Information:
Error:
ID
11970
Description
Pharmacodynamics Form for Protocol #40 - PR4003 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=CCE4149D-4174-4BF9-E034-0003BA12F5E7
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Versions (2)
- 9/19/12 9/19/12 -
- 8/27/15 8/27/15 - Martin Dugas
Uploaded on
August 27, 2015
DOI
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License
Creative Commons BY-NC 3.0 Legacy
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Pharmacodynamics Form Sarcoma, Kaposi Protocol #40 - PR4003
No Instruction available.
- StudyEvent: Pharmacodynamics Form for Protocol #40 - PR4003
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No Instruction available.
- StudyEvent: Pharmacodynamics Form for Protocol #40 - PR4003
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Patient Initials
Item
Patient Initials
text
C2986440 (UMLS CUI [1])
Study#
Item
Study#
text
Site#
Item
Site#
text
ID#
Item
ID#
text
Cycle#
Item
Cycle#
text
Visit date
Item
Visit date
date
C1320303 (UMLS CUI [1])
Height
Item
Height
float
C0005890 (UMLS CUI [1])
Weight
Item
Body weight
float
C0005910 (UMLS CUI [1])
BSA
Item
Body surface area
float
C0005902 (UMLS CUI [1])
TotalFlavopiridoldoseforthecycle
Item
Total Flavopiridol dose for the cycle
text
Justpriortothestartofflavopiridol,date
Item
Just prior to the start of flavopiridol, date
text
Justpriortothestartofflavopiridol,time
Item
Just prior to the start of flavopiridol, time
text
Atcompletionofflavopiridolinfusion,date
Item
At completion of flavopiridol infusion, date
text
Atcompletionofflavopiridolinfusion,time
Item
At completion of flavopiridol infusion, time
text
60minutespost-initiationofflavopiridolinfusion,date
Item
60 minutes post-initiation of flavopiridol infusion, date
text
60minutespost-initiationofflavopiridolinfusion,time
Item
60 minutes post-initiation of flavopiridol infusion, time
text
20hourspost-initiationofflavopiridolinfusion,date
Item
20 hours post-initiation of flavopiridol infusion, date
text
20hourspost-initiationofflavopiridolinfusion,time
Item
20 hours post-initiation of flavopiridol infusion, time
text