ID
9308
Description
NCIC-PR.11 Eligibility Worksheet Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=6B77A6FA-9AF8-CC7A-E040-BB89AD434302
Link
Keywords
Versions (2)
- 12/18/14 12/18/14 - Martin Dugas
- 1/9/15 1/9/15 - Martin Dugas
Uploaded on
January 9, 2015
DOI
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License
Creative Commons BY-NC 3.0 Legacy
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Prostate Cancer NCT00499174 Registration - NCIC-PR.11 Eligibility Worksheet Form - 2897735v1.0
National Cancer Institute of Canada Clinical Trials Group (NCIC CTG)
- StudyEvent: NCIC-PR.11 Eligibility Worksheet Form
Description
Ineligibility Criteria
Description
PatientNeoplasmPersonalMedicalHistoryInd-2
Data type
boolean
Alias
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C3262
- UMLS 2011AA Property
- C0027651
- NCI Thesaurus Property-2
- C18772
- UMLS 2011AA Property-2
- C0262926
Description
AndrogenSuppressionTherapyAdministrationInd-2
Data type
boolean
Alias
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus Property
- C25409
- UMLS 2011AA Property
- C1533734
- NCI Thesaurus ObjectClass-2
- C15676
- UMLS 2011AA ObjectClass
- C1515985
Description
For U.s. Patients
Description
HealthInsurancePortabilityandAccountabilityActAuthorizationIndicator
Data type
boolean
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
- NCI Thesaurus ObjectClass
- C62504
- UMLS 2011AA ObjectClass
- C0600593
- NCI Thesaurus Property
- C41192
- UMLS 2011AA Property
- C1524004
Description
PatientSignedDischargeMedicalRecordDate
Data type
date
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25679
- NCI Metathesaurus Property
- C0012621
- NCI Thesaurus Property-2
- C45258
- UMLS 2011AA Property
- C0025102
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
Description
Stratification Factors
Description
PerformanceStatusAssessmentType
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus Property
- C25367
- NCI Thesaurus ObjectClass
- C20641
- UMLS 2011AA ObjectClass
- C1518965
Description
PatientTStageProstateAdenocarcinomaClinicalTrialEligibilityCriteriaStatus
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C16112
- UMLS 2011AA Property
- C1516637
- NCI Thesaurus Property-2
- C25728
- UMLS 2011AA Property-2
- C0475455
- NCI Thesaurus Property-3
- C2919
- UMLS 2011AA Property-3
- C0007112
- NCI Thesaurus ValueDomain
- C25688
- UMLS 2011AA ValueDomain
- C0449438
Description
LaboratoryProcedureBaselineProstate-SpecificAntigenOutcomeStatus
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C17525
- UMLS 2011AA Property
- C0138741
- NCI Thesaurus Property-2
- C25213
- UMLS 2011AA Property-2
- C1442488
- NCI Thesaurus Property-3
- C20200
- UMLS 2011AA Property-3
- C1274040
- NCI Thesaurus ValueDomain
- C25688
- UMLS 2011AA ValueDomain
- C0449438
Description
PatientFirstProtocolRegistrationAgeYearCount
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25320
- UMLS 2011AA Property
- C1507394
- NCI Thesaurus Property-2
- C25646
- UMLS 2011AA Property-2
- C1514821
- NCI Thesaurus Property-3
- C25509
- UMLS 2011AA Property-3
- C1279901
- NCI Thesaurus ValueDomain
- C29848
- UMLS 2011AA ValueDomain
- C0439234
- NCI Thesaurus ValueDomain-2
- C25463
- UMLS 2011AA ValueDomain-2
- C0750480
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National Cancer Institute of Canada Clinical Trials Group (NCIC CTG)
- StudyEvent: NCIC-PR.11 Eligibility Worksheet Form
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C17047 (NCI Thesaurus ObjectClass)
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