ID
10186
Beschrijving
CALGB: 40101 TREATMENT SUMMARY SUBSET FORM Four Versus Six Cycles of Cyclophosphamide/Doxorubicin or Paclitaxel in Adjuvant Breast Cancer NCT00041119 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A46C8094-22BA-26B0-E034-080020C9C0E0
Link
Trefwoorden
Versies (2)
- 26-08-12 26-08-12 -
- 24-04-15 24-04-15 - Martin Dugas
Geüploaded op
24 april 2015
DOI
Voor een aanvraag inloggen.
Licentie
Creative Commons BY-NC 3.0 Legacy
Model Commentaren :
Hier kunt u commentaar leveren op het model. U kunt de tekstballonnen bij de itemgroepen en items gebruiken om er specifiek commentaar op te geven.
Itemgroep Commentaren voor :
Item Commentaren voor :
U moet ingelogd zijn om formulieren te downloaden. AUB inloggen of schrijf u gratis in.
Breast Cancer Treatment CALGB 40101 NCT00041119
INSTRUCTIONS: Complete and submit this form as required by the protocol. Information in the upper right box must be completed for this form to be accepted. For optimal accuracy use black ink. Mark an X in the appropriate box for fields with a choice. Print text in capital letters. Avoid contact with the edges of the boxes. Circle amended items and check "Amended data" box to the right. If submitting by mail, retain a copy for your records and send the original to the CALGB Statistical Center, Data Operations. If faxing, use an original form for maximum clarity in transmission and fax to 919-416-4990. If submitting electronically, click the Send button when you have completed the PDF version of the form.
Beschrijving
Breast cancer treatment
Alias
- UMLS CUI-1
- C1511300
Beschrijving
Current cycle number
Datatype
integer
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C2045829
Beschrijving
BSA
Datatype
text
Beschrijving
Totaldosageforthiscycle,Doxorubicin
Datatype
float
Maateenheden
- mg
Alias
- UMLS CUI-1
- C0013089
- UMLS CUI-2
- C0178602
Beschrijving
Totaldosageforthiscycle,Cyclophosphamide
Datatype
float
Maateenheden
- mg
Alias
- UMLS CUI-1
- C0010583
- UMLS CUI-2
- C0178602
Beschrijving
Totaldosageforthiscycle,Paclitaxel
Datatype
float
Maateenheden
- mg
Alias
- UMLS CUI-1
- C0144576
- UMLS CUI-2
- C0178602
Beschrijving
Dose adjustments (mark one with an X)
Datatype
text
Alias
- UMLS CUI-1
- C2826232
Beschrijving
Reasonforadjustment
Datatype
text
Alias
- UMLS CUI-1
- C2826286
Beschrijving
Specify(reasonforadjustment)
Datatype
text
Alias
- UMLS CUI-1
- C2826286
Similar models
INSTRUCTIONS: Complete and submit this form as required by the protocol. Information in the upper right box must be completed for this form to be accepted. For optimal accuracy use black ink. Mark an X in the appropriate box for fields with a choice. Print text in capital letters. Avoid contact with the edges of the boxes. Circle amended items and check "Amended data" box to the right. If submitting by mail, retain a copy for your records and send the original to the CALGB Statistical Center, Data Operations. If faxing, use an original form for maximum clarity in transmission and fax to 919-416-4990. If submitting electronically, click the Send button when you have completed the PDF version of the form.
C1257890 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C2045829 (UMLS CUI-1)
C0178602 (UMLS CUI-2)
C0178602 (UMLS CUI-2)
C0178602 (UMLS CUI-2)
C0205421 (UMLS CUI-2)
C1556365 (UMLS CUI-2)
C1560130 (UMLS CUI-2)
C1559311 (UMLS CUI-2)
C1560949 (UMLS CUI-2)
C1560950 (UMLS CUI-3)