ID
694
Description
ECOG Long-Term Follow-up Form (E2100) Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=AC32795E-CBE0-2328-E034-0003BA12F5E7
Link
Keywords
Versions (2)
- 8/26/12 8/26/12 -
- 1/22/15 1/22/15 - Martin Dugas
Uploaded on
August 26, 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.
Breast Cancer Follow-Up - ECOG Long-Term Follow-up Form (E2100) - 2069056v3.0
Form No. 1555
- StudyEvent: ECOG Long-Term Follow-up Form (E2100)
Description
Unnamed2
Description
Unnamed3
Description
Vital Status
Description
Patient'sVitalStatus
Data type
text
Description
DeathDate/LastContactDate
Data type
date
Description
DeathReason
Data type
text
Description
DeathReason,Specify
Data type
text
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 Progression
Description
HASTHEPATIENTDEVELOPEDAFIRSTPROGRESSIONTHATHASNOTBEENPREVIOUSLYREPORTED?
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
Description
ProgressionDate
Data type
date
Description
ProgressionSite
Data type
text
Description
PhysicianProgressiveDiagnosisInd-3
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
- NCI Thesaurus ObjectClass
- C25741
- UMLS 2011AA ObjectClass
- C0031831
- NCI Thesaurus Property
- C25254
- UMLS 2011AA Property
- C0205329
- NCI Thesaurus Property
- C15220
- UMLS 2011AA Property
- C0011900
Description
Notice Of New Primary
Description
Toxicity
Description
Hasthepatientexperienced(priortodiagnosisofrecurrenceorsecondprimary)anysevere(Grade>=3)longtermtoxicitythathasnotbeenpreviouslyreported?
Data type
text
Description
Non-protocol Therapy
Description
Hasthepatientreceivedanynon-protocolcancertherapypriortofirstprogression(notpreviouslyreported)?
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
Description
Comments
Description
Ccrr Module For Ecog Long-term Follow-up Form (e2100)
Similar models
Form No. 1555
- StudyEvent: ECOG Long-Term Follow-up Form (E2100)
C0237753 (UMLS 2011AA ValueDomain)
C16154 (NCI Thesaurus ValueDomain)
C1704379 (UMLS 2011AA ValueDomain)
C1511726 (UMLS 2011AA ObjectClass)
C25416 (NCI Thesaurus Property)
C1691222 (UMLS 2011AA Property)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C0012634 (UMLS 2011AA ObjectClass)
C25365 (NCI Thesaurus Property)
C0678257 (UMLS 2011AA Property)
C1527021 (UMLS 2011AA ValueDomain)
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C1512699 (UMLS 2011AA ValueDomain)
C25741 (NCI Thesaurus ObjectClass)
C0031831 (UMLS 2011AA ObjectClass)
C25254 (NCI Thesaurus Property)
C0205329 (UMLS 2011AA Property)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C1512699 (UMLS 2011AA ValueDomain)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C1519316 (UMLS 2011AA Property)
C17089 (NCI Thesaurus ObjectClass)
C0035173 (UMLS 2011AA ObjectClass)