ID
4707
Beschrijving
CALGB: Secondary Malignancy Form Trastuzumab With or Without Tamoxifen in Treating Women With Progressive Stage IV Breast Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A73D10AA-19A6-4733-E034-0003BA0B1A09
Link
Trefwoorden
Versies (2)
- 26-08-12 26-08-12 -
- 20-03-14 20-03-14 - Martin Dugas
Geüploaded op
20 maart 2014
DOI
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Licentie
Creative Commons BY-NC 3.0 Legacy
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Breast Cancer NCT00053339 Follow-Up - CALGB: Secondary Malignancy Form - 2029264v3.0
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. Do not leave any entries blank. Enter -1 to indicate that an answer in unknown, unobtainable, not applicable, or not done. Retain a copy for your records and submit ORIGINAL to the CALGB Data Management Center.
- StudyEvent: CALGB: Secondary Malignancy Form
Beschrijving
Patient'sName
Datatype
text
Beschrijving
ParticipatingGroup
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C17005
- UMLS 2011AA ObjectClass
- C1257890
- NCI Thesaurus Property
- C25364
- UMLS 2011AA Property
- C0600091
Beschrijving
PatientHospitalNumber
Datatype
text
Beschrijving
ParticipatingGroupProtocolNo.
Datatype
text
Beschrijving
AffiliateName
Datatype
text
Beschrijving
ParticipatingGroupPatientID
Datatype
text
Beschrijving
Typeofsecondarymalignancy
Datatype
text
Beschrijving
Dateoffirstpathologicdiagnosisofsecondarymalignancy
Datatype
text
Beschrijving
NCI/CTEPSecondaryAML/MDSFormInd
Datatype
text
Beschrijving
NCI/CTEPSecondaryAML/MDSFormSentDate
Datatype
date
Beschrijving
NCI/CTEPSecondaryAML/MDSForm,NotSentReason
Datatype
text
Beschrijving
Comments
Datatype
text
Beschrijving
PersonCompletingForm,FirstName
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus Property
- C25364
- UMLS 2011AA Property
- C0600091
Beschrijving
FormCompletionDate,Original
Datatype
date
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. Do not leave any entries blank. Enter -1 to indicate that an answer in unknown, unobtainable, not applicable, or not done. Retain a copy for your records and submit ORIGINAL to the CALGB Data Management Center.
- StudyEvent: CALGB: Secondary Malignancy Form
C25416 (NCI Thesaurus Property)
C1511726 (UMLS CUI)
C1691222 (UMLS CUI)
C1705108 (UMLS 2011AA)
C1257890 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0027361 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)