ID
11841
Description
E1505 Hypertension Status Form Chemotherapy With or Without Bevacizumab in Treating Patients With Stage IB, Stage II, or Stage IIIA Non-Small Lung Cancer That Was Removed By Surgery Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=1C55F49C-6CD4-6958-E044-0003BA3F9857
Link
Keywords
Versions (5)
- 9/19/12 9/19/12 -
- 8/8/14 8/8/14 - Martin Dugas
- 12/16/14 12/16/14 - Martin Dugas
- 1/9/15 1/9/15 - Martin Dugas
- 8/7/15 8/7/15 - Martin Dugas
Uploaded on
August 7, 2015
DOI
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License
Creative Commons BY-NC 3.0 Legacy
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Hypertension Status Form Lung Cancer E1505 NCT00324805
INSTRUCTIONS: After patient is off treatment, complete this form for each required follow-up report period (see forms submission schedule).
- StudyEvent: E1505 Hypertension Status Form
Description
Reporting Period
Description
Systolic
Data type
integer
Measurement units
- mmHg
Alias
- NCI Thesaurus ValueDomain
- C25209
- NCI Thesaurus Property
- C25214
- NCI Thesaurus ObjectClass
- C25298
- UMLS CUI [1]
- C0871470
Description
Diastolic
Data type
integer
Measurement units
- mmHg
Alias
- NCI Thesaurus ValueDomain
- C25209
- NCI Thesaurus Property
- C25214
- NCI Thesaurus ObjectClass
- C25299
- UMLS CUI [1]
- C0428883
Description
Laboratory Procedure Not Performed
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C0022885
- NCI Thesaurus Property
- C25594
- UMLS CUI-2
- C0445106
- NCI Thesaurus Property-2
- C38000
- NCI Thesaurus ObjectClass
- C25294
Description
Assessment Date
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C2985720
- NCI Thesaurus ObjectClass
- C25367
- NCI Thesaurus ValueDomain-2
- C25367
- NCI Thesaurus Property
- C38000
Description
Anti-Hypertensive Drugs
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- NCI Thesaurus ObjectClass
- C270
- NCI Thesaurus ObjectClass-2
- C25730
- NCI Thesaurus Property
- C25382
- UMLS CUI [1]
- C0003364
Description
Other, specify
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- NCI Thesaurus ObjectClass
- C270
- NCI Thesaurus ObjectClass-2
- C25730
- NCI Thesaurus Property
- C25382
- UMLS CUI [1]
- C0003364
Description
Clinical Trial Period
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS CUI-1
- C2347804
- NCI Thesaurus ObjectClass
- C25214
- NCI Thesaurus Property
- C25616
- NCI Thesaurus ObjectClass-2
- C25651
Description
PersonOff-TreatmentTimePeriodType
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus Property
- C25616
- UMLS 2011AA Property
- C1948053
- NCI Thesaurus Property-2
- C25601
- UMLS 2011AA Property-2
- C1518544
- NCI Thesaurus Property-3
- C25207
- UMLS 2011AA Property-3
- C0040223
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
Description
Comments
Description
Investigator Signature
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C2346576
- NCI Thesaurus Property
- C25678
- NCI Thesaurus ObjectClass
- C17089
Description
Investigator Signature Date
Data type
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: After patient is off treatment, complete this form for each required follow-up report period (see forms submission schedule).
- StudyEvent: E1505 Hypertension Status Form
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C25367 (NCI Thesaurus ObjectClass)
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C0205394 (UMLS CUI-1)
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C25730 (NCI Thesaurus ObjectClass-2)
C25382 (NCI Thesaurus Property)
C0003364 (UMLS CUI [1])
C2347804 (UMLS CUI-1)
C25214 (NCI Thesaurus ObjectClass)
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