ID
9528
Descrizione
RTOG 1115 QL: Phase III RT + Standard ADT vs RT + Enhanced ADT + TAK-700 PSQI/GLTEQ Form Hormone Therapy, Radiation Therapy, and Steroid 17alpha-monooxygenase TAK-700 in Treating Patients With High-Risk Prostate Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=AE8E92E1-C6E3-6523-E040-BB89AD436A37
collegamento
Keywords
versioni (3)
- 19/09/12 19/09/12 -
- 09/01/15 09/01/15 - Martin Dugas
- 09/01/15 09/01/15 - Martin Dugas
Caricato su
9 gennaio 2015
DOI
Per favore, per richiedere un accesso.
Licenza
Creative Commons BY-NC 3.0 Legacy
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Prostate Cancer NCT01546987 Quality of Life - RTOG 1115 QL: Phase III RT + Standard ADT vs RT + Enhanced ADT + TAK-700 PSQI/GLTEQ Form - 3288970v1.0
INSTRUCTIONS: This page must be completed by the medical staff( nurse, data manager, physician, etc.) Questionnaires for all time points are required even if submission time points deviate from the specified intervals. Only patient death or documented patient refusal will be an acceptable reason for omission of the QOL questionnaires. However, this page must be completed and submitted for every time point on the calendar regardless of whether the QOL questionnaire was completed. Every effort possible should be made to collect the data on time
- StudyEvent: RTOG 1115 QL: Phase III RT + Standard ADT vs RT + Enhanced ADT + TAK-700 PSQI/GLTEQ Form
Descrizione
Unamed Module 2
Descrizione
AssessmentPeriodType
Tipo di dati
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
Descrizione
AssessmentPeriodSpecify
Tipo di dati
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
- NCI Thesaurus ObjectClass
- C20989
- UMLS 2011AA ObjectClass
- C0031809
- NCI Thesaurus Property
- C25616
- UMLS 2011AA Property
- C1948053
Descrizione
PatientQuestionnaireCompleteInd-2
Tipo di dati
boolean
Alias
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25250
- UMLS 2011AA Property
- C0205197
- NCI Thesaurus Property-2
- C17048
- UMLS 2011AA Property-2
- C0034394
Descrizione
QualityofLifeCompleteAssessmentDate
Tipo di dati
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C17047
- UMLS 2011AA ObjectClass
- C0518214
- NCI Thesaurus Property
- C25250
- UMLS 2011AA Property
- C0205197
- NCI Thesaurus Property-2
- C25367
Descrizione
Incomplete documentation, reason
Tipo di dati
text
Alias
- NCI Thesaurus ValueDomain
- C25638
- UMLS CUI-1
- C1548386
- NCI Thesaurus ObjectClass
- C16960
- UMLS CUI-2
- C0566251
- NCI Metathesaurus Property
- C0034394
Descrizione
PatientRefuseIncompleteQuestionnaireSpecify
Tipo di dati
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Metathesaurus Property
- C0034394
- NCI Thesaurus Property
- C49160
- UMLS 2011AA Property
- C0205257
- NCI Thesaurus Property-2
- C49161
- UMLS 2011AA Property-2
- C1705116
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
Descrizione
PatientIncompleteQuestionnaireOtherSpecify
Tipo di dati
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
Descrizione
PatientQuestionnaireAssistanceInd
Tipo di dati
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C17048
- UMLS 2011AA Property
- C0034394
- NCI Metathesaurus Property
- C0018896
Descrizione
PatientQuestionnaireAssistanceType
Tipo di dati
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C17048
- UMLS 2011AA Property
- C0034394
- NCI Metathesaurus Property
- C0018896
Descrizione
PatientQuestionnaireAssistanceCombinedSpecify
Tipo di dati
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C17048
- UMLS 2011AA Property
- C0034394
- NCI Metathesaurus Property
- C0018896
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
- NCI Thesaurus ValueDomain-2
- C25454
- UMLS 2011AA ValueDomain-2
- C0205195
Descrizione
PatientQuestionnaireAssistanceOtherSpecify
Tipo di dati
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C17048
- UMLS 2011AA Property
- C0034394
- NCI Metathesaurus Property
- C0018896
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
- NCI Thesaurus ValueDomain-2
- C17649
- UMLS 2011AA ValueDomain-2
- C0205394
Descrizione
PatientQuestionnaireAssistancePersonCategory
Tipo di dati
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C17048
- UMLS 2011AA Property
- C0034394
- NCI Metathesaurus Property
- C0018896
- NCI Thesaurus ValueDomain
- C25190
- UMLS 2011AA ValueDomain
- C0027361
- NCI Thesaurus ValueDomain-2
- C25372
- UMLS 2011AA ValueDomain-2
- C0683312
Descrizione
PatientQuestionnaireCompleteMethodofCollectionType
Tipo di dati
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25250
- UMLS 2011AA Property
- C0205197
- NCI Thesaurus Property-2
- C17048
- UMLS 2011AA Property-2
- C0034394
Descrizione
Research Comments
Tipo di dati
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C0947611
- NCI Thesaurus ObjectClass
- C15319
- NCI Thesaurus Property
- C25393
Descrizione
Responsible Person Signature
Tipo di dati
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C1550483
- NCI Thesaurus ObjectClass
- C25190
- NCI Thesaurus ObjectClass-2
- C25657
- NCI Thesaurus Property
- C25678
Descrizione
Form Completion Date
Tipo di dati
date
Alias
- NCI Thesaurus ObjectClass
- C19464
- UMLS CUI-1
- C1549507
- NCI Thesaurus Property
- C25250
- NCI Thesaurus Property-2
- C25604
- NCI Thesaurus ValueDomain
- C25164
- NCI Thesaurus ValueDomain-2
- C25367
Descrizione
Exercise
Descrizione
QualityofLifeMildExercisePerformedAssessmentWeekFrequency
Tipo di dati
float
Alias
- NCI Thesaurus ObjectClass
- C17047
- UMLS 2011AA ObjectClass
- C0518214
- NCI Thesaurus Property
- C25217
- UMLS 2011AA Property
- C1516048
- NCI Thesaurus Property-2
- C70666
- UMLS 2011AA Property-2
- C2945599
- NCI Thesaurus Property-3
- C38000
- UMLS 2011AA Property-3
- C0884358
- NCI Thesaurus Property-4
- C16567
- UMLS 2011AA Property-4
- C0015259
- NCI Thesaurus ValueDomain
- C29844
- UMLS 2011AA ValueDomain
- C0439230
- NCI Thesaurus ValueDomain-2
- C25515
- UMLS 2011AA ValueDomain-2
- C0439603
Descrizione
QualityofLifeMildExercisePerformedAssessmentDuration
Tipo di dati
float
Unità di misura
- min
Alias
- NCI Thesaurus ObjectClass
- C17047
- UMLS 2011AA ObjectClass
- C0518214
- NCI Thesaurus Property
- C25217
- UMLS 2011AA Property
- C1516048
- NCI Thesaurus Property-2
- C70666
- UMLS 2011AA Property-2
- C2945599
- NCI Thesaurus Property-3
- C38000
- UMLS 2011AA Property-3
- C0884358
- NCI Thesaurus Property-4
- C16567
- UMLS 2011AA Property-4
- C0015259
- NCI Thesaurus ValueDomain
- C25330
- UMLS 2011AA ValueDomain
- C0449238
Descrizione
QualityofLifeModerateExercisePerformedAssessmentWeekFrequency
Tipo di dati
float
Alias
- NCI Thesaurus ObjectClass
- C17047
- UMLS 2011AA ObjectClass
- C0518214
- NCI Thesaurus Property
- C25217
- UMLS 2011AA Property
- C1516048
- NCI Thesaurus Property-2
- C38000
- UMLS 2011AA Property-2
- C0884358
- NCI Thesaurus Property-3
- C61376
- UMLS 2011AA Property-3
- C1881878
- NCI Thesaurus Property-4
- C16567
- UMLS 2011AA Property-4
- C0015259
- NCI Thesaurus ValueDomain
- C29844
- UMLS 2011AA ValueDomain
- C0439230
- NCI Thesaurus ValueDomain-2
- C25515
- UMLS 2011AA ValueDomain-2
- C0439603
Descrizione
QualityofLifeModerateExercisePerformedAssessmentDuration
Tipo di dati
float
Unità di misura
- min
Alias
- NCI Thesaurus ObjectClass
- C17047
- UMLS 2011AA ObjectClass
- C0518214
- NCI Thesaurus Property
- C25217
- UMLS 2011AA Property
- C1516048
- NCI Thesaurus Property-2
- C38000
- UMLS 2011AA Property-2
- C0884358
- NCI Thesaurus Property-3
- C61376
- UMLS 2011AA Property-3
- C1881878
- NCI Thesaurus Property-4
- C16567
- UMLS 2011AA Property-4
- C0015259
- NCI Thesaurus ValueDomain
- C25330
- UMLS 2011AA ValueDomain
- C0449238
Descrizione
QualityofLifeHighExercisePerformedAssessmentWeekFrequency
Tipo di dati
float
Alias
- NCI Thesaurus ObjectClass
- C17047
- UMLS 2011AA ObjectClass
- C0518214
- NCI Thesaurus Property
- C25217
- UMLS 2011AA Property
- C1516048
- NCI Thesaurus Property-2
- C38000
- UMLS 2011AA Property-2
- C0884358
- NCI Thesaurus Property-3
- C25227
- UMLS 2011AA Property-3
- C0205250
- NCI Thesaurus Property-4
- C16567
- UMLS 2011AA Property-4
- C0015259
- NCI Thesaurus ValueDomain
- C29844
- UMLS 2011AA ValueDomain
- C0439230
- NCI Thesaurus ValueDomain-2
- C25515
- UMLS 2011AA ValueDomain-2
- C0439603
Descrizione
QualityofLifeHighExercisePerformedAssessmentDuration
Tipo di dati
float
Unità di misura
- min
Alias
- NCI Thesaurus ObjectClass
- C17047
- UMLS 2011AA ObjectClass
- C0518214
- NCI Thesaurus Property
- C25217
- UMLS 2011AA Property
- C1516048
- NCI Thesaurus Property-2
- C38000
- UMLS 2011AA Property-2
- C0884358
- NCI Thesaurus Property-3
- C25227
- UMLS 2011AA Property-3
- C0205250
- NCI Thesaurus Property-4
- C16567
- UMLS 2011AA Property-4
- C0015259
- NCI Thesaurus ValueDomain
- C25330
- UMLS 2011AA ValueDomain
- C0449238
Descrizione
QualityofLifeMuscleWeaknessAssessmentScore
Tipo di dati
text
Alias
- NCI Thesaurus ObjectClass
- C17047
- UMLS 2011AA ObjectClass
- C0518214
- NCI Thesaurus Property
- C25217
- UMLS 2011AA Property
- C1516048
- NCI Thesaurus Property-2
- C50658
- UMLS 2011AA Property-2
- C0151786
- NCI Thesaurus ValueDomain
- C25338
- UMLS 2011AA ValueDomain
- C0449820
Descrizione
QualityofLifeSleepQualityAssessmentScore
Tipo di dati
text
Alias
- NCI Thesaurus ObjectClass
- C17047
- UMLS 2011AA ObjectClass
- C0518214
- NCI Thesaurus Property
- C25217
- UMLS 2011AA Property
- C1516048
- NCI Thesaurus Property-2
- C73425
- UMLS 2011AA Property-2
- C0037313
- NCI Thesaurus Property-3
- C25283
- UMLS 2011AA Property-3
- C0332306
- NCI Thesaurus ValueDomain
- C25338
- UMLS 2011AA ValueDomain
- C0449820
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INSTRUCTIONS: This page must be completed by the medical staff( nurse, data manager, physician, etc.) Questionnaires for all time points are required even if submission time points deviate from the specified intervals. Only patient death or documented patient refusal will be an acceptable reason for omission of the QOL questionnaires. However, this page must be completed and submitted for every time point on the calendar regardless of whether the QOL questionnaire was completed. Every effort possible should be made to collect the data on time
- StudyEvent: RTOG 1115 QL: Phase III RT + Standard ADT vs RT + Enhanced ADT + TAK-700 PSQI/GLTEQ Form
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1514695 (UMLS CUI-2)
C19778 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
C0030705 (UMLS 2011AA ObjectClass)
C19778 (NCI Thesaurus ObjectClass-2)
C1514695 (UMLS 2011AA ObjectClass-2)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C49152 (NCI Thesaurus Property-2)
C1706256 (UMLS 2011AA Property-2)
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C21541 (NCI Thesaurus ValueDomain-2)
C25364 (NCI Thesaurus Property)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C0805701 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1514695 (UMLS CUI-2)
C19778 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25616 (NCI Thesaurus Property)
C1948053 (UMLS 2011AA Property)
C1442488 (UMLS 2011AA)
C0205394 (UMLS 2011AA)
C1521902 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25616 (NCI Thesaurus Property)
C1948053 (UMLS 2011AA Property)
C1512698 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C17048 (NCI Thesaurus Property-2)
C0034394 (UMLS 2011AA Property-2)
C0011008 (UMLS 2011AA ValueDomain)
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C25367 (NCI Thesaurus Property-2)
C1548386 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C0566251 (UMLS CUI-2)
C0034394 (NCI Metathesaurus Property)
C0030705 (UMLS 2011AA ObjectClass)
C0034394 (NCI Metathesaurus Property)
C49160 (NCI Thesaurus Property)
C0205257 (UMLS 2011AA Property)
C49161 (NCI Thesaurus Property-2)
C1705116 (UMLS 2011AA Property-2)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C17649 (NCI Thesaurus ValueDomain-2)
C0205394 (UMLS 2011AA ValueDomain-2)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C0034394 (NCI Metathesaurus Property)
C1522602 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C17048 (NCI Thesaurus Property)
C0034394 (UMLS 2011AA Property)
C0018896 (NCI Metathesaurus Property)
C1272460 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0332307 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C17048 (NCI Thesaurus Property)
C0034394 (UMLS 2011AA Property)
C0018896 (NCI Metathesaurus Property)
C1272460 (UMLS 2011AA)
C0205394 (UMLS 2011AA)
C0030705 (UMLS 2011AA ObjectClass)
C17048 (NCI Thesaurus Property)
C0034394 (UMLS 2011AA Property)
C0018896 (NCI Metathesaurus Property)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C25454 (NCI Thesaurus ValueDomain-2)
C0205195 (UMLS 2011AA ValueDomain-2)
C0030705 (UMLS 2011AA ObjectClass)
C17048 (NCI Thesaurus Property)
C0034394 (UMLS 2011AA Property)
C0018896 (NCI Metathesaurus Property)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C17649 (NCI Thesaurus ValueDomain-2)
C0205394 (UMLS 2011AA ValueDomain-2)
C0030705 (UMLS 2011AA ObjectClass)
C17048 (NCI Thesaurus Property)
C0034394 (UMLS 2011AA Property)
C0018896 (NCI Metathesaurus Property)
C25190 (NCI Thesaurus ValueDomain)
C0027361 (UMLS 2011AA ValueDomain)
C25372 (NCI Thesaurus ValueDomain-2)
C0683312 (UMLS 2011AA ValueDomain-2)
C1272460 (UMLS 2011AA)
C0205394 (UMLS 2011AA)
C0332307 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C17048 (NCI Thesaurus Property-2)
C0034394 (UMLS 2011AA Property-2)
C0439673 (UMLS 2011AA)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C1550483 (UMLS CUI-1)
C25190 (NCI Thesaurus ObjectClass)
C25657 (NCI Thesaurus ObjectClass-2)
C25678 (NCI Thesaurus Property)
C1549507 (UMLS CUI-1)
C25250 (NCI Thesaurus Property)
C25604 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
C0518214 (UMLS 2011AA ObjectClass)
C25217 (NCI Thesaurus Property)
C1516048 (UMLS 2011AA Property)
C70666 (NCI Thesaurus Property-2)
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C16567 (NCI Thesaurus Property-4)
C0015259 (UMLS 2011AA Property-4)
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C25515 (NCI Thesaurus ValueDomain-2)
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C25515 (NCI Thesaurus ValueDomain-2)
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C25217 (NCI Thesaurus Property)
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C1516048 (UMLS 2011AA Property)
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C0205250 (UMLS 2011AA Property-3)
C16567 (NCI Thesaurus Property-4)
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C0439230 (UMLS 2011AA ValueDomain)
C25515 (NCI Thesaurus ValueDomain-2)
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C25217 (NCI Thesaurus Property)
C1516048 (UMLS 2011AA Property)
C38000 (NCI Thesaurus Property-2)
C0884358 (UMLS 2011AA Property-2)
C25227 (NCI Thesaurus Property-3)
C0205250 (UMLS 2011AA Property-3)
C16567 (NCI Thesaurus Property-4)
C0015259 (UMLS 2011AA Property-4)
C25330 (NCI Thesaurus ValueDomain)
C0449238 (UMLS 2011AA ValueDomain)
C0518214 (UMLS 2011AA ObjectClass)
C25217 (NCI Thesaurus Property)
C1516048 (UMLS 2011AA Property)
C50658 (NCI Thesaurus Property-2)
C0151786 (UMLS 2011AA Property-2)
C25338 (NCI Thesaurus ValueDomain)
C0449820 (UMLS 2011AA ValueDomain)
C0205448 (UMLS 2011AA)
C0518214 (UMLS 2011AA ObjectClass)
C25217 (NCI Thesaurus Property)
C1516048 (UMLS 2011AA Property)
C73425 (NCI Thesaurus Property-2)
C0037313 (UMLS 2011AA Property-2)
C25283 (NCI Thesaurus Property-3)
C0332306 (UMLS 2011AA Property-3)
C25338 (NCI Thesaurus ValueDomain)
C0449820 (UMLS 2011AA ValueDomain)
C0205448 (UMLS 2011AA)