ID

22850

Descripción

Randomized, Open Label Multi-Center Study Comparing Cabazitaxel at 20 mg/m² and at 25 mg/m² Every 3 Weeks in Combination With Prednisone for the Treatment of Metastatic Castration Resistant Prostate Cancer Previously Treated With a Docetaxel-Containing Regimen Other drug name: Jevtana® Study Source & Descriptions: https://clinicaltrials.gov/ct2/show/NCT01308580 Sponsor: Sanofi

Link

https://clinicaltrials.gov/ct2/show/NCT01308580

Palabras clave

  1. 13/6/17 13/6/17 -
Subido en

13 de junio de 2017

DOI

Para solicitar uno, por favor iniciar sesión.

Licencia

Creative Commons BY 4.0

Comentarios del modelo :

Puede comentar sobre el modelo de datos aquí. A través de las burbujas de diálogo en los grupos de elementos y elementos, puede agregar comentarios específicos.

Comentarios de grupo de elementos para :

Comentarios del elemento para :

Para descargar modelos de datos, debe haber iniciado sesión. Por favor iniciar sesión o Registrate gratis.

CRFs Cabazitaxel Prostate Cancer DRKS00006520 NCT01308580 Follow-Up 4

CRFs Cabazitaxel Prostate Cancer NCT01308580 Follow-Up 4

Visit Information
Descripción

Visit Information

Alias
UMLS CUI-1
C0545082
Date of Visit:
Descripción

Date of Visit

Tipo de datos

date

Unidades de medida
  • dd-mmm-yyyy
Alias
UMLS CUI [1]
C1320303
dd-mmm-yyyy
Vital Signs
Descripción

Vital Signs

Alias
UMLS CUI-1
C0518766
Date performed:
Descripción

Assessment Date

Tipo de datos

date

Unidades de medida
  • dd-mmm-yyyy
Alias
UMLS CUI [1]
C2985720
dd-mmm-yyyy
Weight
Descripción

Weight

Tipo de datos

float

Unidades de medida
  • kg
Alias
UMLS CUI [1]
C0005910
kg
Performance Status: ECOG
Descripción

ECOG Performance Status

Tipo de datos

integer

Alias
UMLS CUI [1]
C1520224
Tumor Assessment - Recist 1.1 (to follow until radiological progression) - Target Lesion (Previously identified). Note: If new lesion appears, please report it on the specific page "Tumor assessment (new lesion)".
Descripción

Tumor Assessment - Recist 1.1 (to follow until radiological progression) - Target Lesion (Previously identified). Note: If new lesion appears, please report it on the specific page "Tumor assessment (new lesion)".

Alias
UMLS CUI-1
C3889740
UMLS CUI-2
C2986546
Lesion Number - The Lesion number should be entered and saved to display `Lesion location` and `Lesion Description (Subsite). The lesion number entered should be similar to the lesion number from `Target Lesion (at Baseline)`.
Descripción

Target Lesion Number

Tipo de datos

float

Alias
UMLS CUI [1,1]
C0449791
UMLS CUI [1,2]
C2986546
Lesion Location
Descripción

Target Lesion Location

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0450429
UMLS CUI [1,2]
C2986546
Lesion Description (Subsite)
Descripción

Target Lesion Description

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0678257
UMLS CUI [1,2]
C2986546
Date of Assessment
Descripción

Target Lesion Assessment Date

Tipo de datos

date

Unidades de medida
  • dd-mmm-yyyy
Alias
UMLS CUI [1,1]
C2986546
UMLS CUI [1,2]
C2985720
dd-mmm-yyyy
Method of Tumor Measurement
Descripción

Target Lesion Method of Measurement

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1299991
UMLS CUI [1,2]
C2986546
Measurement of Target Lesion: Diameter
Descripción

Target Lesion Diameter

Tipo de datos

float

Unidades de medida
  • mm
Alias
UMLS CUI [1,1]
C2986546
UMLS CUI [1,2]
C1301886
mm
Tumor Assessment - Recist 1.1 (to follow until radiological progression) - Non-Target Lesion (Previously identified). Overall Response of Non-Target Lesions. Note: If new lesion appears, please report it on the specific page "Tumor assessment (new lesion)".
Descripción

Tumor Assessment - Recist 1.1 (to follow until radiological progression) - Non-Target Lesion (Previously identified). Overall Response of Non-Target Lesions. Note: If new lesion appears, please report it on the specific page "Tumor assessment (new lesion)".

Alias
UMLS CUI-1
C3889740
UMLS CUI-2
C2986547
Date of Assessment
Descripción

Non-Target Lesion Assessment Date

Tipo de datos

date

Unidades de medida
  • dd-mmm-yyyy
Alias
UMLS CUI [1,1]
C2985720
UMLS CUI [1,2]
C2986547
dd-mmm-yyyy
Overall Response of Non-Target Lesions:
Descripción

Overall Response of Non-Target Lesion

Tipo de datos

text

Alias
UMLS CUI [1,1]
C3272903
UMLS CUI [1,2]
C2986547
If Response is NE, Please Specify the Reason:
Descripción

Overall Response of Non-Target Lesion Specification

Tipo de datos

text

Alias
UMLS CUI [1,1]
C3272903
UMLS CUI [1,2]
C2986547
UMLS CUI [1,3]
C2348235
If Response is PD, Please Specify the Concerned Non-Target Lesion(s) Below:
Descripción

Non-Target Lesion Progressive Disease Location

Tipo de datos

text

Alias
UMLS CUI [1,1]
C2986547
UMLS CUI [1,2]
C1335499
UMLS CUI [1,3]
C0450429
Tumor Assessment - New Lesion
Descripción

Tumor Assessment - New Lesion

Alias
UMLS CUI-1
C3889740
UMLS CUI-2
C2986548
Lesion Location
Descripción

New Lesion Location

Tipo de datos

text

Alias
UMLS CUI [1,1]
C2986548
UMLS CUI [1,2]
C0450429
New Lesion Description (Specify Exact Location)
Descripción

New Lesion Description

Tipo de datos

text

Alias
UMLS CUI [1,1]
C2986548
UMLS CUI [1,2]
C0678257
Date of Assessment
Descripción

New Lesion Assessment Date

Tipo de datos

date

Unidades de medida
  • dd-mmm-yyyy
Alias
UMLS CUI [1,1]
C2986548
UMLS CUI [1,2]
C2985720
dd-mmm-yyyy
Method of Tumor Measurement
Descripción

New Lesion Method of Measurement

Tipo de datos

text

Alias
UMLS CUI [1,1]
C2986548
UMLS CUI [1,2]
C1299991
Bone Check (to follow until radiological progression)
Descripción

Bone Check (to follow until radiological progression)

Alias
UMLS CUI-1
C0203668
In case of Bone scan done, indicate the total number of Hot spots:
Descripción

Bone Scan Hot Spot

Tipo de datos

float

Alias
UMLS CUI [1,1]
C0203668
UMLS CUI [1,2]
C0203637
Tumor Markers - to follow until PSA progression.
Descripción

Tumor Markers - to follow until PSA progression.

Alias
UMLS CUI-1
C0041365
Test: PSA
Descripción

Tumor Markers: PSA Test

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0041365
UMLS CUI [1,2]
C0201544
Date of evaluation
Descripción

Tumor Markers: Assessment Date

Tipo de datos

date

Unidades de medida
  • dd-mmm-yyyy
Alias
UMLS CUI [1,1]
C0041365
UMLS CUI [1,2]
C2985720
dd-mmm-yyyy
PSA Test Value
Descripción

Tumor Markers: PSA Test Value

Tipo de datos

float

Alias
UMLS CUI [1,1]
C0041365
UMLS CUI [1,2]
C0201544
UMLS CUI [1,3]
C1275372
PSA Test: Unit
Descripción

Tumor Markers: PSA Test Unit

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0041365
UMLS CUI [1,2]
C0201544
UMLS CUI [1,3]
C1519795
PSA Test: Normal Range - Lower Limit
Descripción

Tumor Markers: PSA Test Lower Limit

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0041365
UMLS CUI [1,2]
C0201544
UMLS CUI [1,3]
C1518030
PSA Test: Normal Range - Upper Limit
Descripción

Tumor Markers: PSA Test Upper Limit

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0041365
UMLS CUI [1,2]
C0201544
UMLS CUI [1,3]
C1519815
Present Pain Intensity and Analgesic Questionnaire for Cancer Pain (to follow until the first documented progression).
Descripción

Present Pain Intensity and Analgesic Questionnaire for Cancer Pain (to follow until the first documented progression).

Alias
UMLS CUI-1
C0596240
UMLS CUI-2
C0034394
Was the Patient questionnaire completed for this visit?
Descripción

Cancer Pain Questionnaire: Complete

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0596240
UMLS CUI [1,2]
C0034394
UMLS CUI [1,3]
C0205197
If NO, please specify the primary reason:
Descripción

Cancer Pain Questionnaire: Primary Reason

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0596240
UMLS CUI [1,2]
C0034394
UMLS CUI [1,3]
C1549995
If NO and OTHER, Specify:
Descripción

Cancer Pain Questionnaire: Primary Reason Specification

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0596240
UMLS CUI [1,2]
C0034394
UMLS CUI [1,3]
C1549995
UMLS CUI [1,4]
C2348235
If YES, Please complete the PAIN ASSESSMENT below: Date Corresponds to current cycle (7 days prior to dosing Day 1) Date
Descripción

Note: Repeat on Day 01, 02, 03, 04, 05, 06, 07.

Tipo de datos

date

Unidades de medida
  • dd-mmm-yyyy
Alias
UMLS CUI [1,1]
C1161170
UMLS CUI [1,2]
C2985720
dd-mmm-yyyy
If YES, Please complete the PAIN ASSESSMENT below: Date Corresponds to current cycle (7 days prior to dosing Day 1) Present Pain Intensity
Descripción

Note: Repeat on Day 01, 02, 03, 04, 05, 06, 07.

Tipo de datos

float

Alias
UMLS CUI [1]
C1320357
If YES, Please complete the PAIN ASSESSMENT below: Date Corresponds to current cycle (7 days prior to dosing Day 1) Analgesic Score
Descripción

Note: Repeat on Day 01, 02, 03, 04, 05, 06, 07.

Tipo de datos

text

Alias
UMLS CUI [1,1]
C3202977
UMLS CUI [1,2]
C0449820
Disease Status
Descripción

Disease Status

Alias
UMLS CUI-1
C0699749
Disease Status (tick one box only):
Descripción

Disease Status

Tipo de datos

text

Alias
UMLS CUI [1]
C0699749
Disease Status: Progression - please specify the assessment:
Descripción

Progressive Disease: Assessment

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1335499
UMLS CUI [1,2]
C0220825
FACT P Questionnaire (to follow until the first documented progression).
Descripción

FACT P Questionnaire (to follow until the first documented progression).

Was the assessment performed at this visit?
Descripción

FACT P Questionnaire

Tipo de datos

boolean

Alias
UMLS CUI [1]
C3641634
If NO, please specify the primary reason:
Descripción

FACT P Questionnaire: Primary Reason

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1549995
UMLS CUI [1,2]
C3641634
If OTHER, Specify:
Descripción

FACT P Questionnaire: Primary Reason Specification

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1549995
UMLS CUI [1,2]
C3641634
UMLS CUI [1,3]
C2348235
If YES, Please indicate how true each statement has been for the patient during the past 7 days: Date performed
Descripción

FACT P Questionnaire: Date

Tipo de datos

date

Unidades de medida
  • dd-mmm-yyyy
Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C1549995
dd-mmm-yyyy
FACT P Questionnaire - Physical Well-Being: If YES, Please indicate how true each statement has been for the patient during the past 7 days.
Descripción

FACT P Questionnaire - Physical Well-Being: If YES, Please indicate how true each statement has been for the patient during the past 7 days.

Alias
UMLS CUI-1
C0517226
I have a lack of energy.
Descripción

Lack of Energy

Tipo de datos

text

Alias
UMLS CUI [1]
C4048330
I have nausea.
Descripción

Nausea

Tipo de datos

text

Alias
UMLS CUI [1]
C0027497
Because of my physical condition, I have trouble meeting the needs of my family
Descripción

Trouble meeting needs of family

Tipo de datos

text

Alias
UMLS CUI [1]
C4287855
I have Pain.
Descripción

Pain

Tipo de datos

text

Alias
UMLS CUI [1]
C0030193
I am bothered by side effects of treatment.
Descripción

Bothered by side effects of treatment

Tipo de datos

text

Alias
UMLS CUI [1]
C4289375
I feel ill.
Descripción

Illness

Tipo de datos

text

Alias
UMLS CUI [1]
C0221423
I am forced to spend time in bed.
Descripción

Time spend in bed

Tipo de datos

text

Alias
UMLS CUI [1]
C4289366
FACT P Questionnaire - Social/ Family Well-Being: If YES, Please indicate how true each statement has been for the patient during the past 7 days.
Descripción

FACT P Questionnaire - Social/ Family Well-Being: If YES, Please indicate how true each statement has been for the patient during the past 7 days.

Alias
UMLS CUI-1
C3476515
I feel close to my friends.
Descripción

Feel Close to Friends

Tipo de datos

text

Alias
UMLS CUI [1]
C2984048
I get emotional suport from my family.
Descripción

Emotional Support from family

Tipo de datos

text

Alias
UMLS CUI [1]
C2984050
I get support from my friends.
Descripción

Receive Support from Friends

Tipo de datos

text

Alias
UMLS CUI [1]
C2984072
My family has accepted my illness.
Descripción

Illness acceptancy by family

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0278069
UMLS CUI [1,2]
C0015576
I am satisfied with my family communication about my illness.
Descripción

Satisfied with Family Communication

Tipo de datos

text

Alias
UMLS CUI [1]
C2984054
I feel close to my partner (or the person who is my main support).
Descripción

Feeling close to partner

Tipo de datos

text

Alias
UMLS CUI [1]
C2984059
(If the patient prefers not to answer to the following question, please tick for this question NOT ANSWERED.) I am satisfied with my sex life.
Descripción

Satisfied with Sex Life

Tipo de datos

text

Alias
UMLS CUI [1]
C2984060
FACT P Questionnaire - Emotional Well-Being: If YES, Please indicate how true each statement has been for the patient during the past 7 days.
Descripción

FACT P Questionnaire - Emotional Well-Being: If YES, Please indicate how true each statement has been for the patient during the past 7 days.

Alias
UMLS CUI-1
C2984554
I feel sad.
Descripción

Feeling sad

Tipo de datos

text

Alias
UMLS CUI [1]
C3536794
I am satisfied with how I am coping with my illness.
Descripción

Coping

Tipo de datos

text

Alias
UMLS CUI [1]
C0009967
I am losing hope in the fight against my illness.
Descripción

Losing hope against illness

Tipo de datos

text

Alias
UMLS CUI [1]
C2984056
I feel nervous.
Descripción

Feeling nervous

Tipo de datos

text

Alias
UMLS CUI [1]
C0849963
I worry about dying.
Descripción

Worry About Dying

Tipo de datos

text

Alias
UMLS CUI [1]
C2984076
I worry that my condition will get worse.
Descripción

Worry About Worsening Condition

Tipo de datos

text

Alias
UMLS CUI [1]
C2984075
FACT P Quesionnaire - Functional Well-Being: If YES, Please indicate how true each statement has been for the patient during the past 7 days.
Descripción

FACT P Quesionnaire - Functional Well-Being: If YES, Please indicate how true each statement has been for the patient during the past 7 days.

Alias
UMLS CUI-1
C3483376
I am able to work (include work at home).
Descripción

Able to work

Tipo de datos

text

Alias
UMLS CUI [1]
C2984044
My Work (include work at home) is fulfilling.
Descripción

Work is fulfilling

Tipo de datos

text

Alias
UMLS CUI [1]
C2984074
I am able to enjoy life.
Descripción

Able to enjoy life

Tipo de datos

text

Alias
UMLS CUI [1]
C2984051
I have accepted my illness.
Descripción

Acceptance of illness

Tipo de datos

text

Alias
UMLS CUI [1]
C0278069
I am sleeping well.
Descripción

Sleeping behaviour

Tipo de datos

text

Alias
UMLS CUI [1]
C0474396
I am enjoying the things I usually do for fun.
Descripción

Anhedonia

Tipo de datos

text

Alias
UMLS CUI [1]
C0178417
I am content with the quality of my life right now.
Descripción

Quality of life

Tipo de datos

text

Alias
UMLS CUI [1]
C0034380
Questionnaire - Additional Concerns FACT P Questionnaire - Additional Concerns: If YES, Please indicate how true each statement has been for the patient during the past 7 days.
Descripción

Questionnaire - Additional Concerns FACT P Questionnaire - Additional Concerns: If YES, Please indicate how true each statement has been for the patient during the past 7 days.

Alias
UMLS CUI-1
C3482667
I am losing weight.
Descripción

Losing Weight

Tipo de datos

text

Alias
UMLS CUI [1]
C1262477
I have a good appetite.
Descripción

Appetite

Tipo de datos

text

Alias
UMLS CUI [1]
C0003618
I have aches and pains that bother me.
Descripción

Bothered by pain

Tipo de datos

text

Alias
UMLS CUI [1,1]
C3830278
UMLS CUI [1,2]
C0030193
I have certain parts of my body where I experience pain.
Descripción

Painful Body Parts

Tipo de datos

text

Alias
UMLS CUI [1]
C3641636
My pain keeps me from doing things I want to do.
Descripción

Pain Keeps Me From Doing Things I Want to Do

Tipo de datos

text

Alias
UMLS CUI [1]
C3641680
I am satisfied with my present comfort level.
Descripción

Comfort Level

Tipo de datos

text

Alias
UMLS CUI [1]
C0517225
I am able to feel like a man.
Descripción

Feel like a man

Tipo de datos

text

Alias
UMLS CUI [1]
C3641638
I have trouble moving my bowels.
Descripción

Trouble Moving Bowels

Tipo de datos

text

Alias
UMLS CUI [1]
C3641639
I have difficulty urinating.
Descripción

Difficulty urinating

Tipo de datos

text

Alias
UMLS CUI [1]
C0241705
I urinate more frequently than usual.
Descripción

Frequency of urination

Tipo de datos

text

Alias
UMLS CUI [1]
C2584336
My problems with urinating limit my activities.
Descripción

Activities Limited by Urination Problems

Tipo de datos

text

Alias
UMLS CUI [1]
C3641641
I am able to have and maintain an erection.
Descripción

Erection

Tipo de datos

text

Alias
UMLS CUI [1]
C0030847

Similar models

CRFs Cabazitaxel Prostate Cancer NCT01308580 Follow-Up 4

Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
Visit Information
C0545082 (UMLS CUI-1)
Date of Visit
Item
Date of Visit:
date
C1320303 (UMLS CUI [1])
Item Group
Vital Signs
C0518766 (UMLS CUI-1)
Assessment Date
Item
Date performed:
date
C2985720 (UMLS CUI [1])
Weight
Item
Weight
float
C0005910 (UMLS CUI [1])
Item
Performance Status: ECOG
integer
C1520224 (UMLS CUI [1])
Code List
Performance Status: ECOG
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
Item Group
Tumor Assessment - Recist 1.1 (to follow until radiological progression) - Target Lesion (Previously identified). Note: If new lesion appears, please report it on the specific page "Tumor assessment (new lesion)".
C3889740 (UMLS CUI-1)
C2986546 (UMLS CUI-2)
Target Lesion Number
Item
Lesion Number - The Lesion number should be entered and saved to display `Lesion location` and `Lesion Description (Subsite). The lesion number entered should be similar to the lesion number from `Target Lesion (at Baseline)`.
float
C0449791 (UMLS CUI [1,1])
C2986546 (UMLS CUI [1,2])
Target Lesion Location
Item
Lesion Location
text
C0450429 (UMLS CUI [1,1])
C2986546 (UMLS CUI [1,2])
Target Lesion Description
Item
Lesion Description (Subsite)
text
C0678257 (UMLS CUI [1,1])
C2986546 (UMLS CUI [1,2])
Target Lesion Assessment Date
Item
Date of Assessment
date
C2986546 (UMLS CUI [1,1])
C2985720 (UMLS CUI [1,2])
Target Lesion Method of Measurement
Item
Method of Tumor Measurement
text
C1299991 (UMLS CUI [1,1])
C2986546 (UMLS CUI [1,2])
Target Lesion Diameter
Item
Measurement of Target Lesion: Diameter
float
C2986546 (UMLS CUI [1,1])
C1301886 (UMLS CUI [1,2])
Item Group
Tumor Assessment - Recist 1.1 (to follow until radiological progression) - Non-Target Lesion (Previously identified). Overall Response of Non-Target Lesions. Note: If new lesion appears, please report it on the specific page "Tumor assessment (new lesion)".
C3889740 (UMLS CUI-1)
C2986547 (UMLS CUI-2)
Non-Target Lesion Assessment Date
Item
Date of Assessment
date
C2985720 (UMLS CUI [1,1])
C2986547 (UMLS CUI [1,2])
Item
Overall Response of Non-Target Lesions:
text
C3272903 (UMLS CUI [1,1])
C2986547 (UMLS CUI [1,2])
Code List
Overall Response of Non-Target Lesions:
CL Item
CR (CR)
CL Item
NE (NE)
CL Item
Non CR/Non PD (Non CR/Non PD)
CL Item
PD (PD)
Overall Response of Non-Target Lesion Specification
Item
If Response is NE, Please Specify the Reason:
text
C3272903 (UMLS CUI [1,1])
C2986547 (UMLS CUI [1,2])
C2348235 (UMLS CUI [1,3])
Non-Target Lesion Progressive Disease Location
Item
If Response is PD, Please Specify the Concerned Non-Target Lesion(s) Below:
text
C2986547 (UMLS CUI [1,1])
C1335499 (UMLS CUI [1,2])
C0450429 (UMLS CUI [1,3])
Item Group
Tumor Assessment - New Lesion
C3889740 (UMLS CUI-1)
C2986548 (UMLS CUI-2)
New Lesion Location
Item
Lesion Location
text
C2986548 (UMLS CUI [1,1])
C0450429 (UMLS CUI [1,2])
New Lesion Description
Item
New Lesion Description (Specify Exact Location)
text
C2986548 (UMLS CUI [1,1])
C0678257 (UMLS CUI [1,2])
New Lesion Assessment Date
Item
Date of Assessment
date
C2986548 (UMLS CUI [1,1])
C2985720 (UMLS CUI [1,2])
New Lesion Method of Measurement
Item
Method of Tumor Measurement
text
C2986548 (UMLS CUI [1,1])
C1299991 (UMLS CUI [1,2])
Item Group
Bone Check (to follow until radiological progression)
C0203668 (UMLS CUI-1)
Bone Scan Hot Spot
Item
In case of Bone scan done, indicate the total number of Hot spots:
float
C0203668 (UMLS CUI [1,1])
C0203637 (UMLS CUI [1,2])
Item Group
Tumor Markers - to follow until PSA progression.
C0041365 (UMLS CUI-1)
Item
Test: PSA
text
C0041365 (UMLS CUI [1,1])
C0201544 (UMLS CUI [1,2])
Code List
Test: PSA
CL Item
PSA (PSA)
Tumor Markers: Assessment Date
Item
Date of evaluation
date
C0041365 (UMLS CUI [1,1])
C2985720 (UMLS CUI [1,2])
Tumor Markers: PSA Test Value
Item
PSA Test Value
float
C0041365 (UMLS CUI [1,1])
C0201544 (UMLS CUI [1,2])
C1275372 (UMLS CUI [1,3])
Tumor Markers: PSA Test Unit
Item
PSA Test: Unit
text
C0041365 (UMLS CUI [1,1])
C0201544 (UMLS CUI [1,2])
C1519795 (UMLS CUI [1,3])
Tumor Markers: PSA Test Lower Limit
Item
PSA Test: Normal Range - Lower Limit
text
C0041365 (UMLS CUI [1,1])
C0201544 (UMLS CUI [1,2])
C1518030 (UMLS CUI [1,3])
Tumor Markers: PSA Test Upper Limit
Item
PSA Test: Normal Range - Upper Limit
text
C0041365 (UMLS CUI [1,1])
C0201544 (UMLS CUI [1,2])
C1519815 (UMLS CUI [1,3])
Item Group
Present Pain Intensity and Analgesic Questionnaire for Cancer Pain (to follow until the first documented progression).
C0596240 (UMLS CUI-1)
C0034394 (UMLS CUI-2)
Cancer Pain Questionnaire: Complete
Item
Was the Patient questionnaire completed for this visit?
boolean
C0596240 (UMLS CUI [1,1])
C0034394 (UMLS CUI [1,2])
C0205197 (UMLS CUI [1,3])
Item
If NO, please specify the primary reason:
text
C0596240 (UMLS CUI [1,1])
C0034394 (UMLS CUI [1,2])
C1549995 (UMLS CUI [1,3])
Code List
If NO, please specify the primary reason:
CL Item
Death (Death)
CL Item
Failure to distribute the questionnaire (Failure to distribute the questionnaire)
CL Item
Other (Other)
CL Item
Patient did not wish to show up (Patient did not wish to show up)
CL Item
Patient refusal (Patient refusal)
CL Item
Subject is unable due to toxicity disease (Subject is unable due to toxicity disease)
CL Item
Translation not available (Translation not available)
Cancer Pain Questionnaire: Primary Reason Specification
Item
If NO and OTHER, Specify:
text
C0596240 (UMLS CUI [1,1])
C0034394 (UMLS CUI [1,2])
C1549995 (UMLS CUI [1,3])
C2348235 (UMLS CUI [1,4])
Pain Assessment: Date
Item
If YES, Please complete the PAIN ASSESSMENT below: Date Corresponds to current cycle (7 days prior to dosing Day 1) Date
date
C1161170 (UMLS CUI [1,1])
C2985720 (UMLS CUI [1,2])
Present Pain Intensity
Item
If YES, Please complete the PAIN ASSESSMENT below: Date Corresponds to current cycle (7 days prior to dosing Day 1) Present Pain Intensity
float
C1320357 (UMLS CUI [1])
Analgesic Score
Item
If YES, Please complete the PAIN ASSESSMENT below: Date Corresponds to current cycle (7 days prior to dosing Day 1) Analgesic Score
text
C3202977 (UMLS CUI [1,1])
C0449820 (UMLS CUI [1,2])
Item Group
Disease Status
C0699749 (UMLS CUI-1)
Item
Disease Status (tick one box only):
text
C0699749 (UMLS CUI [1])
Code List
Disease Status (tick one box only):
CL Item
No progression (No progression)
CL Item
Not evaluable (Not evaluable)
CL Item
Previously reported progression (Previously reported progression)
CL Item
Progression (please specify the assessment) (Progression (please specify the assessment))
Item
Disease Status: Progression - please specify the assessment:
text
C1335499 (UMLS CUI [1,1])
C0220825 (UMLS CUI [1,2])
Code List
Disease Status: Progression - please specify the assessment:
CL Item
Pain (Pain)
CL Item
PSA (PSA)
CL Item
Tumor assessment (Tumor assessment)
Item Group
FACT P Questionnaire (to follow until the first documented progression).
FACT P Questionnaire
Item
Was the assessment performed at this visit?
boolean
C3641634 (UMLS CUI [1])
Item
If NO, please specify the primary reason:
text
C1549995 (UMLS CUI [1,1])
C3641634 (UMLS CUI [1,2])
Code List
If NO, please specify the primary reason:
CL Item
Death (Death)
CL Item
Failure to distribute the questionnaire (Failure to distribute the questionnaire)
CL Item
Other (Other)
CL Item
Patient did not wish to show up (Patient did not wish to show up)
CL Item
Patient refusal (Patient refusal)
CL Item
Subject is unable due to toxicity disease (Subject is unable due to toxicity disease)
CL Item
Translation not available (Translation not available)
FACT P Questionnaire: Primary Reason Specification
Item
If OTHER, Specify:
text
C1549995 (UMLS CUI [1,1])
C3641634 (UMLS CUI [1,2])
C2348235 (UMLS CUI [1,3])
FACT P Questionnaire: Date
Item
If YES, Please indicate how true each statement has been for the patient during the past 7 days: Date performed
date
C0011008 (UMLS CUI [1,1])
C1549995 (UMLS CUI [1,2])
Item Group
FACT P Questionnaire - Physical Well-Being: If YES, Please indicate how true each statement has been for the patient during the past 7 days.
C0517226 (UMLS CUI-1)
Item
I have a lack of energy.
text
C4048330 (UMLS CUI [1])
Code List
I have a lack of energy.
CL Item
A little bit (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all (Not at all)
CL Item
Quite a bit (Quite a bit)
CL Item
Somewhat (Somewhat)
CL Item
Very Much (Very Much)
Item
I have nausea.
text
C0027497 (UMLS CUI [1])
Code List
I have nausea.
CL Item
A little bit (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all (Not at all)
CL Item
Quite a bit (Quite a bit)
CL Item
Somewhat (Somewhat)
CL Item
Very Much (Very Much)
Item
Because of my physical condition, I have trouble meeting the needs of my family
text
C4287855 (UMLS CUI [1])
Code List
Because of my physical condition, I have trouble meeting the needs of my family
CL Item
A little bit (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all (Not at all)
CL Item
Quite a bit (Quite a bit)
CL Item
Somewhat (Somewhat)
CL Item
Very Much (Very Much)
Item
I have Pain.
text
C0030193 (UMLS CUI [1])
Code List
I have Pain.
CL Item
A little bit (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all (Not at all)
CL Item
Quite a bit (Quite a bit)
CL Item
Somewhat (Somewhat)
CL Item
Very Much (Very Much)
Item
I am bothered by side effects of treatment.
text
C4289375 (UMLS CUI [1])
Code List
I am bothered by side effects of treatment.
CL Item
A little bit (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all (Not at all)
CL Item
Quite a bit (Quite a bit)
CL Item
Somewhat (Somewhat)
CL Item
Very Much (Very Much)
Item
I feel ill.
text
C0221423 (UMLS CUI [1])
Code List
I feel ill.
CL Item
A little bit (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all (Not at all)
CL Item
Quite a bit (Quite a bit)
CL Item
Somewhat (Somewhat)
CL Item
Very Much (Very Much)
Item
I am forced to spend time in bed.
text
C4289366 (UMLS CUI [1])
Code List
I am forced to spend time in bed.
CL Item
A little bit (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all (Not at all)
CL Item
Quite a bit (Quite a bit)
CL Item
Somewhat (Somewhat)
CL Item
Very Much (Very Much)
Item Group
FACT P Questionnaire - Social/ Family Well-Being: If YES, Please indicate how true each statement has been for the patient during the past 7 days.
C3476515 (UMLS CUI-1)
Item
I feel close to my friends.
text
C2984048 (UMLS CUI [1])
Code List
I feel close to my friends.
CL Item
A little bit (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all (Not at all)
CL Item
Quite a bit (Quite a bit)
CL Item
Somewhat (Somewhat)
CL Item
Very Much (Very Much)
Item
I get emotional suport from my family.
text
C2984050 (UMLS CUI [1])
Code List
I get emotional suport from my family.
CL Item
A little bit (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all (Not at all)
CL Item
Quite a bit (Quite a bit)
CL Item
Somewhat (Somewhat)
CL Item
Very Much (Very Much)
Item
I get support from my friends.
text
C2984072 (UMLS CUI [1])
Code List
I get support from my friends.
CL Item
A little bit (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all (Not at all)
CL Item
Quite a bit (Quite a bit)
CL Item
Somewhat (Somewhat)
CL Item
Very Much (Very Much)
Item
My family has accepted my illness.
text
C0278069 (UMLS CUI [1,1])
C0015576 (UMLS CUI [1,2])
Code List
My family has accepted my illness.
CL Item
A little bit (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all (Not at all)
CL Item
Quite a bit (Quite a bit)
CL Item
Somewhat (Somewhat)
CL Item
Very Much (Very Much)
Item
I am satisfied with my family communication about my illness.
text
C2984054 (UMLS CUI [1])
Code List
I am satisfied with my family communication about my illness.
CL Item
A little bit (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all (Not at all)
CL Item
Quite a bit (Quite a bit)
CL Item
Somewhat (Somewhat)
CL Item
Very Much (Very Much)
Item
I feel close to my partner (or the person who is my main support).
text
C2984059 (UMLS CUI [1])
Code List
I feel close to my partner (or the person who is my main support).
CL Item
A little bit (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all (Not at all)
CL Item
Quite a bit (Quite a bit)
CL Item
Somewhat (Somewhat)
CL Item
Very Much (Very Much)
Item
(If the patient prefers not to answer to the following question, please tick for this question NOT ANSWERED.) I am satisfied with my sex life.
text
C2984060 (UMLS CUI [1])
Code List
(If the patient prefers not to answer to the following question, please tick for this question NOT ANSWERED.) I am satisfied with my sex life.
CL Item
A little bit  (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all  (Not at all)
CL Item
Quite a bit  (Quite a bit)
CL Item
Somewhat  (Somewhat)
CL Item
Very Much (Very Much)
Item Group
FACT P Questionnaire - Emotional Well-Being: If YES, Please indicate how true each statement has been for the patient during the past 7 days.
C2984554 (UMLS CUI-1)
Item
I feel sad.
text
C3536794 (UMLS CUI [1])
Code List
I feel sad.
CL Item
A little bit  (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all  (Not at all)
CL Item
Quite a bit  (Quite a bit)
CL Item
Somewhat  (Somewhat)
CL Item
Very Much (Very Much)
Item
I am satisfied with how I am coping with my illness.
text
C0009967 (UMLS CUI [1])
Code List
I am satisfied with how I am coping with my illness.
CL Item
A little bit  (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all  (Not at all)
CL Item
Quite a bit  (Quite a bit)
CL Item
Somewhat  (Somewhat)
CL Item
Very Much (Very Much)
Item
I am losing hope in the fight against my illness.
text
C2984056 (UMLS CUI [1])
Code List
I am losing hope in the fight against my illness.
CL Item
A little bit  (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all  (Not at all)
CL Item
Quite a bit  (Quite a bit)
CL Item
Somewhat  (Somewhat)
CL Item
Very Much (Very Much)
Item
I feel nervous.
text
C0849963 (UMLS CUI [1])
Code List
I feel nervous.
CL Item
A little bit  (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all  (Not at all)
CL Item
Quite a bit  (Quite a bit)
CL Item
Somewhat  (Somewhat)
CL Item
Very Much (Very Much)
Item
I worry about dying.
text
C2984076 (UMLS CUI [1])
Code List
I worry about dying.
CL Item
A little bit  (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all  (Not at all)
CL Item
Quite a bit  (Quite a bit)
CL Item
Somewhat  (Somewhat)
CL Item
Very Much (Very Much)
Item
I worry that my condition will get worse.
text
C2984075 (UMLS CUI [1])
Code List
I worry that my condition will get worse.
CL Item
A little bit  (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all  (Not at all)
CL Item
Quite a bit  (Quite a bit)
CL Item
Somewhat  (Somewhat)
CL Item
Very Much (Very Much)
Item Group
FACT P Quesionnaire - Functional Well-Being: If YES, Please indicate how true each statement has been for the patient during the past 7 days.
C3483376 (UMLS CUI-1)
Item
I am able to work (include work at home).
text
C2984044 (UMLS CUI [1])
Code List
I am able to work (include work at home).
CL Item
A little bit  (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all  (Not at all)
CL Item
Quite a bit  (Quite a bit)
CL Item
Somewhat  (Somewhat)
CL Item
Very Much (Very Much)
Item
My Work (include work at home) is fulfilling.
text
C2984074 (UMLS CUI [1])
Code List
My Work (include work at home) is fulfilling.
CL Item
A little bit  (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all  (Not at all)
CL Item
Quite a bit  (Quite a bit)
CL Item
Somewhat  (Somewhat)
CL Item
Very Much (Very Much)
Item
I am able to enjoy life.
text
C2984051 (UMLS CUI [1])
Code List
I am able to enjoy life.
CL Item
A little bit  (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all  (Not at all)
CL Item
Quite a bit  (Quite a bit)
CL Item
Somewhat  (Somewhat)
CL Item
Very Much (Very Much)
Item
I have accepted my illness.
text
C0278069 (UMLS CUI [1])
Code List
I have accepted my illness.
CL Item
A little bit  (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all  (Not at all)
CL Item
Quite a bit  (Quite a bit)
CL Item
Somewhat  (Somewhat)
CL Item
Very Much (Very Much)
Item
I am sleeping well.
text
C0474396 (UMLS CUI [1])
Code List
I am sleeping well.
CL Item
A little bit  (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all  (Not at all)
CL Item
Quite a bit  (Quite a bit)
CL Item
Somewhat  (Somewhat)
CL Item
Very Much (Very Much)
Item
I am enjoying the things I usually do for fun.
text
C0178417 (UMLS CUI [1])
Code List
I am enjoying the things I usually do for fun.
CL Item
A little bit  (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all  (Not at all)
CL Item
Quite a bit  (Quite a bit)
CL Item
Somewhat  (Somewhat)
CL Item
Very Much (Very Much)
Item
I am content with the quality of my life right now.
text
C0034380 (UMLS CUI [1])
Code List
I am content with the quality of my life right now.
CL Item
A little bit  (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all  (Not at all)
CL Item
Quite a bit  (Quite a bit)
CL Item
Somewhat  (Somewhat)
CL Item
Very Much (Very Much)
Item Group
Questionnaire - Additional Concerns FACT P Questionnaire - Additional Concerns: If YES, Please indicate how true each statement has been for the patient during the past 7 days.
C3482667 (UMLS CUI-1)
Item
I am losing weight.
text
C1262477 (UMLS CUI [1])
Code List
I am losing weight.
CL Item
A little bit  (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all  (Not at all)
CL Item
Quite a bit  (Quite a bit)
CL Item
Somewhat  (Somewhat)
CL Item
Very Much (Very Much)
Item
I have a good appetite.
text
C0003618 (UMLS CUI [1])
Code List
I have a good appetite.
CL Item
A little bit  (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all  (Not at all)
CL Item
Quite a bit  (Quite a bit)
CL Item
Somewhat  (Somewhat)
CL Item
Very Much (Very Much)
Item
I have aches and pains that bother me.
text
C3830278 (UMLS CUI [1,1])
C0030193 (UMLS CUI [1,2])
Code List
I have aches and pains that bother me.
CL Item
A little bit  (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all  (Not at all)
CL Item
Quite a bit  (Quite a bit)
CL Item
Somewhat  (Somewhat)
CL Item
Very Much (Very Much)
Item
I have certain parts of my body where I experience pain.
text
C3641636 (UMLS CUI [1])
Code List
I have certain parts of my body where I experience pain.
CL Item
A little bit  (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all  (Not at all)
CL Item
Quite a bit  (Quite a bit)
CL Item
Somewhat  (Somewhat)
CL Item
Very Much (Very Much)
Item
My pain keeps me from doing things I want to do.
text
C3641680 (UMLS CUI [1])
Code List
My pain keeps me from doing things I want to do.
CL Item
A little bit  (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all  (Not at all)
CL Item
Quite a bit  (Quite a bit)
CL Item
Somewhat  (Somewhat)
CL Item
Very Much (Very Much)
Item
I am satisfied with my present comfort level.
text
C0517225 (UMLS CUI [1])
Code List
I am satisfied with my present comfort level.
CL Item
A little bit  (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all  (Not at all)
CL Item
Quite a bit  (Quite a bit)
CL Item
Somewhat  (Somewhat)
CL Item
Very Much (Very Much)
Item
I am able to feel like a man.
text
C3641638 (UMLS CUI [1])
Code List
I am able to feel like a man.
CL Item
A little bit  (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all  (Not at all)
CL Item
Quite a bit  (Quite a bit)
CL Item
Somewhat  (Somewhat)
CL Item
Very Much (Very Much)
Item
I have trouble moving my bowels.
text
C3641639 (UMLS CUI [1])
Code List
I have trouble moving my bowels.
CL Item
A little bit  (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all  (Not at all)
CL Item
Quite a bit  (Quite a bit)
CL Item
Somewhat  (Somewhat)
CL Item
Very Much (Very Much)
Item
I have difficulty urinating.
text
C0241705 (UMLS CUI [1])
Code List
I have difficulty urinating.
CL Item
A little bit  (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all  (Not at all)
CL Item
Quite a bit  (Quite a bit)
CL Item
Somewhat  (Somewhat)
CL Item
Very Much (Very Much)
Item
I urinate more frequently than usual.
text
C2584336 (UMLS CUI [1])
Code List
I urinate more frequently than usual.
CL Item
A little bit  (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all  (Not at all)
CL Item
Quite a bit  (Quite a bit)
CL Item
Somewhat  (Somewhat)
CL Item
Very Much (Very Much)
Item
My problems with urinating limit my activities.
text
C3641641 (UMLS CUI [1])
Code List
My problems with urinating limit my activities.
CL Item
A little bit  (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all  (Not at all)
CL Item
Quite a bit  (Quite a bit)
CL Item
Somewhat  (Somewhat)
CL Item
Very Much (Very Much)
Item
I am able to have and maintain an erection.
text
C0030847 (UMLS CUI [1])
Code List
I am able to have and maintain an erection.
CL Item
A little bit  (A little bit)
CL Item
Not answered (Not answered)
CL Item
Not at all  (Not at all)
CL Item
Quite a bit  (Quite a bit)
CL Item
Somewhat  (Somewhat)
CL Item
Very Much (Very Much)

Utilice este formulario para comentarios, preguntas y sugerencias.

Los campos marcados con * son obligatorios.

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial