ID
11925
Description
Cycle Dose Drug Form (D2R) GOG-0262 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=
Link
https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=
Keywords
Versions (2)
- 12/18/14 12/18/14 - Martin Dugas
- 8/22/15 8/22/15 - Martin Dugas
Uploaded on
August 22, 2015
DOI
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License
Creative Commons BY-NC 3.0 Legacy
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Cycle Dose Drug Form (D2R) GOG-0262
No Instruction available.
- StudyEvent: SE.0000
Description
Treatment Cycle And Modification
Description
TreatmentCurrentCourseNumber
Data type
float
Description
TreatmentDelayedCycleInd-3
Data type
boolean
Description
TreatmentDelayDayCount
Data type
float
Description
TreatmentDelayedCycleReason
Data type
text
Description
TreatmentCourseBeginDate
Data type
date
Description
Agent Name
Data type
text
Alias
- UMLS CUI [1]
- C1521826
Description
AgentDoseLevelValue
Data type
text
Description
DoseModificationInd
Data type
text
Description
AgentCourseTotalDose
Data type
float
Description
AgentDoseUOM
Data type
text
Description
Body weight
Data type
float
Measurement units
- kg
Alias
- UMLS CUI [1]
- C0005910
Description
Body surface area
Data type
float
Measurement units
- m²
Alias
- UMLS CUI [1]
- C0005902
Description
ECOG performance status grade
Data type
integer
Alias
- UMLS CUI [1]
- C1632812
Description
Pretreatment Hematology And Chemistry Values
Description
LesionAssessmentDate
Data type
date
Description
Hemoglobin
Data type
float
Measurement units
- g/dL
Alias
- UMLS CUI [1]
- C0019046
Description
LaboratoryProcedureErythrocyteResultCount
Data type
float
Description
WBC
Data type
float
Measurement units
- /ul
Alias
- UMLS CUI [1]
- C0023508
Description
ANC
Data type
float
Measurement units
- 1000/ul
Alias
- UMLS CUI [1]
- C0200633
Description
Peripheral Platelet Count
Data type
float
Measurement units
- 1000/uL
Alias
- UMLS CUI [1]
- C0005821
Description
LaboratoryProcedureProthrombinTimeResultValue
Data type
float
Measurement units
- seconds
Description
PTT
Data type
float
Measurement units
- seconds
Alias
- UMLS CUI [1]
- C0030605
Description
BUN
Data type
float
Measurement units
- mg/dL
Alias
- UMLS CUI [1]
- C0005845
Description
Creatinine
Data type
float
Measurement units
- mg/dL
Alias
- UMLS CUI [1]
- C0201976
Description
Creatinine Clearance
Data type
float
Measurement units
- mL/min
Alias
- UMLS CUI [1]
- C0373595
Description
AST (SGOT)
Data type
float
Measurement units
- U/L
Alias
- UMLS CUI [1]
- C0201899
Description
Bilirubin, total
Data type
float
Measurement units
- mg/dL
Alias
- UMLS CUI [1]
- C0201913
Description
Alkaline Phosphatase
Data type
float
Measurement units
- U/L
Alias
- UMLS CUI [1]
- C0201850
Description
LaboratoryProcedureCA-125AntigenTumorMarkerResultValue
Data type
float
Description
INR
Data type
float
Alias
- UMLS CUI [1]
- C0525032
Description
LaboratoryProcedureSecondOptionalPerformedSpecify
Data type
text
Description
LaboratoryProcedurePerformedValue
Data type
float
Description
Comments
Similar models
No Instruction available.
- StudyEvent: SE.0000