ID
10097
Description
E5103 Hematology/Chemistry Form Doxorubicin, Cyclophosphamide, and Paclitaxel With or Without Bevacizumab in Treating Patients With Lymph Node-Positive or High-Risk, Lymph Node-Negative Breast Cancer NCT00433511 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=3AE26832-8814-18AE-E044-0003BA3F9857
Link
Keywords
Versions (5)
- 8/26/12 8/26/12 -
- 1/8/15 1/8/15 - Martin Dugas
- 1/9/15 1/9/15 - Martin Dugas
- 1/9/15 1/9/15 - Martin Dugas
- 3/27/15 3/27/15 - Martin Dugas
Uploaded on
March 27, 2015
DOI
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License
Creative Commons BY-NC 3.0 Legacy
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Breast Cancer Hematology/Chemistry NCT00433511
INSTRUCTIONS: Complete this form and submit original to the ECOG Coordinating Center within one week of registration. Keep a copy for your files
- StudyEvent: E5103 Hematology/Chemistry Form
Description
Pre-registration Hematology/chemistry
Description
Cycle number
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS CUI-1
- C2045829
- NCI Thesaurus Property
- C25214
- NCI Thesaurus Property-2
- C25616
- NCI Thesaurus ObjectClass
- C15368
Description
HematologyLabCollectedDate
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- NCI Thesaurus Property
- C20200
- NCI Thesaurus ObjectClass
- C25294
- NCI Thesaurus ValueDomain-2
- C25452
- UMLS CUI-1
- C1317250
Description
HematologyAssessedInd-3
Data type
boolean
Alias
- NCI Thesaurus ValueDomain
- C38148
- NCI Thesaurus Property
- C25217
- NCI Thesaurus ObjectClass
- C16673
- UMLS CUI-1
- C0474523
Description
Granulocyte count
Data type
float
Measurement units
- 1000/uL
Alias
- NCI Thesaurus Property
- C20200
- UMLS CUI-1
- C0857490
- NCI Thesaurus Property-2
- C12530
- NCI Thesaurus ValueDomain
- C25463
- NCI Thesaurus ObjectClass
- C25294
Description
Platelets
Data type
float
Measurement units
- 1000/uL
Alias
- NCI Thesaurus Property
- C20200
- UMLS CUI-1
- C0005821
- NCI Thesaurus Property-2
- C12520
- NCI Thesaurus ObjectClass
- C25294
- NCI Thesaurus ValueDomain
- C25712
Description
Hemoglobin
Data type
float
Alias
- NCI Thesaurus Property
- C16676
- UMLS CUI-1
- C0019046
- NCI Thesaurus Property-2
- C20200
- NCI Thesaurus ObjectClass
- C25294
- NCI Thesaurus ValueDomain
- C25712
Description
Creatinine, Serum
Data type
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS CUI-1
- C0201976
- NCI Thesaurus Property
- C20200
- NCI Thesaurus Property-2
- C399
- NCI Thesaurus ValueDomain
- C38046
- NCI Thesaurus ValueDomain-2
- C25712
Description
Creatinine, serum ULN
Data type
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS CUI-1
- C0201976
- NCI Thesaurus Property
- C20200
- UMLS CUI-2
- C1519815
- NCI Thesaurus Property-2
- C399
- NCI Thesaurus ValueDomain
- C25712
- NCI Thesaurus ValueDomain-2
- C25706
Description
LaboratoryProcedureSodiumElectrolytesOutcomeUnspecifiedValue
Data type
float
Measurement units
- mmol/L
Alias
- NCI Thesaurus ObjectClass
- C25294
- NCI Thesaurus Property
- C20200
- NCI Thesaurus Property-2
- C830
- NCI Thesaurus Property-3
- C464
- NCI Thesaurus ValueDomain
- C38046
- NCI Thesaurus ValueDomain-2
- C25712
- UMLS CUI-1
- C0337443
Description
Laboratory Procedure Not Performed
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C0022885
- NCI Thesaurus Property
- C25594
- UMLS CUI-2
- C0445106
- NCI Thesaurus Property-2
- C38000
- NCI Thesaurus ObjectClass
- C25294
Description
Units
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C20989
- NCI Thesaurus Property
- C37984
- NCI Thesaurus ValueDomain
- C25709
- UMLS CUI-1
- C1519795
Description
CTC AE Attribution Code (Leave attribution box blank if no adverse event.)
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25664
- NCI Thesaurus ObjectClass
- C49704
- NCI Thesaurus Property
- C25358
- UMLS CUI-1
- C1706735
Description
DoseChemotherapyAdverseEventModificationStatus
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C25488
- NCI Thesaurus Property
- C15632
- NCI Thesaurus Property-2
- C41331
- NCI Thesaurus Property-3
- C25572
- NCI Thesaurus ValueDomain
- C25688
- UMLS CUI-1
- C0178602
- UMLS CUI-2
- C0392920
- UMLS CUI-3
- C0877248
- UMLS CUI-4
- C0449438
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INSTRUCTIONS: Complete this form and submit original to the ECOG Coordinating Center within one week of registration. Keep a copy for your files
- StudyEvent: E5103 Hematology/Chemistry Form
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