ID
370
Description
S0100 FOLLOW UP FORM Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=AEB52E43-75AF-43F2-E034-0003BA12F5E7
Link
Keywords
Versions (2)
- 5/25/12 5/25/12 -
- 1/22/15 1/22/15 - Martin Dugas
Uploaded on
May 25, 2012
DOI
To request one please log in.
License
Creative Commons BY-NC 3.0 Legacy
Model comments :
You can comment on the data model here. Via the speech bubbles at the itemgroups and items you can add comments to those specificially.
Itemgroup comments for :
Item comments for :
In order to download data models you must be logged in. Please log in or register for free.
Leukemia Follow-Up - S0100 FOLLOW UP FORM - 2071711v3.0
No Instruction available.
- StudyEvent: S0100 FOLLOW UP FORM
Description
Disease Follow Up Status
Description
CancerFollow-upStatusInd
Data type
text
Description
CancerFollow-upStatusDate
Data type
date
Alias
- NCI Thesaurus ObjectClass
- C2991
- UMLS 2011AA ObjectClass
- C0012634
- NCI Thesaurus Property
- C25365
- UMLS 2011AA Property
- C0678257
Description
Notice Of First Relapse Or Progression
Description
Hasthepatientdevelopedafirstrelapseorprogressionthathasnotbeenpreviouslyreported?
Data type
text
Description
DateofRelapseorProgression
Data type
text
Description
Site(s)ofRelapseorProgression
Data type
text
Description
Notice Of New Primary
Description
Non-protocol Treatment
Description
Long Term Toxicity
Description
LateAdverseEventInd
Data type
text
Description
CTCAdverseEventTerm
Data type
text
Description
Comments
Data type
text
Description
Ccrr Module For S0100 Follow Up Form
Description
SWOGPatientID
Data type
text
Description
SWOGStudyNo.
Data type
text
Description
RegistrationStep
Data type
text
Description
PatientInitials
Data type
text
Description
MainMemberInstitution/Affiliate
Data type
text
Description
TreatingPhysician
Data type
text
Alias
- NCI Thesaurus Property
- C25364
- UMLS 2011AA Property
- C0600091
- NCI Thesaurus ObjectClass
- C25741
- UMLS 2011AA ObjectClass
- C0031831
- NCI Thesaurus ObjectClass
- C25705
- UMLS 2011AA ObjectClass
- C1522326
Description
GroupName
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS 2011AA ValueDomain
- C1547383
- NCI Thesaurus ObjectClass
- C17005
- UMLS 2011AA ObjectClass
- C1257890
- NCI Thesaurus Property
- C25364
- UMLS 2011AA Property
- C0600091
Description
StudyNo.
Data type
text
Description
Pt.ID
Data type
text
Similar models
No Instruction available.
- StudyEvent: S0100 FOLLOW UP FORM
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0012634 (UMLS 2011AA ObjectClass)
C25365 (NCI Thesaurus Property)
C0678257 (UMLS 2011AA Property)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0600091 (UMLS 2011AA Property)
C25741 (NCI Thesaurus ObjectClass)
C0031831 (UMLS 2011AA ObjectClass)
C25705 (NCI Thesaurus ObjectClass)
C1522326 (UMLS 2011AA ObjectClass)
C1547383 (UMLS 2011AA ValueDomain)
C17005 (NCI Thesaurus ObjectClass)
C1257890 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)