0 Avaliações

ID

9225

Descrição

Surgical Report (SR) Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=B1229F05-2708-4D58-E034-0003BA12F5E7

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=B1229F05-2708-4D58-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 Treatment - Surgical Report (SR) - 2074581v3.0

    No Instruction available.

    1. StudyEvent: Surgical Report (SR)
      1. No Instruction available.
    Type Of Procedure
    Descrição

    Type Of Procedure

    Excision/Sentinel Node Biopsy
    Descrição

    SentinelNodeBiopsyInd

    Tipo de dados

    boolean

    Completion Lymphadenectomy
    Descrição

    LymphNodeSamplingInd

    Tipo de dados

    boolean

    Location(s) of basin(s):
    Descrição

    DiseaseSite,LymphNodes

    Tipo de dados

    text

    Re-excision
    Descrição

    Re-excision

    Tipo de dados

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38148 (undefined)
    UMLS 2011AA ValueDomain
    C1512699 (Yes, No, or Unknown Response)
    Indication:
    Descrição

    Indication:

    Tipo de dados

    text

    Other, specify (Other, specify)
    Descrição

    Other,specify

    Tipo de dados

    text

    Adjunctive Procedure: (Mark only one)
    Descrição

    AdjunctiveProcedure:

    Tipo de dados

    text

    Name of surgeon responsible for case:
    Descrição

    SurgeonName

    Tipo de dados

    text

    Signature of surgeon/PI:
    Descrição

    SurgeonSignature

    Tipo de dados

    text

    Alias
    NCI Thesaurus Property
    C25678 (undefined)
    UMLS 2011AA Property
    C1519316 (Signature)
    LOINC
    LP248948-4
    NCI Thesaurus ObjectClass
    C18071 (undefined)
    UMLS 2011AA ObjectClass
    C0582175 (Surgeon)
    SNOMED
    304292004
    Completed by:
    Descrição

    CompletedBy

    Tipo de dados

    text

    Date: (Year Month Day)
    Descrição

    FormCompletionDate,Original

    Tipo de dados

    date

    Date: (Year Month Day)
    Descrição

    FormCompletionDate,Original

    Tipo de dados

    date

    Ccrr Module For Surgical Report (sr)
    Descrição

    Ccrr Module For Surgical Report (sr)

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

    PatientIdentifier

    Tipo de dados

    text

    Alias
    NCI Thesaurus ObjectClass
    C16960 (undefined)
    UMLS 2011AA ObjectClass
    C0030705 (Patients)
    SNOMED
    116154003
    NCI Thesaurus Property
    C25364 (undefined)
    UMLS 2011AA Property
    C0600091 (Identifier)
    SNOMED
    118522005
    LOINC
    LP31795-5
    NCI Thesaurus ValueDomain
    C25364 (undefined)
    UMLS 2011AA ValueDomain
    C0600091 (Identifier)
    SNOMED
    118522005
    LOINC
    LP31795-5
    Institution ID:
    Descrição

    InstitutionNo.

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337 (undefined)
    UMLS 2011AA ValueDomain
    C0237753 (Numbers)
    SNOMED
    260299005
    LOINC
    LP6841-3
    Patient Initials: (F ML)
    Descrição

    Patient Initials

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191 (undefined)
    UMLS CUI-1
    C2986440 (Person Initials)
    NCI Thesaurus ObjectClass
    C16960 (undefined)
    NCI Thesaurus Property
    C25536 (undefined)
    Institution:
    Descrição

    InstitutionName

    Tipo de dados

    text

    Date of Surgery: (within 30 days of randomization)
    Descrição

    SurgeryDate

    Tipo de dados

    date

    Type of Surgery:
    Descrição

    TypeofSurgery:

    Tipo de dados

    text

    Similar models

    No Instruction available.

    1. StudyEvent: Surgical Report (SR)
      1. No Instruction available.
    Name
    Tipo
    Description | Question | Decode (Coded Value)
    Tipo de dados
    Alias
    Item Group
    Type Of Procedure
    SentinelNodeBiopsyInd
    Item
    Excision/Sentinel Node Biopsy
    boolean
    LymphNodeSamplingInd
    Item
    Completion Lymphadenectomy
    boolean
    DiseaseSite,LymphNodes
    Item
    Location(s) of basin(s):
    text
    Re-excision
    Item
    Re-excision
    boolean
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    Item
    Indication:
    text
    Code List
    Indication:
    CL Item
    Invasive Primary Tumor Present Within 1 Mm Of Any Margin (Invasive primary tumor present within 1 mm of any margin)
    CL Item
    Microsatellite Tumor Present Within 1mm Of Any Margin (Microsatellite tumor present within 1mm of any margin)
    CL Item
    In Situ Tumor Present At Any Margin (In Situ tumor present at any margin)
    CL Item
    Other, Specify (Other, specify)
    Other,specify
    Item
    Other, specify (Other, specify)
    text
    Item
    Adjunctive Procedure: (Mark only one)
    text
    Code List
    Adjunctive Procedure: (Mark only one)
    CL Item
    Primary Closure With Or Without Undermining (Primary closure with or without undermining)
    CL Item
    Reconstructive Flap And/or Skin Graft (Reconstructive flap and/or skin graft)
    SurgeonName
    Item
    Name of surgeon responsible for case:
    text
    SurgeonSignature
    Item
    Signature of surgeon/PI:
    text
    C25678 (NCI Thesaurus Property)
    C1519316 (UMLS 2011AA Property)
    C18071 (NCI Thesaurus ObjectClass)
    C0582175 (UMLS 2011AA ObjectClass)
    CompletedBy
    Item
    Completed by:
    text
    FormCompletionDate,Original
    Item
    Date: (Year Month Day)
    date
    FormCompletionDate,Original
    Item
    Date: (Year Month Day)
    date
    Item Group
    Ccrr Module For Surgical Report (sr)
    PatientIdentifier
    Item
    Patient ID (Pt. ID issued during registration or previously issued patient ID)
    text
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C25364 (NCI Thesaurus Property)
    C0600091 (UMLS 2011AA Property)
    C25364 (NCI Thesaurus ValueDomain)
    C0600091 (UMLS 2011AA ValueDomain)
    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
    SurgeryDate
    Item
    Date of Surgery: (within 30 days of randomization)
    date
    TypeofSurgery:
    Item
    Type of Surgery:
    text

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