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Treatment phase completion Chronic Lymphocytic Leukemia NCT00090051 BO17072

1 Formulär  
In the case of patient’s death
Beskrivning

In the case of patient’s death

Alias
UMLS CUI-1
C0011065
Date of Death
Beskrivning

Date of Death

Datatyp

date

Måttenheter
  • dd/mm/yy
Alias
UMLS CUI [1]
C1148348
dd/mm/yy
Cause of Death
Beskrivning

Primary Cause of Death

Datatyp

text

Alias
UMLS CUI [1]
C0007465
Cause of death
Beskrivning

Underlying cause of death (if applicable)

Datatyp

text

Alias
UMLS CUI [1]
C0007465
Death related to test drugs
Beskrivning

Relationship of death to test drugs

Datatyp

integer

Alias
UMLS CUI [1,1]
C0439849
UMLS CUI [1,2]
C0007465
Was autopsy performed?
Beskrivning

Autopsy

Datatyp

boolean

Alias
UMLS CUI [1]
C0004398
Autopsy findings
Beskrivning

Autopsy findings

Datatyp

text

Alias
UMLS CUI [1]
C0004398
Comments
Beskrivning

General comments on patient's death

Datatyp

text

Alias
UMLS CUI [1,1]
C0947611
UMLS CUI [1,2]
C1306577
Treatment phase completion
Beskrivning

Treatment phase completion

Date of last dosing
Beskrivning

Date of last dosing

Datatyp

date

Måttenheter
  • dd/mm/yy
Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C1762893
dd/mm/yy
Did the patient complete the study up to the end of the treatment phase?
Beskrivning

Study completion

Datatyp

boolean

Reason for no completion
Beskrivning

Reason for no completion

Datatyp

integer

Specify violation of selection criteria
Beskrivning

Specify violation of selection criteria

Datatyp

text

Specify other protocol violation
Beskrivning

Specify other protocol violation

Datatyp

text

Specify other reason
Beskrivning

Specify other reason

Datatyp

text

Additional observations
Beskrivning

Additional observations

Alias
UMLS CUI-1
C1524062
Additional observations
Beskrivning

Please record any significant clinical observations related to the trial drug, not reported in other parts of the CRF, including observations toward a possible therapeutic activity outside the studied indication and potential drug interactions.

Datatyp

text

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Treatment phase completion Chronic Lymphocytic Leukemia NCT00090051 BO17072

1 Formulär
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
In the case of patient’s death
C0011065 (UMLS CUI-1)
Date of Death
Item
date
C1148348 (UMLS CUI [1])
Cause of Death
Item
text
C0007465 (UMLS CUI [1])
Cause of death
Item
text
C0007465 (UMLS CUI [1])
Item
Death related to test drugs
integer
C0439849 (UMLS CUI [1,1])
C0007465 (UMLS CUI [1,2])
Death related to test drugs
Code List
Death related to test drugs
CL Item
unrelated (1)
C0445356 (UMLS CUI-1)
CL Item
remote (2)
C0205157 (UMLS CUI-1)
CL Item
possible (3)
C0332149 (UMLS CUI-1)
CL Item
probable (4)
C1709683 (UMLS CUI-1)
Autopsy
Item
Was autopsy performed?
boolean
C0004398 (UMLS CUI [1])
Autopsy findings
Item
Autopsy findings
text
C0004398 (UMLS CUI [1])
Comments
Item
text
C0947611 (UMLS CUI [1,1])
C1306577 (UMLS CUI [1,2])
Item Group
Treatment phase completion
Date of last dosing
Item
date
C0011008 (UMLS CUI [1,1])
C1762893 (UMLS CUI [1,2])
Study completion
Item
Did the patient complete the study up to the end of the treatment phase?
boolean
Reason for no completion
Code List
Reason for no completion
CL Item
adverse event/intercurrent illness (1)
CL Item
death (complete death page) (2)
CL Item
insufficient therapeutic response (3)
CL Item
failure to return (4)
CL Item
violation of selection criteria at entry (5)
CL Item
other protocol violation (6)
CL Item
refused treatment/did not cooperate/withdrew consent (7)
CL Item
early improvement (8)
CL Item
administrative/other (9)
Specify violation of selection criteria
Item
text
Specify other protocol violation
Item
text
Specify other reason
Item
text
Item Group
Additional observations
C1524062 (UMLS CUI-1)
Additional observations
Item
text
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