ID
10766
Description
E4A03 Thrombotic Event Form - After September 14, 2005 NCT00098475 Lenalidomide and Dexamethasone With or Without Thalidomide in Treating Patients With Multiple Myeloma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=05DBF8A6-800B-1B35-E044-0003BA3F9857
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Mots-clés
Versions (3)
- 19/09/2012 19/09/2012 -
- 08/01/2015 08/01/2015 - Martin Dugas
- 08/06/2015 08/06/2015 -
Téléchargé le
8 juin 2015
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E4A03 Thrombotic Event Form - After September 14, 2005 NCT00098475
INSTRUCTIONS: Use this form to capture the first occurrence of non-protocol anti-tumor therapy per registration step
- StudyEvent: E4A03 Thrombotic Event Form - After September 14, 2005
Description
Data amendment
Description
Data amended
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C0680532
- NCI Thesaurus ObjectClass
- C25474
- NCI Thesaurus Property
- C25416
Description
Data amended date
Type de données
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C0680532
- NCI Thesaurus ObjectClass
- C25474
- UMLS CUI-2
- C0011008
- NCI Thesaurus Property
- C25416
- NCI Thesaurus ValueDomain-2
- C25367
Description
On Treatment Report Period
Description
Deep Vein Thrombosis
Description
Deep Vein Thrombosis prophylaxis
Type de données
boolean
Alias
- NCI Thesaurus ObjectClass
- C49343
- UMLS CUI-1
- C0853245
- NCI Thesaurus ObjectClass-2
- C15368
- NCI Thesaurus ObjectClass-3
- C15405
- NCI Thesaurus Property
- C25639
- NCI Thesaurus ValueDomain
- C38147
Description
DVT prophylaxis start date
Type de données
date
Alias
- NCI Thesaurus ObjectClass
- C49343
- UMLS CUI-1
- C0853245
- NCI Thesaurus ObjectClass-2
- C15368
- NCI Thesaurus ObjectClass-3
- C15405
- NCI Thesaurus Property
- C25639
- UMLS CUI-2
- C0808070
- NCI Thesaurus ValueDomain
- C25164
- NCI Thesaurus ValueDomain-2
- C25431
Description
DVT prophylaxis most recent date
Type de données
date
Alias
- NCI Thesaurus ObjectClass
- C49343
- UMLS CUI-1
- C0853245
- NCI Thesaurus ObjectClass-2
- C15368
- NCI Thesaurus ObjectClass-3
- C15405
- NCI Thesaurus Property
- C25639
- UMLS CUI-2
- C1513491
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-3
- C0011008
- NCI Thesaurus ValueDomain-2
- C25577
Description
Aspirin 81 mg
Type de données
boolean
Alias
- NCI Thesaurus ObjectClass
- C49343
- UMLS CUI-1
- C0783425
- NCI Thesaurus ObjectClass-2
- C15368
- NCI Thesaurus ObjectClass-3
- C15405
- NCI Thesaurus Property
- C25639
- NCI Thesaurus Property-2
- C49341
- NCI Thesaurus Property-3
- C287
- NCI Thesaurus ValueDomain
- C38147
Description
Aspirin 325 mg
Type de données
boolean
Alias
- NCI Thesaurus ObjectClass
- C49343
- UMLS CUI-1
- C0714615
- NCI Thesaurus ObjectClass-2
- C15368
- NCI Thesaurus ObjectClass-3
- C15405
- NCI Thesaurus Property
- C25639
- NCI Thesaurus Property-2
- C287
- NCI Thesaurus Property-3
- C49342
- NCI Thesaurus ValueDomain
- C38147
Description
Aspirin, other dose
Type de données
boolean
Alias
- NCI Thesaurus ObjectClass
- C49343
- UMLS CUI-1
- C0004057
- NCI Thesaurus ObjectClass-2
- C15368
- NCI Thesaurus ObjectClass-3
- C15405
- NCI Thesaurus Property
- C17649
- NCI Thesaurus Property-2
- C25639
- NCI Thesaurus Property-3
- C287
- NCI Thesaurus Property-4
- C25256
- NCI Thesaurus ValueDomain
- C38147
Description
Aspirin dose
Type de données
float
Alias
- NCI Thesaurus ObjectClass
- C49343
- UMLS CUI-1
- C0004057
- NCI Thesaurus ObjectClass-2
- C15368
- NCI Thesaurus ObjectClass-3
- C15405
- NCI Thesaurus Property
- C17649
- UMLS CUI-2
- C0178602
- NCI Thesaurus Property-2
- C25639
- NCI Thesaurus Property-3
- C287
- NCI Thesaurus Property-4
- C25256
- NCI Thesaurus ValueDomain
- C25488
Description
Warfarin
Type de données
boolean
Alias
- NCI Thesaurus ObjectClass
- C49343
- UMLS CUI-1
- C0043031
- NCI Thesaurus ObjectClass-2
- C15368
- NCI Thesaurus ObjectClass-3
- C15405
- NCI Thesaurus Property
- C25639
- NCI Thesaurus Property-2
- C945
- NCI Thesaurus ValueDomain
- C38147
Description
Warfarin dose
Type de données
boolean
Alias
- NCI Thesaurus ObjectClass
- C49343
- UMLS CUI-1
- C0366686
- NCI Thesaurus ObjectClass-2
- C15368
- NCI Thesaurus ObjectClass-3
- C15405
- NCI Thesaurus Property
- C25639
- NCI Thesaurus Property-2
- C945
- NCI Thesaurus ValueDomain
- C25488
Description
Heparin, Low-Molecular-Weight
Type de données
boolean
Alias
- NCI Thesaurus ObjectClass
- C49343
- UMLS CUI-1
- C0019139
- NCI Thesaurus ObjectClass-2
- C15368
- NCI Thesaurus ObjectClass-3
- C15405
- NCI Thesaurus Property
- C25639
- NCI Thesaurus Property-2
- C2578
- NCI Thesaurus ValueDomain
- C38147
Description
DVT prevention, specify
Type de données
text
Alias
- NCI Thesaurus ObjectClass
- C49343
- UMLS CUI-1
- C0853245
- NCI Thesaurus ObjectClass-2
- C15368
- NCI Thesaurus ObjectClass-3
- C15405
- NCI Thesaurus Property
- C25639
- UMLS CUI-2
- C1521902
- NCI Thesaurus ValueDomain
- C25685
Description
Erythropoietin-type agents
Type de données
boolean
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS CUI-1
- C0014822
- NCI Thesaurus ObjectClass
- C20429
- NCI Thesaurus ObjectClass-2
- C37902
- NCI Thesaurus Property
- C25382
Description
Thrombotic Event
Description
ThrombosisAdverseEventObservedInd-3
Type de données
boolean
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
- NCI Thesaurus ObjectClass
- C41331
- UMLS 2011AA ObjectClass
- C0877248
- NCI Thesaurus ObjectClass-2
- C26891
- UMLS 2011AA ObjectClass-2
- C0040053
- NCI Thesaurus Property
- C25599
- UMLS 2011AA Property
- C1441672
Description
ThrombosisAdverseEventObservedDate
Type de données
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C41331
- UMLS 2011AA ObjectClass
- C0877248
- NCI Thesaurus ObjectClass-2
- C26891
- UMLS 2011AA ObjectClass-2
- C0040053
- NCI Thesaurus Property
- C25599
- UMLS 2011AA Property
- C1441672
Description
DataUnknownText
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus ObjectClass
- C25474
- UMLS 2011AA ObjectClass
- C1511726
- NCI Thesaurus Property
- C17998
- UMLS 2011AA Property
- C0439673
Description
ThrombosisPreventionTherapyReceivedInd-2
Type de données
boolean
Alias
- NCI Thesaurus ObjectClass
- C26891
- UMLS 2011AA ObjectClass
- C0040053
- NCI Thesaurus ObjectClass-2
- C15368
- NCI Thesaurus ObjectClass-3
- C15405
- NCI Thesaurus Property
- C25639
- UMLS 2011AA Property
- C1514756
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Description
Comments
Description
Investigator Signature
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C2346576
- NCI Thesaurus Property
- C25678
- NCI Thesaurus ObjectClass
- C17089
Description
Investigator Signature Date
Type de données
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C2346576
- NCI Thesaurus Property
- C25678
- UMLS CUI-2
- C0011008
- NCI Thesaurus ValueDomain-2
- C25367
- NCI Thesaurus ObjectClass
- C17089
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INSTRUCTIONS: Use this form to capture the first occurrence of non-protocol anti-tumor therapy per registration step
- StudyEvent: E4A03 Thrombotic Event Form - After September 14, 2005
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C15405 (NCI Thesaurus ObjectClass-3)
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C0853245 (UMLS CUI-1)
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C25639 (NCI Thesaurus Property)
C1513491 (UMLS CUI-2)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS CUI-3)
C25577 (NCI Thesaurus ValueDomain-2)
C0783425 (UMLS CUI-1)
C15368 (NCI Thesaurus ObjectClass-2)
C15405 (NCI Thesaurus ObjectClass-3)
C25639 (NCI Thesaurus Property)
C49341 (NCI Thesaurus Property-2)
C287 (NCI Thesaurus Property-3)
C38147 (NCI Thesaurus ValueDomain)
C0714615 (UMLS CUI-1)
C15368 (NCI Thesaurus ObjectClass-2)
C15405 (NCI Thesaurus ObjectClass-3)
C25639 (NCI Thesaurus Property)
C287 (NCI Thesaurus Property-2)
C49342 (NCI Thesaurus Property-3)
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C0004057 (UMLS CUI-1)
C15368 (NCI Thesaurus ObjectClass-2)
C15405 (NCI Thesaurus ObjectClass-3)
C17649 (NCI Thesaurus Property)
C0178602 (UMLS CUI-2)
C25639 (NCI Thesaurus Property-2)
C287 (NCI Thesaurus Property-3)
C25256 (NCI Thesaurus Property-4)
C25488 (NCI Thesaurus ValueDomain)
C0043031 (UMLS CUI-1)
C15368 (NCI Thesaurus ObjectClass-2)
C15405 (NCI Thesaurus ObjectClass-3)
C25639 (NCI Thesaurus Property)
C945 (NCI Thesaurus Property-2)
C38147 (NCI Thesaurus ValueDomain)
C0366686 (UMLS CUI-1)
C15368 (NCI Thesaurus ObjectClass-2)
C15405 (NCI Thesaurus ObjectClass-3)
C25639 (NCI Thesaurus Property)
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C0019139 (UMLS CUI-1)
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C0853245 (UMLS CUI-1)
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C15405 (NCI Thesaurus ObjectClass-3)
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C0014822 (UMLS CUI-1)
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C37902 (NCI Thesaurus ObjectClass-2)
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C0877248 (UMLS 2011AA ObjectClass)
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C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
C26891 (NCI Thesaurus ObjectClass-2)
C0040053 (UMLS 2011AA ObjectClass-2)
C25599 (NCI Thesaurus Property)
C1441672 (UMLS 2011AA Property)
C1527021 (UMLS 2011AA ValueDomain)
C25474 (NCI Thesaurus ObjectClass)
C1511726 (UMLS 2011AA ObjectClass)
C17998 (NCI Thesaurus Property)
C0439673 (UMLS 2011AA Property)
C0040053 (UMLS 2011AA ObjectClass)
C15368 (NCI Thesaurus ObjectClass-2)
C15405 (NCI Thesaurus ObjectClass-3)
C25639 (NCI Thesaurus Property)
C1514756 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C2346576 (UMLS CUI-1)
C25678 (NCI Thesaurus Property)
C17089 (NCI Thesaurus ObjectClass)
C2346576 (UMLS CUI-1)
C25678 (NCI Thesaurus Property)
C0011008 (UMLS CUI-2)
C25367 (NCI Thesaurus ValueDomain-2)
C17089 (NCI Thesaurus ObjectClass)