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Adverse Event AML Pazopanib NCT01361334

1 forms  
Adverse Event
Description

Adverse Event

Alias
UMLS CUI-1
C0877248
Patientennummer (derived)
Description

Patientennummer (derived)

Data type

text

AE: Sheet number
Description

AE: Sheet number

Data type

integer

AE: Signature date
Description

AE: Signature date

Data type

date

AE: Signature date Status
Description

AE: Signature date Status

Data type

text

AE: Signature Investigator
Description

AE: Signature Investigator

Data type

text

AE: Neue eForm
Description

AE: Neue eForm

Data type

text

Kommentar Adverse Event
Description

Kommentar Adverse Event

Data type

text

AERQG
Description

AERQG

AE: Nummer
Description

AE: Nummer

Data type

integer

Alias
UMLS CUI [1]
C2826275
AE: Term
Description

AE: Term

Data type

text

Alias
UMLS CUI [1]
C2826934
AE: Start Datum
Description

AE: Start Datum

Data type

date

Alias
UMLS CUI [1]
C2697888
AE: Start date Status
Description

AE: Start date Status

Data type

text

AE: Schwerwiegendes Ereignis
Description

AE: Schwerwiegendes Ereignis

Data type

boolean

Alias
UMLS CUI [1]
C1519255
AE: Toxizität (CTCAE) Grad
Description

AE: Toxizität (CTCAE) Grad

Data type

text

Alias
UMLS CUI [1]
C2985911
AE: Relationship to study treatment XXX
Description

AE: Relationship to study treatment XXX

Data type

text

AE: Action taken with study treatment XXX
Description

AE: Action taken with study treatment XXX

Data type

text

AE: AE that caused study discontinuation
Description

AE: AE that caused study discontinuation

Data type

text

AE: Endedatum
Description

AE: Endedatum

Data type

date

Alias
UMLS CUI [1]
C2697886
AE: End date Status
Description

AE: End date Status

Data type

text

AE: Ongoing
Description

AE: Ongoing

Data type

text

AE: Outcome XXX
Description

AE: Outcome XXX

Data type

text

AE: Toxicity (CTCAE) Grade
Description

AE: Toxicity (CTCAE) Grade

Data type

text

AE: Relationship to study treatment
Description

AE: Relationship to study treatment

Data type

text

AE: Action taken with study treatment
Description

AE: Action taken with study treatment

Data type

text

AE: Outcome
Description

AE: Outcome

Data type

text

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Similar models

Adverse Event AML Pazopanib NCT01361334

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Adverse Event
C0877248 (UMLS CUI-1)
Patientennummer (derived)
Item
text
AE: Sheet number
Item
integer
AE: Signature date
Item
date
AE: Signature date Status
Code List
AE: Signature date Status
CL Item
T (1)
CL Item
TM (2)
CL Item
M (3)
AE: Signature Investigator
Code List
AE: Signature Investigator
CL Item
ja (1)
CL Item
nein (0)
AE: Neue eForm
Code List
AE: Neue eForm
CL Item
ja (1)
Kommentar Adverse Event
Item
text
Item Group
AERQG
Adverse Event Number
Item
AE: Nummer
integer
C2826275 (UMLS CUI [1])
Adverse Event Term
Item
AE: Term
text
C2826934 (UMLS CUI [1])
Adverse Event Start Date
Item
AE: Start Datum
date
C2697888 (UMLS CUI [1])
AE: Start date Status
Code List
AE: Start date Status
CL Item
T (1)
CL Item
TM (2)
CL Item
M (3)
SAE
Item
AE: Schwerwiegendes Ereignis
boolean
C1519255 (UMLS CUI [1])
Item
AE: Toxizität (CTCAE) Grad
text
C2985911 (UMLS CUI [1])
AE: Toxicity (CTCAE) Grade XXX
Code List
AE: Toxizität (CTCAE) Grad
CL Item
1 (1)
CL Item
2 (2)
CL Item
3 (3)
CL Item
4 (4)
CL Item
5 (5)
CL Item
0 (0)
AE: Relationship to study treatment XXX
Code List
AE: Relationship to study treatment XXX
CL Item
0 (0)
CL Item
1 (1)
AE: Action taken with study treatment XXX
Code List
AE: Action taken with study treatment XXX
CL Item
0 (0)
CL Item
1 (1)
CL Item
2 (2)
CL Item
3 (3)
AE: AE that caused study discontinuation
Code List
AE: AE that caused study discontinuation
CL Item
ja (1)
CL Item
nein (0)
AE End date
Item
AE: Endedatum
date
C2697886 (UMLS CUI [1])
AE: End date Status
Code List
AE: End date Status
CL Item
T (1)
CL Item
TM (2)
CL Item
M (3)
Item
text
AE: Ongoing
Code List
AE: Ongoing
CL Item
ja (1)
AE: Outcome XXX
Code List
AE: Outcome XXX
CL Item
0 (0)
CL Item
1 (1)
CL Item
2 (2)
CL Item
3 (3)
CL Item
4 (4)
CL Item
5 (5)
AE: Toxicity (CTCAE) Grade
Code List
AE: Toxicity (CTCAE) Grade
CL Item
leicht (1)
CL Item
mittel (2)
CL Item
schwer (3)
CL Item
lebensbedrohlich (4)
CL Item
Tod (5)
CL Item
fehlend (0)
AE: Relationship to study treatment
Code List
AE: Relationship to study treatment
CL Item
keine vernünftige Möglichkeit eines Zus.hangs (0)
CL Item
vernünftige Möglichkeit eines Zus.hangs (1)
AE: Action taken with study treatment
Code List
AE: Action taken with study treatment
CL Item
keine (0)
CL Item
Dosis geändert (1)
CL Item
Medikament vorübergehend abgesetzt (2)
CL Item
Medikament endgültig abgesetzt (3)
Item
text
AE: Outcome
Code List
AE: Outcome
CL Item
wiederhergestellt (0)
CL Item
gebessert (1)
CL Item
noch nicht gebessert (2)
CL Item
wiederhergestellt mit bleibendem Schaden (3)
CL Item
Tod (4)
CL Item
unbekannt (5)
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