No Instruction available.

  1. StudyEvent: SOUTHWEST ONCOLOGY GROUP (S0307) OSTEONECROTIC JAW LESION FORM
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Header
Trial subject ID SWOG
Item
SWOG Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1519429 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25699 (NCI Thesaurus Property-2)
Protocol ID SWOG
Item
SWOG Study No.
text
C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1519429 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25699 (NCI Thesaurus Property-2)
Registration Number
Item
Registration Step
text
C25337 (NCI Thesaurus ValueDomain)
C1514821 (UMLS CUI-1)
C25646 (NCI Thesaurus ObjectClass)
C0237753 (UMLS CUI-2)
C16154 (NCI Thesaurus Property)
C16154 (NCI Thesaurus ValueDomain-2)
Patient Initials
Item
Patient Initials (L, F, M)
text
C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
Institution Name
Item
Institution/Affiliate
text
C25454 (NCI Thesaurus ObjectClass)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C25191 (NCI Thesaurus ValueDomain)
C21541 (NCI Thesaurus ValueDomain-2)
Investigator Name
Item
Physician
text
C25191 (NCI Thesaurus ValueDomain)
C2826892 (UMLS CUI-1)
C25364 (NCI Thesaurus Property)
C17089 (NCI Thesaurus ObjectClass)
C25644 (NCI Thesaurus ObjectClass-2)
Participating Group
Item
Participating Group Name
text
C25191 (NCI Thesaurus ValueDomain)
C2347449 (UMLS CUI-1)
C25608 (NCI Thesaurus ObjectClass)
C17005 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
Study Number Participating Group
Item
Participating Group Study No.
text
C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
Trial subject ID Participating Group
Item
Participating Group Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
Item Group
Osteonecrotic lesions
Item
Number of osteonecrotic lesions
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C12366 (NCI Thesaurus ObjectClass)
C0262950 (UMLS 2011AA ObjectClass)
C0221198 (NCI Metathesaurus Property)
Code List
Number of osteonecrotic lesions
CL Item
1 (1)
CL Item
2 (2)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (3)
DiseaseOnsetDate
Item
Date of onset
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C25279 (NCI Thesaurus Property)
C0332162 (UMLS 2011AA Property)
PatientInfectionInd-2
Item
Any signs/symptoms of infection (e.g., mucosal erythema, swelling, pus, bad taste?)
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C26726 (NCI Thesaurus Property)
C0009450 (UMLS 2011AA Property)
Item
Maxilla
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C3824 (NCI Thesaurus ObjectClass)
C0221198 (UMLS 2011AA ObjectClass)
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
C26470 (NCI Thesaurus Property-2)
C0024947 (UMLS 2011AA Property-2)
Code List
Maxilla
CL Item
Anterior (Anterior)
C25231 (NCI Thesaurus)
C0205094 (UMLS 2011AA)
CL Item
Posterior (Posterior)
C25622 (NCI Thesaurus)
C0205095 (UMLS 2011AA)
CL Item
Buccal (Buccal)
CL Item
Lingual (Lingual)
CL Item
Alveolar Ridge (Alveolar ridge)
CL Item
Palate (Palate)
C12229 (NCI Thesaurus)
C0700374 (UMLS 2011AA)
Item
Maxilla
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C3824 (NCI Thesaurus ObjectClass)
C0221198 (UMLS 2011AA ObjectClass)
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
C26470 (NCI Thesaurus Property-2)
C0024947 (UMLS 2011AA Property-2)
Code List
Maxilla
CL Item
Anterior (Anterior)
C25231 (NCI Thesaurus)
C0205094 (UMLS 2011AA)
CL Item
Posterior (Posterior)
C25622 (NCI Thesaurus)
C0205095 (UMLS 2011AA)
CL Item
Buccal (Buccal)
CL Item
Lingual (Lingual)
CL Item
Alveolar Ridge (Alveolar ridge)
CL Item
Palate (Palate)
C12229 (NCI Thesaurus)
C0700374 (UMLS 2011AA)
Item
Maxilla
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C3824 (NCI Thesaurus ObjectClass)
C0221198 (UMLS 2011AA ObjectClass)
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
C26470 (NCI Thesaurus Property-2)
C0024947 (UMLS 2011AA Property-2)
Code List
Maxilla
CL Item
Anterior (Anterior)
C25231 (NCI Thesaurus)
C0205094 (UMLS 2011AA)
CL Item
Posterior (Posterior)
C25622 (NCI Thesaurus)
C0205095 (UMLS 2011AA)
CL Item
Buccal (Buccal)
CL Item
Lingual (Lingual)
CL Item
Alveolar Ridge (Alveolar ridge)
CL Item
Palate (Palate)
C12229 (NCI Thesaurus)
C0700374 (UMLS 2011AA)
Item
Mandible
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C3824 (NCI Thesaurus ObjectClass)
C0221198 (UMLS 2011AA ObjectClass)
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
Code List
Mandible
CL Item
Anterior (Anterior)
C25231 (NCI Thesaurus)
C0205094 (UMLS 2011AA)
CL Item
Posterior (Posterior)
C25622 (NCI Thesaurus)
C0205095 (UMLS 2011AA)
CL Item
Buccal (Buccal)
CL Item
Lingual (Lingual)
CL Item
Alveolar Ridge (Alveolar ridge)
CL Item
Mylohyoid Plate (Mylohyoid plate)
Item
Mandible
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C3824 (NCI Thesaurus ObjectClass)
C0221198 (UMLS 2011AA ObjectClass)
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
Code List
Mandible
CL Item
Anterior (Anterior)
C25231 (NCI Thesaurus)
C0205094 (UMLS 2011AA)
CL Item
Posterior (Posterior)
C25622 (NCI Thesaurus)
C0205095 (UMLS 2011AA)
CL Item
Buccal (Buccal)
CL Item
Lingual (Lingual)
CL Item
Alveolar Ridge (Alveolar ridge)
CL Item
Mylohyoid Plate (Mylohyoid plate)
Item
Mandible
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C3824 (NCI Thesaurus ObjectClass)
C0221198 (UMLS 2011AA ObjectClass)
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
Code List
Mandible
CL Item
Anterior (Anterior)
C25231 (NCI Thesaurus)
C0205094 (UMLS 2011AA)
CL Item
Posterior (Posterior)
C25622 (NCI Thesaurus)
C0205095 (UMLS 2011AA)
CL Item
Buccal (Buccal)
CL Item
Lingual (Lingual)
CL Item
Alveolar Ridge (Alveolar ridge)
CL Item
Mylohyoid Plate (Mylohyoid plate)
LesionSizeNumber
Item
Size of lesion (mm)
float
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C3824 (NCI Thesaurus ObjectClass)
C0221198 (UMLS 2011AA ObjectClass)
C25681 (NCI Thesaurus Property)
C0456389 (UMLS 2011AA Property)
LesionSizeNumber
Item
Size of lesion (mm)
float
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C3824 (NCI Thesaurus ObjectClass)
C0221198 (UMLS 2011AA ObjectClass)
C25681 (NCI Thesaurus Property)
C0456389 (UMLS 2011AA Property)
LesionSizeNumber
Item
Size of lesion (mm)
float
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C3824 (NCI Thesaurus ObjectClass)
C0221198 (UMLS 2011AA ObjectClass)
C25681 (NCI Thesaurus Property)
C0456389 (UMLS 2011AA Property)
Item
Associated causative factor(s) (select all that apply:)
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C12366 (NCI Thesaurus ObjectClass)
C0262950 (UMLS 2011AA ObjectClass)
C0221198 (NCI Metathesaurus Property)
Code List
Associated causative factor(s) (select all that apply:)
CL Item
Periodontal Infection (Periodontal infection)
CL Item
Dental Extraction (Dental extraction)
CL Item
Denture Trauma (Denture trauma)
CL Item
Other Dental Surgery (Other dental surgery)
CL Item
No Identified Factor (No identified factor)
Item
Associated causative factor(s) (select all that apply:)
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C12366 (NCI Thesaurus ObjectClass)
C0262950 (UMLS 2011AA ObjectClass)
C0221198 (NCI Metathesaurus Property)
Code List
Associated causative factor(s) (select all that apply:)
CL Item
Periodontal Infection (Periodontal infection)
CL Item
Dental Extraction (Dental extraction)
CL Item
Denture Trauma (Denture trauma)
CL Item
Other Dental Surgery (Other dental surgery)
CL Item
No Identified Factor (No identified factor)
Item
Associated causative factor(s) (select all that apply:)
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C12366 (NCI Thesaurus ObjectClass)
C0262950 (UMLS 2011AA ObjectClass)
C0221198 (NCI Metathesaurus Property)
Code List
Associated causative factor(s) (select all that apply:)
CL Item
Periodontal Infection (Periodontal infection)
CL Item
Dental Extraction (Dental extraction)
CL Item
Denture Trauma (Denture trauma)
CL Item
Other Dental Surgery (Other dental surgery)
CL Item
No Identified Factor (No identified factor)
Item Group
Steroid Use
TherapeuticProcedureSteroidCompoundAnti-inflammatoryAdministeredInd-2
Item
Did the patient receive steroids within 12 months of occurrence of the current jaw lesion(s)?
boolean
C49236 (NCI Thesaurus ObjectClass)
C0087111 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
C843 (NCI Thesaurus Property-2)
C0038317 (UMLS 2011AA Property-2)
C28347 (NCI Thesaurus Property-3)
C1515999 (UMLS 2011AA Property-3)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
Agent
Item
list drug name (If Yes,)
text
C25364 (NCI Thesaurus Property)
C1521826 (UMLS CUI-1)
C1708 (NCI Thesaurus ObjectClass)
C1708 (NCI Thesaurus ValueDomain)
C42614 (NCI Thesaurus ValueDomain-2)
Medication Start Date
Item
Dates of administration (to:)
date
C25164 (NCI Thesaurus ValueDomain)
C1521826 (UMLS CUI-1)
C25431 (NCI Thesaurus ValueDomain-2)
C0808070 (UMLS CUI-2)
C1708 (NCI Thesaurus ObjectClass)
C25275 (NCI Thesaurus Property)
Medication End Date
Item
Dates of administration
date
C25164 (NCI Thesaurus ValueDomain)
C1521826 (UMLS CUI-1)
C1708 (NCI Thesaurus ObjectClass)
C0806020 (UMLS CUI-2)
C25275 (NCI Thesaurus Property)
Item Group
Comments
Research Comments
Item
Comments
text
C25704 (NCI Thesaurus ValueDomain)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)

Please use this form for feedback, questions and suggestions for improvements.

Fields marked with * are required.

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial