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  1. StudyEvent: Sarcoma - Functional Evaluation Form for Extremity Primary
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Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Crf Header
Protocol ID Coordinating Group
Item
Coordinating Group Protocol No.
text
C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1711341 (UMLS CUI-2)
C25462 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
Coordinating Group Code
Item
Coordinating Group Code
text
C25162 (NCI Thesaurus ValueDomain)
C1711341 (UMLS CUI-1)
C17005 (NCI Thesaurus ObjectClass)
C0805701 (UMLS CUI-2)
C25462 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
Protocol Title
Item
Protocol Title
text
C25191 (NCI Thesaurus ValueDomain)
C2986303 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C42774 (NCI Thesaurus 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)
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)
Trial subject ID Participating Group
Item
Other 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)
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)
Patient Name
Item
Patient Name (initials acceptable)
text
C25191 (NCI Thesaurus ValueDomain)
C1299487 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)
Item Group
Sarcoma: Form Administration
Person Completing Form
Item
Person Completing Form
text
C25191 (NCI Thesaurus ValueDomain)
C1550483 (UMLS CUI-1)
C25657 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)
Data amended
Item
Are data amended (If data are amended, please circle in red when using paper form)
boolean
C38148 (NCI Thesaurus ValueDomain)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
Item Group
Sarcoma: Functional Evaluation
Item
Function (Lower Limb Assessment)
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C25518 (NCI Thesaurus Property)
C0542341 (UMLS 2011AA Property)
C25309 (NCI Thesaurus ObjectClass)
C0441994 (UMLS 2011AA ObjectClass)
C0015385 (NCI Metathesaurus ObjectClass)
CL.2
Code List
Function (Lower Limb Assessment)
CL Item
No Restriction (No restriction)
CL Item
Recreational Restriction (Recreational restriction)
CL Item
Partial Disability (Partial disability)
CL Item
Total Disability (Total disability)
Item
Supports
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C25309 (NCI Thesaurus ObjectClass)
C0441994 (UMLS 2011AA ObjectClass)
C0015385 (NCI Metathesaurus ObjectClass)
C0006086 (NCI Metathesaurus Property)
CL.3
Code List
Supports
CL Item
None (None)
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
Brace (Brace)
CL Item
1 Cane Or Crutch (1 cane or crutch)
CL Item
2 Canes Or Crutches (2 canes or crutches)
Item
Walking
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0080331 (NCI Metathesaurus ObjectClass)
CL.4
Code List
Walking
CL Item
Unlimited (Unlimited)
CL Item
Limited (Limited)
CL110648 (NCI Metathesaurus)
CL Item
Inside Only (Inside only)
CL Item
Not Independently (Not independently)
Item
Gait
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0016928 (NCI Metathesaurus Property)
CL.5
Code List
Gait
CL Item
Normal (Normal)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
CL Item
Minor Cosmetic (Minor cosmetic)
CL Item
Major Cosmetic, Minor Handicap (Major cosmetic, minor handicap)
CL Item
Major Handicap (Major handicap)
Item
Pain
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C3303 (NCI Thesaurus Property)
C0030193 (UMLS 2011AA Property)
C25309 (NCI Thesaurus ObjectClass)
C0441994 (UMLS 2011AA ObjectClass)
C0015385 (NCI Metathesaurus ObjectClass)
CL.6
Code List
Pain
CL Item
None (None)
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
Modest (Modest)
CL Item
Moderate (Moderate)
CL Item
Severe (Severe)
Item
Emotional Acceptance
text
C25309 (NCI Thesaurus ObjectClass)
C0441994 (UMLS 2011AA ObjectClass)
C0015385 (NCI Metathesaurus ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C25495 (NCI Thesaurus ValueDomain-2)
CL.7
Code List
Emotional Acceptance
CL Item
Enthused (Enthused)
CL Item
Likes (Likes)
CL Item
Satisfied (Satisfied)
CL Item
Intermediate (Intermediate)
C0205103 (NCI Metathesaurus)
CL Item
Accepts (Accepts)
CL Item
Dislikes (Dislikes)
Item
Function (Upper Limb Assessment)
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C25518 (NCI Thesaurus Property)
C0542341 (UMLS 2011AA Property)
C25355 (NCI Thesaurus ObjectClass)
C1282910 (UMLS 2011AA ObjectClass)
C0015385 (NCI Metathesaurus ObjectClass)
CL.8
Code List
Function (Upper Limb Assessment)
CL Item
No Restriction (No restriction)
CL Item
Recreational Restriction (Recreational restriction)
CL Item
Partial Disability (Partial disability)
CL Item
Total Disability (Total disability)
Item
Hand Position
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C32712 (NCI Thesaurus Property)
C0018563 (UMLS 2011AA Property)
C25339 (NCI Thesaurus Property-2)
C0733755 (UMLS 2011AA Property-2)
CL.9
Code List
Hand Position
CL Item
No Limitations (No limitations)
CL Item
Not Above Shoulder Or No Pro/supination (Not above shoulder or no pro/supination)
CL Item
Not Above Waist (Not above waist)
CL Item
Flail (Flail)
Item
Dexterity
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25214 (NCI Thesaurus ObjectClass-2)
C0220825 (UMLS 2011AA ObjectClass-2)
C25518 (NCI Thesaurus Property)
C0542341 (UMLS 2011AA Property)
C0237569 (NCI Metathesaurus Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.10
Code List
Dexterity
CL Item
Normal (Normal)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
CL Item
Loss Of Fine Movement (Loss of fine movement)
CL Item
Cannot Pinch (Cannot pinch)
CL Item
Cannot Grasp (Cannot grasp)
Item
Lifting
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C25518 (NCI Thesaurus Property)
C0542341 (UMLS 2011AA Property)
C25355 (NCI Thesaurus ObjectClass)
C1282910 (UMLS 2011AA ObjectClass)
C0015385 (NCI Metathesaurus ObjectClass)
CL.11
Code List
Lifting
CL Item
Normal (Normal)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
CL Item
Limited (Limited)
CL110648 (NCI Metathesaurus)
CL Item
Helping Capacity Only (Helping capacity only)
CL Item
Cannot Be Used To Help (Cannot be used to help)
Item
Pain
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C3303 (NCI Thesaurus Property)
C0030193 (UMLS 2011AA Property)
C25355 (NCI Thesaurus ObjectClass)
C1282910 (UMLS 2011AA ObjectClass)
C0015385 (NCI Metathesaurus ObjectClass)
CL.12
Code List
Pain
CL Item
None (None)
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
Modest (Modest)
CL Item
Moderate (Moderate)
CL Item
Severe (Severe)
Item
Emotional Acceptance
text
C25355 (NCI Thesaurus ObjectClass)
C1282910 (UMLS 2011AA ObjectClass)
C0015385 (NCI Metathesaurus ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C25495 (NCI Thesaurus ValueDomain-2)
CL.13
Code List
Emotional Acceptance
CL Item
Enthused (Enthused)
CL Item
Likes (Likes)
CL Item
Satisfied (Satisfied)
CL Item
Intermediate (Intermediate)
C0205103 (NCI Metathesaurus)
CL Item
Accepts (Accepts)
CL Item
Dislikes (Dislikes)
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