- NCI Thesaurus Property-2
- C214
- UMLS 2011AA Property-2
- C0001924
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
- NCI Thesaurus ValueDomain-2
- C25555
- UMLS 2011AA ValueDomain-2
- C1518030
Descripción
LaboratoryProcedureAlbuminResultUpperLimitNormalValue
Tipo de datos
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C20200
- UMLS 2011AA Property
- C1274040
- NCI Thesaurus Property-2
- C214
- UMLS 2011AA Property-2
- C0001924
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
- NCI Thesaurus ValueDomain-2
- C25706
- UMLS 2011AA ValueDomain-2
- C1519815
Descripción
Unnamed6
Descripción
Disease History/prior Treatment
Descripción
PrimarySurgeryDate
Tipo de datos
date
Descripción
NStage,Pathologic
Tipo de datos
text
Descripción
HistologicType
Tipo de datos
text
Descripción
TStage,Pathologic
Tipo de datos
text
Descripción
StageGrouping,Pathologic
Tipo de datos
text
Descripción
HistologicType,OtherName
Tipo de datos
text
Descripción
HistologicGrade
Tipo de datos
text
Descripción
VascularInvasionInd
Tipo de datos
text
Descripción
ParietalPleuralMarginInvolvedInd
Tipo de datos
text
Descripción
LymphNodeSamplingInd
Tipo de datos
text
Descripción
LymphNode(s)ExaminedNumber
Tipo de datos
float
Alias
- NCI Thesaurus Property
- C25500
- UMLS 2011AA Property
- C0332128
- NCI Thesaurus ObjectClass
- C12745
- UMLS 2011AA ObjectClass
- C0024204
Descripción
LymphNode(s)PositiveNumber
Tipo de datos
float
Alias
- NCI Thesaurus Property
- C25246
- UMLS 2011AA Property
- C1446409
- NCI Thesaurus ObjectClass
- C12745
- UMLS 2011AA ObjectClass
- C0024204
Descripción
LymphNodesType
Tipo de datos
text
Descripción
LymphNodeInvolvement
Tipo de datos
text
Descripción
Unnamed7
Descripción
Disease History/prior Treatment Continued
Descripción
SurgicalProcedureType
Tipo de datos
text
Descripción
TumorSize,MaximumDiameter
Tipo de datos
float
Descripción
TumorLocation,Side
Tipo de datos
text
Descripción
TumorLocation,Area
Tipo de datos
text
Descripción
TumorLocation,AreaOther
Tipo de datos
text
Descripción
TumorLocation,Zone
Tipo de datos
text
Descripción
PleuraInvolvedInd
Tipo de datos
text
Descripción
TumorMarginInd
Tipo de datos
text
Alias
- NCI Thesaurus ObjectClass
- C3262
- UMLS 2011AA ObjectClass
- C0027651
- NCI Thesaurus Property
- C25563
- UMLS 2011AA Property
- C0205284
Descripción
TumorExtension
Tipo de datos
text
Descripción
TumorExtension,OtherStructures
Tipo de datos
text
Descripción
Prior Treatment
Descripción
PriorAdjuvantRTInd
Tipo de datos
text
Descripción
AdjuvantRTBeginDate
Tipo de datos
date
Descripción
AdjuvantRTEndDate
Tipo de datos
date
Descripción
RTTotalDose
Tipo de datos
float
Descripción
PriorAdjuvantChemotherapyInd
Tipo de datos
text
Descripción
Unnamed8
Descripción
Baseline Symptoms/"toxicity" Status
Descripción
Comments
Tipo de datos
text
Descripción
CTCAdverseEventTerm
Tipo de datos
text
Descripción
CTCAdverseEventTerm,Other
Tipo de datos
text
Descripción
CTCAdverseEventCategory
Tipo de datos
text
Descripción
CTCAdverseEventGrade
Tipo de datos
text
Descripción
Concomitant Medications
Descripción
Unnamed9
Descripción
Other Major Medical Problems
Descripción
PatientMedicalConditionDate
Tipo de datos
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25261
- UMLS 2011AA Property
- C0205476
- NCI Thesaurus Property-2
- C25457
- UMLS 2011AA Property-2
- C0348080
Descripción
PatientMedicalConditionText
Tipo de datos
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25261
- UMLS 2011AA Property
- C0205476
- NCI Thesaurus Property-2
- C25457
- UMLS 2011AA Property-2
- C0348080
Descripción
PatientHistoryText
Tipo de datos
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C18772
- UMLS 2011AA Property
- C0262926
Descripción
Comments
Descripción
Investigator Signature
Descripción
InvestigatorSignature
Tipo de datos
text
Alias
- NCI Thesaurus Property
- C25678
- UMLS 2011AA Property
- C1519316
- NCI Thesaurus ObjectClass
- C17089
- UMLS 2011AA ObjectClass
- C0035173
Descripción
PersonCompletingForm,LastName
Tipo de datos
text
Descripción
PersonCompletingForm,FirstName
Tipo de datos
text
Alias
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus Property
- C25364
- UMLS 2011AA Property
- C0600091
Descripción
FormCompletionDate,Original
Tipo de datos
date
Descripción
Ccrr Module For Form 1 - Eligibility Checklist And Initial Evaluation
Similar models
No Instruction available.
- StudyEvent: Form 1 - Eligibility Checklist and Initial Evaluation
C0683312 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C17357 (NCI Thesaurus Property)
C0079399 (UMLS 2011AA Property)
C1706180 (UMLS 2011AA)
C0015780 (UMLS 2011AA)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C0030705 (UMLS 2011AA ObjectClass)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
C0030705 (UMLS 2011AA ObjectClass)
C17049 (NCI Thesaurus Property)
C0034510 (UMLS 2011AA Property)
C0439673 (UMLS 2011AA)
C0030705 (UMLS 2011AA ObjectClass)
C17049 (NCI Thesaurus Property)
C0034510 (UMLS 2011AA Property)
C0439673 (UMLS 2011AA)
C0018717 (UMLS 2011AA)
C0205394 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C1507394 (UMLS 2011AA ObjectClass)
C25425 (NCI Thesaurus Property)
C0205540 (UMLS 2011AA Property)
C0011008 (UMLS 2011AA ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C0007137 (UMLS 2011AA)
C0001418 (UMLS 2011AA)
C0205394 (UMLS 2011AA)
C1512699 (UMLS 2011AA ValueDomain)
C15329 (NCI Thesaurus Property)
C0543467 (UMLS 2011AA Property)
C4878 (NCI Thesaurus ObjectClass)
C0684249 (UMLS 2011AA ObjectClass)
C0683312 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C17357 (NCI Thesaurus Property)
C0079399 (UMLS 2011AA Property)
C1706180 (UMLS 2011AA)
C0015780 (UMLS 2011AA)
C0007137 (UMLS 2011AA)
C0001418 (UMLS 2011AA)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C305 (NCI Thesaurus Property-2)
C0005437 (UMLS 2011AA Property-2)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25706 (NCI Thesaurus ValueDomain-2)
C1519815 (UMLS 2011AA ValueDomain-2)
C1522609 (UMLS 2011AA ValueDomain)
C25706 (NCI Thesaurus ValueDomain-2)
C1519815 (UMLS 2011AA ValueDomain-2)
C1522609 (UMLS 2011AA ValueDomain)
C25706 (NCI Thesaurus ValueDomain-2)
C1519815 (UMLS 2011AA ValueDomain-2)
C0151420 (UMLS CUI-1)
C20200 (NCI Thesaurus Property)
C16276 (NCI Thesaurus Property-2)
C25712 (NCI Thesaurus ValueDomain)
C25706 (NCI Thesaurus ValueDomain-2)
C0201976 (UMLS CUI-1)
C20200 (NCI Thesaurus Property)
C1519815 (UMLS CUI-2)
C399 (NCI Thesaurus Property-2)
C25712 (NCI Thesaurus ValueDomain)
C25706 (NCI Thesaurus ValueDomain-2)
C1512698 (UMLS 2011AA ValueDomain)
C0011923 (UMLS 2011AA ObjectClass)
C17204 (NCI Thesaurus ObjectClass-2)
C0040405 (UMLS 2011AA ObjectClass-2)
C25389 (NCI Thesaurus ObjectClass-3)
C0817096 (UMLS 2011AA ObjectClass-3)
C16809 (NCI Thesaurus ObjectClass-4)
C0024485 (UMLS 2011AA ObjectClass-4)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C25482 (NCI Thesaurus ObjectClass)
C0348026 (UMLS 2011AA ObjectClass)
C0013798 (NCI Metathesaurus ObjectClass)
C0011008 (UMLS 2011AA ValueDomain)
C0030705 (UMLS 2011AA ObjectClass)
C16033 (NCI Thesaurus Property)
C1522577 (UMLS 2011AA Property)
C49236 (NCI Thesaurus Property-2)
C0087111 (UMLS 2011AA Property-2)
C25171 (NCI Thesaurus Property-3)
C0013893 (UMLS 2011AA Property-3)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C1519316 (UMLS 2011AA Property)
C17089 (NCI Thesaurus ObjectClass)
C0035173 (UMLS 2011AA ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C1705108 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C0205448 (UMLS 2011AA)
C0030705 (UMLS 2011AA ObjectClass)
C25347 (NCI Thesaurus Property)
C0489786 (UMLS 2011AA Property)
C1515974 (UMLS 2011AA ValueDomain)
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
C16502 (NCI Thesaurus ObjectClass)
C0011923 (UMLS 2011AA ObjectClass)
C25421 (NCI Thesaurus Property-2)
C0002808 (UMLS 2011AA Property-2)
C0817096 (UMLS 2011AA)
C0006104 (UMLS 2011AA)
C0230168 (UMLS 2011AA)
C0262950 (UMLS 2011AA)
C1522601 (UMLS 2011AA)
C1456803 (UMLS 2011AA)
C0203668 (UMLS 2011AA)
C1446409 (UMLS 2011AA)
C0205160 (UMLS 2011AA)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C305 (NCI Thesaurus Property-2)
C0005437 (UMLS 2011AA Property-2)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25706 (NCI Thesaurus ValueDomain-2)
C1519815 (UMLS 2011AA ValueDomain-2)
C1522609 (UMLS 2011AA ValueDomain)
C25706 (NCI Thesaurus ValueDomain-2)
C1519815 (UMLS 2011AA ValueDomain-2)
C1522609 (UMLS 2011AA ValueDomain)
C25706 (NCI Thesaurus ValueDomain-2)
C1519815 (UMLS 2011AA ValueDomain-2)
C0151420 (UMLS CUI-1)
C20200 (NCI Thesaurus Property)
C16276 (NCI Thesaurus Property-2)
C25712 (NCI Thesaurus ValueDomain)
C25706 (NCI Thesaurus ValueDomain-2)
C0201976 (UMLS CUI-1)
C20200 (NCI Thesaurus Property)
C1519815 (UMLS CUI-2)
C399 (NCI Thesaurus Property-2)
C25712 (NCI Thesaurus ValueDomain)
C25706 (NCI Thesaurus ValueDomain-2)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C61019 (NCI Thesaurus Property-2)
C0005845 (UMLS 2011AA Property-2)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25706 (NCI Thesaurus ValueDomain-2)
C1519815 (UMLS 2011AA ValueDomain-2)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C464 (NCI Thesaurus Property-2)
C0013832 (UMLS 2011AA Property-2)
C765 (NCI Thesaurus Property-3)
C0032821 (UMLS 2011AA Property-3)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25555 (NCI Thesaurus ValueDomain-2)
C1518030 (UMLS 2011AA ValueDomain-2)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C464 (NCI Thesaurus Property-2)
C0013832 (UMLS 2011AA Property-2)
C765 (NCI Thesaurus Property-3)
C0032821 (UMLS 2011AA Property-3)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25706 (NCI Thesaurus ValueDomain-2)
C1519815 (UMLS 2011AA ValueDomain-2)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C830 (NCI Thesaurus Property-2)
C0037473 (UMLS 2011AA Property-2)
C464 (NCI Thesaurus Property-3)
C0013832 (UMLS 2011AA Property-3)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25555 (NCI Thesaurus ValueDomain-2)
C1518030 (UMLS 2011AA ValueDomain-2)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C830 (NCI Thesaurus Property-2)
C0037473 (UMLS 2011AA Property-2)
C464 (NCI Thesaurus Property-3)
C0013832 (UMLS 2011AA Property-3)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25706 (NCI Thesaurus ValueDomain-2)
C1519815 (UMLS 2011AA ValueDomain-2)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C464 (NCI Thesaurus Property-2)
C0013832 (UMLS 2011AA Property-2)
C1741 (NCI Thesaurus Property-3)
C0596019 (UMLS 2011AA Property-3)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25555 (NCI Thesaurus ValueDomain-2)
C1518030 (UMLS 2011AA ValueDomain-2)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C464 (NCI Thesaurus Property-2)
C0013832 (UMLS 2011AA Property-2)
C1741 (NCI Thesaurus Property-3)
C0596019 (UMLS 2011AA Property-3)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25706 (NCI Thesaurus ValueDomain-2)
C1519815 (UMLS 2011AA ValueDomain-2)
C0022885 (UMLS 2011AA ObjectClass)
C331 (NCI Thesaurus Property)
C0006675 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property-2)
C1274040 (UMLS 2011AA Property-2)
C464 (NCI Thesaurus Property-3)
C0013832 (UMLS 2011AA Property-3)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25555 (NCI Thesaurus ValueDomain-2)
C1518030 (UMLS 2011AA ValueDomain-2)
C0022885 (UMLS 2011AA ObjectClass)
C331 (NCI Thesaurus Property)
C0006675 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property-2)
C1274040 (UMLS 2011AA Property-2)
C464 (NCI Thesaurus Property-3)
C0013832 (UMLS 2011AA Property-3)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25706 (NCI Thesaurus ValueDomain-2)
C1519815 (UMLS 2011AA ValueDomain-2)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C214 (NCI Thesaurus Property-2)
C0001924 (UMLS 2011AA Property-2)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25555 (NCI Thesaurus ValueDomain-2)
C1518030 (UMLS 2011AA ValueDomain-2)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C214 (NCI Thesaurus Property-2)
C0001924 (UMLS 2011AA Property-2)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25706 (NCI Thesaurus ValueDomain-2)
C1519815 (UMLS 2011AA ValueDomain-2)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C0007137 (UMLS 2011AA)
C0001418 (UMLS 2011AA)
C0205615 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C0332128 (UMLS 2011AA Property)
C12745 (NCI Thesaurus ObjectClass)
C0024204 (UMLS 2011AA ObjectClass)
C1446409 (UMLS 2011AA Property)
C12745 (NCI Thesaurus ObjectClass)
C0024204 (UMLS 2011AA ObjectClass)
C0475302 (UMLS 2011AA)
C0332241 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C0023928 (UMLS 2011AA)
C0032284 (UMLS 2011AA)
C0205091 (UMLS 2011AA)
C0205090 (UMLS 2011AA)
C0225594 (UMLS 2011AA)
C0205258 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C0027651 (UMLS 2011AA ObjectClass)
C25563 (NCI Thesaurus Property)
C0205284 (UMLS 2011AA Property)
C1705108 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C62484 (NCI Thesaurus)
C0205076 (UMLS 2011AA)
C0031050 (UMLS 2011AA)
C0025066 (UMLS 2011AA)
C0011980 (UMLS 2011AA)
C0014876 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C0011008 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25261 (NCI Thesaurus Property)
C0205476 (UMLS 2011AA Property)
C25457 (NCI Thesaurus Property-2)
C0348080 (UMLS 2011AA Property-2)
C1527021 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25261 (NCI Thesaurus Property)
C0205476 (UMLS 2011AA Property)
C25457 (NCI Thesaurus Property-2)
C0348080 (UMLS 2011AA Property-2)
C1527021 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C18772 (NCI Thesaurus Property)
C0262926 (UMLS 2011AA Property)
C1519316 (UMLS 2011AA Property)
C17089 (NCI Thesaurus ObjectClass)
C0035173 (UMLS 2011AA ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)