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  1. StudyEvent: CALGB Randomization (CALGB 49903)
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Header
CALGBPatientID
Item
CALGB Patient ID
text
AffiliateName
Item
Affiliate/Treating Institution
text
ParticipatingGroupPatientID
Item
Participating Group Patient No.
text
PatientMedicalRecordNumber
Item
Patient Hospital Record No.
text
ParticipatingGroupCode
Item
Participating Group Code
text
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
RegisteredInvestigator
Item
Physician of Record
text
FaxNumber
Item
Fax
float
PhoneNumber
Item
Phone
float
Item Group
Protocol Administration
IRBApprovalDate
Item
IRB Approval Date
date
C25320 (NCI Thesaurus ObjectClass)
C1507394 (UMLS 2011AA ObjectClass)
C25425 (NCI Thesaurus Property)
C0205540 (UMLS 2011AA Property)
InformedConsentDateSigned
Item
Consent Form Date
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
ProjectedTreatmentBeginDate
Item
Projected Start Date
date
PersonCompletingForm,LastName
Item
Person Completing Form, Last Name
text
PersonCompletingForm,FirstName
Item
Person Completing Form, first Name
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
PersonCompletingForm,Phone
Item
Person Phone
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
PersonCompletingForm,Fax
Item
Fax
float
Item Group
Patient Demographics / Pre-treatment Characteristics
PatientName
Item
Patient Name (l,f,m.i.)
text
PatientSocialSecurityNumber
Item
Social Security # (USA Only)
float
Item
Patient Race/Ethnicity
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C17049 (NCI Thesaurus Property)
C0034510 (UMLS 2011AA Property)
CL.1
Code List
Patient Race/Ethnicity
CL Item
White_cdus (White)
CL Item
Hispanic (Hispanic)
CL Item
Black_cdus (Black)
CL Item
Asian_cdus (Oriental)
CL Item
Pacific_islander_cdus (Native Hawaiian)
CL Item
Native_american_cdus (Native American)
CL Item
Indian (Indian)
CL Item
Filipino (Filipino)
CL Item
Other (Other)
CL Item
Patient refusal (Patient refusal)
CL Item
Institution refusal (Institution refusal)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Sex
text
C25372 (NCI Thesaurus ValueDomain)
C0683312 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C17357 (NCI Thesaurus Property)
C0079399 (UMLS 2011AA Property)
CL.2
Code List
Sex
CL Item
Male (M)
C46109 (NCI Thesaurus)
C1706180 (UMLS 2011AA)
CL Item
Female (F)
C46110 (NCI Thesaurus)
C0086287 (UMLS 2011AA)
PatientBirthDate
Item
Birthdate (M)
date
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
Item
Method of Payment
text
CL.3
Code List
Method of Payment
CL Item
Private Insurance (Private Insurance)
CL Item
Medicare (Medicare)
CL Item
Medicare and Private Insurance (Medicare and Private Insurance)
CL Item
Medicaid (Medicaid)
CL Item
Medicaid and Medicare (Medicaid and Medicare)
CL Item
Military or Veterans Administration Sponsored (Military or Veterans Administration Sponsored)
CL Item
Self Pay (Self Pay)
CL Item
No means of payment (No means of payment)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
PatientAddress,PostalCode
Item
Zip Code (USA Only)
float
PatientAddress,Country
Item
Country of Residence (if not USA)
text
Item
Performance Status
text
CL.4
Code List
Performance Status
CL Item
0 (Fully active, able to carry on all pre-disease performance without restriction)
C0919414 (NCI Metathesaurus)
CL Item
1 (Restricted physically strenuous activity but ambulatory)
CL Item
2 (Ambulatory and capable of all selfcare but unable to carry out any work activities)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (Capable of limited selfcare, confined to bed or chair more than 50% of waking hours)
CL Item
4 (Completely disabled)
PatientHeight
Item
Pt Height (cm)
float
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25347 (NCI Thesaurus Property)
C0489786 (UMLS 2011AA Property)
PatientWeight
Item
Pt Weight (kg)
float
BodySurfaceArea
Item
BSA
float
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25157 (NCI Thesaurus Property)
C0005902 (UMLS 2011AA Property)
Item Group
Certification Of Eligibility
PatientEligibilityInd
Item
Patient eligible? (STRATIFICATION FACTORS)
boolean
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25171 (NCI Thesaurus Property)
C0013893 (UMLS 2011AA Property)
Item Group
Registration data
Item
ASSIGNED TREATMENT ARM
text
CL.6
Code List
ASSIGNED TREATMENT ARM
CL Item
Arm 1 (Arm 1)
CL Item
Arm 2 (Arm 2)
RegistrationDate
Item
Date of Registration
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
Registrar
Item
Registrar
text
Item Group
Ccrr Module For Calgb Randomization (calgb 49903)
ParticipatingGroup
Item
Participating Group Name
text
C17005 (NCI Thesaurus ObjectClass)
C1257890 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
CALGBPatientID
Item
CALGB Patient ID
text
IRBApprovalDate
Item
IRB Approval Date
date
C25320 (NCI Thesaurus ObjectClass)
C1507394 (UMLS 2011AA ObjectClass)
C25425 (NCI Thesaurus Property)
C0205540 (UMLS 2011AA Property)
AffiliateName
Item
Affiliate/Treating Institution
text
Patient Initials
Item
Patient Initials
text
C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
PriorChemotherapyInd
Item
Prior Chemotherapy
text
Institution
Item
Main Member Institution
text
ContactPersonatInstitution
Item
Responsible Contact
text
C21541 (NCI Thesaurus ObjectClass)
C0018704 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C25461 (NCI Thesaurus ObjectClass-2)
C0337611 (UMLS 2011AA ObjectClass-2)
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