ID
765
Description
CALGB: TRACKING FORM (TISSUE BLOCKS) Four Versus Six Cycles of Cyclophosphamide/Doxorubicin or Paclitaxel in Adjuvant Breast Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A4CFD446-0ADA-6A9F-E034-080020C9C0E0
Link
Keywords
Versions (3)
- 8/26/12 8/26/12 -
- 7/8/15 7/8/15 -
- 7/8/15 7/8/15 -
Uploaded on
August 26, 2012
DOI
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License
Creative Commons BY-NC 3.0 Legacy
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Breast Cancer NCT00041119 Pathology - CALGB: TRACKING FORM (TISSUE BLOCKS) - 2038962v3.0
No samples should be submitted without an accompanying form. If a specimen will not be submitted, specify the reason below and submit the form as stated above.
- StudyEvent: CALGB: TRACKING FORM (TISSUE BLOCKS)
Description
Unnamed2
Description
Patient'sName
Data type
text
Description
ParticipatingGroup
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C17005
- UMLS 2011AA ObjectClass
- C1257890
- NCI Thesaurus Property
- C25364
- UMLS 2011AA Property
- C0600091
Description
PatientHospitalNumber
Data type
text
Description
ParticipatingGroupProtocolNo.
Data type
text
Description
MainMemberInstitution/Adjunct
Data type
text
Description
ParticipatingGroupPatientNo.
Data type
text
Description
Unnamed3
Description
Dotissueblock/slidesaccompanythisform?
Data type
text
Description
specifyreason(specimenwillnotbesubmitted)
Data type
text
Description
Ispatientenrolledinacorrelativesciencestudy?
Data type
text
Description
correlativestudynumber(s)
Data type
text
Description
SurgicalProcedureDate
Data type
text
Description
Dateblocksandpathologyreportssubmitted
Data type
text
Description
Tissuepathology
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus ObjectClass
- C12801
- UMLS 2011AA ObjectClass
- C0040300
- NCI Thesaurus Property
- C25683
- UMLS 2011AA Property
- C0449416
- NCI Thesaurus ObjectClass
- C18189
- UMLS 2011AA ObjectClass
- C0030664
Description
Methodofextraction
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus Property
- C16847
- UMLS 2011AA Property
- C0449851
- NCI Thesaurus Property
- C15329
- UMLS 2011AA Property
- C0543467
- NCI Thesaurus ObjectClass
- C19157
- UMLS 2011AA ObjectClass
- C0370003
Description
Pathology/accessionnumber
Data type
text
Description
PersonSpecimenSubmittedName
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS 2011AA ValueDomain
- C1547383
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus Property
- C19157
- UMLS 2011AA Property
- C0370003
- NCI Thesaurus Property
- C25695
- UMLS 2011AA Property
- C1515023
Description
PhoneNo.
Data type
text
Description
Ccrr Module For Calgb: Tracking Form (tissue Blocks)
Similar models
No samples should be submitted without an accompanying form. If a specimen will not be submitted, specify the reason below and submit the form as stated above.
- StudyEvent: CALGB: TRACKING FORM (TISSUE BLOCKS)
C1705108 (UMLS 2011AA)
C1257890 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0332307 (UMLS 2011AA ValueDomain)
C12801 (NCI Thesaurus ObjectClass)
C0040300 (UMLS 2011AA ObjectClass)
C25683 (NCI Thesaurus Property)
C0449416 (UMLS 2011AA Property)
C18189 (NCI Thesaurus ObjectClass)
C0030664 (UMLS 2011AA ObjectClass)
C0027627 (UMLS 2011AA)
C0332307 (UMLS 2011AA ValueDomain)
C16847 (NCI Thesaurus Property)
C0449851 (UMLS 2011AA Property)
C15329 (NCI Thesaurus Property)
C0543467 (UMLS 2011AA Property)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C0005558 (UMLS 2011AA)
C0024881 (UMLS 2011AA)
C0184913 (UMLS 2011AA)
C0024885 (UMLS 2011AA)
C1547383 (UMLS 2011AA ValueDomain)
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C19157 (NCI Thesaurus Property)
C0370003 (UMLS 2011AA Property)
C25695 (NCI Thesaurus Property)
C1515023 (UMLS 2011AA Property)