ID
10766
Descrição
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
Link
Palavras-chave
Versões (3)
- 19/09/2012 19/09/2012 -
- 08/01/2015 08/01/2015 - Martin Dugas
- 08/06/2015 08/06/2015 -
Transferido a
8 de junho de 2015
DOI
Para um pedido faça login.
Licença
Creative Commons BY-NC 3.0 Legacy
Comentários do modelo :
Aqui pode comentar o modelo. Pode comentá-lo especificamente através dos balões de texto nos grupos de itens e itens.
Comentários do grupo de itens para :
Comentários do item para :
Para descarregar formulários, precisa de ter uma sessão iniciada. Por favor faça login ou registe-se gratuitamente.
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
Descrição
Data amendment
Descrição
Data amended
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C0680532
- NCI Thesaurus ObjectClass
- C25474
- NCI Thesaurus Property
- C25416
Descrição
Data amended date
Tipo de dados
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
Descrição
On Treatment Report Period
Descrição
Deep Vein Thrombosis
Descrição
Deep Vein Thrombosis prophylaxis
Tipo de dados
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
Descrição
DVT prophylaxis start date
Tipo de dados
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
Descrição
DVT prophylaxis most recent date
Tipo de dados
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
Descrição
Aspirin 81 mg
Tipo de dados
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
Descrição
Aspirin 325 mg
Tipo de dados
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
Descrição
Aspirin, other dose
Tipo de dados
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
Descrição
Aspirin dose
Tipo de dados
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
Descrição
Warfarin
Tipo de dados
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
Descrição
Warfarin dose
Tipo de dados
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
Descrição
Heparin, Low-Molecular-Weight
Tipo de dados
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
Descrição
DVT prevention, specify
Tipo de dados
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
Descrição
Erythropoietin-type agents
Tipo de dados
boolean
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS CUI-1
- C0014822
- NCI Thesaurus ObjectClass
- C20429
- NCI Thesaurus ObjectClass-2
- C37902
- NCI Thesaurus Property
- C25382
Descrição
Thrombotic Event
Descrição
ThrombosisAdverseEventObservedInd-3
Tipo de dados
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
Descrição
ThrombosisAdverseEventObservedDate
Tipo de dados
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
Descrição
DataUnknownText
Tipo de dados
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
Descrição
ThrombosisPreventionTherapyReceivedInd-2
Tipo de dados
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
Descrição
Comments
Descrição
Investigator Signature
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C2346576
- NCI Thesaurus Property
- C25678
- NCI Thesaurus ObjectClass
- C17089
Descrição
Investigator Signature Date
Tipo de dados
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
Similar models
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
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1512162 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25491 (NCI Thesaurus Property-2)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1512162 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25491 (NCI Thesaurus Property-2)
C3242750 (UMLS CUI-1)
C19464 (NCI Thesaurus Property)
C25474 (NCI Thesaurus ObjectClass)
C25452 (NCI Thesaurus ObjectClass-2)
C1514821 (UMLS CUI-1)
C25646 (NCI Thesaurus ObjectClass)
C0237753 (UMLS CUI-2)
C16154 (NCI Thesaurus Property)
C16154 (NCI Thesaurus ValueDomain-2)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C25191 (NCI Thesaurus ValueDomain)
C21541 (NCI Thesaurus ValueDomain-2)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C0011008 (UMLS CUI-2)
C25416 (NCI Thesaurus Property)
C25367 (NCI Thesaurus ValueDomain-2)
C2045829 (UMLS CUI-1)
C25214 (NCI Thesaurus Property)
C25616 (NCI Thesaurus Property-2)
C15368 (NCI Thesaurus ObjectClass)
C0853245 (UMLS CUI-1)
C15368 (NCI Thesaurus ObjectClass-2)
C15405 (NCI Thesaurus ObjectClass-3)
C25639 (NCI Thesaurus Property)
C38147 (NCI Thesaurus ValueDomain)
C0853245 (UMLS CUI-1)
C15368 (NCI Thesaurus ObjectClass-2)
C15405 (NCI Thesaurus ObjectClass-3)
C25639 (NCI Thesaurus Property)
C0808070 (UMLS CUI-2)
C25164 (NCI Thesaurus ValueDomain)
C25431 (NCI Thesaurus ValueDomain-2)
C0853245 (UMLS CUI-1)
C15368 (NCI Thesaurus ObjectClass-2)
C15405 (NCI Thesaurus ObjectClass-3)
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)
C38147 (NCI Thesaurus ValueDomain)
C0004057 (UMLS CUI-1)
C15368 (NCI Thesaurus ObjectClass-2)
C15405 (NCI Thesaurus ObjectClass-3)
C17649 (NCI Thesaurus Property)
C25639 (NCI Thesaurus Property-2)
C287 (NCI Thesaurus Property-3)
C25256 (NCI Thesaurus Property-4)
C38147 (NCI Thesaurus ValueDomain)
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)
C945 (NCI Thesaurus Property-2)
C25488 (NCI Thesaurus ValueDomain)
C0019139 (UMLS CUI-1)
C15368 (NCI Thesaurus ObjectClass-2)
C15405 (NCI Thesaurus ObjectClass-3)
C25639 (NCI Thesaurus Property)
C2578 (NCI Thesaurus Property-2)
C38147 (NCI Thesaurus ValueDomain)
C0853245 (UMLS CUI-1)
C15368 (NCI Thesaurus ObjectClass-2)
C15405 (NCI Thesaurus ObjectClass-3)
C25639 (NCI Thesaurus Property)
C1521902 (UMLS CUI-2)
C25685 (NCI Thesaurus ValueDomain)
C0014822 (UMLS CUI-1)
C20429 (NCI Thesaurus ObjectClass)
C37902 (NCI Thesaurus ObjectClass-2)
C25382 (NCI Thesaurus Property)
C1512699 (UMLS 2011AA ValueDomain)
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)
C0011008 (UMLS 2011AA ValueDomain)
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)