ID

22902

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. 15/6/17 15/6/17 -
Subido en

15 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 Additional

CRFs Cabazitaxel Prostate Cancer NCT01308580 Additional

Laboratory Tests Hematology
Descripción

Laboratory Tests Hematology

Alias
UMLS CUI-1
C0022885
UMLS CUI-2
C0474523
Date
Descripción

Laboratory Test Date

Tipo de datos

date

Unidades de medida
  • dd-mmm-yyyy
Alias
UMLS CUI [1]
C2826641
dd-mmm-yyyy
Hemoglobin
Descripción

Hemoglobin

Tipo de datos

float

Unidades de medida
  • g/dL
Alias
UMLS CUI [1]
C0019046
g/dL
Platelet Count (Thrombocyte Count)
Descripción

Platelets

Tipo de datos

float

Unidades de medida
  • 10^9/L
Alias
UMLS CUI [1]
C0005821
10^9/L
White Blood Cell Count (Leukocyte Count)
Descripción

White Blood Cell Count

Tipo de datos

float

Unidades de medida
  • 10^9/L
Alias
UMLS CUI [1]
C0023508
10^9/L
Neutrophils
Descripción

Neutrophils

Tipo de datos

float

Unidades de medida
  • 10^9/L
Alias
UMLS CUI [1]
C0948762
10^9/L
Lymphocytes
Descripción

Lymphocytes

Tipo de datos

float

Unidades de medida
  • 10^9/L
Alias
UMLS CUI [1]
C0024264
10^9/L
Monocytes
Descripción

Monocytes

Tipo de datos

float

Unidades de medida
  • 10^9/L
Alias
UMLS CUI [1]
C0026473
10^9/L
Eosinophils
Descripción

Eosinophils

Tipo de datos

float

Unidades de medida
  • 10^9/L
Alias
UMLS CUI [1]
C0200638
10^9/L
Basophils
Descripción

Basophils

Tipo de datos

float

Unidades de medida
  • 10^9/L
Alias
UMLS CUI [1]
C0200641
10^9/L
Laboratory Tests Biochemistry
Descripción

Laboratory Tests Biochemistry

Alias
UMLS CUI-1
C0022885
UMLS CUI-2
C0005477
Date
Descripción

Laboratory Test Biochemistry Date

Tipo de datos

date

Unidades de medida
  • dd-mmm-yyyy
Alias
UMLS CUI [1,1]
C2826641
UMLS CUI [1,2]
C0005477
dd-mmm-yyyy
Sodium
Descripción

Sodium

Tipo de datos

float

Unidades de medida
  • mmol/L
Alias
UMLS CUI [1]
C0337443
mmol/L
Potassium
Descripción

Potassium

Tipo de datos

float

Unidades de medida
  • mmol/L
Alias
UMLS CUI [1]
C0202194
mmol/L
Calcium
Descripción

Calcium

Tipo de datos

float

Unidades de medida
  • mmol/L
Alias
UMLS CUI [1]
C0201925
mmol/L
Phosphorus
Descripción

Phosphorus

Tipo de datos

float

Unidades de medida
  • mmol/L
Alias
UMLS CUI [1]
C0031705
mmol/L
Blood urea nitrogen
Descripción

Blood Urea Nitrogen

Tipo de datos

float

Unidades de medida
  • mmol/L
Alias
UMLS CUI [1]
C0005845
mmol/L
Magnesium
Descripción

Magnesium

Tipo de datos

float

Unidades de medida
  • mmol/L
Alias
UMLS CUI [1]
C0373675
mmol/L
Total Proteins
Descripción

Total Proteins

Tipo de datos

float

Unidades de medida
  • g/L
Alias
UMLS CUI [1]
C0555903
g/L
Albumin
Descripción

Albumin

Tipo de datos

float

Unidades de medida
  • g/L
Alias
UMLS CUI [1]
C0201838
g/L
Glucose
Descripción

Blood Glucose

Tipo de datos

float

Unidades de medida
  • mmol/L
Alias
UMLS CUI [1]
C0202042
mmol/L
AST (SGOT - ASAT)
Descripción

AST

Tipo de datos

float

Unidades de medida
  • U/L
Alias
UMLS CUI [1]
C0201899
U/L
AST (SGOT - ASAT): Normal Range - Upper Limit
Descripción

AST: Upper Limit

Tipo de datos

float

Unidades de medida
  • U/L
Alias
UMLS CUI [1,1]
C0201899
UMLS CUI [1,2]
C1519815
U/L
ALT (SGPT - ALAT)
Descripción

ALT

Tipo de datos

float

Unidades de medida
  • U/L
Alias
UMLS CUI [1]
C0201836
U/L
ALT (SGPT - ALAT): Normal Range - Upper Limit
Descripción

ALT: Upper Limit

Tipo de datos

float

Unidades de medida
  • U/L
Alias
UMLS CUI [1,1]
C0201836
UMLS CUI [1,2]
C1519815
U/L
Alkaline Phosphatase
Descripción

Alkaline Phosphatase

Tipo de datos

float

Unidades de medida
  • U/L
Alias
UMLS CUI [1]
C0201850
U/L
Alkaline Phosphatase: Normal Range - Upper Limit
Descripción

Alkaline Phosphatase: Upper Limit

Tipo de datos

float

Unidades de medida
  • U/L
Alias
UMLS CUI [1,1]
C0201850
UMLS CUI [1,2]
C1519815
U/L
Total Bilirubin
Descripción

Total Bilirubin

Tipo de datos

float

Unidades de medida
  • umol/L
Alias
UMLS CUI [1]
C0201913
umol/L
Total Bilirubin: Normal Range - Upper Limit
Descripción

Total Bilirubin: Upper Limit

Tipo de datos

float

Unidades de medida
  • umol/L
Alias
UMLS CUI [1,1]
C0201913
UMLS CUI [1,2]
C1519815
umol/L
Creatinine
Descripción

Creatinine

Tipo de datos

float

Unidades de medida
  • umol/L
Alias
UMLS CUI [1]
C0201976
umol/L
Creatinine: Normal Range - Upper Limit
Descripción

Creatinine: Upper Limit

Tipo de datos

float

Unidades de medida
  • umol/L
Alias
UMLS CUI [1,1]
C0201976
UMLS CUI [1,2]
C1519815
umol/L
Lactate Dehydrogenase
Descripción

Lactate Dehydrogenase

Tipo de datos

float

Unidades de medida
  • U/L
Alias
UMLS CUI [1]
C0202113
U/L
Lactate Dehydrogenase: Normal Range - Upper Limit
Descripción

Lactate Dehydrogenase: Upper Limit

Tipo de datos

float

Unidades de medida
  • U/L
Alias
UMLS CUI [1,1]
C0202113
UMLS CUI [1,2]
C1519815
U/L
Laboratory Tests Urinanalysis
Descripción

Laboratory Tests Urinanalysis

Alias
UMLS CUI-1
C0042014
Sodium (Urine)
Descripción

Urine Sodium

Tipo de datos

float

Unidades de medida
  • mmol/L
Alias
UMLS CUI [1]
C1256585
mmol/L
Potassium (Urine)
Descripción

Urine Potassium

Tipo de datos

float

Unidades de medida
  • mmol/L
Alias
UMLS CUI [1]
C0202195
mmol/L
Calcium (Urine)
Descripción

Urine Calcium

Tipo de datos

float

Unidades de medida
  • mmol/L
Alias
UMLS CUI [1]
C0428303
mmol/L
Cholride (Urine)
Descripción

Urine Chloride

Tipo de datos

float

Unidades de medida
  • mmol/L
Alias
UMLS CUI [1]
C0201953
mmol/L
White Blood Cell Count (Urine)
Descripción

Urine White Blood Cell Count

Tipo de datos

float

Unidades de medida
  • /mm3
Alias
UMLS CUI [1]
C0919738
/mm3
Eosinophils (Urine)
Descripción

Urine Eosinophils

Tipo de datos

float

Unidades de medida
  • /mm3
Alias
UMLS CUI [1]
C1141979
/mm3
Red Blood Cells (Urine)
Descripción

Macroscopic Hematuria

Tipo de datos

float

Unidades de medida
  • /mm3
Alias
UMLS CUI [1]
C0473237
/mm3
Urea (Urine)
Descripción

Urine Urea

Tipo de datos

float

Unidades de medida
  • mmol/L
Alias
UMLS CUI [1]
C0428278
mmol/L
Total Proteins (Urine)
Descripción

Proteinuria

Tipo de datos

float

Unidades de medida
  • mg/dL
Alias
UMLS CUI [1]
C0033687
mg/dL
Creatinine (Urine)
Descripción

Urine Creatinine

Tipo de datos

float

Unidades de medida
  • mg/dL
Alias
UMLS CUI [1]
C0236441
mg/dL
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
Laboratory Tests Unplanned
Descripción

Laboratory Tests Unplanned

Alias
UMLS CUI-1
C0022885
UMLS CUI-2
C3854240
Date
Descripción

Unplanned Laboratory Test Date

Tipo de datos

date

Unidades de medida
  • dd-mmm-yyyy
Alias
UMLS CUI [1,1]
C2826641
UMLS CUI [1,2]
C3854240
dd-mmm-yyyy
Test
Descripción

Unplanned Laboratory Test

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0022885
UMLS CUI [1,2]
C3854240
Value
Descripción

Unplanned Laboratory Test Value

Tipo de datos

float

Alias
UMLS CUI [1,1]
C0022885
UMLS CUI [1,2]
C3854240
UMLS CUI [1,3]
C1522609
Unit
Descripción

Unplanned Laboratory Test Unit

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0022885
UMLS CUI [1,2]
C3854240
UMLS CUI [1,3]
C1519795
Unplanned Laboratory Test: Normal Range - Lower Limit
Descripción

Unplanned Laboratory Test Lower Limit

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0022885
UMLS CUI [1,2]
C3854240
UMLS CUI [1,3]
C1518030
Unplanned Laboratory Test: Normal Range - Upper Limit
Descripción

Unplanned Laboratory Test Upper Limit

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0022885
UMLS CUI [1,2]
C3854240
UMLS CUI [1,3]
C1519815
Vital Signs (Additional)
Descripción

Vital Signs (Additional)

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
Blood Pressure: Systolic
Descripción

Systolic Blood Pressure

Tipo de datos

float

Unidades de medida
  • mmHg
Alias
UMLS CUI [1]
C0871470
mmHg
Blood Pressure: Diastolic
Descripción

Diastolic Blood Pressure

Tipo de datos

float

Unidades de medida
  • mmHg
Alias
UMLS CUI [1]
C0428883
mmHg
Heart rate
Descripción

Heart Rate

Tipo de datos

float

Unidades de medida
  • bpm
Alias
UMLS CUI [1]
C0018810
bpm
Temperature
Descripción

Body Temperature

Tipo de datos

float

Unidades de medida
  • Celsius
Alias
UMLS CUI [1]
C0005903
Celsius
Performance Status: ECOG
Descripción

ECOG Performance Status

Tipo de datos

integer

Alias
UMLS CUI [1]
C1520224
Electrocardiogram (12 Lead) (Additional)
Descripción

Electrocardiogram (12 Lead) (Additional)

Alias
UMLS CUI-1
C0013798
Date performed:
Descripción

ECG Date

Tipo de datos

date

Unidades de medida
  • dd-mmm-yyyy
Alias
UMLS CUI [1]
C2826640
dd-mmm-yyyy
Interpretation
Descripción

ECG finding

Tipo de datos

text

Alias
UMLS CUI [1]
C0438154
Interpretation - If abnormal, clinically significant?
Descripción

If abnormal, clinically significant, record on the AE Form.

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0438154
UMLS CUI [1,2]
C2826279
Dipstick Urinanalysis - Complete this page only if microscopic urinanalysis is not possible.
Descripción

Dipstick Urinanalysis - Complete this page only if microscopic urinanalysis is not possible.

Alias
UMLS CUI-1
C0430370
Date of sampling
Descripción

Collection date

Tipo de datos

date

Unidades de medida
  • dd-mmm-yyyy
Alias
UMLS CUI [1]
C1317250
dd-mmm-yyyy
White Blood Cells (qualitative)
Descripción

Urine Dipstick: White Blood Cells

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0023508
UMLS CUI [1,2]
C0430370
Red Blood Cells (qualitative)
Descripción

Urine Dipstick: Red Blood Cells

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0014772
UMLS CUI [1,2]
C0430370
Proteins (qualitative)
Descripción

Urine Dipstick: Proteins

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0033684
UMLS CUI [1,2]
C0430370
Glucose (qualitiatve)
Descripción

Urine Dipstick: Glucose

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0017725
UMLS CUI [1,2]
C0430370
Other Urine Dipstick Test
Descripción

Urine Dipstick: Other

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0205394
UMLS CUI [1,2]
C0430370
Result of other Urine Dipstick Test:
Descripción

Urine Dipstick: Other Specification

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0205394
UMLS CUI [1,2]
C2348235
UMLS CUI [1,3]
C0430370
Medication - Prior and Concomitant (Record all medications that the subject has taken within 21 days prior randomization and any medication taken during study)
Descripción

Medication - Prior and Concomitant (Record all medications that the subject has taken within 21 days prior randomization and any medication taken during study)

Alias
UMLS CUI-1
C2826257
UMLS CUI-3
C2347852
Drug/Medication (Brand or generic name)
Descripción

Medication

Tipo de datos

text

Alias
UMLS CUI [1]
C0013227
Reason
Descripción

Indication

Tipo de datos

text

Alias
UMLS CUI [1]
C3146298
Route
Descripción

Administration Route

Tipo de datos

text

Alias
UMLS CUI [1]
C0013153
Start Date
Descripción

Medication Start Date

Tipo de datos

date

Unidades de medida
  • dd-mmm-yyyy
Alias
UMLS CUI [1]
C3173309
dd-mmm-yyyy
End Date
Descripción

Medication End Date

Tipo de datos

date

Unidades de medida
  • dd-mmm-yyyy
Alias
UMLS CUI [1]
C2826744
dd-mmm-yyyy
OR Ongoing
Descripción

Medication Ongoing

Tipo de datos

boolean

Alias
UMLS CUI [1]
C2826666
Radiation Therapy: Concomitant - Post Treatment
Descripción

Radiation Therapy: Concomitant - Post Treatment

Alias
UMLS CUI-1
C1522449
Location
Descripción

Radiation Therapy: Location

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1515974
UMLS CUI [1,2]
C1522449
Start Date
Descripción

Radiation Therapy: Start Date

Tipo de datos

date

Unidades de medida
  • dd-mmm-yyyy
Alias
UMLS CUI [1,1]
C0808070
UMLS CUI [1,2]
C1522449
dd-mmm-yyyy
Stop Date
Descripción

Radtiation Therapy: Stop Date

Tipo de datos

date

Unidades de medida
  • dd-mmm-yyyy
Alias
UMLS CUI [1,1]
C0806020
UMLS CUI [1,2]
C1522449
dd-mmm-yyyy
Total Dose
Descripción

Radiation Therapy: Total Dose

Tipo de datos

float

Alias
UMLS CUI [1,1]
C2986497
UMLS CUI [1,2]
C1522449
Unit
Descripción

Radiation Therapy: Unit

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1519795
UMLS CUI [1,2]
C1522449
Intent
Descripción

Radiation Therapy: Intention

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1283828
UMLS CUI [1,2]
C1522449
Anti-Cancer Therapy: Concomitant - Post Systemic Therapies
Descripción

Anti-Cancer Therapy: Concomitant - Post Systemic Therapies

Alias
UMLS CUI-1
C0920425
Regimen No.
Descripción

Regimen Number

Tipo de datos

float

Alias
UMLS CUI [1,1]
C0040808
UMLS CUI [1,2]
C0237753
Drug Per Regimen
Descripción

Chemotherapy Regimen

Tipo de datos

text

Alias
UMLS CUI [1]
C0392920
Previously Reported
Descripción

Previously Reported

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0205309
Therapy Type
Descripción

Therapy Type

Tipo de datos

text

Alias
UMLS CUI [1]
C0087111
Anti-Cancer Therapy: Start Date
Descripción

Anti-Cancer Therapy: Start Date

Tipo de datos

date

Unidades de medida
  • dd-mmm-yyyy
Alias
UMLS CUI [1,1]
C0808070
UMLS CUI [1,2]
C0920425
dd-mmm-yyyy
End Date
Descripción

Anti-Cancer Therapy: End Date

Tipo de datos

date

Unidades de medida
  • dd-mmm-yyyy
Alias
UMLS CUI [1,1]
C0806020
UMLS CUI [1,2]
C0920425
dd-mmm-yyyy
Ongoing
Descripción

Anti-Cancer Therapy: Ongoing

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0549178
UMLS CUI [1,2]
C0920425
Surgery for Prostate Cancer: Concomitant - Post Treatment (Record relevant surgery information)
Descripción

Surgery for Prostate Cancer: Concomitant - Post Treatment (Record relevant surgery information)

Alias
UMLS CUI-1
C0194790
Surgery
Descripción

Operation on prostate

Tipo de datos

text

Alias
UMLS CUI [1]
C0194790
Surgery Date
Descripción

Date of operation on prostate

Tipo de datos

date

Unidades de medida
  • dd-mmm-yyyy
Alias
UMLS CUI [1,1]
C0194790
UMLS CUI [1,2]
C3258210
dd-mmm-yyyy
Other Procedures - Only for additional procedures related or performed as a result of an adverse event or for additional procedures not planned in the protocol but of interest to support safety analysis in the protocol.)
Descripción

Other Procedures - Only for additional procedures related or performed as a result of an adverse event or for additional procedures not planned in the protocol but of interest to support safety analysis in the protocol.)

Alias
UMLS CUI-1
C0393107
Procedure Description
Descripción

Procedure Description

Tipo de datos

text

Alias
UMLS CUI [1]
C0807506
Procedure Date
Descripción

Procedure Date

Tipo de datos

date

Unidades de medida
  • dd-mmm-yyyy
Alias
UMLS CUI [1]
C2584899
dd-mmm-yyyy
Outcome
Descripción

Outcome

Tipo de datos

text

Alias
UMLS CUI [1]
C0085415
If abnormal, Clinical significant?
Descripción

Abnormal Outcome

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0205161
UMLS CUI [1,2]
C0085415
If YES, Specify:
Descripción

Abnormal Outcome Specification

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0205161
UMLS CUI [1,2]
C0085415
UMLS CUI [1,3]
C2348235
Renal Failure Investigation
Descripción

Renal Failure Investigation

Alias
UMLS CUI-1
C0035078
UMLS CUI-2
C0220825
Procedure Description: Nephrological Examination - performed
Descripción

Nephrological Examination

Tipo de datos

boolean

Alias
UMLS CUI [1]
C1696488
Procedure Description: Kidney Biopsy - Performed?
Descripción

Kidney Biopsy

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0194073
Procedure Date
Descripción

Renal Failure: Procedure Date

Tipo de datos

date

Unidades de medida
  • dd-mmm-yyyy
Alias
UMLS CUI [1,1]
C2584899
UMLS CUI [1,2]
C0035078
dd-mmm-yyyy
Outcome
Descripción

Renal Failure: Outcome

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0085565
UMLS CUI [1,2]
C0035078
If Abnormal, Specify:
Descripción

Renal Failure: Outcome Specification

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0085565
UMLS CUI [1,2]
C0035078
UMLS CUI [1,3]
C2348235
Procedures - Cystoscopy
Descripción

Procedures - Cystoscopy

Alias
UMLS CUI-1
C0010702
Procedure Description: Cystoscopy - Performed?
Descripción

Cystoscopy

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0010702
Procedure Description: Bladder Biopsy - Performed?
Descripción

Bladder Biopsy

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0194379
Procedure Date
Descripción

Cystoscopy: Procedure Date

Tipo de datos

date

Unidades de medida
  • dd-mmm-yyyy
Alias
UMLS CUI [1,1]
C2584899
UMLS CUI [1,2]
C0010702
dd-mmm-yyyy
Outcome
Descripción

Cystoscopy: Outcome

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0085565
UMLS CUI [1,2]
C0010702
If Abnormal, Specify:
Descripción

Specification

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0085565
UMLS CUI [1,2]
C0010702
UMLS CUI [1,3]
C2348235
Symptomatic Deterioration (To be filled in only in case of symptomatic deterioration without documented objective progression on tumor assessment, PSA and/or pain as defined in the protocol.)
Descripción

Symptomatic Deterioration (To be filled in only in case of symptomatic deterioration without documented objective progression on tumor assessment, PSA and/or pain as defined in the protocol.)

Alias
UMLS CUI-1
C4086879
Date
Descripción

Symptomatic Deterioration: Date

Tipo de datos

date

Unidades de medida
  • dd-mmm-yyyy
Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C4086879
dd-mmm-yyyy
Subject Status
Descripción

Subject Status

Alias
UMLS CUI-1
C3891295
Date of last available information*:
Descripción

*In case of failing to recontact the patient, please use the information from the last actual contact for date of last available information.

Tipo de datos

date

Unidades de medida
  • dd-mmm-yyyy
Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C1533716
dd-mmm-yyyy
Method of contact:
Descripción

Method of Contact

Tipo de datos

text

Alias
UMLS CUI [1]
C1997600
If Other, Specify:
Descripción

Method of Contact Specification

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1997600
UMLS CUI [1,2]
C2348235
Subject Status
Descripción

*In case of failing to recontact the patient, please use the information from the last actual contact for date of last available information. **If the patient died, please complete a DEATH report form

Tipo de datos

text

Alias
UMLS CUI [1]
C3891295
Consent withdrawn
Descripción

Informed Consent

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0021430
If ticked, specify reason:
Descripción

Informed Consent Specification

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0021430
UMLS CUI [1,2]
C2348235

Similar models

CRFs Cabazitaxel Prostate Cancer NCT01308580 Additional

Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
Laboratory Tests Hematology
C0022885 (UMLS CUI-1)
C0474523 (UMLS CUI-2)
Laboratory Test Date
Item
Date
date
C2826641 (UMLS CUI [1])
Hemoglobin
Item
Hemoglobin
float
C0019046 (UMLS CUI [1])
Platelets
Item
Platelet Count (Thrombocyte Count)
float
C0005821 (UMLS CUI [1])
White Blood Cell Count
Item
White Blood Cell Count (Leukocyte Count)
float
C0023508 (UMLS CUI [1])
Neutrophils
Item
Neutrophils
float
C0948762 (UMLS CUI [1])
Lymphocytes
Item
Lymphocytes
float
C0024264 (UMLS CUI [1])
Monocytes
Item
Monocytes
float
C0026473 (UMLS CUI [1])
Eosinophils
Item
Eosinophils
float
C0200638 (UMLS CUI [1])
Basophils
Item
Basophils
float
C0200641 (UMLS CUI [1])
Item Group
Laboratory Tests Biochemistry
C0022885 (UMLS CUI-1)
C0005477 (UMLS CUI-2)
Laboratory Test Biochemistry Date
Item
Date
date
C2826641 (UMLS CUI [1,1])
C0005477 (UMLS CUI [1,2])
Sodium
Item
Sodium
float
C0337443 (UMLS CUI [1])
Potassium
Item
Potassium
float
C0202194 (UMLS CUI [1])
Calcium
Item
Calcium
float
C0201925 (UMLS CUI [1])
Phosphorus
Item
Phosphorus
float
C0031705 (UMLS CUI [1])
Blood Urea Nitrogen
Item
Blood urea nitrogen
float
C0005845 (UMLS CUI [1])
Magnesium
Item
Magnesium
float
C0373675 (UMLS CUI [1])
Total Proteins
Item
Total Proteins
float
C0555903 (UMLS CUI [1])
Albumin
Item
Albumin
float
C0201838 (UMLS CUI [1])
Blood Glucose
Item
Glucose
float
C0202042 (UMLS CUI [1])
AST
Item
AST (SGOT - ASAT)
float
C0201899 (UMLS CUI [1])
AST: Upper Limit
Item
AST (SGOT - ASAT): Normal Range - Upper Limit
float
C0201899 (UMLS CUI [1,1])
C1519815 (UMLS CUI [1,2])
ALT
Item
ALT (SGPT - ALAT)
float
C0201836 (UMLS CUI [1])
ALT: Upper Limit
Item
ALT (SGPT - ALAT): Normal Range - Upper Limit
float
C0201836 (UMLS CUI [1,1])
C1519815 (UMLS CUI [1,2])
Alkaline Phosphatase
Item
Alkaline Phosphatase
float
C0201850 (UMLS CUI [1])
Alkaline Phosphatase: Upper Limit
Item
Alkaline Phosphatase: Normal Range - Upper Limit
float
C0201850 (UMLS CUI [1,1])
C1519815 (UMLS CUI [1,2])
Total Bilirubin
Item
Total Bilirubin
float
C0201913 (UMLS CUI [1])
Total Bilirubin: Upper Limit
Item
Total Bilirubin: Normal Range - Upper Limit
float
C0201913 (UMLS CUI [1,1])
C1519815 (UMLS CUI [1,2])
Creatinine
Item
Creatinine
float
C0201976 (UMLS CUI [1])
Creatinine: Upper Limit
Item
Creatinine: Normal Range - Upper Limit
float
C0201976 (UMLS CUI [1,1])
C1519815 (UMLS CUI [1,2])
Lactate Dehydrogenase
Item
Lactate Dehydrogenase
float
C0202113 (UMLS CUI [1])
Lactate Dehydrogenase: Upper Limit
Item
Lactate Dehydrogenase: Normal Range - Upper Limit
float
C0202113 (UMLS CUI [1,1])
C1519815 (UMLS CUI [1,2])
Item Group
Laboratory Tests Urinanalysis
C0042014 (UMLS CUI-1)
Urine Sodium
Item
Sodium (Urine)
float
C1256585 (UMLS CUI [1])
Urine Potassium
Item
Potassium (Urine)
float
C0202195 (UMLS CUI [1])
Urine Calcium
Item
Calcium (Urine)
float
C0428303 (UMLS CUI [1])
Urine Chloride
Item
Cholride (Urine)
float
C0201953 (UMLS CUI [1])
Urine White Blood Cell Count
Item
White Blood Cell Count (Urine)
float
C0919738 (UMLS CUI [1])
Urine Eosinophils
Item
Eosinophils (Urine)
float
C1141979 (UMLS CUI [1])
Macroscopic Hematuria
Item
Red Blood Cells (Urine)
float
C0473237 (UMLS CUI [1])
Urine Urea
Item
Urea (Urine)
float
C0428278 (UMLS CUI [1])
Proteinuria
Item
Total Proteins (Urine)
float
C0033687 (UMLS CUI [1])
Urine Creatinine
Item
Creatinine (Urine)
float
C0236441 (UMLS CUI [1])
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
Laboratory Tests Unplanned
C0022885 (UMLS CUI-1)
C3854240 (UMLS CUI-2)
Unplanned Laboratory Test Date
Item
Date
date
C2826641 (UMLS CUI [1,1])
C3854240 (UMLS CUI [1,2])
Unplanned Laboratory Test
Item
Test
text
C0022885 (UMLS CUI [1,1])
C3854240 (UMLS CUI [1,2])
Unplanned Laboratory Test Value
Item
Value
float
C0022885 (UMLS CUI [1,1])
C3854240 (UMLS CUI [1,2])
C1522609 (UMLS CUI [1,3])
Unplanned Laboratory Test Unit
Item
Unit
text
C0022885 (UMLS CUI [1,1])
C3854240 (UMLS CUI [1,2])
C1519795 (UMLS CUI [1,3])
Unplanned Laboratory Test Lower Limit
Item
Unplanned Laboratory Test: Normal Range - Lower Limit
text
C0022885 (UMLS CUI [1,1])
C3854240 (UMLS CUI [1,2])
C1518030 (UMLS CUI [1,3])
Unplanned Laboratory Test Upper Limit
Item
Unplanned Laboratory Test: Normal Range - Upper Limit
text
C0022885 (UMLS CUI [1,1])
C3854240 (UMLS CUI [1,2])
C1519815 (UMLS CUI [1,3])
Item Group
Vital Signs (Additional)
C0518766 (UMLS CUI-1)
Assessment Date
Item
Date performed:
date
C2985720 (UMLS CUI [1])
Weight
Item
Weight
float
C0005910 (UMLS CUI [1])
Systolic Blood Pressure
Item
Blood Pressure: Systolic
float
C0871470 (UMLS CUI [1])
Diastolic Blood Pressure
Item
Blood Pressure: Diastolic
float
C0428883 (UMLS CUI [1])
Heart Rate
Item
Heart rate
float
C0018810 (UMLS CUI [1])
Body Temperature
Item
Temperature
float
C0005903 (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
Electrocardiogram (12 Lead) (Additional)
C0013798 (UMLS CUI-1)
ECG Date
Item
Date performed:
date
C2826640 (UMLS CUI [1])
Item
Interpretation
text
C0438154 (UMLS CUI [1])
Code List
Interpretation
CL Item
Abnormal (Abnormal)
CL Item
Normal (Normal)
ECG finding abnormal
Item
Interpretation - If abnormal, clinically significant?
boolean
C0438154 (UMLS CUI [1,1])
C2826279 (UMLS CUI [1,2])
Item Group
Dipstick Urinanalysis - Complete this page only if microscopic urinanalysis is not possible.
C0430370 (UMLS CUI-1)
Collection date
Item
Date of sampling
date
C1317250 (UMLS CUI [1])
Item
White Blood Cells (qualitative)
text
C0023508 (UMLS CUI [1,1])
C0430370 (UMLS CUI [1,2])
Code List
White Blood Cells (qualitative)
CL Item
Absent (Absent)
CL Item
+ (+)
CL Item
++ (++)
CL Item
+++ (+++)
CL Item
Not evalubale (Not evalubale)
CL Item
Not done (Not done)
Item
Red Blood Cells (qualitative)
text
C0014772 (UMLS CUI [1,1])
C0430370 (UMLS CUI [1,2])
Code List
Red Blood Cells (qualitative)
CL Item
Absent (Absent)
CL Item
+ (+)
CL Item
++ (++)
CL Item
+++ (+++)
CL Item
Not evalubale (Not evalubale)
CL Item
Not done (Not done)
Item
Proteins (qualitative)
text
C0033684 (UMLS CUI [1,1])
C0430370 (UMLS CUI [1,2])
Code List
Proteins (qualitative)
CL Item
Absent (Absent)
CL Item
+ (+)
CL Item
++ (++)
CL Item
+++ (+++)
CL Item
Not evalubale (Not evalubale)
CL Item
Not done (Not done)
Item
Glucose (qualitiatve)
text
C0017725 (UMLS CUI [1,1])
C0430370 (UMLS CUI [1,2])
Code List
Glucose (qualitiatve)
CL Item
Absent (Absent)
CL Item
+ (+)
CL Item
++ (++)
CL Item
+++ (+++)
CL Item
Not evalubale (Not evalubale)
CL Item
Not done (Not done)
Urine Dipstick: Other
Item
Other Urine Dipstick Test
text
C0205394 (UMLS CUI [1,1])
C0430370 (UMLS CUI [1,2])
Item
Result of other Urine Dipstick Test:
text
C0205394 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
C0430370 (UMLS CUI [1,3])
Code List
Result of other Urine Dipstick Test:
CL Item
Absent (Absent)
CL Item
+ (+)
CL Item
++ (++)
CL Item
+++ (+++)
CL Item
Not evalubale (Not evalubale)
CL Item
Not done (Not done)
Item Group
Medication - Prior and Concomitant (Record all medications that the subject has taken within 21 days prior randomization and any medication taken during study)
C2826257 (UMLS CUI-1)
C2347852 (UMLS CUI-3)
Medication
Item
Drug/Medication (Brand or generic name)
text
C0013227 (UMLS CUI [1])
Indication
Item
Reason
text
C3146298 (UMLS CUI [1])
Administration Route
Item
Route
text
C0013153 (UMLS CUI [1])
Medication Start Date
Item
Start Date
date
C3173309 (UMLS CUI [1])
Medication End Date
Item
End Date
date
C2826744 (UMLS CUI [1])
Medication Ongoing
Item
OR Ongoing
boolean
C2826666 (UMLS CUI [1])
Item Group
Radiation Therapy: Concomitant - Post Treatment
C1522449 (UMLS CUI-1)
Radiation Therapy: Location
Item
Location
text
C1515974 (UMLS CUI [1,1])
C1522449 (UMLS CUI [1,2])
Radiation Therapy: Start Date
Item
Start Date
date
C0808070 (UMLS CUI [1,1])
C1522449 (UMLS CUI [1,2])
Radtiation Therapy: Stop Date
Item
Stop Date
date
C0806020 (UMLS CUI [1,1])
C1522449 (UMLS CUI [1,2])
Radiation Therapy: Total Dose
Item
Total Dose
float
C2986497 (UMLS CUI [1,1])
C1522449 (UMLS CUI [1,2])
Item
Unit
text
C1519795 (UMLS CUI [1,1])
C1522449 (UMLS CUI [1,2])
CL Item
Grays (Grays)
CL Item
Rads (Rads)
Item
Intent
text
C1283828 (UMLS CUI [1,1])
C1522449 (UMLS CUI [1,2])
CL Item
Palliative (Palliative)
CL Item
Curative (Curative)
Item Group
Anti-Cancer Therapy: Concomitant - Post Systemic Therapies
C0920425 (UMLS CUI-1)
Regimen Number
Item
Regimen No.
float
C0040808 (UMLS CUI [1,1])
C0237753 (UMLS CUI [1,2])
Chemotherapy Regimen
Item
Drug Per Regimen
text
C0392920 (UMLS CUI [1])
Previously Reported
Item
Previously Reported
boolean
C0205309 (UMLS CUI [1])
Therapy Type
Item
Therapy Type
text
C0087111 (UMLS CUI [1])
Anti-Cancer Therapy: Start Date
Item
date
C0808070 (UMLS CUI [1,1])
C0920425 (UMLS CUI [1,2])
Anti-Cancer Therapy: End Date
Item
End Date
date
C0806020 (UMLS CUI [1,1])
C0920425 (UMLS CUI [1,2])
Anti-Cancer Therapy: Ongoing
Item
Ongoing
boolean
C0549178 (UMLS CUI [1,1])
C0920425 (UMLS CUI [1,2])
Item Group
Surgery for Prostate Cancer: Concomitant - Post Treatment (Record relevant surgery information)
C0194790 (UMLS CUI-1)
Operation on prostate
Item
Surgery
text
C0194790 (UMLS CUI [1])
Date of operation on prostate
Item
Surgery Date
date
C0194790 (UMLS CUI [1,1])
C3258210 (UMLS CUI [1,2])
Item Group
Other Procedures - Only for additional procedures related or performed as a result of an adverse event or for additional procedures not planned in the protocol but of interest to support safety analysis in the protocol.)
C0393107 (UMLS CUI-1)
Procedure Description
Item
Procedure Description
text
C0807506 (UMLS CUI [1])
Procedure Date
Item
Procedure Date
date
C2584899 (UMLS CUI [1])
Item
Outcome
text
C0085415 (UMLS CUI [1])
Code List
Outcome
CL Item
Not applicable (Not applicable)
CL Item
Normal (Normal)
CL Item
Abnormal (Abnormal)
Abnormal Outcome
Item
If abnormal, Clinical significant?
boolean
C0205161 (UMLS CUI [1,1])
C0085415 (UMLS CUI [1,2])
Abnormal Outcome Specification
Item
If YES, Specify:
text
C0205161 (UMLS CUI [1,1])
C0085415 (UMLS CUI [1,2])
C2348235 (UMLS CUI [1,3])
Item Group
Renal Failure Investigation
C0035078 (UMLS CUI-1)
C0220825 (UMLS CUI-2)
Nephrological Examination
Item
Procedure Description: Nephrological Examination - performed
boolean
C1696488 (UMLS CUI [1])
Kidney Biopsy
Item
Procedure Description: Kidney Biopsy - Performed?
boolean
C0194073 (UMLS CUI [1])
Renal Failure: Procedure Date
Item
Procedure Date
date
C2584899 (UMLS CUI [1,1])
C0035078 (UMLS CUI [1,2])
Item
Outcome
text
C0085565 (UMLS CUI [1,1])
C0035078 (UMLS CUI [1,2])
Code List
Outcome
CL Item
Normal (Normal)
CL Item
Abnormal (Abnormal)
Renal Failure: Outcome Specification
Item
If Abnormal, Specify:
text
C0085565 (UMLS CUI [1,1])
C0035078 (UMLS CUI [1,2])
C2348235 (UMLS CUI [1,3])
Item Group
Procedures - Cystoscopy
C0010702 (UMLS CUI-1)
Cystoscopy
Item
Procedure Description: Cystoscopy - Performed?
boolean
C0010702 (UMLS CUI [1])
Bladder Biopsy
Item
Procedure Description: Bladder Biopsy - Performed?
boolean
C0194379 (UMLS CUI [1])
Cystoscopy: Procedure Date
Item
Procedure Date
date
C2584899 (UMLS CUI [1,1])
C0010702 (UMLS CUI [1,2])
Item
Outcome
text
C0085565 (UMLS CUI [1,1])
C0010702 (UMLS CUI [1,2])
Code List
Outcome
CL Item
Normal (Normal)
CL Item
Abnormal (Abnormal)
Specification
Item
If Abnormal, Specify:
text
C0085565 (UMLS CUI [1,1])
C0010702 (UMLS CUI [1,2])
C2348235 (UMLS CUI [1,3])
Item Group
Symptomatic Deterioration (To be filled in only in case of symptomatic deterioration without documented objective progression on tumor assessment, PSA and/or pain as defined in the protocol.)
C4086879 (UMLS CUI-1)
Symptomatic Deterioration: Date
Item
Date
date
C0011008 (UMLS CUI [1,1])
C4086879 (UMLS CUI [1,2])
Item Group
Subject Status
C3891295 (UMLS CUI-1)
Date of Last Information
Item
Date of last available information*:
date
C0011008 (UMLS CUI [1,1])
C1533716 (UMLS CUI [1,2])
Item
Method of contact:
text
C1997600 (UMLS CUI [1])
Code List
Method of contact:
CL Item
Scheduled Visit (Scheduled Visit)
CL Item
Phone (Phone)
CL Item
Other (Other)
Method of Contact Specification
Item
If Other, Specify:
text
C1997600 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
Item
Subject Status
text
C3891295 (UMLS CUI [1])
Code List
Subject Status
CL Item
Alive  (Alive )
CL Item
Lost to follow-up* (Lost to follow-up*)
CL Item
Dead** (Dead**)
Informed Consent
Item
Consent withdrawn
boolean
C0021430 (UMLS CUI [1])
Informed Consent Specification
Item
If ticked, specify reason:
text
C0021430 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])

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