ID

25168

Description

CALGB 50901 Off-Treatment Form Ofatumumab in Treating Patients With Previously Untreated Stage II, Stage III, or Stage IV Follicular Non-Hodgkin Lymphoma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=9F3C69B5-BEE4-AEDA-E040-BB89AD436BFE

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=9F3C69B5-BEE4-AEDA-E040-BB89AD436BFE

Keywords

  1. 9/19/12 9/19/12 -
  2. 8/28/17 8/28/17 -
Uploaded on

August 28, 2017

DOI

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License

Creative Commons BY-NC 3.0 Legacy

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CALGB 50901 Off-Treatment Form

No Instruction available.

  1. StudyEvent: CALGB 50901 Off-Treatment Form
    1. No Instruction available.
Treatment Schedule (oral Antiandrogen)
Description

Treatment Schedule (oral Antiandrogen)

Alias
UMLS CUI-1
C0040808
UMLS CUI-2
C0002842
UMLS CUI-3
C0024301
Date of Last Dose of Protocol Systemic Therapy
Description

LastDoseSystemicProtocolDate

Data type

date

Alias
NCI Thesaurus ObjectClass
C25488
NCI Thesaurus ObjectClass-2
C25551
NCI Thesaurus Property
C25320
NCI Thesaurus Property-2
C13310
NCI Thesaurus ValueDomain
C25164
NCI Thesaurus ValueDomain-2
C25367
UMLS CUI [1,1]
C0178602
UMLS CUI [1,2]
C1517741
UMLS CUI [1,3]
C0011008
Reason Treatment Ended
Description

Off Treatment Reason

Data type

integer

Alias
NCI Thesaurus ValueDomain
C25638
NCI Thesaurus ObjectClass
C25601
NCI Thesaurus Property
C25365
UMLS CUI [1,1]
C1518544
UMLS CUI [1,2]
C0392360
Adverse event/side effects/complications specify
Description

Off-TreatmentAdverseEventReasonSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
NCI Thesaurus Property
C25638
NCI Thesaurus Property-2
C41331
NCI Thesaurus ObjectClass
C25601
UMLS CUI [1]
C0877248
UMLS CUI [2]
C0001688
UMLS CUI [3]
C0009566
UMLS CUI [4]
C1518544
Patient off-treatment for other complicating disease, specify
Description

Off-TreatmentConditionSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
NCI Thesaurus ObjectClass
C25601
NCI Thesaurus Property
C25457
UMLS CUI [1,1]
C0348080
UMLS CUI [1,2]
C1518544
Other specify
Description

Off Treatment Reason, specify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
NCI Thesaurus ObjectClass
C25601
NCI Thesaurus Property
C25365
UMLS CUI [1,1]
C1518544
UMLS CUI [1,2]
C0392360

Similar models

No Instruction available.

  1. StudyEvent: CALGB 50901 Off-Treatment Form
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Treatment Schedule (oral Antiandrogen)
C0040808 (UMLS CUI-1)
C0002842 (UMLS CUI-2)
C0024301 (UMLS CUI-3)
Date of Last Dose
Item
Date of Last Dose of Protocol Systemic Therapy
date
C25488 (NCI Thesaurus ObjectClass)
C25551 (NCI Thesaurus ObjectClass-2)
C25320 (NCI Thesaurus Property)
C13310 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
C0178602 (UMLS CUI [1,1])
C1517741 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
Item
Reason Treatment Ended
integer
C25638 (NCI Thesaurus ValueDomain)
C25601 (NCI Thesaurus ObjectClass)
C25365 (NCI Thesaurus Property)
C1518544 (UMLS CUI [1,1])
C0392360 (UMLS CUI [1,2])
Code List
Reason Treatment Ended
CL Item
Treatment Completed Per Protocol Criteria (1)
CL Item
Patient Withdrawal Or Refusal After Beginning Protocol Therapy (2)
CL Item
Patient Withdrawal Or Refusal Before Beginning Protocol Therapy (3)
CL Item
Adverse Event/side Effects/complications (4)
CL Item
Disease Progression, Relapse During Active Treatment (5)
CL Item
Disease Progression Before Active Treatment (6)
CL Item
Alternative Therapy (7)
CL Item
Patient Off-treatment For Other Complicating Disease (8)
CL Item
Death On Study (9)
CL Item
Other (10)
Adverse event/side effects/complications
Item
Adverse event/side effects/complications specify
text
C25685 (NCI Thesaurus ValueDomain)
C25638 (NCI Thesaurus Property)
C41331 (NCI Thesaurus Property-2)
C25601 (NCI Thesaurus ObjectClass)
C0877248 (UMLS CUI [1])
C0001688 (UMLS CUI [2])
C0009566 (UMLS CUI [3])
C1518544 (UMLS CUI [4])
Off-TreatmentConditionSpecify
Item
Patient off-treatment for other complicating disease, specify
text
C25685 (NCI Thesaurus ValueDomain)
C25601 (NCI Thesaurus ObjectClass)
C25457 (NCI Thesaurus Property)
C0348080 (UMLS CUI [1,1])
C1518544 (UMLS CUI [1,2])
Off Treatment Reason, specify
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C25601 (NCI Thesaurus ObjectClass)
C25365 (NCI Thesaurus Property)
C1518544 (UMLS CUI [1,1])
C0392360 (UMLS CUI [1,2])

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