ID
25174
Description
AMC-053 Lymphoma Response Form (LYR) Bortezomib, Ifosfamide, Carboplatin, and Etoposide, With or Without Rituximab, in Treating Patients With Relapsed or Refractory AIDS-Related Non-Hodgkin Lymphoma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=8B73192C-C1AD-46D4-E040-BB89AD433800
Lien
Mots-clés
Versions (2)
- 19/09/2012 19/09/2012 -
- 28/08/2017 28/08/2017 -
Téléchargé le
28 août 2017
DOI
Pour une demande vous connecter.
Licence
Creative Commons BY-NC 3.0 Legacy
Modèle Commentaires :
Ici, vous pouvez faire des commentaires sur le modèle. À partir des bulles de texte, vous pouvez laisser des commentaires spécifiques sur les groupes Item et les Item.
Groupe Item commentaires pour :
Item commentaires pour :
Vous devez être connecté pour pouvoir télécharger des formulaires. Veuillez vous connecter ou s’inscrire gratuitement.
AMC-053 Lymphoma Response Form (LYR)
This form is to be updated at each response assessment time point defined in the protocol
- StudyEvent: AMC-048 Lymphoma Response Form (LYR)
Description
Complete Response
Alias
- UMLS CUI-1
- C0006826 (Malignant Neoplasms)
- SNOMED
- 363346000
- LOINC
- LP100805-3
- UMLS CUI-2
- C0677874 (In complete remission)
- SNOMED
- 103338009
- UMLS CUI-3
- C1332051 (AIDS-Related Non-Hodgkin Lymphoma)
Description
CompleteResponseFirstObservedInd-2 (CR)
Type de données
boolean
Alias
- NCI Thesaurus ObjectClass
- C25755 (undefined)
- NCI Thesaurus ObjectClass-2
- C25250 (undefined)
- NCI Thesaurus Property
- C25509 (undefined)
- NCI Thesaurus Property-2
- C25599 (undefined)
- NCI Thesaurus ValueDomain
- C38147 (undefined)
- UMLS CUI [1,1]
- C0006826 (Malignant Neoplasms)
- SNOMED
- 363346000
- LOINC
- LP100805-3
- UMLS CUI [1,2]
- C0677874 (In complete remission)
- SNOMED
- 103338009
Description
Complete Response First Observed Date
Type de données
date
Alias
- NCI Thesaurus ObjectClass
- C25755 (undefined)
- NCI Thesaurus ObjectClass-2
- C25250 (undefined)
- NCI Thesaurus Property
- C25509 (undefined)
- NCI Thesaurus Property-2
- C25599 (undefined)
- NCI Thesaurus ValueDomain
- C25164 (undefined)
- NCI Thesaurus ValueDomain-2
- C25367 (undefined)
- UMLS CUI [1,1]
- C0006826 (Malignant Neoplasms)
- SNOMED
- 363346000
- LOINC
- LP100805-3
- UMLS CUI [1,2]
- C0677874 (In complete remission)
- SNOMED
- 103338009
- UMLS CUI [1,3]
- C0011008 (Date in time)
- SNOMED
- 410671006
Description
CompleteResponseConfirmedInd-3 (CR)
Type de données
boolean
Alias
- NCI Thesaurus ValueDomain
- C38148 (undefined)
- NCI Thesaurus ObjectClass
- C25755 (undefined)
- NCI Thesaurus ObjectClass-2
- C25250 (undefined)
- NCI Thesaurus Property
- C25458 (undefined)
- UMLS CUI [1,1]
- C0006826 (Malignant Neoplasms)
- SNOMED
- 363346000
- LOINC
- LP100805-3
- UMLS CUI [1,2]
- C0677874 (In complete remission)
- SNOMED
- 103338009
- UMLS CUI [1,3]
- C0750484 (Confirmation)
- LOINC
- LA15290-2
Description
CompleteResponseConfirmedDate (mm/dd/yyyy)
Type de données
date
Alias
- NCI Thesaurus ValueDomain
- C25164 (undefined)
- NCI Thesaurus ObjectClass
- C25755 (undefined)
- NCI Thesaurus ObjectClass-2
- C25250 (undefined)
- NCI Thesaurus Property
- C25458 (undefined)
- UMLS CUI [1,1]
- C0006826 (Malignant Neoplasms)
- SNOMED
- 363346000
- LOINC
- LP100805-3
- UMLS CUI [1,2]
- C0677874 (In complete remission)
- SNOMED
- 103338009
- UMLS CUI [1,3]
- C0750484 (Confirmation)
- LOINC
- LA15290-2
- UMLS CUI [1,4]
- C0011008 (Date in time)
- SNOMED
- 410671006
Description
Complete Response Unconfirmed
Alias
- UMLS CUI-1
- C0006826 (Malignant Neoplasms)
- SNOMED
- 363346000
- LOINC
- LP100805-3
- UMLS CUI-2
- C0677874 (In complete remission)
- SNOMED
- 103338009
- UMLS CUI-3
- C1332051 (AIDS-Related Non-Hodgkin Lymphoma)
Description
UncertainCompleteResponseFirstObservedInd-2
Type de données
boolean
Alias
- NCI Thesaurus ObjectClass
- C25755 (undefined)
- NCI Thesaurus ObjectClass-2
- C25250 (undefined)
- NCI Thesaurus ObjectClass-3
- C47944 (undefined)
- NCI Thesaurus Property
- C25509 (undefined)
- NCI Thesaurus Property-2
- C25599 (undefined)
- NCI Thesaurus ValueDomain
- C38147 (undefined)
- UMLS CUI [1,1]
- C0006826 (Malignant Neoplasms)
- SNOMED
- 363346000
- LOINC
- LP100805-3
- UMLS CUI [1,2]
- C0677874 (In complete remission)
- SNOMED
- 103338009
- UMLS CUI [1,3]
- C0087130 (Uncertainty)
- SNOMED
- 64957009
- LOINC
- LA12719-3
Description
UncertainCompleteResponseNon-HodgkinLymphomaObservedDate
Type de données
date
Alias
- NCI Thesaurus ObjectClass
- C47944 (undefined)
- NCI Metathesaurus ObjectClass
- C0677874 (In complete remission)
- SNOMED
- 103338009
- NCI Thesaurus Property
- C3211 (undefined)
- NCI Thesaurus Property-2
- C25599 (undefined)
- NCI Thesaurus ValueDomain
- C25164 (undefined)
- NCI Thesaurus ValueDomain-2
- C25367 (undefined)
- UMLS CUI [1,1]
- C0006826 (Malignant Neoplasms)
- SNOMED
- 363346000
- LOINC
- LP100805-3
- UMLS CUI [1,2]
- C0677874 (In complete remission)
- SNOMED
- 103338009
- UMLS CUI [1,3]
- C0087130 (Uncertainty)
- SNOMED
- 64957009
- LOINC
- LA12719-3
- UMLS CUI [1,4]
- C0011008 (Date in time)
- SNOMED
- 410671006
Description
UncertainCompleteResponseConfirmedInd-2 (CRU)
Type de données
boolean
Alias
- NCI Thesaurus ObjectClass
- C25755 (undefined)
- NCI Thesaurus ObjectClass-2
- C25250 (undefined)
- NCI Thesaurus ObjectClass-3
- C47944 (undefined)
- NCI Thesaurus Property
- C25458 (undefined)
- NCI Thesaurus ValueDomain
- C38147 (undefined)
- UMLS CUI [1,1]
- C0006826 (Malignant Neoplasms)
- SNOMED
- 363346000
- LOINC
- LP100805-3
- UMLS CUI [1,2]
- C0677874 (In complete remission)
- SNOMED
- 103338009
- UMLS CUI [1,3]
- C0087130 (Uncertainty)
- SNOMED
- 64957009
- LOINC
- LA12719-3
- UMLS CUI [1,4]
- C0750484 (Confirmation)
- LOINC
- LA15290-2
Description
UncertainCompleteResponseConfirmedDate
Type de données
date
Alias
- NCI Thesaurus ObjectClass
- C25755 (undefined)
- NCI Thesaurus ObjectClass-2
- C25250 (undefined)
- NCI Thesaurus ObjectClass-3
- C47944 (undefined)
- NCI Thesaurus Property
- C25458 (undefined)
- NCI Thesaurus ValueDomain
- C25164 (undefined)
- UMLS CUI [1,1]
- C0006826 (Malignant Neoplasms)
- SNOMED
- 363346000
- LOINC
- LP100805-3
- UMLS CUI [1,2]
- C0677874 (In complete remission)
- SNOMED
- 103338009
- UMLS CUI [1,3]
- C0087130 (Uncertainty)
- SNOMED
- 64957009
- LOINC
- LA12719-3
- UMLS CUI [1,4]
- C0750484 (Confirmation)
- LOINC
- LA15290-2
- UMLS CUI [1,5]
- C0011008 (Date in time)
- SNOMED
- 410671006
Description
Partial Response
Alias
- UMLS CUI-1
- C1521726 (partial response)
- SNOMED
- 103337004
- UMLS CUI-2
- C1332051 (AIDS-Related Non-Hodgkin Lymphoma)
Description
PartialResponseFirstObservedInd-2 (PR)
Type de données
boolean
Alias
- NCI Thesaurus ObjectClass
- C25755 (undefined)
- NCI Thesaurus ObjectClass-2
- C25378 (undefined)
- NCI Thesaurus Property
- C25509 (undefined)
- NCI Thesaurus Property-2
- C25599 (undefined)
- NCI Thesaurus ValueDomain
- C38147 (undefined)
- UMLS CUI [1]
- C1521726 (partial response)
- SNOMED
- 103337004
Description
Partial Response First Observed Date
Type de données
date
Alias
- NCI Thesaurus ObjectClass
- C25755 (undefined)
- NCI Thesaurus ObjectClass-2
- C25378 (undefined)
- NCI Thesaurus Property
- C25509 (undefined)
- NCI Thesaurus Property-2
- C25599 (undefined)
- NCI Thesaurus ValueDomain
- C25164 (undefined)
- NCI Thesaurus ValueDomain-2
- C25367 (undefined)
- UMLS CUI [1,1]
- C1521726 (partial response)
- SNOMED
- 103337004
- UMLS CUI [1,2]
- C0011008 (Date in time)
- SNOMED
- 410671006
Description
PartialResponseConfirmedInd-3 (PR)
Type de données
boolean
Alias
- NCI Thesaurus ObjectClass
- C25755 (undefined)
- NCI Thesaurus ObjectClass-2
- C25378 (undefined)
- NCI Thesaurus Property
- C25458 (undefined)
- NCI Thesaurus ValueDomain
- C38148 (undefined)
- NCI Thesaurus ValueDomain-2
- C25755 (undefined)
- UMLS CUI [1,1]
- C1521726 (partial response)
- SNOMED
- 103337004
- UMLS CUI [1,2]
- C0750484 (Confirmation)
- LOINC
- LA15290-2
Description
PartialResponseConfirmedDate (mm/dd/yyyy)
Type de données
date
Alias
- NCI Thesaurus ValueDomain
- C25164 (undefined)
- NCI Thesaurus ObjectClass
- C25755 (undefined)
- NCI Thesaurus Property
- C25458 (undefined)
- NCI Thesaurus ObjectClass-2
- C25378 (undefined)
- UMLS CUI [1,1]
- C1521726 (partial response)
- SNOMED
- 103337004
- UMLS CUI [1,2]
- C0750484 (Confirmation)
- LOINC
- LA15290-2
- UMLS CUI [1,3]
- C0011008 (Date in time)
- SNOMED
- 410671006
Description
Progressive Disease
Alias
- UMLS CUI-1
- C1335499 (Progressive Disease)
- UMLS CUI-2
- C1332051 (AIDS-Related Non-Hodgkin Lymphoma)
Description
Disease New Progression
Type de données
boolean
Alias
- NCI Thesaurus ValueDomain
- C38147 (undefined)
- NCI Thesaurus Property
- C25586 (undefined)
- NCI Thesaurus Property-2
- C25331 (undefined)
- NCI Thesaurus ObjectClass
- C2991 (undefined)
- UMLS CUI [1]
- C1335499 (Progressive Disease)
Description
Progression First Observed Date
Type de données
date
Alias
- NCI Thesaurus ObjectClass
- C25331 (undefined)
- NCI Thesaurus Property
- C25509 (undefined)
- NCI Thesaurus Property-2
- C25599 (undefined)
- NCI Thesaurus ValueDomain
- C25164 (undefined)
- NCI Thesaurus ValueDomain-2
- C25367 (undefined)
- UMLS CUI [1,1]
- C1335499 (Progressive Disease)
- UMLS CUI [1,2]
- C0011008 (Date in time)
- SNOMED
- 410671006
Description
Disease Progression Site
Type de données
integer
Alias
- NCI Thesaurus ValueDomain
- C13717 (undefined)
- NCI Thesaurus Property
- C25331 (undefined)
- NCI Thesaurus ObjectClass
- C2991 (undefined)
- UMLS CUI [1,1]
- C1515974 (Anatomic Site)
- UMLS CUI [1,2]
- C1335499 (Progressive Disease)
Description
Central Nervous System Progression
Type de données
boolean
Alias
- NCI Thesaurus ValueDomain
- C38148 (undefined)
- NCI Thesaurus Property
- C25331 (undefined)
- NCI Thesaurus ObjectClass
- C12438 (undefined)
- UMLS CUI [1,1]
- C0449389 (CNS involvement status)
- SNOMED
- 260766009
- UMLS CUI [1,2]
- C1335499 (Progressive Disease)
Description
Leptomeninges CNS Involved
Type de données
boolean
Alias
- NCI Thesaurus ValueDomain
- C38148 (undefined)
- NCI Thesaurus ObjectClass
- C12438 (undefined)
- NCI Thesaurus Property
- C25547 (undefined)
- NCI Thesaurus ObjectClass-2
- C32979 (undefined)
- UMLS CUI [1]
- C0228126 (Leptomeninges)
- SNOMED
- 66697007
- UMLS CUI [2,1]
- C0449389 (CNS involvement status)
- SNOMED
- 260766009
- UMLS CUI [2,2]
- C1335499 (Progressive Disease)
Description
Brain Parenchymal Involved
Type de données
boolean
Alias
- NCI Thesaurus ValueDomain
- C38148 (undefined)
- NCI Thesaurus ObjectClass
- C12439 (undefined)
- NCI Thesaurus Property
- C25547 (undefined)
- NCI Thesaurus Property-2
- C74601 (undefined)
- UMLS CUI [1,1]
- C0933845 (Parenchyma)
- UMLS CUI [1,2]
- C0006104 (Brain)
- SNOMED
- 12738006
- LOINC
- LP7084-9
- UMLS CUI [2,1]
- C0449389 (CNS involvement status)
- SNOMED
- 260766009
- UMLS CUI [2,2]
- C1335499 (Progressive Disease)
Description
Comments
Alias
- UMLS CUI-1
- C1332051 (AIDS-Related Non-Hodgkin Lymphoma)
- UMLS CUI-2
- C0947611 (Comment)
- LOINC
- LP72293-1
Description
Research Comments
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25704 (undefined)
- NCI Thesaurus ObjectClass
- C15319 (undefined)
- NCI Thesaurus Property
- C25393 (undefined)
- UMLS CUI [1,1]
- C0947611 (Comment)
- LOINC
- LP72293-1
- UMLS CUI [1,2]
- C1332051 (AIDS-Related Non-Hodgkin Lymphoma)
Similar models
This form is to be updated at each response assessment time point defined in the protocol
- StudyEvent: AMC-048 Lymphoma Response Form (LYR)
C1314939 (UMLS CUI-2)
C0220825 (UMLS CUI-3)
C1332051 (UMLS CUI-4)
C16033 (NCI Thesaurus Property)
C25365 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
C1522577 (UMLS CUI [1,1])
C0006826 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
C0677874 (UMLS CUI-2)
C1332051 (UMLS CUI-3)
C25250 (NCI Thesaurus ObjectClass-2)
C25509 (NCI Thesaurus Property)
C25599 (NCI Thesaurus Property-2)
C38147 (NCI Thesaurus ValueDomain)
C0006826 (UMLS CUI [1,1])
C0677874 (UMLS CUI [1,2])
C25250 (NCI Thesaurus ObjectClass-2)
C25509 (NCI Thesaurus Property)
C25599 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
C0006826 (UMLS CUI [1,1])
C0677874 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
C25755 (NCI Thesaurus ObjectClass)
C25250 (NCI Thesaurus ObjectClass-2)
C25458 (NCI Thesaurus Property)
C0006826 (UMLS CUI [1,1])
C0677874 (UMLS CUI [1,2])
C0750484 (UMLS CUI [1,3])
C25755 (NCI Thesaurus ObjectClass)
C25250 (NCI Thesaurus ObjectClass-2)
C25458 (NCI Thesaurus Property)
C0006826 (UMLS CUI [1,1])
C0677874 (UMLS CUI [1,2])
C0750484 (UMLS CUI [1,3])
C0011008 (UMLS CUI [1,4])
C0677874 (UMLS CUI-2)
C1332051 (UMLS CUI-3)
C25250 (NCI Thesaurus ObjectClass-2)
C47944 (NCI Thesaurus ObjectClass-3)
C25509 (NCI Thesaurus Property)
C25599 (NCI Thesaurus Property-2)
C38147 (NCI Thesaurus ValueDomain)
C0006826 (UMLS CUI [1,1])
C0677874 (UMLS CUI [1,2])
C0087130 (UMLS CUI [1,3])
C0677874 (NCI Metathesaurus ObjectClass)
C3211 (NCI Thesaurus Property)
C25599 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
C0006826 (UMLS CUI [1,1])
C0677874 (UMLS CUI [1,2])
C0087130 (UMLS CUI [1,3])
C0011008 (UMLS CUI [1,4])
C25250 (NCI Thesaurus ObjectClass-2)
C47944 (NCI Thesaurus ObjectClass-3)
C25458 (NCI Thesaurus Property)
C38147 (NCI Thesaurus ValueDomain)
C0006826 (UMLS CUI [1,1])
C0677874 (UMLS CUI [1,2])
C0087130 (UMLS CUI [1,3])
C0750484 (UMLS CUI [1,4])
C25250 (NCI Thesaurus ObjectClass-2)
C47944 (NCI Thesaurus ObjectClass-3)
C25458 (NCI Thesaurus Property)
C25164 (NCI Thesaurus ValueDomain)
C0006826 (UMLS CUI [1,1])
C0677874 (UMLS CUI [1,2])
C0087130 (UMLS CUI [1,3])
C0750484 (UMLS CUI [1,4])
C0011008 (UMLS CUI [1,5])
C25378 (NCI Thesaurus ObjectClass-2)
C25509 (NCI Thesaurus Property)
C25599 (NCI Thesaurus Property-2)
C38147 (NCI Thesaurus ValueDomain)
C1521726 (UMLS CUI [1])
C25378 (NCI Thesaurus ObjectClass-2)
C25509 (NCI Thesaurus Property)
C25599 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
C1521726 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C25378 (NCI Thesaurus ObjectClass-2)
C25458 (NCI Thesaurus Property)
C38148 (NCI Thesaurus ValueDomain)
C25755 (NCI Thesaurus ValueDomain-2)
C1521726 (UMLS CUI [1,1])
C0750484 (UMLS CUI [1,2])
C25755 (NCI Thesaurus ObjectClass)
C25458 (NCI Thesaurus Property)
C25378 (NCI Thesaurus ObjectClass-2)
C1521726 (UMLS CUI [1,1])
C0750484 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
C25586 (NCI Thesaurus Property)
C25331 (NCI Thesaurus Property-2)
C2991 (NCI Thesaurus ObjectClass)
C1335499 (UMLS CUI [1])
C25509 (NCI Thesaurus Property)
C25599 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
C1335499 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C25331 (NCI Thesaurus Property)
C2991 (NCI Thesaurus ObjectClass)
C1515974 (UMLS CUI [1,1])
C1335499 (UMLS CUI [1,2])
C25331 (NCI Thesaurus Property)
C12438 (NCI Thesaurus ObjectClass)
C0449389 (UMLS CUI [1,1])
C1335499 (UMLS CUI [1,2])
C12438 (NCI Thesaurus ObjectClass)
C25547 (NCI Thesaurus Property)
C32979 (NCI Thesaurus ObjectClass-2)
C0228126 (UMLS CUI [1])
C0449389 (UMLS CUI [2,1])
C1335499 (UMLS CUI [2,2])
C12439 (NCI Thesaurus ObjectClass)
C25547 (NCI Thesaurus Property)
C74601 (NCI Thesaurus Property-2)
C0933845 (UMLS CUI [1,1])
C0006104 (UMLS CUI [1,2])
C0449389 (UMLS CUI [2,1])
C1335499 (UMLS CUI [2,2])
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C0947611 (UMLS CUI [1,1])
C1332051 (UMLS CUI [1,2])
Aucun commentaire