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  1. StudyEvent: RTOG-0522 I1: Initial Evaluation Form
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Header
Protocol ID RTOG
Item
RTOG Study No.
text
C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1514695 (UMLS CUI-2)
C19778 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
RTOG Case number
Item
RTOG Case #
text
C16960 (NCI Thesaurus ObjectClass)
C19778 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C49152 (NCI Thesaurus Property-2)
C25337 (NCI Thesaurus ValueDomain)
C1514695 (UMLS CUI [1,1])
C0600091 (UMLS CUI [1,2])
Institution Name
Item
Institution Name
text
C25191 (NCI Thesaurus ValueDomain)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C21541 (NCI Thesaurus ValueDomain-2)
C25364 (NCI Thesaurus Property)
Institution Number
Item
Institution No.
text
C25337 (NCI Thesaurus ValueDomain)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C0805701 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
Patient Initials
Item
Patient Initials
text
C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
Trial subject ID RTOG
Item
RTOG Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1514695 (UMLS CUI-2)
C19778 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
Data amended
Item
Amended data
boolean
C38148 (NCI Thesaurus ValueDomain)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
Item Group
Patient demographics
C1704791 (UMLS CUI-1)
Age
Item
Age
integer
C16960 (NCI Thesaurus ObjectClass)
C29848 (NCI Thesaurus ValueDomain)
C25463 (NCI Thesaurus ValueDomain-2)
C25150 (NCI Thesaurus Property)
C0001779 (UMLS CUI [1])
Item
Gender
text
C25372 (NCI Thesaurus ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C17357 (NCI Thesaurus Property)
C0079399 (UMLS CUI [1])
Code List
Gender
CL Item
Male (M)
C0086582 (UMLS CUI-1)
CL Item
Female (F)
C0086287 (UMLS CUI-1)
Item
PERFORMANCE STATUS (ZUBROD)
text
C25664 (NCI Thesaurus ValueDomain)
C1520224 (UMLS CUI-1)
C25367 (NCI Thesaurus Property)
C25491 (NCI Thesaurus ValueDomain-2)
C20641 (NCI Thesaurus ObjectClass)
Code List
PERFORMANCE STATUS (ZUBROD)
CL Item
Fully Active, Able To Carry On All Pre-disease Performance Without Restriction. (0)
CL Item
Restricted In Physically Strenuous Activity But Ambulatory And Able To Carry Out Work Of A Light Or Sedentary Nature, E.g., Light Housework, Office Work. (1)
CL Item
Ambulatory And Capable Of All Selfcare But Unable To Carry Out Any Work Activities. Up And About More Than 50% Of Waking Hours. (2)
CL Item
Capable Of Only Limited Selfcare, Confined To Bed Or Chair More Than 50% Of Waking Hours. (3)
CL Item
Completely Disabled. Cannot Carry On Any Selfcare. Totally Confined To Bed Or Chair. (4)
PatientPriorMalignantNeoplasmHistoryInd-2
Item
History of Prior Malignancy (INVASIVE EXCEPT NON-MELANOMATOUS SKIN CANCER)
boolean
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus ObjectClass-2)
C0332152 (UMLS 2011AA ObjectClass-2)
C9305 (NCI Thesaurus Property)
C0006826 (UMLS 2011AA Property)
C25629 (NCI Thesaurus Property-2)
C0332152 (UMLS 2011AA Property-2)
C18772 (NCI Thesaurus Property-3)
C0262926 (UMLS 2011AA Property-3)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
PriorCancerDiagnosisSite
Item
Site of Prior Cancer
text
C13717 (NCI Thesaurus ValueDomain)
C1515974 (UMLS 2011AA ValueDomain)
C9305 (NCI Thesaurus ObjectClass)
C0006826 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus ObjectClass-2)
C0332152 (UMLS 2011AA ObjectClass-2)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)
CancerAblationDate
Item
Prior Cancer Date Eradicated
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C9305 (NCI Thesaurus ObjectClass)
C0006826 (UMLS 2011AA ObjectClass)
C20985 (NCI Thesaurus Property)
C0547070 (UMLS 2011AA Property)
Item Group
Prior Treatment
C1514463 (UMLS CUI-1)
Prior Surgery
Item
Prior Surgery (FOR HEAD AND NECK CANCER-EXCLUDES DIAGNOSTIC BIOPSY AND NODAL SAMPLING)
boolean
C38148 (NCI Thesaurus ValueDomain)
C0744961 (UMLS CUI-1)
C38000 (NCI Thesaurus Property)
C15329 (NCI Thesaurus ObjectClass)
C25629 (NCI Thesaurus ObjectClass-2)
PriorChemotherapyAdministeredInd-3
Item
Prior Chemotherapy (FOR OTHER REASONS)
boolean
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C15632 (NCI Thesaurus ObjectClass)
C0392920 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus ObjectClass-2)
C0332152 (UMLS 2011AA ObjectClass-2)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
Prior Radiation Therapy
Item
Prior Radiation Therapy (FOR HEAD AND NECK CANCER)
boolean
C38148 (NCI Thesaurus ValueDomain)
C1522449 (UMLS CUI-1)
C15313 (NCI Thesaurus ObjectClass)
C0332152 (UMLS CUI-2)
C25629 (NCI Thesaurus ObjectClass-2)
C25382 (NCI Thesaurus Property)
PriorEpidermalGrowthFactorReceptorTherapyPerformedInd-3
Item
Prior therapy that targeted EGFR pathway (Type shown on CRF - "EGRF")
boolean
C25629 (NCI Thesaurus ObjectClass)
C0332152 (UMLS 2011AA ObjectClass)
C15368 (NCI Thesaurus ObjectClass-2)
C17068 (NCI Thesaurus ObjectClass-3)
C0034802 (UMLS 2011AA ObjectClass-2)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
Item Group
Co-morbidities
C0009488 (UMLS CUI-1)
UnstableAnginaHospitalizationInd-2
Item
Hospitalized for unstable angina and/or CHF in last 6 months
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C25179 (NCI Thesaurus Property)
C0019993 (UMLS 2011AA Property)
C0002965 (NCI Metathesaurus ObjectClass)
TransmuralMyocardialInfarctionConfirmedInd-2
Item
Transmural MI in last 6 months
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C25458 (NCI Thesaurus Property)
C0750484 (UMLS 2011AA Property)
C27996 (NCI Thesaurus ObjectClass)
C0027051 (UMLS 2011AA ObjectClass)
CL233186 (NCI Metathesaurus ObjectClass)
IntravenousAntibioticAtRegistrationInd-2
Item
IV antibiotics at time of registration
boolean
C13346 (NCI Thesaurus ObjectClass)
C0348016 (UMLS 2011AA ObjectClass)
C258 (NCI Thesaurus ObjectClass-2)
C0003232 (UMLS 2011AA ObjectClass-2)
C25646 (NCI Thesaurus Property)
C1514821 (UMLS 2011AA Property)
C25427 (NCI Thesaurus Property-2)
C1516077 (UMLS 2011AA Property-2)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
ChronicObstructiveAirwaysDiseaseRespiratoryEventHospitalizationInd-2
Item
COPD exacerbation or other respiratory illness requiring hospitalization or precluding study therapy at registration
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C25179 (NCI Thesaurus Property)
C0019993 (UMLS 2011AA Property)
C3199 (NCI Thesaurus ObjectClass)
C0024117 (UMLS 2011AA ObjectClass)
CL316903 (NCI Metathesaurus ObjectClass)
CisplatinPriorAllergicReactionInd-2
Item
Prior allergic reaction to Cisplatin
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C376 (NCI Thesaurus ObjectClass)
C0008838 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus Property)
C0332152 (UMLS 2011AA Property)
CL240612 (NCI Metathesaurus Property)
CetuximabPriorAllergicReactionInd-3
Item
Prior allergic reaction to C225
boolean
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C1723 (NCI Thesaurus ObjectClass)
C0879636 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus Property)
C0332152 (UMLS 2011AA Property)
CL240612 (NCI Metathesaurus Property)
Item Group
Diagnostic Work-up
Item
CT scan of tumor site
text
C17204 (NCI Thesaurus ObjectClass)
C0040405 (UMLS 2011AA ObjectClass)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
C0475445 (NCI Metathesaurus ObjectClass)
Code List
CT scan of tumor site
CL Item
Not Done (Not done)
CL281691 (NCI Metathesaurus)
CL Item
Normal (Normal)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
CL Item
Abnormal (Abnormal)
C25401 (NCI Thesaurus)
C0205161 (UMLS 2011AA)
Item
MRI result (of tumor site)
text
C16809 (NCI Thesaurus ObjectClass)
C0024485 (UMLS 2011AA ObjectClass)
C25218 (NCI Thesaurus ValueDomain)
C1948041 (UMLS 2011AA ValueDomain)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
Code List
MRI result (of tumor site)
CL Item
Not Done (Not done)
CL281691 (NCI Metathesaurus)
CL Item
Normal (Normal)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
CL Item
Abnormal (Abnormal)
C25401 (NCI Thesaurus)
C0205161 (UMLS 2011AA)
Item
PET/CT
text
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C17007 (NCI Thesaurus ObjectClass)
C0032743 (UMLS 2011AA ObjectClass)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
C16831 (NCI Thesaurus ObjectClass-2)
Code List
PET/CT
CL Item
Abnormal (Abnormal)
C25401 (NCI Thesaurus)
C0205161 (UMLS 2011AA)
CL Item
Normal (Normal)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
CL Item
Not Done (Not done)
CL281691 (NCI Metathesaurus)
Item
PET/CT chest
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C17007 (NCI Thesaurus Property)
C0032743 (UMLS 2011AA Property)
C17204 (NCI Thesaurus Property-2)
C0040405 (UMLS 2011AA Property-2)
C25389 (NCI Thesaurus Property-3)
C0817096 (UMLS 2011AA Property-3)
C38000 (NCI Thesaurus Property-4)
C0884358 (UMLS 2011AA Property-4)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
Code List
PET/CT chest
CL Item
Abnormal (Abnormal)
C25401 (NCI Thesaurus)
C0205161 (UMLS 2011AA)
CL Item
Normal (Normal)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
CL Item
Not Done (Not done)
CL281691 (NCI Metathesaurus)
Item
Chest X-Ray Result
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C25389 (NCI Thesaurus ObjectClass)
C0817096 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C17261 (NCI Thesaurus ObjectClass-2)
Code List
Chest X-Ray Result
CL Item
Abnormal (Abnormal)
C25401 (NCI Thesaurus)
C0205161 (UMLS 2011AA)
CL Item
Normal (Normal)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
CL Item
Not Done (Not done)
CL281691 (NCI Metathesaurus)
Item
Chest CT
text
C17204 (NCI Thesaurus ObjectClass)
C0040405 (UMLS 2011AA ObjectClass)
C25389 (NCI Thesaurus ObjectClass-2)
C0817096 (UMLS 2011AA ObjectClass-2)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
Code List
Chest CT
CL Item
Not Done (Not done)
CL281691 (NCI Metathesaurus)
CL Item
Normal (Normal)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
CL Item
Abnormal (Abnormal)
C25401 (NCI Thesaurus)
C0205161 (UMLS 2011AA)
Item
ECHO and/or MUGA
text
C37945 (NCI Thesaurus ObjectClass)
C2243117 (UMLS 2011AA ObjectClass)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
C0521317 (NCI Metathesaurus ObjectClass)
Code List
ECHO and/or MUGA
CL Item
Not Done (Not done)
CL281691 (NCI Metathesaurus)
CL Item
Normal (Normal)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
CL Item
Abnormal (Abnormal)
C25401 (NCI Thesaurus)
C0205161 (UMLS 2011AA)
Item
Baseline LVEF
text
C12727 (NCI Thesaurus ObjectClass)
C0018787 (UMLS 2011AA ObjectClass)
C25294 (NCI Thesaurus Property)
C0022885 (UMLS 2011AA Property)
C37946 (NCI Thesaurus Property-2)
C2700377 (UMLS 2011AA Property-2)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
Code List
Baseline LVEF
CL Item
Abnormal (Abnormal)
C25401 (NCI Thesaurus)
C0205161 (UMLS 2011AA)
CL Item
Normal (Normal)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
CL Item
Not Done (Not done)
CL281691 (NCI Metathesaurus)
LVEF baseline
Item
Baseline LVEF
float
C12727 (NCI Thesaurus ObjectClass)
C25213 (NCI Thesaurus Property)
C25294 (NCI Thesaurus Property-2)
C37946 (NCI Thesaurus Property-3)
C25613 (NCI Thesaurus ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)
C0428772 (UMLS CUI [1,1])
C1442488 (UMLS CUI [1,2])
Item Group
Laboratory Tests
C0022885 (UMLS CUI-1)
Item
ANC
text
C12533 (NCI Thesaurus Property)
C0027950 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property-2)
C1274040 (UMLS 2011AA Property-2)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
Code List
ANC
CL Item
Abnormal (Abnormal, eligibility not affected)
C25401 (NCI Thesaurus)
C0205161 (UMLS 2011AA)
C25401 (NCI Thesaurus-3)
C0205161 (UMLS 2011AA-4)
CL Item
Abnormal Not Eligible (Abnormal, not eligible)
CL Item
Not Done (Not done)
CL281691 (NCI Metathesaurus)
CL Item
Normal (Within normal limits)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
C14165 (NCI Thesaurus-3)
C0205307 (UMLS 2011AA-4)
Item
Platelet Count
text
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C12520 (NCI Thesaurus Property-2)
C0005821 (UMLS 2011AA Property-2)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
Code List
Platelet Count
CL Item
Abnormal (Abnormal, eligibility not affected)
C25401 (NCI Thesaurus)
C0205161 (UMLS 2011AA)
C25401 (NCI Thesaurus-3)
C0205161 (UMLS 2011AA-4)
CL Item
Abnormal Not Eligible (Abnormal, not eligible)
CL Item
Not Done (Not done)
CL281691 (NCI Metathesaurus)
CL Item
Normal (Within normal limits)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
C14165 (NCI Thesaurus-3)
C0205307 (UMLS 2011AA-4)
Item
Hemoglobin
text
C16676 (NCI Thesaurus Property)
C0019046 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property-2)
C1274040 (UMLS 2011AA Property-2)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
Code List
Hemoglobin
CL Item
Abnormal (Abnormal, eligibility not affected)
C25401 (NCI Thesaurus)
C0205161 (UMLS 2011AA)
C25401 (NCI Thesaurus-3)
C0205161 (UMLS 2011AA-4)
CL Item
Abnormal Not Eligible (Abnormal, not eligible)
CL Item
Not Done (Not done)
CL281691 (NCI Metathesaurus)
CL Item
Normal (Within normal limits)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
C14165 (NCI Thesaurus-3)
C0205307 (UMLS 2011AA-4)
Hemoglobin
Item
Hemoglobin
float
C16676 (NCI Thesaurus Property)
C20200 (NCI Thesaurus Property-2)
C25294 (NCI Thesaurus ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C0019046 (UMLS CUI [1])
Item
Bilirubin
text
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C305 (NCI Thesaurus Property-2)
C0005437 (UMLS 2011AA Property-2)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
Code List
Bilirubin
CL Item
Abnormal (Abnormal, eligibility not affected)
C25401 (NCI Thesaurus)
C0205161 (UMLS 2011AA)
C25401 (NCI Thesaurus-3)
C0205161 (UMLS 2011AA-4)
CL Item
Abnormal Not Eligible (Abnormal, not eligible)
CL Item
Not Done (Not done)
CL281691 (NCI Metathesaurus)
CL Item
Normal (Within normal limits)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
C14165 (NCI Thesaurus-3)
C0205307 (UMLS 2011AA-4)
Item
SGOT (AST)
text
C25202 (NCI Thesaurus Property)
C0242192 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property-2)
C1274040 (UMLS 2011AA Property-2)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
Code List
SGOT (AST)
CL Item
Abnormal (Abnormal, eligibility not affected)
C25401 (NCI Thesaurus)
C0205161 (UMLS 2011AA)
C25401 (NCI Thesaurus-3)
C0205161 (UMLS 2011AA-4)
CL Item
Abnormal Not Eligible (Abnormal, not eligible)
CL Item
Not Done (Not done)
CL281691 (NCI Metathesaurus)
CL Item
Normal (Within normal limits)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
C14165 (NCI Thesaurus-3)
C0205307 (UMLS 2011AA-4)
Item
SGPT (ALT)
text
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25293 (NCI Thesaurus Property-2)
C0376147 (UMLS 2011AA Property-2)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
Code List
SGPT (ALT)
CL Item
Abnormal (Abnormal, eligibility not affected)
C25401 (NCI Thesaurus)
C0205161 (UMLS 2011AA)
C25401 (NCI Thesaurus-3)
C0205161 (UMLS 2011AA-4)
CL Item
Abnormal Not Eligible (Abnormal, not eligible)
CL Item
Not Done (Not done)
CL281691 (NCI Metathesaurus)
CL Item
Normal (Within normal limits)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
C14165 (NCI Thesaurus-3)
C0205307 (UMLS 2011AA-4)
Item
Serum Creatinine
text
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C399 (NCI Thesaurus Property-2)
C0010294 (UMLS 2011AA Property-2)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
Code List
Serum Creatinine
CL Item
Abnormal (Abnormal, eligibility not affected)
C25401 (NCI Thesaurus)
C0205161 (UMLS 2011AA)
C25401 (NCI Thesaurus-3)
C0205161 (UMLS 2011AA-4)
CL Item
Abnormal Not Eligible (Abnormal, not eligible)
CL Item
Not Done (Not done)
CL281691 (NCI Metathesaurus)
CL Item
Normal (Within normal limits)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
C14165 (NCI Thesaurus-3)
C0205307 (UMLS 2011AA-4)
Item
Creatinine Clearance
text
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25747 (NCI Thesaurus Property-2)
C0373595 (UMLS 2011AA Property-2)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
Code List
Creatinine Clearance
CL Item
Abnormal (Abnormal, eligibility not affected)
C25401 (NCI Thesaurus)
C0205161 (UMLS 2011AA)
C25401 (NCI Thesaurus-3)
C0205161 (UMLS 2011AA-4)
CL Item
Abnormal Not Eligible (Abnormal, not eligible)
CL Item
Not Done (Not done)
CL281691 (NCI Metathesaurus)
CL Item
Normal (Within normal limits)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
C14165 (NCI Thesaurus-3)
C0205307 (UMLS 2011AA-4)
Item
Serum Calcium
text
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C331 (NCI Thesaurus Property)
C0006675 (UMLS 2011AA Property)
C13325 (NCI Thesaurus Property-2)
C0229671 (UMLS 2011AA Property-2)
C20200 (NCI Thesaurus Property-3)
C1274040 (UMLS 2011AA Property-3)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
Code List
Serum Calcium
CL Item
Abnormal (Abnormal, eligibility not affected)
C25401 (NCI Thesaurus)
C0205161 (UMLS 2011AA)
C25401 (NCI Thesaurus-3)
C0205161 (UMLS 2011AA-4)
CL Item
Abnormal Not Eligible (Abnormal, not eligible)
CL Item
Not Done (Not done)
CL281691 (NCI Metathesaurus)
CL Item
Normal (Within normal limits)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
C14165 (NCI Thesaurus-3)
C0205307 (UMLS 2011AA-4)
Item
Corrected Serum Calcium
text
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
C74950 (NCI Thesaurus Property-2)
C0455288 (UMLS 2011AA Property-2)
Code List
Corrected Serum Calcium
CL Item
Abnormal (Abnormal, eligibility not affected)
C25401 (NCI Thesaurus)
C0205161 (UMLS 2011AA)
C25401 (NCI Thesaurus-3)
C0205161 (UMLS 2011AA-4)
CL Item
Abnormal Not Eligible (Abnormal, not eligible)
CL Item
Not Done (Not done)
CL281691 (NCI Metathesaurus)
CL Item
Normal (Within normal limits)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
C14165 (NCI Thesaurus-3)
C0205307 (UMLS 2011AA-4)
Item
Ionized Serum Calcium
text
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C464 (NCI Thesaurus Property-2)
C0013832 (UMLS 2011AA Property-2)
C61660 (NCI Thesaurus Property-3)
C0596235 (UMLS 2011AA Property-3)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
Code List
Ionized Serum Calcium
CL Item
Abnormal (Abnormal, eligibility not affected)
C25401 (NCI Thesaurus)
C0205161 (UMLS 2011AA)
C25401 (NCI Thesaurus-3)
C0205161 (UMLS 2011AA-4)
CL Item
Abnormal Not Eligible (Abnormal, not eligible)
CL Item
Not Done (Not done)
CL281691 (NCI Metathesaurus)
CL Item
Normal (Within normal limits)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
C14165 (NCI Thesaurus-3)
C0205307 (UMLS 2011AA-4)
Item
Magnesium
text
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
C29239 (NCI Thesaurus Property-2)
C0024467 (UMLS 2011AA Property-2)
Code List
Magnesium
CL Item
Abnormal (Abnormal, eligibility not affected)
C25401 (NCI Thesaurus)
C0205161 (UMLS 2011AA)
C25401 (NCI Thesaurus-3)
C0205161 (UMLS 2011AA-4)
CL Item
Abnormal Not Eligible (Abnormal, not eligible)
CL Item
Not Done (Not done)
CL281691 (NCI Metathesaurus)
CL Item
Normal (Within normal limits)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
C14165 (NCI Thesaurus-3)
C0205307 (UMLS 2011AA-4)
Item
Primary Site (If site within region cannot be determined, specify region)
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12418 (NCI Thesaurus ObjectClass-2)
C0460004 (UMLS 2011AA ObjectClass-2)
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
C25251 (NCI Thesaurus Property-2)
C0205225 (UMLS 2011AA Property-2)
C13717 (NCI Thesaurus ValueDomain)
C1515974 (UMLS 2011AA ValueDomain)
Code List
Primary Site (If site within region cannot be determined, specify region)
CL Item
Oral Cavity Nos (ORAL CAVITY, NOS)
CL Item
Oral Tongue (Oral tongue)
CL Item
Floor Of Mouth (Floor of mouth)
C0026638 (NCI Metathesaurus)
CL Item
Buccal Mucosa (Buccal mucosa)
C12505 (NCI Thesaurus)
C1578559 (UMLS 2011AA)
CL Item
Lower Gingiva (Lower gingiva)
CL Item
Upper Gingiva (Upper gingiva)
CL Item
Retromolar Trigone (Retromolar trigone)
CL Item
Hard Palate (Hard palate)
C12230 (NCI Thesaurus)
C0226901 (UMLS 2011AA)
CL Item
Nasopharynx Nos (NASOPHARYNX, NOS)
CL Item
Posterior Superior Wall (Posterior superior wall)
CL Item
Lateral Wall (Lateral wall)
CL Item
Oropharynx Nos (OROPHARYNX, NOS)
CL Item
Faucial Arch (Faucial arch)
CL Item
Tonsillar Fossa Tonsil (Tonsillar fossa, tonsil)
CL Item
Base Of Tongue (Base of tongue)
C0226958 (NCI Metathesaurus)
CL Item
Pharyngeal Oropharynx (Pharyngeal Oropharynx)
CL Item
Soft Palate (Soft Palate)
C12231 (NCI Thesaurus)
C0030219 (UMLS 2011AA)
CL Item
Hypopharynx Nos (HYPOPHARYNX, NOS)
CL Item
Pyriform Fossa (Pyriform fossa)
CL Item
Postcricoid Area (Postcricoid area)
CL Item
Posterior Wall (Posterior wall)
CL Item
Supraglottic Larynx Nos (SUPRAGLOTTIC LARYNX, NOS)
CL Item
Ventricular Band (Ventricular band)
CL Item
Arytenoid (Arytenoid)
CL Item
Suprahyoid Epiglottis (Suprahyoid epiglottis)
CL Item
Infrahyoid Epiglottis (Infrahyoid epiglottis)
CL Item
Aryepiglottic Fold (Aryepiglottic fold)
CL Item
Glottic Larynx Nos (GLOTTIC LARYNX, NOS)
CL Item
Vocal Cords (Vocal cords)
CL Item
Subglottic Larynx Nos (SUBGLOTTIC LARYNX, NOS)
CL Item
Subglottic (Subglottic)
CL Item
Paranasal Sinuses Nos (PARANASAL SINUSES, NOS)
CL Item
Antrum (Antrum)
CL Item
Ethmoid (Ethmoid)
CL Item
Sphenoid (Sphenoid)
CL Item
Frontal (Frontal)
CL Item
Nose Nos (NOSE, NOS)
CL Item
Nasal Cavity (Nasal cavity)
C12424 (NCI Thesaurus)
C0027423 (UMLS 2011AA)
CL Item
Other (OTHER)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
CL Item
Unknown (UNKNOWN)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Primary Disease Site
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C0449695 (UMLS CUI-1)
C25341 (NCI Thesaurus Property)
C25251 (NCI Thesaurus ObjectClass)
C2991 (NCI Thesaurus ObjectClass-2)
Item
Indicate other involved sites within region of origin or extension at study entry (Use previous codetable)
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12418 (NCI Thesaurus ObjectClass-2)
C0460004 (UMLS 2011AA ObjectClass-2)
C17649 (NCI Thesaurus Property)
C0205394 (UMLS 2011AA Property)
C25341 (NCI Thesaurus Property-2)
C0450429 (UMLS 2011AA Property-2)
C13717 (NCI Thesaurus ValueDomain)
C1515974 (UMLS 2011AA ValueDomain)
Code List
Indicate other involved sites within region of origin or extension at study entry (Use previous codetable)
CL Item
Oral Cavity Nos (ORAL CAVITY, NOS)
CL Item
Oral Tongue (Oral tongue)
CL Item
Floor Of Mouth (Floor of mouth)
C0026638 (NCI Metathesaurus)
CL Item
Buccal Mucosa (Buccal mucosa)
C12505 (NCI Thesaurus)
C1578559 (UMLS 2011AA)
CL Item
Lower Gingiva (Lower gingiva)
CL Item
Upper Gingiva (Upper gingiva)
CL Item
Retromolar Trigone (Retromolar trigone)
CL Item
Hard Palate (Hard palate)
C12230 (NCI Thesaurus)
C0226901 (UMLS 2011AA)
CL Item
Nasopharynx Nos (NASOPHARYNX, NOS)
CL Item
Posterior Superior Wall (Posterior superior wall)
CL Item
Lateral Wall (Lateral wall)
CL Item
Oropharynx Nos (OROPHARYNX, NOS)
CL Item
Faucial Arch (Faucial arch)
CL Item
Tonsillar Fossa Tonsil (Tonsillar fossa, tonsil)
CL Item
Base Of Tongue (Base of tongue)
C0226958 (NCI Metathesaurus)
CL Item
Pharyngeal Oropharynx (Pharyngeal Oropharynx)
CL Item
Soft Palate (Soft Palate)
C12231 (NCI Thesaurus)
C0030219 (UMLS 2011AA)
CL Item
Hypopharynx Nos (HYPOPHARYNX, NOS)
CL Item
Pyriform Fossa (Pyriform fossa)
CL Item
Postcricoid Area (Postcricoid area)
CL Item
Posterior Wall (Posterior wall)
CL Item
Supraglottic Larynx Nos (SUPRAGLOTTIC LARYNX, NOS)
CL Item
Ventricular Band (Ventricular band)
CL Item
Arytenoid (Arytenoid)
CL Item
Suprahyoid Epiglottis (Suprahyoid epiglottis)
CL Item
Infrahyoid Epiglottis (Infrahyoid epiglottis)
CL Item
Aryepiglottic Fold (Aryepiglottic fold)
CL Item
Glottic Larynx Nos (GLOTTIC LARYNX, NOS)
CL Item
Vocal Cords (Vocal cords)
CL Item
Subglottic Larynx Nos (SUBGLOTTIC LARYNX, NOS)
CL Item
Subglottic (Subglottic)
CL Item
Paranasal Sinuses Nos (PARANASAL SINUSES, NOS)
CL Item
Antrum (Antrum)
CL Item
Ethmoid (Ethmoid)
CL Item
Sphenoid (Sphenoid)
CL Item
Frontal (Frontal)
CL Item
Nose Nos (NOSE, NOS)
CL Item
Nasal Cavity (Nasal cavity)
C12424 (NCI Thesaurus)
C0027423 (UMLS 2011AA)
CL Item
Other (OTHER)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
CL Item
Unknown (UNKNOWN)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
DiseaseInvolvedSiteSpecify
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
C25547 (NCI Thesaurus Property-2)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
Item Group
Tumor Measurements At Presentation
Item
Histologic Type
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12418 (NCI Thesaurus ObjectClass-2)
C0460004 (UMLS 2011AA ObjectClass-2)
C25526 (NCI Thesaurus Property)
C0205462 (UMLS 2011AA Property)
C25161 (NCI Thesaurus Property-2)
C0008902 (UMLS 2011AA Property-2)
C25372 (NCI Thesaurus ValueDomain)
C0683312 (UMLS 2011AA ValueDomain)
C25526 (NCI Thesaurus ValueDomain-2)
C0205462 (UMLS 2011AA ValueDomain-2)
Code List
Histologic Type
CL Item
Squamous Cell Carcinoma, Including Variants (Squamous cell carcinoma, including variants)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
Tumor diameter
Item
Tumor diameter
float
C25209 (NCI Thesaurus ValueDomain)
C25285 (NCI Thesaurus Property)
C3262 (NCI Thesaurus ObjectClass)
C25564 (NCI Thesaurus Property-2)
C3272927 (UMLS CUI [1])
LymphNodeMassSizeMeasurement
Item
Nodal mass (cm)
float
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
C35521 (NCI Thesaurus ObjectClass)
C0746921 (UMLS 2011AA ObjectClass)
C25681 (NCI Thesaurus Property)
C0456389 (UMLS 2011AA Property)
Item
Primary Tumor Laterality
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C25251 (NCI Thesaurus ObjectClass-2)
C0205225 (UMLS 2011AA ObjectClass-2)
C25185 (NCI Thesaurus Property)
C0332304 (UMLS 2011AA Property)
Code List
Primary Tumor Laterality
CL Item
Left (Left)
C25229 (NCI Thesaurus)
C0205091 (UMLS 2011AA)
CL Item
Right (Right)
C25228 (NCI Thesaurus)
C0205090 (UMLS 2011AA)
Item
Clinical T Stage
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12418 (NCI Thesaurus ObjectClass-2)
C0460004 (UMLS 2011AA ObjectClass-2)
C25398 (NCI Thesaurus Property)
C0205210 (UMLS 2011AA Property)
C25728 (NCI Thesaurus Property-2)
C0475455 (UMLS 2011AA Property-2)
C16899 (NCI Thesaurus ValueDomain)
C1300072 (UMLS 2011AA ValueDomain)
Code List
Clinical T Stage
CL Item
T0, According To Ajcc Criteria (T0)
CL Item
T1, According To Ajcc Criteria (T1)
CL Item
T2, According To Ajcc Criteria (T2)
CL Item
T3, According To Ajcc Criteria (T3)
CL Item
T4, According To Ajcc Criteria (T4)
CL Item
Tis, According To Ajcc Criteria (TIS)
CL Item
Tx, According To Ajcc Criteria (TX)
Item
Clinical N Stage (OVERALL)
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12418 (NCI Thesaurus ObjectClass-2)
C0460004 (UMLS 2011AA ObjectClass-2)
C25398 (NCI Thesaurus Property)
C0205210 (UMLS 2011AA Property)
C25580 (NCI Thesaurus Property-2)
C0456532 (UMLS 2011AA Property-2)
C16899 (NCI Thesaurus ValueDomain)
C1300072 (UMLS 2011AA ValueDomain)
Code List
Clinical N Stage (OVERALL)
CL Item
N0, According To Ajcc Guidelines (N0)
CL Item
N1, According To Ajcc Criteria (N1)
CL Item
N2a, According To Ajcc Guidelines (N2a)
CL Item
N2b, According To Ajcc Guidelines (N2b)
CL Item
N2c, According To Ajcc Guidelines (N2c)
CL Item
N3, According To Ajcc Guidelines (N3)
CL Item
Nx, According To Ajcc Guidelines (NX)
Item
Clinical N Stage, Right side
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12418 (NCI Thesaurus ObjectClass-2)
C0460004 (UMLS 2011AA ObjectClass-2)
C25228 (NCI Thesaurus Property)
C0205090 (UMLS 2011AA Property)
C25580 (NCI Thesaurus Property-2)
C0456532 (UMLS 2011AA Property-2)
C16899 (NCI Thesaurus ValueDomain)
C1300072 (UMLS 2011AA ValueDomain)
Code List
Clinical N Stage, Right side
CL Item
N0, According To Ajcc Guidelines (N0)
CL Item
N1, According To Ajcc Criteria (N1)
CL Item
N2a, According To Ajcc Guidelines (N2a)
CL Item
N2b, According To Ajcc Guidelines (N2b)
CL Item
N2c, According To Ajcc Guidelines (N2c)
CL Item
N3, According To Ajcc Guidelines (N3)
CL Item
Nx, According To Ajcc Guidelines (NX)
Item
Clinical N Stage, Left side
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12418 (NCI Thesaurus ObjectClass-2)
C0460004 (UMLS 2011AA ObjectClass-2)
C25229 (NCI Thesaurus Property)
C0205091 (UMLS 2011AA Property)
C25580 (NCI Thesaurus Property-2)
C0456532 (UMLS 2011AA Property-2)
C16899 (NCI Thesaurus ValueDomain)
C1300072 (UMLS 2011AA ValueDomain)
Code List
Clinical N Stage, Left side
CL Item
N0, According To Ajcc Guidelines (N0)
CL Item
N1, According To Ajcc Criteria (N1)
CL Item
N2a, According To Ajcc Guidelines (N2a)
CL Item
N2b, According To Ajcc Guidelines (N2b)
CL Item
N2c, According To Ajcc Guidelines (N2c)
CL Item
N3, According To Ajcc Guidelines (N3)
CL Item
Nx, According To Ajcc Guidelines (NX)
Item
Clinical M Stage
text
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C12418 (NCI Thesaurus ObjectClass-2)
C0460004 (UMLS 2011AA ObjectClass-2)
C25398 (NCI Thesaurus Property)
C0205210 (UMLS 2011AA Property)
C25727 (NCI Thesaurus Property-2)
C0456533 (UMLS 2011AA Property-2)
C16899 (NCI Thesaurus ValueDomain)
C1300072 (UMLS 2011AA ValueDomain)
Code List
Clinical M Stage
CL Item
M0, According To Ajcc Guidelines (M0)
CL Item
M1, According To Ajcc Staging Definitions (M1)
Item
Weight Loss in Previous Six Months
text
C25664 (NCI Thesaurus ValueDomain)
C1262477 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C3828652 (UMLS CUI-2)
C3445 (NCI Thesaurus Property)
C25613 (NCI Thesaurus ValueDomain-2)
Code List
Weight Loss in Previous Six Months
CL Item
<5% Of Body Weight (< 5% of body weight)
CL Item
5 To <10% Of Body Weight (5 to < 10% of body weight)
CL Item
10 To <20% Of Body Weight (10 to < 20% of body weight)
CL Item
> Or = 20% Of Body Weight (> or = 20% of body weight)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Does the patient have a past history of swallowing problems
text
C25518 (NCI Thesaurus ObjectClass)
C0542341 (UMLS 2011AA ObjectClass)
C38028 (NCI Thesaurus ObjectClass-2)
C0011167 (UMLS 2011AA ObjectClass-2)
C25629 (NCI Thesaurus Property)
C0332152 (UMLS 2011AA Property)
C37940 (NCI Thesaurus Property-2)
C0011155 (UMLS 2011AA Property-2)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
Code List
Does the patient have a past history of swallowing problems
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
How long were swallowing problems apparent (If yes,)
text
C25518 (NCI Thesaurus ObjectClass)
C0542341 (UMLS 2011AA ObjectClass)
C38028 (NCI Thesaurus ObjectClass-2)
C0011167 (UMLS 2011AA ObjectClass-2)
C25629 (NCI Thesaurus Property)
C0332152 (UMLS 2011AA Property)
C37940 (NCI Thesaurus Property-2)
C0011155 (UMLS 2011AA Property-2)
C25330 (NCI Thesaurus ValueDomain)
C0449238 (UMLS 2011AA ValueDomain)
Code List
How long were swallowing problems apparent (If yes,)
CL Item
Less Than 1 Month (Less than 1 month)
CL Item
1 To <7 Months (1 to <7 months)
CL Item
7 To <13 Months (7 to <13 months)
CL Item
13 To <19 Months (13 to <19 months)
CL Item
19 To <24 Months (19 to <24 months)
CL Item
2 Years Or Longer (2 years or longer)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Does the patient currently have swallowing problems
text
C25518 (NCI Thesaurus ObjectClass)
C0542341 (UMLS 2011AA ObjectClass)
C38028 (NCI Thesaurus ObjectClass-2)
C0011167 (UMLS 2011AA ObjectClass-2)
C25471 (NCI Thesaurus Property)
C0521116 (UMLS 2011AA Property)
C37940 (NCI Thesaurus Property-2)
C0011155 (UMLS 2011AA Property-2)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
Code List
Does the patient currently have swallowing problems
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
How long have swallowing problems been present (If yes,)
text
C25518 (NCI Thesaurus ObjectClass)
C0542341 (UMLS 2011AA ObjectClass)
C38028 (NCI Thesaurus ObjectClass-2)
C0011167 (UMLS 2011AA ObjectClass-2)
C25471 (NCI Thesaurus Property)
C0521116 (UMLS 2011AA Property)
C37940 (NCI Thesaurus Property-2)
C0011155 (UMLS 2011AA Property-2)
C25330 (NCI Thesaurus ValueDomain)
C0449238 (UMLS 2011AA ValueDomain)
Code List
How long have swallowing problems been present (If yes,)
CL Item
7 To <13 Months (7 to <13 months)
CL Item
13 To <19 Months (13 to <19 months)
CL Item
19 To <24 Months (19 to <24 months)
CL Item
Less Than 1 Month (Less than 1 month)
CL Item
2 Years Or Longer (2 years or longer)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
CL Item
1 To <7 Months (1 to <7 months)
Item
Does the patient have a past history of tube feedings
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25629 (NCI Thesaurus Property)
C0332152 (UMLS 2011AA Property)
C73430 (NCI Thesaurus ObjectClass)
C0041281 (UMLS 2011AA ObjectClass)
C25409 (NCI Thesaurus Property-2)
C1533734 (UMLS 2011AA Property-2)
Code List
Does the patient have a past history of tube feedings
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
How long were tube feedings given (If yes,)
text
C25629 (NCI Thesaurus Property)
C0332152 (UMLS 2011AA Property)
C73430 (NCI Thesaurus ObjectClass)
C0041281 (UMLS 2011AA ObjectClass)
C25409 (NCI Thesaurus Property-2)
C1533734 (UMLS 2011AA Property-2)
C25330 (NCI Thesaurus ValueDomain)
C0449238 (UMLS 2011AA ValueDomain)
Code List
How long were tube feedings given (If yes,)
CL Item
Less Than 1 Month (Less than 1 month)
CL Item
1 To <7 Months (1 to <7 months)
CL Item
7 To <13 Months (7 to <13 months)
CL Item
13 To <19 Months (13 to <19 months)
CL Item
19 To <24 Months (19 to <24 months)
CL Item
2 Years Or Longer (2 years or longer)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Does the patient currently require tube feeding
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25471 (NCI Thesaurus Property)
C0521116 (UMLS 2011AA Property)
C73430 (NCI Thesaurus ObjectClass)
C0041281 (UMLS 2011AA ObjectClass)
C25409 (NCI Thesaurus Property-2)
C1533734 (UMLS 2011AA Property-2)
Code List
Does the patient currently require tube feeding
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Is patient dependent on tube feeding for >50% of nutritional support (If yes,)
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25251 (NCI Thesaurus Property)
C0205225 (UMLS 2011AA Property)
C73430 (NCI Thesaurus ObjectClass)
C0041281 (UMLS 2011AA ObjectClass)
C25409 (NCI Thesaurus Property-2)
C1533734 (UMLS 2011AA Property-2)
Code List
Is patient dependent on tube feeding for >50% of nutritional support (If yes,)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Smoking History
text
C25284 (NCI Thesaurus ValueDomain)
C1519384 (UMLS CUI-1)
C17934 (NCI Thesaurus ObjectClass)
C18772 (NCI Thesaurus Property)
Code List
Smoking History
CL Item
Cigarette Smoker 20-40 Pack-years (Cigarette smoker, 20-40 pack-years)
CL Item
Cigarette Smoker <20 Pack-years (Cigarette smoker, <20 pack-years)
CL Item
Cigarette Smoker >40 Pack-years (Cigarette smoker, >40 pack-years)
CL Item
Never Smoked (Never smoked)
CL Item
Pipe Or Cigar Smoker Only (Pipe or cigar smoker only)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Does the patient currently smoke (cigarettes)
text
C25180 (NCI Thesaurus ValueDomain)
C3241966 (UMLS CUI-1)
C25471 (NCI Thesaurus Property)
C17934 (NCI Thesaurus ObjectClass)
C0449865 (NCI Metathesaurus Property)
Code List
Does the patient currently smoke (cigarettes)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Patient Refused To Answer (Patient Refused to Answer)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
Number of Cigarettes per day (Need to add this new question to CRF to capture value for current smokers - values need to match existing CDE)
text
C17934 (NCI Thesaurus ObjectClass)
C1608325 (UMLS CUI-1)
C25471 (NCI Thesaurus Property)
C0449865 (NCI Metathesaurus Property)
C25473 (NCI Thesaurus ValueDomain)
C25515 (NCI Thesaurus ValueDomain-2)
Code List
Number of Cigarettes per day (Need to add this new question to CRF to capture value for current smokers - values need to match existing CDE)
CL Item
14 Or Fewer (14 or fewer)
CL Item
15-24 (15-24)
CL Item
25 Or More (25 or more)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Smoking Discontinued Duration
text
C25484 (NCI Thesaurus Property)
C0453997 (UMLS CUI-1)
C17934 (NCI Thesaurus ObjectClass)
C25330 (NCI Thesaurus ValueDomain)
Code List
Smoking Discontinued Duration
CL Item
1 Month To <6 Months (1 month to <6 months)
CL Item
1 Year To <5 Years (1 year to <5 years)
CL Item
5 Years To <10 Years (5 years to <10 years)
CL Item
6 Months To <1 Year (6 months to <1 year)
CL Item
Less Than 1 Month (Less than 1 month)
CL Item
More Than 10 Years (More than 10 years)
CL Item
Never Smoked (Never smoked)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item Group
Protocol Specific Adverse Event Evaluation
Item
CTC Adverse Event Term
text
C25284 (NCI Thesaurus ValueDomain)
C1516728 (UMLS CUI-1)
C49704 (NCI Thesaurus ObjectClass)
C2826934 (UMLS CUI-2)
C45559 (NCI Thesaurus Property)
Code List
CTC Adverse Event Term
CL Item
Dysphagia (Dysphagia (difficulty swallowing))
C2980 (NCI Thesaurus)
C0011168 (UMLS 2011AA)
MedDRA Code
Item
MedDRA Code
text
C25162 (NCI Thesaurus ValueDomain)
C25364 (NCI Thesaurus Property)
CL104089 (NCI Metathesaurus ObjectClass)
C1552878 (UMLS CUI [1])
CTC Adverse Event Grade
Item
CTC AE Grade
float
C49704 (NCI Thesaurus ObjectClass)
C2985911 (UMLS CUI-1)
C18000 (NCI Thesaurus ValueDomain)
C25365 (NCI Thesaurus Property)
Adverse Event Start Date
Item
CTCAE Begin Date
date
C25164 (NCI Thesaurus ValueDomain)
C2697888 (UMLS CUI-1)
C25375 (NCI Thesaurus Property)
C25431 (NCI Thesaurus ValueDomain-2)
C49704 (NCI Thesaurus ObjectClass)
AdverseEventAssessmentText
Item
Comments
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
Item Group
Comments
Research Comments
Item
COMMENTS
text
C25704 (NCI Thesaurus ValueDomain)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
Person Completing Form
Item
Person completing form
text
C25191 (NCI Thesaurus ValueDomain)
C1550483 (UMLS CUI-1)
C25657 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)
Form Completion Date
Item
Form completion date, original
date
C19464 (NCI Thesaurus ObjectClass)
C1549507 (UMLS CUI-1)
C25250 (NCI Thesaurus Property)
C25604 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)

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