ID
9347
Description
North Central Cancer Treatment Group N0577 - Patient Questionnaire Booklet Compliance Form Radiation Therapy or Radiation Therapy and Temozolomide or Temozolomide Alone in Treating Patients With Newly Diagnosed Anaplastic Glioma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=4C07E8C3-3298-293D-E044-0003BA3F9857
Link
Keywords
Versions (3)
- 8/26/12 8/26/12 -
- 1/8/15 1/8/15 - 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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Brain and Central Nervous System Tumors NCT00887146 Follow-Up - North Central Cancer Treatment Group N0577 - Patient Questionnaire Booklet Compliance Form - 2745216v1.0
Complete this form only if the entire Patient Questionnaire booklet contained absolutely NO patient provided assessment information.
- StudyEvent: North Central Cancer Treatment Group N0577 - Patient Questionnaire Booklet Compliance Form
Description
Header
Description
Clinical Trial Period
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS CUI-1
- C2347804
- NCI Thesaurus ObjectClass
- C25214
- NCI Thesaurus Property
- C25616
- NCI Thesaurus ObjectClass-2
- C25651
Description
Cycle Number Chemotherapeutics
Data type
integer
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C2045829
- NCI Thesaurus Property
- C25471
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus Property-2
- C25379
Description
Date Form Completed
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C1115437
- NCI Thesaurus ObjectClass
- C40988
- NCI Thesaurus Property
- C25250
- NCI Thesaurus ValueDomain-2
- C25367
Description
Incomplete documentation, reason
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25638
- UMLS CUI-1
- C1548386
- NCI Thesaurus ObjectClass
- C16960
- UMLS CUI-2
- C0566251
- NCI Metathesaurus Property
- C0034394
Description
PatientIncompleteQuestionnaireOtherSpecify
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
- NCI Thesaurus ValueDomain-2
- C17649
- UMLS 2011AA ValueDomain-2
- C0205394
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Metathesaurus Property
- C0034394
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Complete this form only if the entire Patient Questionnaire booklet contained absolutely NO patient provided assessment information.
- StudyEvent: North Central Cancer Treatment Group N0577 - Patient Questionnaire Booklet Compliance Form
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