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Day of last Dose-Medication Stem-Cell Transplantation CASLAMB NCT00148148

1 Formulär  
Datum
Beskrivning

Datum

Datum Medikation Tag 1
Beskrivning

Medication

Datatyp

date

liposomales Amphotericin
Beskrivning

liposomales Amphotericin

liposomales Amphotericin B
Beskrivning

liposomales Amphotericin B

Datatyp

boolean

Target dose (3 mg / kg body weight)
Beskrivning

Target dose (3 mg / kg body weight)

Datatyp

float

absolute dose
Beskrivning

absolute dose

Datatyp

float

start of the infusion
Beskrivning

start of the infusion

Datatyp

time

end of infusion
Beskrivning

end of infusion

Datatyp

time

Caspofungin
Beskrivning

Caspofungin

caspofungin
Beskrivning

caspofungin

Datatyp

boolean

Absolut-Dosis
Beskrivning

Absolut-Dosis

Datatyp

float

start of the infusion
Beskrivning

start of the infusion

Datatyp

time

end of infusion
Beskrivning

end of infusion

Datatyp

time

Concomitant Medication
Beskrivning

Concomitant Medication

Concomitant medication log and Adverse Event Log filled?
Beskrivning

Concomitant medication log and Adverse Event Log filled?

Datatyp

boolean

Fulfilled termination criteria?
Beskrivning

Fulfilled termination criteria?

Datatyp

boolean

Date and signature
Beskrivning

Date and signature

Date, signature
Beskrivning

Date, signature

Datatyp

text

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Day of last Dose-Medication Stem-Cell Transplantation CASLAMB NCT00148148

1 Formulär
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Medication
Item
Datum Medikation Tag 1
date
liposomales Amphotericin B
Item
boolean
Target dose (3 mg / kg body weight)
Item
float
absolute dose
Item
float
start of the infusion
Item
time
end of infusion
Item
time
Item Group
caspofungin
Item
boolean
Absolut-Dosis
Item
float
start of the infusion
Item
time
end of infusion
Item
time
Concomitant medication log and Adverse Event Log filled?
Item
boolean
Fulfilled termination criteria?
Item
boolean
Date, signature
Item
text
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