ID

9215

Descrição

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

Link

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

Palavras-chave

  1. 19/09/2012 19/09/2012 -
  2. 09/01/2015 09/01/2015 - Martin Dugas
Transferido a

9 de janeiro de 2015

DOI

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Licença

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)
Descrição

Ccrr Module For Recurrence Information (ri)

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

Pt.ID

Tipo de dados

text

Institution ID:
Descrição

InstitutionNo.

Tipo de dados

text

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

Patient Initials

Tipo de dados

text

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

InstitutionName

Tipo de dados

text

Date of Assessment: (Year Month Day)
Descrição

AssessmentDate

Tipo de dados

date

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

Hasthepatienthadaninitialrecurrenceofthiscancerthathasnotbeenpreviouslyreported?

Tipo de dados

text

Date of Recurrence: (Year Month Day)
Descrição

PriorRecentRecurrenceDate

Tipo de dados

date

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

CompletedBy

Tipo de dados

text

Date: (Year Month Day)
Descrição

FormCompletionDate,Original

Tipo de dados

date

Notice of Initial Recurrence
Descrição

NoticeofInitialRecurrence

Tipo de dados

text

Similar models

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

Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de dados
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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