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ID

9419

Descrição

NSABP Worksheet for Pregnancy Event Form Combination Chemotherapy in Treating Women Who Have Undergone Surgery for Node-Positive Breast Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=7EDC1E5D-3817-778E-E040-BB89AD432648

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=7EDC1E5D-3817-778E-E040-BB89AD432648

Palavras-chave

  1. 26/08/2012 26/08/2012 -
  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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    Breast Cancer NCT00093795 Pathology - NSABP Worksheet for Pregnancy Event Form - 3006894v1.0

    This paper worksheet may be completed to facilitate the entry of the pregnancy event information in NSABP Coordinator Online. Please complete if a patient or the sexual partner of an NSABP patient becomes pregnant during study therapy or within 6 months of completing study therapy. A follow-up report may be necessary to report the pregnancy outcome (e.g., normal baby, birth defect). Partially completed online forms may be saved in Coordinator Online.

    Header
    Descrição

    Header

    Patient Initials
    Descrição

    Patient Initials

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS CUI-1
    C2986440
    NCI Thesaurus ObjectClass
    C16960
    NCI Thesaurus Property
    C25536
    NSABP Patient ID
    Descrição

    Patient ID NSABP

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C2348585
    NCI Thesaurus ObjectClass
    C16960
    UMLS CUI-2
    C1513905
    NCI Thesaurus Property
    C25364
    NCI Thesaurus Property-2
    C15818
    Unnamed 1
    Descrição

    Unnamed 1

    Patient Initials
    Descrição

    Patient Initials

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS CUI-1
    C2986440
    NCI Thesaurus ObjectClass
    C16960
    NCI Thesaurus Property
    C25536
    NSABP Patient ID
    Descrição

    Patient ID NSABP

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C2348585
    NCI Thesaurus ObjectClass
    C16960
    UMLS CUI-2
    C1513905
    NCI Thesaurus Property
    C25364
    NCI Thesaurus Property-2
    C15818
    Treating Investigator
    Descrição

    TreatingPhysicianOrParticipatingInvestigatorName

    Tipo de dados

    text

    Alias
    NCI Thesaurus ObjectClass
    C25608
    UMLS 2011AA ObjectClass
    C0679823
    NCI Thesaurus ObjectClass-2
    C37998
    UMLS 2011AA ObjectClass-2
    C1518602
    NCI Thesaurus ObjectClass-3
    C51883
    UMLS 2011AA ObjectClass-3
    C1710470
    NCI Thesaurus ObjectClass-4
    C25936
    UMLS 2011AA ObjectClass-4
    C0035173
    NCI Thesaurus Property
    C25191
    UMLS 2011AA Property
    C1547383
    NCI Thesaurus ValueDomain
    C25191
    UMLS 2011AA ValueDomain
    C1547383
    Person Completing Form (Reporter)
    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
    Phone (Reporter)
    Descrição

    Person Completing Form Phone

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C1550483
    NCI Thesaurus ObjectClass
    C25190
    UMLS CUI-2
    C1515258
    NCI Thesaurus ObjectClass-2
    C25657
    NCI Thesaurus Property
    C25395
    Fax (Reporter)
    Descrição

    ResponsiblePersonFaxNumber

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS 2011AA ValueDomain
    C0237753
    NCI Thesaurus ObjectClass
    C25190
    UMLS 2011AA ObjectClass
    C0027361
    NCI Thesaurus ObjectClass-2
    C25657
    UMLS 2011AA ObjectClass-2
    C1273518
    NCI Thesaurus Property
    C25210
    UMLS 2011AA Property
    C0085205
    E-mail (Reporter)
    Descrição

    ResponsiblePersonE-mailAddressText

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704
    UMLS 2011AA ValueDomain
    C1527021
    NCI Thesaurus ObjectClass
    C25657
    UMLS 2011AA ObjectClass
    C1273518
    NCI Thesaurus Property
    C42775
    UMLS 2011AA Property
    C1705961
    Date Form Completed
    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
    Cancer Treatment Prior To Pregnancy Diagnosis
    Descrição

    Cancer Treatment Prior To Pregnancy Diagnosis

    Classification of NSABP Protocol Patient
    Descrição

    NationalSurgicalAdjuvantBreastandBowelProjectClinicalTrialPersonPregnancyStatus

    Tipo de dados

    text

    Alias
    NCI Thesaurus ObjectClass
    C25190
    UMLS 2011AA ObjectClass
    C0027361
    NCI Thesaurus ObjectClass-2
    C15818
    UMLS 2011AA ObjectClass-2
    C1513905
    NCI Thesaurus ObjectClass-3
    C71104
    UMLS 2011AA ObjectClass-3
    C0008976
    NCI Thesaurus Property
    C25742
    UMLS 2011AA Property
    C0032961
    NCI Thesaurus ValueDomain
    C25688
    UMLS 2011AA ValueDomain
    C0449438
    Cancer Treatment Prior to Pregnancy Diagnosis (Describe most recent cancer treatment prior to pregnancy diagnosis; please include dates of treatment)
    Descrição

    PersonPriorTherapeuticProcedureMalignantNeoplasmPregnancyText

    Tipo de dados

    text

    Alias
    NCI Thesaurus ObjectClass
    C25190
    UMLS 2011AA ObjectClass
    C0027361
    NCI Thesaurus Property
    C9305
    UMLS 2011AA Property
    C0006826
    NCI Thesaurus Property-2
    C25629
    UMLS 2011AA Property-2
    C0332152
    NCI Thesaurus Property-3
    C49236
    UMLS 2011AA Property-3
    C0087111
    NCI Thesaurus Property-4
    C25742
    UMLS 2011AA Property-4
    C0032961
    NCI Thesaurus ValueDomain
    C25704
    UMLS 2011AA ValueDomain
    C1527021
    Relevant Past Medical History of Pregnant Individual (e.g., diabetes, surgery, concomitant medications)
    Descrição

    PersonPersonalMedicalHistoryPregnancyText

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704
    UMLS 2011AA ValueDomain
    C1527021
    NCI Thesaurus ObjectClass
    C25190
    UMLS 2011AA ObjectClass
    C0027361
    NCI Thesaurus Property
    C25742
    UMLS 2011AA Property
    C0032961
    NCI Thesaurus Property-2
    C18772
    UMLS 2011AA Property-2
    C0262926
    Tests & Procedures Relevant To Pregnancy
    Descrição

    Tests & Procedures Relevant To Pregnancy

    Has the patient had any tests or procedures performed relevant to pregnancy
    Descrição

    TherapeuticProcedurePregnancyAssociatedPerformedInd-2

    Tipo de dados

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    NCI Thesaurus Property
    C38000
    UMLS 2011AA Property
    C0884358
    NCI Thesaurus ObjectClass
    C49236
    UMLS 2011AA ObjectClass
    C0087111
    NCI Thesaurus Property-2
    C25742
    UMLS 2011AA Property-2
    C0032961
    NCI Thesaurus Property-3
    C25281
    UMLS 2011AA Property-3
    C0332281
    Tests/Procedure (Specify)
    Descrição

    TherapeuticProcedurePregnancyAssociatedPerformedName

    Tipo de dados

    text

    Alias
    NCI Thesaurus ObjectClass
    C49236
    UMLS 2011AA ObjectClass
    C0087111
    NCI Thesaurus Property
    C38000
    UMLS 2011AA Property
    C0884358
    NCI Thesaurus Property-2
    C25742
    UMLS 2011AA Property-2
    C0032961
    NCI Thesaurus Property-3
    C25281
    UMLS 2011AA Property-3
    C0332281
    NCI Thesaurus ValueDomain
    C42614
    UMLS 2011AA ValueDomain
    C0027365
    Date of test
    Descrição

    TherapeuticProcedurePregnancyAssociatedPerformedDate

    Tipo de dados

    date

    Alias
    NCI Thesaurus ObjectClass
    C49236
    UMLS 2011AA ObjectClass
    C0087111
    NCI Thesaurus Property
    C38000
    UMLS 2011AA Property
    C0884358
    NCI Thesaurus Property-2
    C25742
    UMLS 2011AA Property-2
    C0032961
    NCI Thesaurus Property-3
    C25281
    UMLS 2011AA Property-3
    C0332281
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    Result of test
    Descrição

    TherapeuticProcedurePregnancyAssociatedPerformedStatus

    Tipo de dados

    text

    Alias
    NCI Thesaurus ObjectClass
    C49236
    UMLS 2011AA ObjectClass
    C0087111
    NCI Thesaurus Property
    C38000
    UMLS 2011AA Property
    C0884358
    NCI Thesaurus Property-2
    C25742
    UMLS 2011AA Property-2
    C0032961
    NCI Thesaurus Property-3
    C25281
    UMLS 2011AA Property-3
    C0332281
    NCI Thesaurus ValueDomain
    C25688
    UMLS 2011AA ValueDomain
    C0449438
    Abnormal (If abnormal, specify)
    Descrição

    TherapeuticProcedurePregnancyAssociatedPerformedAbnormalSpecify

    Tipo de dados

    text

    Alias
    NCI Thesaurus ObjectClass
    C49236
    UMLS 2011AA ObjectClass
    C0087111
    NCI Thesaurus Property
    C38000
    UMLS 2011AA Property
    C0884358
    NCI Thesaurus Property-2
    C25742
    UMLS 2011AA Property-2
    C0032961
    NCI Thesaurus Property-3
    C25281
    UMLS 2011AA Property-3
    C0332281
    NCI Thesaurus ValueDomain
    C25685
    UMLS 2011AA ValueDomain
    C1521902
    NCI Thesaurus ValueDomain-2
    C25401
    UMLS 2011AA ValueDomain-2
    C0205161
    Pregnancy Information
    Descrição

    Pregnancy Information

    Pregnancy prevention measures
    Descrição

    PersonContraceptionUseIndicator

    Tipo de dados

    boolean

    Alias
    NCI Thesaurus ObjectClass
    C25190
    UMLS 2011AA ObjectClass
    C0027361
    NCI Thesaurus ValueDomain
    C25180
    UMLS 2011AA ValueDomain
    C1522602
    NCI Thesaurus ObjectClass-2
    C37932
    UMLS 2011AA ObjectClass-2
    C0700589
    NCI Thesaurus Property
    C25340
    UMLS 2011AA Property
    C0457083
    If yes, specify
    Descrição

    PersonContraceptionUseSpecify

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25685
    UMLS 2011AA ValueDomain
    C1521902
    NCI Thesaurus ObjectClass
    C25190
    UMLS 2011AA ObjectClass
    C0027361
    NCI Thesaurus ObjectClass-2
    C37932
    UMLS 2011AA ObjectClass-2
    C0700589
    NCI Thesaurus Property
    C25340
    UMLS 2011AA Property
    C0457083
    Date of last menstrual period
    Descrição

    LastMenstrualCycleOccurrenceDate

    Tipo de dados

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ObjectClass
    C25551
    UMLS 2011AA ObjectClass
    C1517741
    NCI Thesaurus Property
    C25275
    UMLS 2011AA Property
    C2745955
    NCI Thesaurus ObjectClass-2
    C16838
    UMLS 2011AA ObjectClass-2
    C0025329
    Weeks of gestation when pregnancy first confirmed
    Descrição

    PregnancyWeekNumberCount

    Tipo de dados

    float

    Alias
    NCI Thesaurus Property
    C25337
    UMLS 2011AA Property
    C0237753
    NCI Thesaurus ValueDomain
    C25463
    UMLS 2011AA ValueDomain
    C0750480
    NCI Thesaurus ObjectClass
    C25742
    UMLS 2011AA ObjectClass
    C0032961
    NCI Thesaurus Property-2
    C29844
    UMLS 2011AA Property-2
    C0439230
    Estimated delivery
    Descrição

    PregnancyDeliveryDate

    Tipo de dados

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ObjectClass
    C25742
    UMLS 2011AA ObjectClass
    C0032961
    NCI Thesaurus Property
    C61560
    Pregnancy Status/pregnancy Outcome
    Descrição

    Pregnancy Status/pregnancy Outcome

    Pregnancy Status
    Descrição

    PersonPregnancyPregnancyStatus

    Tipo de dados

    text

    Alias
    NCI Thesaurus ObjectClass
    C25190
    UMLS 2011AA ObjectClass
    C0027361
    NCI Thesaurus Property
    C25742
    UMLS 2011AA Property
    C0032961
    NCI Thesaurus ValueDomain
    C25688
    UMLS 2011AA ValueDomain
    C0449438
    Pregnancy Outcome
    Descrição

    PersonPregnancyOutcomeType

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25284
    UMLS 2011AA ValueDomain
    C0332307
    NCI Thesaurus ObjectClass
    C25190
    UMLS 2011AA ObjectClass
    C0027361
    NCI Thesaurus Property
    C20200
    UMLS 2011AA Property
    C1274040
    NCI Thesaurus Property-2
    C25742
    UMLS 2011AA Property-2
    C0032961
    Date (Provide date of selected outcome)
    Descrição

    PersonPregnancyOutcomeDate

    Tipo de dados

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ObjectClass
    C25190
    UMLS 2011AA ObjectClass
    C0027361
    NCI Thesaurus Property
    C20200
    UMLS 2011AA Property
    C1274040
    NCI Thesaurus Property-2
    C25742
    UMLS 2011AA Property-2
    C0032961
    Fetal/baby Outcome
    Descrição

    Fetal/baby Outcome

    Fetal/Baby Outcome
    Descrição

    PregnancyBirthOutcomeText

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704
    UMLS 2011AA ValueDomain
    C1527021
    NCI Thesaurus Property
    C20200
    UMLS 2011AA Property
    C1274040
    NCI Thesaurus ObjectClass
    C25742
    UMLS 2011AA ObjectClass
    C0032961
    NCI Thesaurus Property-2
    C25155
    UMLS 2011AA Property-2
    C0005615
    Footer Module
    Descrição

    Footer Module

    Comments
    Descrição

    Research Comments

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704
    UMLS CUI-1
    C0947611
    NCI Thesaurus ObjectClass
    C15319
    NCI Thesaurus Property
    C25393

    Similar models

    This paper worksheet may be completed to facilitate the entry of the pregnancy event information in NSABP Coordinator Online. Please complete if a patient or the sexual partner of an NSABP patient becomes pregnant during study therapy or within 6 months of completing study therapy. A follow-up report may be necessary to report the pregnancy outcome (e.g., normal baby, birth defect). Partially completed online forms may be saved in Coordinator Online.

    Name
    Tipo
    Description | Question | Decode (Coded Value)
    Tipo de dados
    Alias
    Item Group
    Header
    Patient Initials
    Item
    Patient Initials
    text
    C25191 (NCI Thesaurus ValueDomain)
    C2986440 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C25536 (NCI Thesaurus Property)
    Patient ID NSABP
    Item
    NSABP Patient ID
    text
    C25337 (NCI Thesaurus ValueDomain)
    C2348585 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C1513905 (UMLS CUI-2)
    C25364 (NCI Thesaurus Property)
    C15818 (NCI Thesaurus Property-2)
    Item Group
    Unnamed 1
    Patient Initials
    Item
    Patient Initials
    text
    C25191 (NCI Thesaurus ValueDomain)
    C2986440 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C25536 (NCI Thesaurus Property)
    Patient ID NSABP
    Item
    NSABP Patient ID
    text
    C25337 (NCI Thesaurus ValueDomain)
    C2348585 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C1513905 (UMLS CUI-2)
    C25364 (NCI Thesaurus Property)
    C15818 (NCI Thesaurus Property-2)
    TreatingPhysicianOrParticipatingInvestigatorName
    Item
    Treating Investigator
    text
    C25608 (NCI Thesaurus ObjectClass)
    C0679823 (UMLS 2011AA ObjectClass)
    C37998 (NCI Thesaurus ObjectClass-2)
    C1518602 (UMLS 2011AA ObjectClass-2)
    C51883 (NCI Thesaurus ObjectClass-3)
    C1710470 (UMLS 2011AA ObjectClass-3)
    C25936 (NCI Thesaurus ObjectClass-4)
    C0035173 (UMLS 2011AA ObjectClass-4)
    C25191 (NCI Thesaurus Property)
    C1547383 (UMLS 2011AA Property)
    C25191 (NCI Thesaurus ValueDomain)
    C1547383 (UMLS 2011AA ValueDomain)
    Person Completing Form
    Item
    Person Completing Form (Reporter)
    text
    C25191 (NCI Thesaurus ValueDomain)
    C1550483 (UMLS CUI-1)
    C25657 (NCI Thesaurus ObjectClass)
    C25364 (NCI Thesaurus Property)
    Person Completing Form Phone
    Item
    Phone (Reporter)
    text
    C25337 (NCI Thesaurus ValueDomain)
    C1550483 (UMLS CUI-1)
    C25190 (NCI Thesaurus ObjectClass)
    C1515258 (UMLS CUI-2)
    C25657 (NCI Thesaurus ObjectClass-2)
    C25395 (NCI Thesaurus Property)
    ResponsiblePersonFaxNumber
    Item
    Fax (Reporter)
    text
    C25337 (NCI Thesaurus ValueDomain)
    C0237753 (UMLS 2011AA ValueDomain)
    C25190 (NCI Thesaurus ObjectClass)
    C0027361 (UMLS 2011AA ObjectClass)
    C25657 (NCI Thesaurus ObjectClass-2)
    C1273518 (UMLS 2011AA ObjectClass-2)
    C25210 (NCI Thesaurus Property)
    C0085205 (UMLS 2011AA Property)
    ResponsiblePersonE-mailAddressText
    Item
    E-mail (Reporter)
    text
    C25704 (NCI Thesaurus ValueDomain)
    C1527021 (UMLS 2011AA ValueDomain)
    C25657 (NCI Thesaurus ObjectClass)
    C1273518 (UMLS 2011AA ObjectClass)
    C42775 (NCI Thesaurus Property)
    C1705961 (UMLS 2011AA Property)
    Date Form Completed
    Item
    Date Form Completed
    date
    C25164 (NCI Thesaurus ValueDomain)
    C1115437 (UMLS CUI-1)
    C40988 (NCI Thesaurus ObjectClass)
    C25250 (NCI Thesaurus Property)
    C25367 (NCI Thesaurus ValueDomain-2)
    Item Group
    Cancer Treatment Prior To Pregnancy Diagnosis
    Item
    Classification of NSABP Protocol Patient
    text
    C25190 (NCI Thesaurus ObjectClass)
    C0027361 (UMLS 2011AA ObjectClass)
    C15818 (NCI Thesaurus ObjectClass-2)
    C1513905 (UMLS 2011AA ObjectClass-2)
    C71104 (NCI Thesaurus ObjectClass-3)
    C0008976 (UMLS 2011AA ObjectClass-3)
    C25742 (NCI Thesaurus Property)
    C0032961 (UMLS 2011AA Property)
    C25688 (NCI Thesaurus ValueDomain)
    C0449438 (UMLS 2011AA ValueDomain)
    Code List
    Classification of NSABP Protocol Patient
    CL Item
    Pregnant Or Post-partum Woman (Pregnant or post-partum woman)
    CL Item
    Male Partner Of Pregnant Or Post-partum Woman (Male partner of pregnant or post-partum woman)
    PersonPriorTherapeuticProcedureMalignantNeoplasmPregnancyText
    Item
    Cancer Treatment Prior to Pregnancy Diagnosis (Describe most recent cancer treatment prior to pregnancy diagnosis; please include dates of treatment)
    text
    C25190 (NCI Thesaurus ObjectClass)
    C0027361 (UMLS 2011AA ObjectClass)
    C9305 (NCI Thesaurus Property)
    C0006826 (UMLS 2011AA Property)
    C25629 (NCI Thesaurus Property-2)
    C0332152 (UMLS 2011AA Property-2)
    C49236 (NCI Thesaurus Property-3)
    C0087111 (UMLS 2011AA Property-3)
    C25742 (NCI Thesaurus Property-4)
    C0032961 (UMLS 2011AA Property-4)
    C25704 (NCI Thesaurus ValueDomain)
    C1527021 (UMLS 2011AA ValueDomain)
    PersonPersonalMedicalHistoryPregnancyText
    Item
    Relevant Past Medical History of Pregnant Individual (e.g., diabetes, surgery, concomitant medications)
    text
    C25704 (NCI Thesaurus ValueDomain)
    C1527021 (UMLS 2011AA ValueDomain)
    C25190 (NCI Thesaurus ObjectClass)
    C0027361 (UMLS 2011AA ObjectClass)
    C25742 (NCI Thesaurus Property)
    C0032961 (UMLS 2011AA Property)
    C18772 (NCI Thesaurus Property-2)
    C0262926 (UMLS 2011AA Property-2)
    Item Group
    Tests & Procedures Relevant To Pregnancy
    TherapeuticProcedurePregnancyAssociatedPerformedInd-2
    Item
    Has the patient had any tests or procedures performed relevant to pregnancy
    boolean
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    C38000 (NCI Thesaurus Property)
    C0884358 (UMLS 2011AA Property)
    C49236 (NCI Thesaurus ObjectClass)
    C0087111 (UMLS 2011AA ObjectClass)
    C25742 (NCI Thesaurus Property-2)
    C0032961 (UMLS 2011AA Property-2)
    C25281 (NCI Thesaurus Property-3)
    C0332281 (UMLS 2011AA Property-3)
    TherapeuticProcedurePregnancyAssociatedPerformedName
    Item
    Tests/Procedure (Specify)
    text
    C49236 (NCI Thesaurus ObjectClass)
    C0087111 (UMLS 2011AA ObjectClass)
    C38000 (NCI Thesaurus Property)
    C0884358 (UMLS 2011AA Property)
    C25742 (NCI Thesaurus Property-2)
    C0032961 (UMLS 2011AA Property-2)
    C25281 (NCI Thesaurus Property-3)
    C0332281 (UMLS 2011AA Property-3)
    C42614 (NCI Thesaurus ValueDomain)
    C0027365 (UMLS 2011AA ValueDomain)
    TherapeuticProcedurePregnancyAssociatedPerformedDate
    Item
    Date of test
    date
    C49236 (NCI Thesaurus ObjectClass)
    C0087111 (UMLS 2011AA ObjectClass)
    C38000 (NCI Thesaurus Property)
    C0884358 (UMLS 2011AA Property)
    C25742 (NCI Thesaurus Property-2)
    C0032961 (UMLS 2011AA Property-2)
    C25281 (NCI Thesaurus Property-3)
    C0332281 (UMLS 2011AA Property-3)
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    Item
    Result of test
    text
    C49236 (NCI Thesaurus ObjectClass)
    C0087111 (UMLS 2011AA ObjectClass)
    C38000 (NCI Thesaurus Property)
    C0884358 (UMLS 2011AA Property)
    C25742 (NCI Thesaurus Property-2)
    C0032961 (UMLS 2011AA Property-2)
    C25281 (NCI Thesaurus Property-3)
    C0332281 (UMLS 2011AA Property-3)
    C25688 (NCI Thesaurus ValueDomain)
    C0449438 (UMLS 2011AA ValueDomain)
    Code List
    Result of test
    CL Item
    Abnormal (Abnormal)
    C25401 (NCI Thesaurus)
    C0205161 (UMLS 2011AA)
    C25401 (NCI Thesaurus-3)
    C0205161 (UMLS 2011AA-4)
    CL Item
    Normal (Normal)
    C14165 (NCI Thesaurus)
    C0205307 (UMLS 2011AA)
    C14165 (NCI Thesaurus-3)
    C0205307 (UMLS 2011AA-4)
    TherapeuticProcedurePregnancyAssociatedPerformedAbnormalSpecify
    Item
    Abnormal (If abnormal, specify)
    text
    C49236 (NCI Thesaurus ObjectClass)
    C0087111 (UMLS 2011AA ObjectClass)
    C38000 (NCI Thesaurus Property)
    C0884358 (UMLS 2011AA Property)
    C25742 (NCI Thesaurus Property-2)
    C0032961 (UMLS 2011AA Property-2)
    C25281 (NCI Thesaurus Property-3)
    C0332281 (UMLS 2011AA Property-3)
    C25685 (NCI Thesaurus ValueDomain)
    C1521902 (UMLS 2011AA ValueDomain)
    C25401 (NCI Thesaurus ValueDomain-2)
    C0205161 (UMLS 2011AA ValueDomain-2)
    Item Group
    Pregnancy Information
    PersonContraceptionUseIndicator
    Item
    Pregnancy prevention measures
    boolean
    C25190 (NCI Thesaurus ObjectClass)
    C0027361 (UMLS 2011AA ObjectClass)
    C25180 (NCI Thesaurus ValueDomain)
    C1522602 (UMLS 2011AA ValueDomain)
    C37932 (NCI Thesaurus ObjectClass-2)
    C0700589 (UMLS 2011AA ObjectClass-2)
    C25340 (NCI Thesaurus Property)
    C0457083 (UMLS 2011AA Property)
    PersonContraceptionUseSpecify
    Item
    If yes, specify
    text
    C25685 (NCI Thesaurus ValueDomain)
    C1521902 (UMLS 2011AA ValueDomain)
    C25190 (NCI Thesaurus ObjectClass)
    C0027361 (UMLS 2011AA ObjectClass)
    C37932 (NCI Thesaurus ObjectClass-2)
    C0700589 (UMLS 2011AA ObjectClass-2)
    C25340 (NCI Thesaurus Property)
    C0457083 (UMLS 2011AA Property)
    LastMenstrualCycleOccurrenceDate
    Item
    Date of last menstrual period
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C25551 (NCI Thesaurus ObjectClass)
    C1517741 (UMLS 2011AA ObjectClass)
    C25275 (NCI Thesaurus Property)
    C2745955 (UMLS 2011AA Property)
    C16838 (NCI Thesaurus ObjectClass-2)
    C0025329 (UMLS 2011AA ObjectClass-2)
    PregnancyWeekNumberCount
    Item
    Weeks of gestation when pregnancy first confirmed
    float
    C25337 (NCI Thesaurus Property)
    C0237753 (UMLS 2011AA Property)
    C25463 (NCI Thesaurus ValueDomain)
    C0750480 (UMLS 2011AA ValueDomain)
    C25742 (NCI Thesaurus ObjectClass)
    C0032961 (UMLS 2011AA ObjectClass)
    C29844 (NCI Thesaurus Property-2)
    C0439230 (UMLS 2011AA Property-2)
    PregnancyDeliveryDate
    Item
    Estimated delivery
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C25742 (NCI Thesaurus ObjectClass)
    C0032961 (UMLS 2011AA ObjectClass)
    C61560 (NCI Thesaurus Property)
    Item Group
    Pregnancy Status/pregnancy Outcome
    Item
    Pregnancy Status
    text
    C25190 (NCI Thesaurus ObjectClass)
    C0027361 (UMLS 2011AA ObjectClass)
    C25742 (NCI Thesaurus Property)
    C0032961 (UMLS 2011AA Property)
    C25688 (NCI Thesaurus ValueDomain)
    C0449438 (UMLS 2011AA ValueDomain)
    Code List
    Pregnancy Status
    CL Item
    Pregnancy Ongoing (Pregnancy ongoing)
    CL Item
    Unknown (Unknown)
    Item
    Pregnancy Outcome
    text
    C25284 (NCI Thesaurus ValueDomain)
    C0332307 (UMLS 2011AA ValueDomain)
    C25190 (NCI Thesaurus ObjectClass)
    C0027361 (UMLS 2011AA ObjectClass)
    C20200 (NCI Thesaurus Property)
    C1274040 (UMLS 2011AA Property)
    C25742 (NCI Thesaurus Property-2)
    C0032961 (UMLS 2011AA Property-2)
    Code List
    Pregnancy Outcome
    CL Item
    Delivery (Delivery)
    CL Item
    Ectopic Pregnancy (Ectopic Pregnancy)
    C34945 (NCI Thesaurus)
    C0032987 (UMLS 2011AA)
    CL Item
    Induced Abortion (Induced abortion)
    CL Item
    Spontaneous Abortion (Spontaneous Abortion)
    C34336 (NCI Thesaurus)
    C0000786 (UMLS 2011AA)
    PersonPregnancyOutcomeDate
    Item
    Date (Provide date of selected outcome)
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C25190 (NCI Thesaurus ObjectClass)
    C0027361 (UMLS 2011AA ObjectClass)
    C20200 (NCI Thesaurus Property)
    C1274040 (UMLS 2011AA Property)
    C25742 (NCI Thesaurus Property-2)
    C0032961 (UMLS 2011AA Property-2)
    Item Group
    Fetal/baby Outcome
    PregnancyBirthOutcomeText
    Item
    Fetal/Baby Outcome
    text
    C25704 (NCI Thesaurus ValueDomain)
    C1527021 (UMLS 2011AA ValueDomain)
    C20200 (NCI Thesaurus Property)
    C1274040 (UMLS 2011AA Property)
    C25742 (NCI Thesaurus ObjectClass)
    C0032961 (UMLS 2011AA ObjectClass)
    C25155 (NCI Thesaurus Property-2)
    C0005615 (UMLS 2011AA Property-2)
    Item Group
    Footer Module
    Research Comments
    Item
    Comments
    text
    C25704 (NCI Thesaurus ValueDomain)
    C0947611 (UMLS CUI-1)
    C15319 (NCI Thesaurus ObjectClass)
    C25393 (NCI Thesaurus Property)

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