ID
6675
Beschrijving
IBCSG Long Term Follow-Up Form (18-LTF) Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=889C3F60-2C47-8540-E040-BB89AD4303DD
Link
Trefwoorden
Versies (2)
- 26-08-12 26-08-12 -
- 08-01-15 08-01-15 - Martin Dugas
Geüploaded op
8 januari 2015
DOI
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Licentie
Creative Commons BY-NC 3.0 Legacy
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Breast Cancer Follow-Up - IBCSG Long Term Follow-Up Form (18-LTF) - 3108506v1.0
Instructions: This form is to be completed every year. Questions on this form refer to events during the time period covered in questions 1 and 2. Use minus one (-1) to indicate that an answer is unknown, unobtainable or not done
Beschrijving
Long Term Follow-up
Beschrijving
Reporting Period Start Date
Datatype
date
Alias
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus Property
- C25616
- UMLS CUI-1
- C2361257
- NCI Thesaurus Property-2
- C25651
- NCI Thesaurus ValueDomain
- C25164
- NCI Thesaurus ValueDomain-2
- C25431
Beschrijving
Reporting Period End Date
Datatype
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C2361259
- NCI Thesaurus Property
- C25616
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus Property-2
- C25651
Beschrijving
PersonSurvivalInformationSource
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus ValueDomain
- C25683
- UMLS 2011AA ValueDomain
- C0449416
- NCI Thesaurus Property
- C48191
- UMLS 2011AA Property
- C1533716
- NCI Thesaurus Property-2
- C17177
- UMLS 2011AA Property-2
- C0038952
Beschrijving
PersonSurvivalInformationSpecify
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus Property
- C48191
- UMLS 2011AA Property
- C1533716
- NCI Thesaurus Property-2
- C17177
- UMLS 2011AA Property-2
- C0038952
Beschrijving
Off-TreatmentStudyFollow-UpSpecify
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
- NCI Thesaurus Property
- C16033
- UMLS 2011AA Property
- C1522577
- NCI Thesaurus ObjectClass
- C25601
- UMLS 2011AA ObjectClass
- C1518544
- NCI Thesaurus ObjectClass-2
- C15206
- UMLS 2011AA ObjectClass-2
- C0008972
Beschrijving
ECOG Performance Status
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- UMLS CUI-1
- C1520224
- NCI Thesaurus Property
- C25367
- NCI Thesaurus ValueDomain-2
- C25491
- NCI Thesaurus ObjectClass
- C20641
Beschrijving
Patient Weight
Datatype
float
Maateenheden
- Kg
Alias
- NCI Thesaurus ValueDomain
- C25209
- UMLS CUI-1
- C0005910
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25208
Beschrijving
PatientInformationCurrentFollow-upCollectedStatus
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus ObjectClass-2
- C48191
- UMLS 2011AA ObjectClass-2
- C1533716
- NCI Thesaurus Property
- C25471
- UMLS 2011AA Property
- C0521116
- NCI Thesaurus Property-2
- C16033
- UMLS 2011AA Property-2
- C1522577
- NCI Thesaurus Property-3
- C25452
- NCI Thesaurus ValueDomain
- C25688
- UMLS 2011AA ValueDomain
- C0449438
Beschrijving
Footer Module
Beschrijving
InvestigatorDesignatedSignatureText
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus Property
- C25678
- UMLS 2011AA Property
- C1519316
- NCI Thesaurus ObjectClass
- C17089
- UMLS 2011AA ObjectClass
- C0035173
- NCI Thesaurus Property-2
- C25479
- UMLS 2011AA Property-2
- C1524084
Beschrijving
Investigator Signature Date
Datatype
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C2346576
- NCI Thesaurus Property
- C25678
- UMLS CUI-2
- C0011008
- NCI Thesaurus ValueDomain-2
- C25367
- NCI Thesaurus ObjectClass
- C17089
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Instructions: This form is to be completed every year. Questions on this form refer to events during the time period covered in questions 1 and 2. Use minus one (-1) to indicate that an answer is unknown, unobtainable or not done
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