ID
9353
Descrição
NSABP-B-47 Missing Data form for Medical Conditions and Lifestyle Questionnaire (Form QMD) A Randomized Phase III Trial of Adjuvant Therapy Comparing Chemotherapy Alone (Six Cycles of Docetaxel Plus Cyclophosphamide or Four Cycles of Doxorubicin Plus Cyclophosphamide Followed by Weekly Paclitaxel) to Chemotherapy Plus Trastuzumab in Women With Node- Positive or High-Risk Node-Negative HER2-Low Invasive Breast Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=9556F723-E572-09D5-E040-BB89AD433F36
Link
Palavras-chave
Versões (2)
- 18/12/2014 18/12/2014 - Martin Dugas
- 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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Breast Cancer NCT01275677 Quality of Life - NSABP-B-47 Missing Data form for Medical Conditions and Lifestyle Questionnaire (Form QMD) - 3161696v1.0
This paper worksheet may be completed to facilitate entry of information in NSABP Coordination Online. Partially completed online forms may be saved in Coordinator Online. DO NOT SUBMIT THIS WORKSHEET VIA FAX OR MAIL. Submit Form QMD online whenever the protocol-scheduled Medical Conditions and Lifestyle Questionnaire Follow-up (MCL-F) form is not filled out by the patient and the assessment cannot be obtained by phone or mail. No missing data form is required for partially completed MCL-F forms
- StudyEvent: NSABP-B-47 Missing Data form for Medical Conditions and Lifestyle Questionnaire (Form QMD)
Descrição
Reason Qol Not Assessed
Descrição
AssessmentPeriodType
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus ObjectClass
- C20989
- UMLS 2011AA ObjectClass
- C0031809
- NCI Thesaurus Property
- C25616
- UMLS 2011AA Property
- C1948053
Descrição
QualityOfLifeNotAssessedReason
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25638
- UMLS 2011AA ValueDomain
- C0392360
- NCI Thesaurus ObjectClass
- C17047
- UMLS 2011AA ObjectClass
- C0518214
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
Descrição
QualityofLifeAbsentAssessmentReason
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25638
- UMLS 2011AA ValueDomain
- C0392360
- NCI Thesaurus ObjectClass
- C17047
- UMLS 2011AA ObjectClass
- C0518214
- NCI Thesaurus Property
- C25217
- UMLS 2011AA Property
- C1516048
- NCI Thesaurus Property-2
- C48190
- UMLS 2011AA Property-2
- C0332197
Descrição
QualityOfLifePatientNotAssessedSpecify
Tipo de dados
text
Alias
- NCI Thesaurus ObjectClass
- C17047
- UMLS 2011AA ObjectClass
- C0518214
- NCI Thesaurus ObjectClass-2
- C16960
- UMLS 2011AA ObjectClass-2
- C0030705
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Thesaurus Property-2
- C25594
- UMLS 2011AA Property-2
- C1518422
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
Descrição
QualityOfLifePatientNotAssessedSpecify
Tipo de dados
text
Alias
- NCI Thesaurus ObjectClass
- C17047
- UMLS 2011AA ObjectClass
- C0518214
- NCI Thesaurus ObjectClass-2
- C16960
- UMLS 2011AA ObjectClass-2
- C0030705
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
- NCI Thesaurus Property-2
- C25594
- UMLS 2011AA Property-2
- C1518422
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
Descrição
Footer
Descrição
Research Comments
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C0947611
- NCI Thesaurus ObjectClass
- C15319
- NCI Thesaurus Property
- C25393
Descrição
Person Completing Form
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS CUI-1
- C1550483
- NCI Thesaurus ObjectClass
- C25657
- NCI Thesaurus Property
- C25364
Descrição
Date Form Completed
Tipo de dados
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C1115437
- NCI Thesaurus ObjectClass
- C40988
- NCI Thesaurus Property
- C25250
- NCI Thesaurus ValueDomain-2
- C25367
Similar models
This paper worksheet may be completed to facilitate entry of information in NSABP Coordination Online. Partially completed online forms may be saved in Coordinator Online. DO NOT SUBMIT THIS WORKSHEET VIA FAX OR MAIL. Submit Form QMD online whenever the protocol-scheduled Medical Conditions and Lifestyle Questionnaire Follow-up (MCL-F) form is not filled out by the patient and the assessment cannot be obtained by phone or mail. No missing data form is required for partially completed MCL-F forms
- StudyEvent: NSABP-B-47 Missing Data form for Medical Conditions and Lifestyle Questionnaire (Form QMD)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1513905 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C15818 (NCI Thesaurus Property-2)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25616 (NCI Thesaurus Property)
C1948053 (UMLS 2011AA Property)
C0392360 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0392360 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25217 (NCI Thesaurus Property)
C1516048 (UMLS 2011AA Property)
C48190 (NCI Thesaurus Property-2)
C0332197 (UMLS 2011AA Property-2)
C0205394 (UMLS 2011AA)
C0518214 (UMLS 2011AA ObjectClass)
C16960 (NCI Thesaurus ObjectClass-2)
C0030705 (UMLS 2011AA ObjectClass-2)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25594 (NCI Thesaurus Property-2)
C1518422 (UMLS 2011AA Property-2)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C0518214 (UMLS 2011AA ObjectClass)
C16960 (NCI Thesaurus ObjectClass-2)
C0030705 (UMLS 2011AA ObjectClass-2)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25594 (NCI Thesaurus Property-2)
C1518422 (UMLS 2011AA Property-2)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C1550483 (UMLS CUI-1)
C25657 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)
C1115437 (UMLS CUI-1)
C40988 (NCI Thesaurus ObjectClass)
C25250 (NCI Thesaurus Property)
C25367 (NCI Thesaurus ValueDomain-2)