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

Lien

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

Mots-clés

  1. 26/08/2012 26/08/2012 -
  2. 18/03/2015 18/03/2015 - Martin Dugas
Téléchargé le

18 mars 2015

DOI

Pour une demande vous connecter.

Licence

Creative Commons BY-NC 3.0 Legacy

Modèle Commentaires :

Ici, vous pouvez faire des commentaires sur le modèle. À partir des bulles de texte, vous pouvez laisser des commentaires spécifiques sur les groupes Item et les Item.

Groupe Item commentaires pour :

Item commentaires pour :

Vous devez être connecté pour pouvoir télécharger des formulaires. Veuillez vous connecter ou s’inscrire gratuitement.

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

Type de données

text

CALGB Study No
Description

CALGBStudyNo

Type de données

text

CALGB Patient ID
Description

CALGBPatientID

Type de données

text

Date Completed (M)
Description

DateCompleted

Type de données

date

Amended data?
Description

Amended data?

Type de données

boolean

Patient's Name
Description

Patient'sName

Type de données

text

Participating Group
Description

ParticipatingGroup

Type de données

text

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

PatientHospitalNumber

Type de données

text

Participating Group Protocol No.
Description

ParticipatingGroupProtocolNo.

Type de données

text

Main Member Institution/Adjunct
Description

MainMemberInstitution/Adjunct

Type de données

text

Participating Group Patient No.
Description

ParticipatingGroupPatientNo.

Type de données

text

Completed By (Print or Type Name)
Description

CompletedBy

Type de données

text

Assessment Number (1.)
Description

Assessment Number (1.)

Type de données

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)

Type de données

integer

Score (Weight)
Description

PerQuestionScore

Type de données

float

Final Score
Description

WeightedScore

Type de données

float

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

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

Type de données

integer

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

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

Type de données

time

TOTAL SCORE
Description

TOTALSCORE

Type de données

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)
Type de données
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

Utilisez ce formulaire pour les retours, les questions et les améliorations suggérées.

Les champs marqués d’un * sont obligatoires.

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial