ID
10453
Description
TX5 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=FF1AAC43-4B80-4030-E034-0003BA3F9857
Link
Keywords
Versions (4)
- 9/19/12 9/19/12 -
- 8/7/14 8/7/14 - Martin Dugas
- 6/2/15 6/2/15 -
- 9/20/21 9/20/21 -
Uploaded on
June 2, 2015
DOI
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License
Creative Commons BY-NC 3.0 Legacy
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TX5
No Instruction available.
- StudyEvent: TX5
Description
Record The Highest Grade Of Toxicity Diagnosed Since The Previous Evaluation. If This Is The First Evaluation, Record The Highest Toxicity Diagnosed Since Day 0. The Toxicity Grades Are Based On The Nci Ctcae Version 3.0.
Description
Allergy/immunologic Toxicity
Description
CTCAdverseEventHypersensitivityDescriptionGrade
Data type
double
Alias
- NCI Thesaurus Property
- C3114
- UMLS 2011AA Property
- C0020517
- NCI Thesaurus ObjectClass
- C49704
- UMLS 2011AA ObjectClass
- C1516728
- NCI Thesaurus ValueDomain
- C18000
- UMLS 2011AA ValueDomain
- C0919553
- NCI Thesaurus Property
- C25365
- UMLS 2011AA Property
- C0678257
Description
CTCAdverseEventAutoimmuneReactionGrade
Data type
double
Alias
- NCI Thesaurus ObjectClass
- C49704
- UMLS 2011AA ObjectClass
- C1516728
- NCI Thesaurus ValueDomain
- C18000
- UMLS 2011AA ValueDomain
- C0919553
- NCI Metathesaurus Property
- CL141183
Description
Gi Toxicity
Description
CommonToxicityCriteriaAdverseEventGastrointestinalStomatitisGrade
Data type
double
Alias
- NCI Thesaurus Property
- C13359
- UMLS 2011AA Property
- C0521362
- NCI Thesaurus Property
- C26887
- UMLS 2011AA Property
- C0038362
- NCI Thesaurus ObjectClass
- C49704
- UMLS 2011AA ObjectClass
- C1516728
- NCI Thesaurus ValueDomain
- C18000
- UMLS 2011AA ValueDomain
- C0919553
Description
Renal Toxicity
Description
CommonToxicityCriteriaAdverseEventGenitourinaryHemorrhageGrade
Data type
double
Alias
- NCI Thesaurus Property
- C26791
- UMLS 2011AA Property
- C0019080
- NCI Thesaurus Property
- C25350
- UMLS 2011AA Property
- C2709259
- NCI Thesaurus ObjectClass
- C49704
- UMLS 2011AA ObjectClass
- C1516728
- NCI Thesaurus ValueDomain
- C18000
- UMLS 2011AA ValueDomain
- C0919553
Description
Didthepatientexperiencerenalfailuresevereenoughtowarrantdialysis
Data type
text
Description
Didthepatientreceivedialysis
Data type
text
Description
Hemorrhagic Toxicity
Description
CommonToxicityCriteriaAdverseEventGastrointestinalHemorrhageGrade
Data type
double
Alias
- NCI Thesaurus Property
- C13359
- UMLS 2011AA Property
- C0521362
- NCI Thesaurus Property
- C26791
- UMLS 2011AA Property
- C0019080
- NCI Thesaurus ObjectClass
- C49704
- UMLS 2011AA ObjectClass
- C1516728
- NCI Thesaurus ValueDomain
- C18000
- UMLS 2011AA ValueDomain
- C0919553
Description
Cardiovascular Toxicity
Description
CommonToxicityCriteriaAdverseEventHypotensionGrade
Data type
double
Alias
- NCI Thesaurus Property
- C3128
- UMLS 2011AA Property
- C0020649
- NCI Thesaurus ObjectClass
- C49704
- UMLS 2011AA ObjectClass
- C1516728
- NCI Thesaurus ValueDomain
- C18000
- UMLS 2011AA ValueDomain
- C0919553
Description
CommonToxicityCriteriaAdverseEventOtherArrhythmiaGrade
Data type
double
Alias
- NCI Thesaurus Property
- C17649
- UMLS 2011AA Property
- C0205394
- NCI Thesaurus Property
- C2881
- UMLS 2011AA Property
- C0003811
- NCI Thesaurus ObjectClass
- C49704
- UMLS 2011AA ObjectClass
- C1516728
- NCI Thesaurus ValueDomain
- C18000
- UMLS 2011AA ValueDomain
- C0919553
Description
CommonToxicityCriteriaAdverseEventLeftVentricularSystolicDysfunctionGrade
Data type
double
Alias
- NCI Thesaurus ObjectClass
- C49704
- UMLS 2011AA ObjectClass
- C1516728
- NCI Thesaurus ValueDomain
- C18000
- UMLS 2011AA ValueDomain
- C0919553
- NCI Metathesaurus Property
- CL286022
Description
Neurologic Toxicity
Description
CommonToxicityCriteriaAdverseEventSomnolenceGrade
Data type
double
Alias
- NCI Thesaurus ObjectClass
- C49704
- UMLS 2011AA ObjectClass
- C1516728
- NCI Thesaurus ValueDomain
- C18000
- UMLS 2011AA ValueDomain
- C0919553
- NCI Thesaurus Property
- C26754
- UMLS 2011AA Property
- C2830004
Description
CommonToxicityCriteriaAdverseEventSeizureGrade
Data type
double
Alias
- NCI Thesaurus Property
- C2962
- UMLS 2011AA Property
- C0036572
- NCI Thesaurus ObjectClass
- C49704
- UMLS 2011AA ObjectClass
- C1516728
- NCI Thesaurus ValueDomain
- C18000
- UMLS 2011AA ValueDomain
- C0919553
Description
Didthepatientexperienceanyseizuresduringthisassessmentperiod
Data type
text
Description
Coagulation Toxicity
Description
Vascular Toxicity
Description
Pulmonary Toxicity
Description
CommonToxicityCriteriaAdverseEventHypoxiaGrade
Data type
double
Alias
- NCI Thesaurus Property
- C3890
- UMLS 2011AA Property
- C0242184
- NCI Thesaurus ObjectClass
- C49704
- UMLS 2011AA ObjectClass
- C1516728
- NCI Thesaurus ValueDomain
- C18000
- UMLS 2011AA ValueDomain
- C0919553
Description
CommonToxicityCriteriaAdverseEventDyspneaGrade
Data type
double
Alias
- NCI Thesaurus Property
- C2998
- UMLS 2011AA Property
- C0013404
- NCI Thesaurus ObjectClass
- C49704
- UMLS 2011AA ObjectClass
- C1516728
- NCI Thesaurus ValueDomain
- C18000
- UMLS 2011AA ValueDomain
- C0919553
Description
Lab,Pulmonary,FEV1
Data type
text
Description
Duringthisassessmentperiod,wasanFEV1performed
Data type
text
Description
Duringthisassessmentperiod,wasanFVCperformed
Data type
text
Description
RecordFVCvalue
Data type
text
Description
Hepatic Toxicity
Description
Did The Patient Develop Any Of The Following Clinical Sugns/symptoms Of Abnormal Liver Function During This Assessment Period
Description
HepatomegalyPresentInd
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
- NCI Thesaurus Property
- C25626
- UMLS 2011AA Property
- C0150312
- NCI Thesaurus ObjectClass
- C3100
- UMLS 2011AA ObjectClass
- C0017924
Description
Weight gain
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25180
- UMLS
- C0043094
Description
PatientPhysicalExaminationOtherSpecify
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
- NCI Thesaurus ValueDomain
- C17649
- UMLS 2011AA ValueDomain
- C0205394
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C20989
- UMLS 2011AA Property
- C0031809
Description
Jaundice
Data type
text
Description
Rightupperquadrantpain
Data type
text
Description
Otherclinicalsigns/symptoms
Data type
text
Description
Indicated The Etiology Of The Abnormal Liver Function
Description
Vod
Description
Gvhd
Description
Infection
Description
AdverseEventInfectionInd-3
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
- NCI Thesaurus ObjectClass
- C41331
- UMLS 2011AA ObjectClass
- C0877248
- NCI Thesaurus Property
- C26726
- UMLS 2011AA Property
- C0009450
Description
Biopsyresults
Data type
text
Description
Dopplerultrasoundresults
Data type
text
Description
Other
Description
Unknown
Description
ResearchCommentsText
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus ObjectClass
- C15319
- NCI Thesaurus Property
- C25393
- UMLS 2011AA Property
- C0282411
Description
Etiology
Data type
text
Description
Specifyotheretiology
Data type
text
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C1516728 (UMLS 2011AA ObjectClass)
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C0919553 (UMLS 2011AA ValueDomain)
C0011065 (UMLS 2011AA)
C0205394 (UMLS 2011AA Property)
C2881 (NCI Thesaurus Property)
C0003811 (UMLS 2011AA Property)
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
C0011065 (UMLS 2011AA)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
CL286022 (NCI Metathesaurus Property)
C0011065 (UMLS 2011AA)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
C26754 (NCI Thesaurus Property)
C2830004 (UMLS 2011AA Property)
C0009421 (UMLS 2011AA)
C0011065 (UMLS 2011AA)
C0036572 (UMLS 2011AA Property)
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
C0011065 (UMLS 2011AA)
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C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
C0011065 (UMLS 2011AA)
C0013404 (UMLS 2011AA Property)
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C1516728 (UMLS 2011AA ObjectClass)
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C0150312 (UMLS 2011AA Property)
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C0017924 (UMLS 2011AA ObjectClass)
C1705108 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
C0043094 (UMLS)
C1705108 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
C1521902 (UMLS 2011AA ValueDomain)
C17649 (NCI Thesaurus ValueDomain)
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