0 Evaluaciones

ID

11264

Descripción

NCT00075777 AMC Clinical Trials - Valproic Acid Administration Form for Protocol #038 - PR3802 Valproic Acid in Treating Patients With Kaposi's Sarcoma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=DB52DD55-D039-4342-E034-0003BA12F5E7

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=DB52DD55-D039-4342-E034-0003BA12F5E7

Palabras clave

  1. 19/9/12 19/9/12 -
  2. 9/1/15 9/1/15 - Martin Dugas
  3. 27/6/15 27/6/15 -
Subido en

27 de junio de 2015

DOI

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Licencia

Creative Commons BY-NC 3.0 Legacy

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    NCT00075777 AMC Clinical Trials - Valproic Acid Administration Form for Protocol #038 - PR3802

    No Instruction available.

    1. StudyEvent: AMC Clinical Trials - Valproic Acid Administration Form for Protocol #038 - PR3802
      1. No Instruction available.
    Header
    Descripción

    Header

    Patient Initials
    Descripción

    Patient Initials

    Tipo de datos

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS CUI-1
    C2986440
    NCI Thesaurus ObjectClass
    C16960
    NCI Thesaurus Property
    C25536
    Patient Study ID
    Descripción

    Patient Study ID

    Tipo de datos

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C2348585
    NCI Thesaurus ObjectClass
    C16960
    NCI Thesaurus Property
    C25462
    NCI Thesaurus Property-2
    C25364
    Valproic Acid Assessment
    Descripción

    Valproic Acid Assessment

    Current Cycle Number
    Descripción

    Cycle Number Chemotherapeutics

    Tipo de datos

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C2045829
    NCI Thesaurus Property
    C25471
    NCI Thesaurus ObjectClass
    C15368
    NCI Thesaurus Property-2
    C25379
    Date of Evaluation
    Descripción

    LesionAssessmentDate

    Tipo de datos

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ObjectClass
    C3824
    UMLS 2011AA ObjectClass
    C0221198
    NCI Thesaurus Property
    C20989
    UMLS 2011AA Property
    C0031809
    NCI Thesaurus ValueDomain-2
    C25367
    Day
    Descripción

    TreatmentDayCount

    Tipo de datos

    float

    Alias
    NCI Thesaurus ValueDomain
    C25301
    UMLS 2011AA ValueDomain
    C0439228
    NCI Thesaurus ObjectClass
    C15368
    NCI Thesaurus ValueDomain-2
    C25463
    UMLS 2011AA ValueDomain-2
    C0750480
    Date Agent Administered
    Descripción

    DateAgentAdministered

    Tipo de datos

    text

    Total # of Capsule(s) Taken per Day
    Descripción

    Total#ofCapsule(s)TakenperDay

    Tipo de datos

    text

    Date of Day 5
    Descripción

    DateofDay5

    Tipo de datos

    text

    Date of Day 28
    Descripción

    DateofDay28

    Tipo de datos

    text

    Total # of Capsule(s) Taken per Day
    Descripción

    Total#ofCapsule(s)TakenperDay

    Tipo de datos

    text

    Reduction grade
    Descripción

    Reduction grade

    Tipo de datos

    text

    Start Date
    Descripción

    StartDate

    Tipo de datos

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    Stop Date
    Descripción

    StopDate

    Tipo de datos

    date

    Alias
    NCI Thesaurus Property
    C25164
    UMLS 2011AA Property
    C0011008
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ObjectClass
    C15368
    NCI Thesaurus Property-2
    C65125
    UMLS 2011AA Property-2
    C1947925
    Total # of Capsule(s) Taken per Day
    Descripción

    Total#ofCapsule(s)TakenperDay

    Tipo de datos

    text

    Were there any dose modifications or additions/omissions to protocol treatment?
    Descripción

    Dose Modification

    Tipo de datos

    text

    Alias
    NCI Thesaurus ValueDomain
    C25180
    UMLS CUI-1
    C1707811
    NCI Thesaurus ObjectClass
    C25256
    NCI Thesaurus Property
    C25572
    NCI Thesaurus ValueDomain-2
    C25572
    valproic acid serum level checked at 72-96 hours (on or about day 8)?
    Descripción

    valproicacidserumlevelcheckedat72-96hours(onoraboutday8)?

    Tipo de datos

    boolean

    record serum valproic acid concentration
    Descripción

    recordserumvalproicacidconcentration

    Tipo de datos

    text

    Is valproic acid therapy discontinued early for the patient?
    Descripción

    Isvalproicacidtherapydiscontinuedearlyforthepatient?

    Tipo de datos

    boolean

    record serum valproic acid concentration at the drug discontinuation
    Descripción

    recordserumvalproicacidconcentrationatthedrugdiscontinuation

    Tipo de datos

    text

    Any additional comments about valproic acid administration?
    Descripción

    Anyadditionalcommentsaboutvalproicacidadministration?

    Tipo de datos

    boolean

    Comments
    Descripción

    Research Comments

    Tipo de datos

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704
    UMLS CUI-1
    C0947611
    NCI Thesaurus ObjectClass
    C15319
    NCI Thesaurus Property
    C25393

    Similar models

    No Instruction available.

    1. StudyEvent: AMC Clinical Trials - Valproic Acid Administration Form for Protocol #038 - PR3802
      1. No Instruction available.
    Name
    Tipo
    Description | Question | Decode (Coded Value)
    Tipo de datos
    Alias
    Item Group
    Header
    Patient Initials
    Item
    Patient Initials
    text
    C25191 (NCI Thesaurus ValueDomain)
    C2986440 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C25536 (NCI Thesaurus Property)
    Patient Study ID
    Item
    Patient Study ID
    text
    C25337 (NCI Thesaurus ValueDomain)
    C2348585 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C25462 (NCI Thesaurus Property)
    C25364 (NCI Thesaurus Property-2)
    Item Group
    Valproic Acid Assessment
    Cycle Number Chemotherapeutics
    Item
    Current Cycle Number
    text
    C25337 (NCI Thesaurus ValueDomain)
    C2045829 (UMLS CUI-1)
    C25471 (NCI Thesaurus Property)
    C15368 (NCI Thesaurus ObjectClass)
    C25379 (NCI Thesaurus Property-2)
    LesionAssessmentDate
    Item
    Date of Evaluation
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C3824 (NCI Thesaurus ObjectClass)
    C0221198 (UMLS 2011AA ObjectClass)
    C20989 (NCI Thesaurus Property)
    C0031809 (UMLS 2011AA Property)
    C25367 (NCI Thesaurus ValueDomain-2)
    TreatmentDayCount
    Item
    Day
    float
    C25301 (NCI Thesaurus ValueDomain)
    C0439228 (UMLS 2011AA ValueDomain)
    C15368 (NCI Thesaurus ObjectClass)
    C25463 (NCI Thesaurus ValueDomain-2)
    C0750480 (UMLS 2011AA ValueDomain-2)
    DateAgentAdministered
    Item
    Date Agent Administered
    text
    Total#ofCapsule(s)TakenperDay
    Item
    Total # of Capsule(s) Taken per Day
    text
    DateofDay5
    Item
    Date of Day 5
    text
    DateofDay28
    Item
    Date of Day 28
    text
    Total#ofCapsule(s)TakenperDay
    Item
    Total # of Capsule(s) Taken per Day
    text
    Item
    Reduction grade
    text
    Code List
    Reduction grade
    CL Item
    1st reduction (1st reduction)
    CL Item
    2nd reduction (2nd reduction)
    CL Item
    3rd reduction (3rd reduction)
    CL Item
    4th reduction (4th reduction)
    StartDate
    Item
    Start Date
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    StopDate
    Item
    Stop Date
    date
    C25164 (NCI Thesaurus Property)
    C0011008 (UMLS 2011AA Property)
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C15368 (NCI Thesaurus ObjectClass)
    C65125 (NCI Thesaurus Property-2)
    C1947925 (UMLS 2011AA Property-2)
    Total#ofCapsule(s)TakenperDay
    Item
    Total # of Capsule(s) Taken per Day
    text
    Item
    Were there any dose modifications or additions/omissions to protocol treatment?
    text
    C25180 (NCI Thesaurus ValueDomain)
    C1707811 (UMLS CUI-1)
    C25256 (NCI Thesaurus ObjectClass)
    C25572 (NCI Thesaurus Property)
    C25572 (NCI Thesaurus ValueDomain-2)
    Code List
    Were there any dose modifications or additions/omissions to protocol treatment?
    CL Item
    Yes, Planned (i.e., The Treatment Was Changed According To Protocol Guidelines) (Yes, planned)
    CL Item
    Yes, Unplanned (i.e., The Treatment Change Was Not Part Of Protocol Guidelines) (Yes, unplanned)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    CL Item
    Unknown (Unknown)
    C17998 (NCI Thesaurus)
    C0439673 (UMLS 2011AA)
    valproicacidserumlevelcheckedat72-96hours(onoraboutday8)?
    Item
    valproic acid serum level checked at 72-96 hours (on or about day 8)?
    boolean
    recordserumvalproicacidconcentration
    Item
    record serum valproic acid concentration
    text
    Isvalproicacidtherapydiscontinuedearlyforthepatient?
    Item
    Is valproic acid therapy discontinued early for the patient?
    boolean
    recordserumvalproicacidconcentrationatthedrugdiscontinuation
    Item
    record serum valproic acid concentration at the drug discontinuation
    text
    Anyadditionalcommentsaboutvalproicacidadministration?
    Item
    Any additional comments about valproic acid administration?
    boolean
    Research Comments
    Item
    Comments
    text
    C25704 (NCI Thesaurus ValueDomain)
    C0947611 (UMLS CUI-1)
    C15319 (NCI Thesaurus ObjectClass)
    C25393 (NCI Thesaurus Property)

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