ID

10234

Descrição

AMC-076 Screen Failure Form (SFF) Infrared Coagulator Ablation or Observation in Preventing Anal Cancer in HIV-Positive Patients With Anal Neoplasia NCT01164722 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A80D02C4-02DA-DA36-E040-BB89AD436D9D

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A80D02C4-02DA-DA36-E040-BB89AD436D9D

Palavras-chave

  1. 26/08/2012 26/08/2012 -
  2. 20/05/2015 20/05/2015 - Martin Dugas
  3. 20/05/2015 20/05/2015 - Martin Dugas
Transferido a

20 de maio de 2015

DOI

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Licença

Creative Commons BY-NC 3.0 Legacy

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    Anal Cancer Screen Failure AMC-076 NCT01164722

    No Instruction available.

    1. StudyEvent: AMC-076 Screen Failure Form (SFF)
      1. No Instruction available.
    Trial Screen Failure
    Descrição

    Trial Screen Failure

    Alias
    UMLS CUI-1
    C1710476
    Anal cytology performed
    Descrição

    AnalCytologyPerformedIndicator

    Tipo de dados

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C25180
    UMLS 2011AA ValueDomain
    C1522602
    NCI Thesaurus ObjectClass
    C16491
    UMLS 2011AA ObjectClass
    C0010819
    NCI Thesaurus Property
    C38000
    UMLS 2011AA Property
    C0884358
    NCI Thesaurus ObjectClass-2
    C28048
    Most Severe Anal Cytology Result (If "Yes",)
    Descrição

    AnalCytologySpecimenResultType

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25284
    UMLS 2011AA ValueDomain
    C0332307
    NCI Thesaurus ObjectClass
    C16491
    UMLS 2011AA ObjectClass
    C0010819
    NCI Thesaurus Property
    C20200
    UMLS 2011AA Property
    C1274040
    NCI Thesaurus ObjectClass-2
    C19157
    UMLS 2011AA ObjectClass-2
    C0370003
    NCI Thesaurus ObjectClass-3
    C28048
    High-resolution anoscopy performed
    Descrição

    AnalEndoscopyDiagnosticProcedurePhysicalExaminationInd-2

    Tipo de dados

    boolean

    Alias
    NCI Thesaurus ObjectClass
    C16546
    UMLS 2011AA ObjectClass
    C0014245
    NCI Thesaurus ObjectClass-2
    C28048
    NCI Thesaurus ObjectClass-3
    C18020
    UMLS 2011AA ObjectClass-2
    C0430022
    NCI Thesaurus Property
    C20989
    UMLS 2011AA Property
    C0031809
    NCI Thesaurus ValueDomain
    C38147
    UMLS 2011AA ValueDomain
    C1512698
    Anal biopsy performed (If "Yes",)
    Descrição

    AnalBiopsyPerformedIndicator

    Tipo de dados

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C25180
    UMLS 2011AA ValueDomain
    C1522602
    NCI Thesaurus ObjectClass
    C15189
    UMLS 2011AA ObjectClass
    C0005558
    NCI Thesaurus Property
    C38000
    UMLS 2011AA Property
    C0884358
    NCI Thesaurus ObjectClass-2
    C28048
    Most severe anal biopsy result (If "Yes",)
    Descrição

    AnalBiopsyResultType

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25284
    UMLS 2011AA ValueDomain
    C0332307
    NCI Thesaurus ObjectClass
    C15189
    UMLS 2011AA ObjectClass
    C0005558
    NCI Thesaurus Property
    C20200
    UMLS 2011AA Property
    C1274040
    NCI Thesaurus ObjectClass-2
    C28048
    Comments
    Descrição

    ResearchCommentsText

    Tipo de dados

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704
    UMLS 2011AA ValueDomain
    C1527021
    NCI Thesaurus ObjectClass
    C15319
    NCI Thesaurus Property
    C25393
    UMLS 2011AA Property
    C0282411
    Primary reason for screen failure
    Descrição

    ScreeningRegistrationClinicalTrialIneligibilityReason

    Tipo de dados

    text

    Alias
    NCI Thesaurus ObjectClass
    C48261
    UMLS 2011AA ObjectClass
    C1710032
    NCI Thesaurus ObjectClass-2
    C25646
    UMLS 2011AA ObjectClass-2
    C1514821
    NCI Thesaurus Property
    C15207
    NCI Thesaurus Property-2
    C40412
    UMLS 2011AA Property
    C1512714
    NCI Thesaurus ValueDomain
    C25638
    UMLS 2011AA ValueDomain
    C0392360
    Other, specify
    Descrição

    ScreeningRegistrationClinicalTrialIneligibilitySpecify

    Tipo de dados

    text

    Alias
    NCI Thesaurus ObjectClass
    C48261
    UMLS 2011AA ObjectClass
    C1710032
    NCI Thesaurus ObjectClass-2
    C25646
    UMLS 2011AA ObjectClass-2
    C1514821
    NCI Thesaurus Property
    C15207
    NCI Thesaurus Property-2
    C40412
    UMLS 2011AA Property
    C1512714
    NCI Thesaurus ValueDomain
    C25685
    UMLS 2011AA ValueDomain
    C1521902

    Similar models

    No Instruction available.

    1. StudyEvent: AMC-076 Screen Failure Form (SFF)
      1. No Instruction available.
    Name
    Tipo
    Description | Question | Decode (Coded Value)
    Tipo de dados
    Alias
    Item Group
    Trial Screen Failure
    C1710476 (UMLS CUI-1)
    AnalCytologyPerformedIndicator
    Item
    Anal cytology performed
    boolean
    C25180 (NCI Thesaurus ValueDomain)
    C1522602 (UMLS 2011AA ValueDomain)
    C16491 (NCI Thesaurus ObjectClass)
    C0010819 (UMLS 2011AA ObjectClass)
    C38000 (NCI Thesaurus Property)
    C0884358 (UMLS 2011AA Property)
    C28048 (NCI Thesaurus ObjectClass-2)
    Item
    Most Severe Anal Cytology Result (If "Yes",)
    text
    C25284 (NCI Thesaurus ValueDomain)
    C0332307 (UMLS 2011AA ValueDomain)
    C16491 (NCI Thesaurus ObjectClass)
    C0010819 (UMLS 2011AA ObjectClass)
    C20200 (NCI Thesaurus Property)
    C1274040 (UMLS 2011AA Property)
    C19157 (NCI Thesaurus ObjectClass-2)
    C0370003 (UMLS 2011AA ObjectClass-2)
    C28048 (NCI Thesaurus ObjectClass-3)
    Code List
    Most Severe Anal Cytology Result (If "Yes",)
    CL Item
    Asc-h (ASC-H)
    CL Item
    Ascus (ASCUS)
    CL Item
    High Grade Sil (High grade SIL)
    CL Item
    Low Grade Sil (Low grade SIL)
    CL Item
    Normal (Normal)
    C14165 (NCI Thesaurus)
    C0205307 (UMLS 2011AA)
    CL Item
    Unevaluable (Unevaluable)
    C62222 (NCI Thesaurus)
    C1883425 (UMLS 2011AA)
    AnalEndoscopyDiagnosticProcedurePhysicalExaminationInd-2
    Item
    High-resolution anoscopy performed
    boolean
    C16546 (NCI Thesaurus ObjectClass)
    C0014245 (UMLS 2011AA ObjectClass)
    C28048 (NCI Thesaurus ObjectClass-2)
    C18020 (NCI Thesaurus ObjectClass-3)
    C0430022 (UMLS 2011AA ObjectClass-2)
    C20989 (NCI Thesaurus Property)
    C0031809 (UMLS 2011AA Property)
    C38147 (NCI Thesaurus ValueDomain)
    C1512698 (UMLS 2011AA ValueDomain)
    AnalBiopsyPerformedIndicator
    Item
    Anal biopsy performed (If "Yes",)
    boolean
    C25180 (NCI Thesaurus ValueDomain)
    C1522602 (UMLS 2011AA ValueDomain)
    C15189 (NCI Thesaurus ObjectClass)
    C0005558 (UMLS 2011AA ObjectClass)
    C38000 (NCI Thesaurus Property)
    C0884358 (UMLS 2011AA Property)
    C28048 (NCI Thesaurus ObjectClass-2)
    Item
    Most severe anal biopsy result (If "Yes",)
    text
    C25284 (NCI Thesaurus ValueDomain)
    C0332307 (UMLS 2011AA ValueDomain)
    C15189 (NCI Thesaurus ObjectClass)
    C0005558 (UMLS 2011AA ObjectClass)
    C20200 (NCI Thesaurus Property)
    C1274040 (UMLS 2011AA Property)
    C28048 (NCI Thesaurus ObjectClass-2)
    Code List
    Most severe anal biopsy result (If "Yes",)
    CL Item
    Colonic Epithelium (Colonic epithelium)
    CL Item
    Condyloma (Condyloma)
    CL Item
    Flat Condyloma (Flat condyloma)
    CL Item
    High-grade Ain (High-grade AIN)
    CL Item
    Invasive Cancer (Invasive cancer)
    CL Item
    Low-grade Ain (Low-grade AIN)
    CL Item
    Normal Squamous Epithelium (Normal squamous epithelium)
    CL Item
    Squamous Metaplasia (Squamous metaplasia)
    C3237 (NCI Thesaurus)
    C0025570 (UMLS 2011AA)
    CL Item
    Unevaluable (Unevaluable)
    C62222 (NCI Thesaurus)
    C1883425 (UMLS 2011AA)
    ResearchCommentsText
    Item
    Comments
    text
    C25704 (NCI Thesaurus ValueDomain)
    C1527021 (UMLS 2011AA ValueDomain)
    C15319 (NCI Thesaurus ObjectClass)
    C25393 (NCI Thesaurus Property)
    C0282411 (UMLS 2011AA Property)
    ScreeningRegistrationClinicalTrialIneligibilityReason
    Item
    Primary reason for screen failure
    text
    C48261 (NCI Thesaurus ObjectClass)
    C1710032 (UMLS 2011AA ObjectClass)
    C25646 (NCI Thesaurus ObjectClass-2)
    C1514821 (UMLS 2011AA ObjectClass-2)
    C15207 (NCI Thesaurus Property)
    C40412 (NCI Thesaurus Property-2)
    C1512714 (UMLS 2011AA Property)
    C25638 (NCI Thesaurus ValueDomain)
    C0392360 (UMLS 2011AA ValueDomain)
    ScreeningRegistrationClinicalTrialIneligibilitySpecify
    Item
    Other, specify
    text
    C48261 (NCI Thesaurus ObjectClass)
    C1710032 (UMLS 2011AA ObjectClass)
    C25646 (NCI Thesaurus ObjectClass-2)
    C1514821 (UMLS 2011AA ObjectClass-2)
    C15207 (NCI Thesaurus Property)
    C40412 (NCI Thesaurus Property-2)
    C1512714 (UMLS 2011AA Property)
    C25685 (NCI Thesaurus ValueDomain)
    C1521902 (UMLS 2011AA ValueDomain)

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