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1 forms
  1. StudyEvent: NSABP PROTOCOL B-36 Cardiac Function Form
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Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Header
Patient Initials Name
Item
Patient Initials (Last, First Middle)
text
C25191 (NCI Thesaurus ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C2986440 (UMLS CUI-1)
NSABP Patient ID
Item
NSABP Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)
C15818 (NCI Thesaurus Property-2)
C2348585 (UMLS CUI-1)
C1513905 (UMLS CUI-2)
Institution Name
Item
Institution Name
text
C25191 (NCI Thesaurus ValueDomain)
C21541 (NCI Thesaurus ObjectClass)
C21541 (NCI Thesaurus ValueDomain-2)
C25364 (NCI Thesaurus Property)
C1301943 (UMLS CUI-1)
Affiliate Name
Item
Affiliate Name
text
C21541 (NCI Thesaurus ObjectClass)
C25413 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C25191 (NCI Thesaurus ValueDomain)
C21541 (NCI Thesaurus ValueDomain-2)
C1510825 (UMLS CUI-1)
Responsible person
Item
Person Completing Form (Phone)
text
C25191 (NCI Thesaurus ValueDomain)
C25657 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)
C0680379 (UMLS CUI-1)
Data amended
Item
Are data amended?
boolean
C38148 (NCI Thesaurus ValueDomain)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
C1691222 (UMLS CUI-1)
ResearchCommentsText
Item
Comments
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C0282411 (UMLS 2011AA Property)
Item Group
Cardiac function
C0232164 (UMLS CUI-1)
Item
Time Point
text
CL.2
Code List
Time Point
CL Item
Baseline (0)
C1442488 (UMLS CUI-1)
CL Item
At 12 Months (12m)
C0420338 (UMLS CUI-1)
LVEF date
Item
Date of LVEF ()
date
C25164 (NCI Thesaurus ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C16847 (NCI Thesaurus Property)
C0428772 (UMLS CUI-1)
C0011008 (UMLS CUI-2)
Item
Method of Assessment (Every effort should be made to schedule the follow-up MUGA or echocardiogram at the same facility that performed the baseline exam, and the same method of assessment should be used at both time points.)
text
C25284 (NCI Thesaurus ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C16847 (NCI Thesaurus Property)
C2911685 (UMLS CUI-1)
CL.3
Code List
Method of Assessment (Every effort should be made to schedule the follow-up MUGA or echocardiogram at the same facility that performed the baseline exam, and the same method of assessment should be used at both time points.)
CL Item
MUGA (1)
C0521317 (UMLS CUI-1)
CL Item
ECHO (2)
C0013516 (UMLS CUI-1)
LVEF
Item
LVEF
float
C0428772 (UMLS CUI-1)
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