ID

9215

Descrizione

Recurrence Information (RI) Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=B122D931-FF39-4DDE-E034-0003BA12F5E7

collegamento

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=B122D931-FF39-4DDE-E034-0003BA12F5E7

Keywords

  1. 19/09/12 19/09/12 -
  2. 09/01/15 09/01/15 - Martin Dugas
Caricato su

9 gennaio 2015

DOI

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Licenza

Creative Commons BY-NC 3.0 Legacy

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Melanoma (Skin) null Follow-Up - Recurrence Information (RI) - 2074747v3.0

NOTE: Submit reports to document the above indicated recurrence. Use appropriate Shuttle CRFs.

Ccrr Module For Recurrence Information (ri)
Descrizione

Ccrr Module For Recurrence Information (ri)

Patient ID (Pt. ID issued during registration or previously issued patient ID)
Descrizione

Pt.ID

Tipo di dati

text

Institution ID:
Descrizione

InstitutionNo.

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
Patient Initials: (F ML)
Descrizione

Patient Initials

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C2986440
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25536
Institution:
Descrizione

InstitutionName

Tipo di dati

text

Date of Assessment: (Year Month Day)
Descrizione

AssessmentDate

Tipo di dati

date

Has the patient had an initial recurrence of this cancer that has not been previously reported?
Descrizione

Hasthepatienthadaninitialrecurrenceofthiscancerthathasnotbeenpreviouslyreported?

Tipo di dati

text

Date of Recurrence: (Year Month Day)
Descrizione

PriorRecentRecurrenceDate

Tipo di dati

date

Alias
NCI Thesaurus ObjectClass
C2991
UMLS 2011AA ObjectClass
C0012634
NCI Thesaurus Property
C25279
UMLS 2011AA Property
C0332162
Completed by:
Descrizione

CompletedBy

Tipo di dati

text

Date: (Year Month Day)
Descrizione

FormCompletionDate,Original

Tipo di dati

date

Notice of Initial Recurrence
Descrizione

NoticeofInitialRecurrence

Tipo di dati

text

Similar models

NOTE: Submit reports to document the above indicated recurrence. Use appropriate Shuttle CRFs.

Name
genere
Description | Question | Decode (Coded Value)
Tipo di dati
Alias
Item Group
Ccrr Module For Recurrence Information (ri)
Pt.ID
Item
Patient ID (Pt. ID issued during registration or previously issued patient ID)
text
InstitutionNo.
Item
Institution ID:
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
Patient Initials
Item
Patient Initials: (F ML)
text
C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
InstitutionName
Item
Institution:
text
AssessmentDate
Item
Date of Assessment: (Year Month Day)
date
Item
Has the patient had an initial recurrence of this cancer that has not been previously reported?
text
Code List
Has the patient had an initial recurrence of this cancer that has not been previously reported?
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
Notice Of Initial Recurrence (Notice of Initial Recurrence)
CL Item
Type Of Recurrence(s): (Type of Recurrence(s):)
CL Item
Local: (Local:)
CL Item
Intransit: (Intransit:)
CL Item
Regional/nodal (Regional/Nodal)
CL Item
Distant: (Distant:)
PriorRecentRecurrenceDate
Item
Date of Recurrence: (Year Month Day)
date
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C25279 (NCI Thesaurus Property)
C0332162 (UMLS 2011AA Property)
CompletedBy
Item
Completed by:
text
FormCompletionDate,Original
Item
Date: (Year Month Day)
date
NoticeofInitialRecurrence
Item
Notice of Initial Recurrence
text

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