ID

26127

Description

AMC-070 HIV Viral Load Form (F40) Lenalidomide in Treating Patients With AIDS-Related Kaposi Sarcoma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=91E39D56-BD37-8820-E040-BB89AD4361FB

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=91E39D56-BD37-8820-E040-BB89AD4361FB

Keywords

Versions (1)
  1. 10/9/17 10/9/17 -
Copyright Holder

National Cancer Institute

Uploaded on

October 9, 2017

DOI

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License

Creative Commons BY-NC 3.0
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AMC-070 HIV Viral Load Form (F40)

English

No Instruction available.

1 forms  
  1. StudyEvent: AMC-070 HIV Viral Load Form (F40)
    1. No Instruction available.
Header - HIV Viral Load Form
Description

Header - HIV Viral Load Form

Alias
UMLS CUI-1
C1320722
UMLS CUI-2
C1168369
UMLS CUI-3
C0276535
Visit number
Description

Visit number

Data type

integer

Alias
NCI Thesaurus ValueDomain
C25337
NCI Thesaurus ObjectClass
C16696
NCI Thesaurus Property
C25385
UMLS CUI [1]
C1549755
Specimen Information
Description

Specimen Information

Alias
UMLS CUI-1
C0370003
UMLS CUI-2
C0276535
Date Specimen Obtained
Description

Specimen Collected Date

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
NCI Thesaurus ObjectClass
C19157
NCI Thesaurus Property
C25452
NCI Thesaurus Property-2
C25275
UMLS CUI [1,1]
C0200345
UMLS CUI [1,2]
C0011008
HIV Viral Load
Description

HIV Viral Load

Alias
UMLS CUI-1
C1168369
UMLS CUI-2
C0276535
Results of HIV viral load assay
Description

HumanImmunodeficiencyVirusViralLoadAssayPerformedAmount (Enter results from right to left.)

Data type

integer

Alias
NCI Thesaurus ObjectClass
C14219
NCI Thesaurus ObjectClass-2
C51952
NCI Thesaurus ObjectClass-3
C16341
NCI Thesaurus Property
C38000
NCI Thesaurus ValueDomain
C25417
UMLS CUI [1,1]
C0376705
UMLS CUI [1,2]
C1168369
HIV viral load value
Description

HumanImmunodeficiencyVirusViralLoadAssayPerformedValue

Data type

float

Alias
NCI Thesaurus ObjectClass
C14219
NCI Thesaurus ObjectClass-2
C51952
NCI Thesaurus ObjectClass-3
C16341
NCI Thesaurus Property
C38000
NCI Thesaurus ValueDomain
C25712
UMLS CUI [1,1]
C0376705
UMLS CUI [1,2]
C1168369
Method of detection
Description

HumanImmunodeficiencyVirusViralLoadAssayPerformedType

Data type

integer

Alias
NCI Thesaurus ObjectClass
C14219
NCI Thesaurus ObjectClass-2
C51952
NCI Thesaurus ObjectClass-3
C16341
NCI Thesaurus Property
C38000
NCI Thesaurus ValueDomain
C25284
UMLS CUI [1,1]
C0449335
UMLS CUI [1,2]
C1168369
Other, specify
Description

HumanImmunodeficiencyVirusViralLoadAssayPerformedSpecify

Data type

text

Alias
NCI Thesaurus ObjectClass
C14219
NCI Thesaurus ObjectClass-2
C51952
NCI Thesaurus ObjectClass-3
C16341
NCI Thesaurus Property
C38000
NCI Thesaurus ValueDomain
C25685
UMLS CUI [1,1]
C0449335
UMLS CUI [1,2]
C1168369
HIV viral load assay type
Description

HumanImmunodeficiencyVirusViralLoadAssayPerformedCategory

Data type

integer

Alias
NCI Thesaurus ObjectClass
C14219
NCI Thesaurus ObjectClass-2
C51952
NCI Thesaurus ObjectClass-3
C16341
NCI Thesaurus Property
C38000
NCI Thesaurus ValueDomain
C25372
UMLS CUI [1,1]
C1168369
UMLS CUI [1,2]
C0005507
UMLS CUI [1,3]
C0332307
Limits of detection
Description

HumanImmunodeficiencyVirusViralLoadAssayLowerThresholdDetectedNumber (Copies/mL)

Data type

float

Alias
NCI Thesaurus ObjectClass
C14219
NCI Thesaurus ObjectClass-2
C51952
NCI Thesaurus ObjectClass-3
C16341
NCI Thesaurus Property
C48228
NCI Thesaurus Property-2
C25309
NCI Thesaurus Property-3
C25481
NCI Thesaurus ValueDomain
C25337
UMLS CUI [1,1]
C2718050
UMLS CUI [1,2]
C1168369
Lab Facility Name
Description

SpecimenLabIdentifierName (Testing Laboratory information)

Data type

text

Alias
NCI Thesaurus ValueDomain
C25191
NCI Thesaurus Property
C25364
NCI Thesaurus ObjectClass
C37984
NCI Thesaurus ObjectClass-2
C19157
UMLS CUI [1,1]
C0600091
UMLS CUI [1,2]
C0022877
UMLS CUI [1,3]
C1168369
Comments
Description

Comments

Alias
UMLS CUI-1
C0947611
UMLS CUI-2
C0276535
Comments
Description

Research Comments

Data type

text

Alias
NCI Thesaurus ValueDomain
C25704
NCI Thesaurus ObjectClass
C15319
NCI Thesaurus Property
C25393
UMLS CUI [1,1]
C0947611
UMLS CUI [1,2]
C0276535
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Similar models

No Instruction available.

1 forms
  1. StudyEvent: AMC-070 HIV Viral Load Form (F40)
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Header - HIV Viral Load Form
C1320722 (UMLS CUI-1)
C1168369 (UMLS CUI-2)
C0276535 (UMLS CUI-3)
Visit number
Item
Visit number
integer
C25337 (NCI Thesaurus ValueDomain)
C16696 (NCI Thesaurus ObjectClass)
C25385 (NCI Thesaurus Property)
C1549755 (UMLS CUI [1])
Item Group
Specimen Information
C0370003 (UMLS CUI-1)
C0276535 (UMLS CUI-2)
Specimen Collected Date
Item
Date Specimen Obtained
date
C25164 (NCI Thesaurus ValueDomain)
C19157 (NCI Thesaurus ObjectClass)
C25452 (NCI Thesaurus Property)
C25275 (NCI Thesaurus Property-2)
C0200345 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Item Group
HIV Viral Load
C1168369 (UMLS CUI-1)
C0276535 (UMLS CUI-2)
Item
Results of HIV viral load assay
integer
C14219 (NCI Thesaurus ObjectClass)
C51952 (NCI Thesaurus ObjectClass-2)
C16341 (NCI Thesaurus ObjectClass-3)
C38000 (NCI Thesaurus Property)
C25417 (NCI Thesaurus ValueDomain)
C0376705 (UMLS CUI [1,1])
C1168369 (UMLS CUI [1,2])
CL.1
Code List
Results of HIV viral load assay
CL Item
Greater Than (>) (1)
CL Item
Less Than (2)
CL Item
Equal To (3)
CL Item
Undetectable (4)
HIV viral load value
Item
HIV viral load value
float
C14219 (NCI Thesaurus ObjectClass)
C51952 (NCI Thesaurus ObjectClass-2)
C16341 (NCI Thesaurus ObjectClass-3)
C38000 (NCI Thesaurus Property)
C25712 (NCI Thesaurus ValueDomain)
C0376705 (UMLS CUI [1,1])
C1168369 (UMLS CUI [1,2])
Item
Method of detection
integer
C14219 (NCI Thesaurus ObjectClass)
C51952 (NCI Thesaurus ObjectClass-2)
C16341 (NCI Thesaurus ObjectClass-3)
C38000 (NCI Thesaurus Property)
C25284 (NCI Thesaurus ValueDomain)
C0449335 (UMLS CUI [1,1])
C1168369 (UMLS CUI [1,2])
CL.2
Code List
Method of detection
CL Item
Roche Amplicor Monitor Assay (1)
CL Item
Versant Hiv-1 Rna Assay By Branched Dna (2)
CL Item
Cobas Ampliprep/taqman Hiv-1 Assay (3)
CL Item
Abbott Realtime Hiv-1 Assay (4)
CL Item
Other (5)
Other, specify
Item
Other, specify
text
C14219 (NCI Thesaurus ObjectClass)
C51952 (NCI Thesaurus ObjectClass-2)
C16341 (NCI Thesaurus ObjectClass-3)
C38000 (NCI Thesaurus Property)
C25685 (NCI Thesaurus ValueDomain)
C0449335 (UMLS CUI [1,1])
C1168369 (UMLS CUI [1,2])
Item
HIV viral load assay type
integer
C14219 (NCI Thesaurus ObjectClass)
C51952 (NCI Thesaurus ObjectClass-2)
C16341 (NCI Thesaurus ObjectClass-3)
C38000 (NCI Thesaurus Property)
C25372 (NCI Thesaurus ValueDomain)
C1168369 (UMLS CUI [1,1])
C0005507 (UMLS CUI [1,2])
C0332307 (UMLS CUI [1,3])
CL.3
Code List
HIV viral load assay type
CL Item
Standard (1)
CL Item
Ultra (2)
Limits of detection
Item
Limits of detection
float
C14219 (NCI Thesaurus ObjectClass)
C51952 (NCI Thesaurus ObjectClass-2)
C16341 (NCI Thesaurus ObjectClass-3)
C48228 (NCI Thesaurus Property)
C25309 (NCI Thesaurus Property-2)
C25481 (NCI Thesaurus Property-3)
C25337 (NCI Thesaurus ValueDomain)
C2718050 (UMLS CUI [1,1])
C1168369 (UMLS CUI [1,2])
Lab Facility Name
Item
Lab Facility Name
text
C25191 (NCI Thesaurus ValueDomain)
C25364 (NCI Thesaurus Property)
C37984 (NCI Thesaurus ObjectClass)
C19157 (NCI Thesaurus ObjectClass-2)
C0600091 (UMLS CUI [1,1])
C0022877 (UMLS CUI [1,2])
C1168369 (UMLS CUI [1,3])
Item Group
Comments
C0947611 (UMLS CUI-1)
C0276535 (UMLS CUI-2)
Research Comments
Item
Comments
text
C25704 (NCI Thesaurus ValueDomain)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C0947611 (UMLS CUI [1,1])
C0276535 (UMLS CUI [1,2])
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