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  1. StudyEvent: GOG Specimen Form- Form SP
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Ccrr Module For Gog Specimen Form- Form Sp
Form Completion Date
Item
Date form originally completed
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)
FormAmendedCompleteDate
Item
Date form amended
date
C19464 (NCI Thesaurus ObjectClass)
C0376315 (UMLS 2011AA ObjectClass)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C25416 (NCI Thesaurus Property-2)
C1691222 (UMLS 2011AA Property-2)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
ResponsiblePersonReportingChangeLastName
Item
Person amending form, last name
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
Patient Study ID
Item
Patient Study ID
text
C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25462 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
SpecimenIdentifierNumber
Item
GOG Bank ID#
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
Person Completing Form
Item
Person completing form, last name
text
C25191 (NCI Thesaurus ValueDomain)
C1550483 (UMLS CUI-1)
C25657 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)
ResponsiblePersonE-mailAddressText
Item
email address
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C25657 (NCI Thesaurus ObjectClass)
C1273518 (UMLS 2011AA ObjectClass)
C42775 (NCI Thesaurus Property)
C1705961 (UMLS 2011AA Property)
TIMEPOINT
Item
Time point
text
Item
Submission status
text
CL.1
Code List
Submission status
CL Item
submitted (submitted)
CL Item
not submitted (not submitted)
SpecimenCollectedDate
Item
Date collected
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C25452 (NCI Thesaurus Property)
C25275 (NCI Thesaurus Property-2)
C2745955 (UMLS 2011AA Property)
SpecimenCollectedTime
Item
Time collected
time
C25207 (NCI Thesaurus ValueDomain)
C0040223 (UMLS 2011AA ValueDomain)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C25452 (NCI Thesaurus Property)
C25275 (NCI Thesaurus Property-2)
C2745955 (UMLS 2011AA Property)
Item
Specimen type
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C25695 (NCI Thesaurus Property)
C1515023 (UMLS 2011AA Property)
CL.2
Code List
Specimen type
CL Item
buffy coat (buffy coat)
CL Item
urine (urine)
CL Item
cells (cells)
CL Item
Peripheral Blood (whole blood)
C0229664 (NCI Metathesaurus)
C0229664 (NCI Metathesaurus-2)
CL Item
Tissue Fixed With Formalin (fixed tissue)
CL Item
Frozen Tissue, Not Fixed, Without The Use Of Oct (frozen tissue)
CL Item
plasma (plasma)
CL Item
Serum (serum)
C13325 (NCI Thesaurus)
C0229671 (UMLS 2011AA)
CL Item
other (other)
SpecimenLabSubmittedDate
Item
Date shipped
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25294 (NCI Thesaurus Property)
C0022885 (UMLS 2011AA Property)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C25695 (NCI Thesaurus Property-2)
C1515023 (UMLS 2011AA Property-2)
Research Comments
Item
Additional information required by protocol
text
C25704 (NCI Thesaurus ValueDomain)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
Platelets
Item
Platelet count
float
C20200 (NCI Thesaurus Property)
C0005821 (UMLS CUI-1)
C12520 (NCI Thesaurus Property-2)
C25294 (NCI Thesaurus ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
HematologyLabCollectedDate
Item
Date of platelet count
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25452 (NCI Thesaurus ValueDomain-2)
SpecimenFixativeType
Item
yes, specify
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C498 (NCI Thesaurus Property)
C0016184 (UMLS 2011AA Property)
SpecimenFixativeType
Item
yes, specify
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C498 (NCI Thesaurus Property)
C0016184 (UMLS 2011AA Property)
Item
Tissue type
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C12801 (NCI Thesaurus ObjectClass)
C0040300 (UMLS 2011AA ObjectClass)
C25365 (NCI Thesaurus Property)
C0678257 (UMLS 2011AA Property)
CL.10
Code List
Tissue type
CL Item
normal (normal)
CL Item
pre-malignant (pre-malignant)
CL Item
Primary (primary tumr)
C25251 (NCI Thesaurus)
C0205225 (UMLS 2011AA)
CL Item
Distant Metastases (metastatic tumor)
CL Item
Recurrent Tumor (recurrent/persistent tumor)
CL Item
Other, Specify (Other)
TissueType,Other
Item
Other, specify (tissue type)
text
Item
Receiving Institution
text
C25639 (NCI Thesaurus Property)
C1514756 (UMLS 2011AA Property)
C37984 (NCI Thesaurus Property-2)
C0022877 (UMLS 2011AA Property-2)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
CL.13
Code List
Receiving Institution
CL Item
GOG tissue bank (GOG tissue bank)
CL Item
laboratory (laboratory)
SpecimenLaboratoryReceivedDate
Item
Date received
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25639 (NCI Thesaurus Property)
C1514756 (UMLS 2011AA Property)
C37984 (NCI Thesaurus Property-2)
C0022877 (UMLS 2011AA Property-2)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
AssessmentLabUOM
Item
Units
text
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C37984 (NCI Thesaurus Property)
C0022877 (UMLS 2011AA Property)
C25709 (NCI Thesaurus ValueDomain)
C1519795 (UMLS 2011AA ValueDomain)
Item
Condition of received specimens
text
CL.14
Code List
Condition of received specimens
CL Item
Useable (satisfactory)
CL Item
Damaged Or Unusable (unsatisfactory)
Name
Item
Name
text
OrganizationPhoneNumber
Item
phone or email
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C25395 (NCI Thesaurus Property)
C0039457 (UMLS 2011AA Property)
C19711 (NCI Thesaurus ObjectClass)
C1522486 (UMLS 2011AA ObjectClass)
OrganizationPhoneNumber
Item
phone or email
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C25395 (NCI Thesaurus Property)
C0039457 (UMLS 2011AA Property)
C19711 (NCI Thesaurus ObjectClass)
C1522486 (UMLS 2011AA ObjectClass)
SpecimenLabIdentifierName
Item
lab name
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C37984 (NCI Thesaurus ObjectClass)
C0022877 (UMLS 2011AA ObjectClass)
C19157 (NCI Thesaurus ObjectClass-2)
C0370003 (UMLS 2011AA ObjectClass-2)
ParticipatingGroupIdentifierCode
Item
Participating Group Code
text
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
C25608 (NCI Thesaurus ObjectClass)
C0679823 (UMLS 2011AA ObjectClass)
C17005 (NCI Thesaurus ObjectClass-2)
C1257890 (UMLS 2011AA ObjectClass-2)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
Study Number Participating Group
Item
Participating Group Protocol Number
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 Patient Study 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)
Specimencode
Item
Specimen code
text
Notsubmitted,specify
Item
Not submitted, specify
text
Other,specify(specimentype)
Item
Other, specify (specimen type)
text
Item
Items shipped
text
CL.3
Code List
Items shipped
CL Item
block (block)
CL Item
OCT-mold (OCT-mold)
CL Item
piece (piece)
CL Item
slide (slide)
CL Item
tube/vial (tube/vial)
CL Item
other (other)
Other,specify(itemsshipped)
Item
Other, specify (items shipped)
text
Quantityofitemsshipped
Item
Quantity of items shipped
text
Item
Processing time
text
CL.4
Code List
Processing time
CL Item
< 1 hour (< 1 hour)
CL Item
1-2 hours (1-2 hours)
CL Item
2-4 hours (2-4 hours)
CL Item
> 4 hours (> 4 hours)
CL Item
NA (NA)
Storagetype
Item
Storage type
text
Item
Room temperature
text
CL.5
Code List
Room temperature
CL Item
refrigerator (refrigerator)
CL Item
standard non-cycling freezer (standard non-cycling freezer)
CL Item
ultracold freezer/liquid N2/dry ice (ultracold freezer/liquid N2/dry ice)
CL Item
other (other)
Other,specify(storagetype)
Item
Other, specify (storage type)
text
FederalExpresstrackingnumber
Item
Federal Express tracking number
text
Item
Type of blood collection tubes
text
CL.6
Code List
Type of blood collection tubes
CL Item
ACD (ACD)
CL Item
EDTA (EDTA)
CL Item
Red top (Red top)
CL Item
Serum separator (Serum separator)
CL Item
Citrate (Citrate)
CL Item
Heparin (Heparin)
CL Item
other (other)
Other,specify(typeofbloodcollectiontubes)
Item
Other, specify (type of blood collection tubes)
text
Plateletcountrequired?
Item
Platelet count required?
boolean
Item
Urine collection method
text
CL.9
Code List
Urine collection method
CL Item
clean catch (clean catch)
CL Item
24-hour (24-hour)
CL Item
other (other)
Other,specify(urinecollectionmethod)
Item
Other, specify (urine collection method)
text
Item
Processing method
text
CL.11
Code List
Processing method
CL Item
ethanol-fixed (ethanol-fixed)
CL Item
fixed & parraffin-embedded (fixed & parraffin-embedded)
CL Item
formalin-fixed (formalin-fixed)
CL Item
OCT-frozen (OCT-frozen)
CL Item
snap-frozen (snap-frozen)
CL Item
other (other)
Other,specify(processingmethod)
Item
Other, specify (processing method)
text
Item
Cell type
text
CL.12
Code List
Cell type
CL Item
buccal (buccal)
CL Item
cervical (cervical)
CL Item
other (other)
Other,specify(celltype)
Item
Other, specify (cell type)
text
Totalvolume/weight
Item
Total volume/weight
text
Unsatisfactory,specify(conditionofspecimen)
Item
Unsatisfactory, specify (condition of specimen)
text
Additionalprocessingrequired
Item
Additional processing required
boolean
yes,specify(additionalprocessing)
Item
yes, specify (additional processing)
text
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