ID

10024

Description

Comparison of Combination Chemotherapy Regimens in Treating Older Women Who Have Undergone Surgery for Breast Cancer NCT00024102 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A50D6435-FF10-3254-E034-080020C9C0E0

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A50D6435-FF10-3254-E034-080020C9C0E0

Keywords

  1. 8/26/12 8/26/12 -
  2. 3/18/15 3/18/15 - Martin Dugas
Uploaded on

March 18, 2015

DOI

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License

Creative Commons BY-NC 3.0 Legacy

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Breast Cancer combination chemotherapies (NCT00024102)

Scoring: Score 1 for each incorrect response; maximum weight score=28.

  1. StudyEvent: CALGB: ORIENTATION-MEMORY-CONCENTRATION TEST FORM
    1. Scoring: Score 1 for each incorrect response; maximum weight score=28.
Header
Description

Header

CALGB Form
Description

CALGBForm

Data type

text

CALGB Study No
Description

CALGBStudyNo

Data type

text

CALGB Patient ID
Description

CALGBPatientID

Data type

text

Date Completed (M)
Description

DateCompleted

Data type

date

Amended data?
Description

Amended data?

Data type

boolean

Patient's Name
Description

Patient'sName

Data type

text

Participating Group
Description

ParticipatingGroup

Data type

text

Alias
NCI Thesaurus ObjectClass
C17005
UMLS 2011AA ObjectClass
C1257890
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Patient Hospital Number
Description

PatientHospitalNumber

Data type

text

Participating Group Protocol No.
Description

ParticipatingGroupProtocolNo.

Data type

text

Main Member Institution/Adjunct
Description

MainMemberInstitution/Adjunct

Data type

text

Participating Group Patient No.
Description

ParticipatingGroupPatientNo.

Data type

text

Completed By (Print or Type Name)
Description

CompletedBy

Data type

text

Assessment Number (1.)
Description

Assessment Number (1.)

Data type

integer

Orientation-memory-concentration Test
Description

Orientation-memory-concentration Test

What year is it now? (Patient's Response)
Description

What year is it now? (Patient's Response)

Data type

integer

Score (Weight)
Description

PerQuestionScore

Data type

float

Final Score
Description

WeightedScore

Data type

float

What month is it now? (Patient's Response)
Description

What month is it now? (Patient's Response)

Data type

integer

About what time is it? ([within 1 hour])
Description

About what time is it? ([within 1 hour])

Data type

time

TOTAL SCORE
Description

TOTALSCORE

Data type

float

Similar models

Scoring: Score 1 for each incorrect response; maximum weight score=28.

  1. StudyEvent: CALGB: ORIENTATION-MEMORY-CONCENTRATION TEST FORM
    1. Scoring: Score 1 for each incorrect response; maximum weight score=28.
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
CALGBForm
Item
CALGB Form
text
CALGBStudyNo
Item
CALGB Study No
text
CALGBPatientID
Item
CALGB Patient ID
text
DateCompleted
Item
Date Completed (M)
date
Amended data
Item
Amended data?
boolean
Patient'sName
Item
Patient's Name
text
ParticipatingGroup
Item
Participating Group
text
C17005 (NCI Thesaurus ObjectClass)
C1257890 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
PatientHospitalNumber
Item
Patient Hospital Number
text
ParticipatingGroupProtocolNo.
Item
Participating Group Protocol No.
text
MainMemberInstitution/Adjunct
Item
Main Member Institution/Adjunct
text
ParticipatingGroupPatientNo.
Item
Participating Group Patient No.
text
CompletedBy
Item
Completed By (Print or Type Name)
text
AssessmentNumber
Item
Assessment Number (1.)
integer
Current year
Item
What year is it now? (Patient's Response)
integer
PerQuestionScore
Item
Score (Weight)
float
WeightedScore
Item
Final Score
float
Current month
Item
What month is it now? (Patient's Response)
integer
Current time
Item
About what time is it? ([within 1 hour])
time
TOTALSCORE
Item
TOTAL SCORE
float

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