ID

24297

Description

Blood Chemistry form for C3D 3.12 Adopters Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=FF04F699-FE6A-56AA-E034-0003BA3F9857

Lien

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=FF04F699-FE6A-56AA-E034-0003BA3F9857

Mots-clés

Versions (2)
  1. 19/09/2012 19/09/2012 -
  2. 29/07/2017 29/07/2017 - Martin Dugas
Téléchargé le

29 juillet 2017

DOI

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Licence

Creative Commons BY-NC 3.0
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C3D Adopter Template Forms

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1 Formulaires  
  1. StudyEvent: BLOOD CHEMISTRY
    1. No Instruction available.
Blood Chemistry
Description

Blood Chemistry

Alias
UMLS CUI-1
C0005774
Course Number
Description

Course Number

Type de données

integer

Alias
NCI Thesaurus Property
C25337
NCI Thesaurus ValueDomain
C25337
NCI Thesaurus ObjectClass
C25379
UMLS CUI [1,1]
C0750729
UMLS CUI [1,2]
C0237753
Course Day Number
Description

Course Day Number

Type de données

integer

Alias
NCI Thesaurus ValueDomain
C25337
NCI Thesaurus Property
C25301
NCI Thesaurus ObjectClass
C25379
UMLS CUI [1,1]
C0750729
UMLS CUI [1,2]
C0439228
Sample Collection Date
Description

Sample Collection Date

Type de données

date

Alias
NCI Thesaurus Property
C25164
NCI Thesaurus ValueDomain
C25164
NCI Thesaurus ObjectClass
C25453
NCI Thesaurus ObjectClass-2
C19157
UMLS CUI [1]
C1302413
Time
Description

Lab Collection Time

Type de données

time

Alias
NCI Thesaurus Property
C25453
NCI Thesaurus Property-2
C25207
NCI Thesaurus ValueDomain
C25207
NCI Thesaurus ObjectClass
C25294
UMLS CUI [1]
C0552379
Lab Test
Description

Laboratory Finding Name

Type de données

text

Alias
NCI Thesaurus ObjectClass
C38470
NCI Thesaurus ValueDomain
C25294
NCI Thesaurus Property
C42614
NCI Thesaurus ValueDomain-2
C42614
UMLS CUI [1]
C0587081
Lab Value
Description

LaboratoryTestResultCharacterValue

Type de données

text

Alias
NCI Thesaurus ObjectClass
C36292
UMLS 2011AA ObjectClass
C0587081
NCI Thesaurus Property
C25712
UMLS 2011AA Property
C1522609
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
NCI Thesaurus ValueDomain-2
C36292
UMLS 2011AA ValueDomain-2
C0587081
NCI Thesaurus ValueDomain-3
C68805
UMLS 2011AA ValueDomain-3
C2350015
Lab Unit of Measure Name
Description

LabUnitofMeasureName

Type de données

text

Alias
NCI Thesaurus ObjectClass
C38470
NCI Thesaurus Property
C25709
UMLS 2011AA Property
C1519795
NCI Thesaurus ValueDomain
C42614
UMLS 2011AA ValueDomain
C0027365
Test Result Significance Indicator
Description

TestResultSignificanceIndicator

Type de données

text

Alias
NCI Thesaurus ObjectClass
C27232
NCI Metathesaurus Property
C0814896
NCI Thesaurus ValueDomain
C25162
UMLS 2011AA ValueDomain
C0805701
NCI Thesaurus ValueDomain-2
C25704
UMLS 2011AA ValueDomain-2
C1527021
NCI Thesaurus ValueDomain-3
C25180
UMLS 2011AA ValueDomain-3
C1522602
Laboratory Test Normal Reference Range Text
Description

LaboratoryTestNormalReferenceRangeText

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus ObjectClass
C38470
NCI Metathesaurus Property
C0034926
Laboratory Test Normal Range Indicator
Description

LaboratoryTestNormalRangeIndicator

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
NCI Thesaurus ObjectClass
C38470
NCI Metathesaurus Property
C0034926
Common Toxicity Criteria Adverse Event Grade
Description

CommonToxicityCriteriaAdverseEventGrade

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus Property
C18000
UMLS 2011AA Property
C0919553
NCI Thesaurus ObjectClass
C25468
Comments
Description

Comments

Note Date
Description

NoteDate

Type de données

date

Alias
NCI Thesaurus Property
C25164
UMLS 2011AA Property
C0011008
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Metathesaurus ObjectClass
C1317574
Research Comments Text
Description

ResearchCommentsText

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus ObjectClass
C15319
NCI Thesaurus Property
C25393
UMLS 2011AA Property
C0282411
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1 Formulaires
  1. StudyEvent: BLOOD CHEMISTRY
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Type de données
Alias
Item Group
Blood Chemistry
C0005774 (UMLS CUI-1)
Course Number
Item
Course Number
integer
C25337 (NCI Thesaurus Property)
C25337 (NCI Thesaurus ValueDomain)
C25379 (NCI Thesaurus ObjectClass)
C0750729 (UMLS CUI [1,1])
C0237753 (UMLS CUI [1,2])
Course Day Number
Item
Course Day Number
integer
C25337 (NCI Thesaurus ValueDomain)
C25301 (NCI Thesaurus Property)
C25379 (NCI Thesaurus ObjectClass)
C0750729 (UMLS CUI [1,1])
C0439228 (UMLS CUI [1,2])
Sample Collection Date
Item
Sample Collection Date
date
C25164 (NCI Thesaurus Property)
C25164 (NCI Thesaurus ValueDomain)
C25453 (NCI Thesaurus ObjectClass)
C19157 (NCI Thesaurus ObjectClass-2)
C1302413 (UMLS CUI [1])
Lab Collection Time
Item
Time
time
C25453 (NCI Thesaurus Property)
C25207 (NCI Thesaurus Property-2)
C25207 (NCI Thesaurus ValueDomain)
C25294 (NCI Thesaurus ObjectClass)
C0552379 (UMLS CUI [1])
Item
Lab Test
text
C38470 (NCI Thesaurus ObjectClass)
C25294 (NCI Thesaurus ValueDomain)
C42614 (NCI Thesaurus Property)
C42614 (NCI Thesaurus ValueDomain-2)
C0587081 (UMLS CUI [1])
CL.1
Code List
Lab Test
CL Item
Cholesterol, Serum (Cholesterol, Serum)
(Comment:en)
CL Item
Serum Blood Urea (BUN)
C0600137 (UMLS CUI-1)
(Comment:en)
CL Item
Serum Creatinine (Creatinine)
C0600061 (UMLS CUI-1)
(Comment:en)
CL Item
Sodium, Serum (Sodium)
C0337443 (UMLS CUI-1)
(Comment:en)
CL Item
Serum Amylase (Amylase)
C0201883 (UMLS CUI-1)
(Comment:en)
CL Item
Creatinine Kinase, Serum (CK)
C1301904 (UMLS CUI-1)
(Comment:en)
CL Item
Potassium, Serum (Potassium)
C0202194 (UMLS CUI-1)
(Comment:en)
CL Item
Chloride, Serum (Chloride)
C0201952 (UMLS CUI-1)
(Comment:en)
CL Item
Magnesium, Serum (Magnesium)
C0373675 (UMLS CUI-1)
(Comment:en)
CL Item
Bicarbonate, Serum (Bicarbonate)
C0202059 (UMLS CUI-1)
(Comment:en)
CL Item
Urate, Serum (Uric Acid)
C0041980 (UMLS CUI-1)
(Comment:en)
CL Item
Serum Total Bilirubin (Bilirubin, Total)
C1278039 (UMLS CUI-1)
(Comment:en)
CL Item
Alkaline Phosphatase, Serum (Alkaline Phosphatase)
C0201850 (UMLS CUI-1)
(Comment:en)
CL Item
Serum Aspartate Aminotransferase (AST)
C2229595 (UMLS CUI-1)
(Comment:en)
CL Item
Serum Alanine Aminotransferase (ALT)
C0201836 (UMLS CUI-1)
(Comment:en)
CL Item
Gamma Glutamyl Transferase, Serum (GGT)
C0202035 (UMLS CUI-1)
(Comment:en)
CL Item
Lactate Dehydrogenase, Serum (LDH)
C0202113 (UMLS CUI-1)
(Comment:en)
CL Item
Total Protein, Serum (Total Protein)
C1318415 (UMLS CUI-1)
(Comment:en)
CL Item
Albumin, Serum (Albumin)
C0523465 (UMLS CUI-1)
(Comment:en)
CL Item
Gamma Globulin, Protein Electrophoresis, Serum (Gamma Globulin)
C0430072 (UMLS CUI-1)
(Comment:en)
CL Item
Calcium, Serum (Calcium)
C0728876 (UMLS CUI-1)
(Comment:en)
CL Item
Phosphate (inorganic Phosphorus), Serum (Phosphate)
C0523826 (UMLS CUI-1)
(Comment:en)
CL Item
Glucose, Fasting, Serum (Fasting Glucose)
C0202045 (UMLS CUI-1)
(Comment:en)
CL Item
Glucose, Non-fasting, Serum (Non-fasting Glucose)
(Comment:en)
LaboratoryTestResultCharacterValue
Item
Lab Value
text
C36292 (NCI Thesaurus ObjectClass)
C0587081 (UMLS 2011AA ObjectClass)
C25712 (NCI Thesaurus Property)
C1522609 (UMLS 2011AA Property)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C36292 (NCI Thesaurus ValueDomain-2)
C0587081 (UMLS 2011AA ValueDomain-2)
C68805 (NCI Thesaurus ValueDomain-3)
C2350015 (UMLS 2011AA ValueDomain-3)
Item
Lab Unit of Measure Name
text
C38470 (NCI Thesaurus ObjectClass)
C25709 (NCI Thesaurus Property)
C1519795 (UMLS 2011AA Property)
C42614 (NCI Thesaurus ValueDomain)
C0027365 (UMLS 2011AA ValueDomain)
CL.2
Code List
Lab Unit of Measure Name
CL Item
Percent (%)
C48570 (NCI Thesaurus)
C0439165 (UMLS 2011AA)
CL Item
Percent Per 100 Wbc (%/100 WBC)
CL Item
Per 100 Identifiable White Blood Cells (/100 WBC)
CL Item
Per Millimeter Cubed (/mm3)
CL Item
10e12 Cells Per Liter (10E12 Cells/L)
CL Item
10e3 Cells Per Microliter (10E3 Cells/microL)
CL Item
10e6 Cells (10E6 Cells)
CL Item
10e6 Cells Per Microliter (10E6 Cells/microL)
CL Item
10e6 Cells Per Millimeter Cubed (10E6 Cells/mm3)
CL Item
10e7 Cells Per Kilogram (10E7 Cells/kg)
CL Item
10e8 Cells (10E8 Cells)
CL Item
10e9 Cells (10E9 Cells)
CL Item
10e9 Cells Per Liter (10E9 Cells/L)
CL Item
Complement Activity Enzyme Unit (CAE Unit)
CL Item
Cells Per Microliter (Cells/microL)
CL Item
Copies (Copies)
CL Item
Cubic Microns (cubic microns)
CL Item
Enzyme Unit (EU)
C64778 (NCI Thesaurus)
C1880519 (UMLS 2011AA)
CL Item
Enzyme Units Per Deciliter (EU/dL)
CL Item
Enzyme Units Per Milliliter (EU/mL)
CL Item
Femtoliter (fL)
C64780 (NCI Thesaurus)
C0475213 (UMLS 2011AA)
CL Item
Grams (g) (g)
C48155 (NCI Thesaurus)
C0439208 (UMLS 2011AA)
CL Item
Gram Per 24 Hours (g/24hr)
CL Item
Gram Per Deciliter (g/dL)
CL Item
Gram Per Liter (g/L)
CL Item
Gram Per Microliter (g/microL)
CL Item
Per High Power Field (HPF)
CL Item
International Unit (Iunit)
C28255 (NCI Thesaurus)
CL Item
International Unit Per Liter (IUnit/L)
C67376 (NCI Thesaurus)
C0439457 (UMLS 2011AA)
CL Item
International Unit Per Meter Squared (IUnit/m2)
CL Item
International Unit Per Milliliter (IUnit/mL)
CL Item
Iu/ml (IUnit/mL)
CL Item
Kilounit Per Liter (kU/L)
C67382 (NCI Thesaurus)
C1532633 (UMLS 2011AA)
CL Item
Liter (L)
CL Item
Liters Per Minute (L/min)
C67388 (NCI Thesaurus)
C0439393 (UMLS 2011AA)
CL Item
Per Low Power Field (LPF)
CL Item
Microgram Per 24 Hours (mcg/24hr)
CL Item
Microgram Per Deciliter (mcg/dL)
CL Item
Microgram Per Liter (mcg/L)
CL Item
Microgram Per Milliliter (mcg/mL)
CL Item
Microgram Per Specimen (mcg/spec)
CL Item
Milliequivalent (mEq)
C48512 (NCI Thesaurus)
C0439152 (UMLS 2011AA)
CL Item
Milliequivalents Per 24 Hours (mEq/24hr)
CL Item
Milliequivalent Per Deciliter (mEq/dL)
C67473 (NCI Thesaurus)
C1532568 (UMLS 2011AA)
CL Item
Milliequivalent Per Kilogram (mEq/kg)
CL Item
Milliequivalent Per Liter (mEq/L)
C67474 (NCI Thesaurus)
C0439375 (UMLS 2011AA)
CL Item
Milligram (mg)
C28253 (NCI Thesaurus)
C0439210 (UMLS 2011AA)
CL Item
Milligram Per 24 Hours (mg/24hr)
C67399 (NCI Thesaurus)
C0439423 (UMLS 2011AA)
CL Item
Milligram Per Deciliter (mg/dL)
CL Item
Milligram Per Kilogram (mg/kg)
CL Item
Milligram Per Liter (mg/L)
CL Item
Milligram Per Milliliter (mg/mL)
CL Item
Milligram Per Milliliter Per Minute (mg/mL/min)
CL Item
Micro International Unit Per Milliliter (microIU/mL)
CL Item
Microliter (microL)
CL Item
Micromole Per 24 Hours (micromol/24hr)
CL Item
Micromole Per Deciliter (micromol/dL)
CL Item
Micromole Per Liter (micromol/L)
CL Item
Million Plaque Forming Units (mill PFU)
C67268 (NCI Thesaurus)
C1881844 (UMLS 2011AA)
CL Item
Million (Million)
C67238 (NCI Thesaurus)
C1881839 (UMLS 2011AA)
CL Item
Million Per Microliter (Million/microL)
CL Item
Million Per Millimeter Cubed (Million/mm3)
CL Item
Milliinternational Unit (miu)
CL Item
Milliinternational Units Per Meter Squared (miu/m2)
CL Item
Milliinternational Unit Per Milliliter (miu/mL)
CL Item
Milliter (mL)
CL Item
Milliliter Per Minute (mL/min)
CL Item
Milliliter Per Minute Times 1.73 Times Bsa (mL/min/1.73/BSA)
CL Item
Milliter Per Minute Per Millimeters Of Mercury (mL/minute/mmHg)
CL Item
Millimeter Per Hour (mm/hr)
CL Item
Millimeter Cubed (mm3)
CL Item
Millimeter Of Mercury (mmHg)
C49670 (NCI Thesaurus)
C0439475 (UMLS 2011AA)
CL Item
Millimole (mmol)
CL Item
Millimole Per 24 Hours (mmol/24hr)
CL Item
Millimole Per Liter (mmol/L)
CL Item
Milliosmole Per Kilogram (mosmol/kg)
CL Item
Million Units Per Milliliter (MU/mL)
CL Item
Not Applicable; No Uom Required (NA)
CL Item
Nanogram Per Deciliter (ng/dL)
CL Item
Nanograms Per Milliliter (ng/mL)
CL Item
Nanogram Per Milliliter Per Hour (ng/mL/hr)
C67430 (NCI Thesaurus)
C1533072 (UMLS 2011AA)
CL Item
Nanomole Per Liter (nmol/L)
C67432 (NCI Thesaurus)
C0439282 (UMLS 2011AA)
CL Item
Nanomole Per Milligram Of Protein (nMol/mg protein)
CL Item
Nanomole Per Milliliter (nmol/mL)
CL Item
No Source Data (No Srce)
C53269 (NCI Thesaurus)
C1546437 (UMLS 2011AA)
CL Item
Picograms (pg)
CL Item
Picogram Per Deciliter (pg/dL)
CL Item
Picrogram Per Milliliter (pg/mL)
CL Item
Pgpge2/mg Protein (pgPGE2/mg protein)
CL Item
Picomole Per Liter (pmol/L)
C67434 (NCI Thesaurus)
C0439284 (UMLS 2011AA)
CL Item
Ratio (Ratio)
CL Item
Rna Copies Per Milliliter (RNA copies/mL)
CL Item
Seconds (sec)
C0457385 (NCI Metathesaurus)
CL Item
Thousand (Thousand)
C67234 (NCI Thesaurus)
C1883310 (UMLS 2011AA)
CL Item
Thousand Per Microliter (Thousand/microL)
CL Item
Thousand Per Millimeter Squared (Thousand/mm2)
CL Item
Thousand Per Millimeter Cubed (Thousand/mm3)
CL Item
Titer (Titer)
CL Item
Unit (Unit)
C44278 (NCI Thesaurus)
C0439148 (UMLS 2011AA)
CL Item
Unit Per 24 Hours (Unit/24hr)
CL Item
Unit Per Liter (Unit/L)
CL Item
Unit Per Meter Squared (Unit/m2)
CL Item
Unit Per Millilliter (Unit/mL)
CL Item
Unit Per Millimeters Cubed (Unit/mm3)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Test Result Significance Indicator
text
C27232 (NCI Thesaurus ObjectClass)
C0814896 (NCI Metathesaurus Property)
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
C25704 (NCI Thesaurus ValueDomain-2)
C1527021 (UMLS 2011AA ValueDomain-2)
C25180 (NCI Thesaurus ValueDomain-3)
C1522602 (UMLS 2011AA ValueDomain-3)
CL.3
Code List
Test Result Significance Indicator
CL Item
No (N)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Y)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
LaboratoryTestNormalReferenceRangeText
Item
Laboratory Test Normal Reference Range Text
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C38470 (NCI Thesaurus ObjectClass)
C0034926 (NCI Metathesaurus Property)
Item
Laboratory Test Normal Range Indicator
text
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C38470 (NCI Thesaurus ObjectClass)
C0034926 (NCI Metathesaurus Property)
CL.4
Code List
Laboratory Test Normal Range Indicator
CL Item
High (High)
C25227 (NCI Thesaurus)
C0205250 (UMLS 2011AA)
CL Item
Low (Low)
C54722 (NCI Thesaurus)
C0205251 (UMLS 2011AA)
CL Item
Nonnumeric (Nonnum)
CL Item
No Range (Norang)
CL Item
Normal (Normal)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
Item
Common Toxicity Criteria Adverse Event Grade
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C18000 (NCI Thesaurus Property)
C0919553 (UMLS 2011AA Property)
C25468 (NCI Thesaurus ObjectClass)
CL.5
Code List
Common Toxicity Criteria Adverse Event Grade
CL Item
No Adverse Event Or Within Normal Limits (0)
CL Item
Mild Adverse Event (1)
C41338 (NCI Thesaurus)
C1513302 (UMLS 2011AA)
CL Item
Moderate Adverse Event (2)
C41339 (NCI Thesaurus)
C1513374 (UMLS 2011AA)
CL Item
Severe And Undesirable Adverse Event (3)
CL Item
Life-threatening Or Disabling Adverse Event (4)
CL Item
Death Related To Adverse Event (5)
C48275 (NCI Thesaurus)
C1705232 (UMLS 2011AA)
Item Group
Comments
NoteDate
Item
Note Date
date
C25164 (NCI Thesaurus Property)
C0011008 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C1317574 (NCI Metathesaurus ObjectClass)
ResearchCommentsText
Item
Research Comments Text
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C0282411 (UMLS 2011AA Property)
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