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1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Header module
Adverse Event Onset Date
Item
Date of Onset
date
C25164 (NCI Thesaurus ValueDomain)
C2985916 (UMLS CUI-1)
C25367 (NCI Thesaurus ValueDomain-2)
C49704 (NCI Thesaurus ObjectClass)
C25279 (NCI Thesaurus Property)
AdverseEventDescriptiveText
Item
Event description
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
C0678257 (NCI Metathesaurus Property)
Segment
Item
Segment
text
Item Group
Laboratory Test Results
RelevantLaboratoryTestIndicator
Item
No relevant laboratory test results
text
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C38470 (NCI Thesaurus ObjectClass)
C0022885 (NCI Metathesaurus Property)
RelevantLaboratoryTestNames
Item
Test
text
C0022885 (NCI Metathesaurus ObjectClass)
C42614 (NCI Thesaurus Property)
C0027365 (UMLS 2011AA Property)
C42614 (NCI Thesaurus ValueDomain)
C0027365 (UMLS 2011AA ValueDomain)
RelevantLaboratoryTestDate
Item
Collection Data
date
C25164 (NCI Thesaurus Property)
C0011008 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C0022885 (NCI Metathesaurus ObjectClass)
RelevantLaboratoryTestResultValueMeasure
Item
Result (including units)
text
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
ResultPending
Item
Result Pending
text
SiteName???(Include??)
Item
Site Name??? (Include??)
text
Item Group
Diagnostic Tests (ex: Mr, Ct Scan, Ultrasound)
RelevantDiagnosticTestPerformedIndicator
Item
No relevant diagnostic tests
text
C25180 (NCI Thesaurus Property)
C1522602 (UMLS 2011AA Property)
C0525034 (NCI Metathesaurus ObjectClass)
DiagnosticTestName
Item
Test
text
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25482 (NCI Thesaurus Property)
C0348026 (UMLS 2011AA Property)
C42614 (NCI Thesaurus ValueDomain)
C0027365 (UMLS 2011AA ValueDomain)
TestPerfomedDate
Item
Date Performed
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25482 (NCI Thesaurus Property)
C0348026 (UMLS 2011AA Property)
Research Comments
Item
Comments
text
C25704 (NCI Thesaurus ValueDomain)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
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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