ID

26135

Description

AMC-070 Overall Assessment Form (RK6) Lenalidomide in Treating Patients With AIDS-Related Kaposi Sarcoma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=91E4BBD6-693F-9CA4-E040-BB89AD437D79

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=91E4BBD6-693F-9CA4-E040-BB89AD437D79

Keywords

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

AIDS Malignancy Consortium

Uploaded on

October 9, 2017

DOI

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License

Creative Commons BY-NC 3.0
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AMC-070 Overall Assessment Form (RK6)

English

No Instruction available.

1 forms  
  1. StudyEvent: AMC-051 Overall Assessment Form (RK6)
    1. No Instruction available.
Header - Overall Assessment Form
Description

Header - Overall Assessment Form

Alias
UMLS CUI-1
C1320722
UMLS CUI-2
C0276535
UMLS CUI-3
C0521982
UMLS CUI-4
C1144149
Visit number
Description

Visit number

Data type

float

Alias
NCI Thesaurus ValueDomain
C25337
NCI Thesaurus ObjectClass
C16696
NCI Thesaurus Property
C25385
UMLS CUI-1
C1549755
Overall Assessment
Description

Overall Assessment

Alias
UMLS CUI-1
C0276535
UMLS CUI-2
C0521982
UMLS CUI-3
C0220825
UMLS CUI-4
C1144149
Best Response
Description

KaposiSarcomaBestResponseType (since Entry/Baseline)

Data type

integer

Alias
NCI Thesaurus ValueDomain
C25284
NCI Thesaurus Property
C25755
NCI Thesaurus ObjectClass
C9087
NCI Thesaurus Property-2
C25432
UMLS CUI [1]
C2986560
UMLS CUI [2]
C0276535
What is the present status of the best response
Description

KaposiSarcomaBestResponseStatus

Data type

integer

Alias
NCI Thesaurus Property
C25755
NCI Thesaurus ObjectClass
C9087
NCI Thesaurus ValueDomain
C25688
NCI Thesaurus Property-2
C25432
UMLS CUI [1,1]
C2986560
UMLS CUI [1,2]
C0449438
UMLS CUI [2]
C0276535
Date of Relapse or Progression
Description

DiseaseRecurrentDiseaseCancerProgressionDiagnosisDate (if applicable mm/dd/yyyy)

Data type

date

Alias
NCI Thesaurus ObjectClass
C2991
NCI Thesaurus Property
C38155
NCI Thesaurus Property-2
C15220
NCI Thesaurus Property-3
C19987
NCI Thesaurus ValueDomain
C25164
UMLS CUI [1,1]
C0242656
UMLS CUI [1,2]
C0011008
UMLS CUI [2]
C0035020
UMLS CUI [3]
C0276535
Disease Response
Description

Disease Response

Alias
UMLS CUI-1
C1704632
UMLS CUI-2
C0276535
UMLS CUI-3
C0521982
Is complete response confirmed
Description

CompleteResponseConfirmedInd-3 (During this reporting period,)

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C38148
NCI Thesaurus ObjectClass
C25755
NCI Thesaurus ObjectClass-2
C25250
NCI Thesaurus Property
C25458
UMLS CUI [1,1]
C0677874
UMLS CUI [1,2]
C0750484
Complete Response Confirmed Date
Description

CompleteResponseConfirmedDate (If Yes,)

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
NCI Thesaurus ObjectClass
C25755
NCI Thesaurus ObjectClass-2
C25250
NCI Thesaurus Property
C25458
UMLS CUI [1,1]
C0677874
UMLS CUI [1,2]
C0750484
UMLS CUI [1,3]
C0011008
Is clinical complete response confirmed
Description

ClinicalCompleteResponseConfirmedInd-2 (During this reporting period,)

Data type

boolean

Alias
NCI Thesaurus ObjectClass
C25755
NCI Thesaurus ObjectClass-2
C25250
NCI Metathesaurus ObjectClass
CL035092
NCI Thesaurus Property
C25458
NCI Thesaurus ValueDomain
C38147
UMLS CUI [1,1]
C4055223
UMLS CUI [1,2]
C0677874
UMLS CUI [1,3]
C0750484
Clinical Complete Response Confirmed Date
Description

ClinicalCompleteResponseConfirmedDate (If Yes,)

Data type

date

Alias
NCI Thesaurus ObjectClass
C25755
NCI Thesaurus ObjectClass-2
C25250
NCI Metathesaurus ObjectClass
CL035092
NCI Thesaurus Property
C25458
NCI Thesaurus ValueDomain
C25164
UMLS CUI [1,1]
C4055223
UMLS CUI [1,2]
C0677874
UMLS CUI [1,3]
C0750484
UMLS CUI [1,4]
C0011008
Is partial response confirmed
Description

PartialResponseConfirmedInd-3 (During this reporting period,)

Data type

boolean

Alias
NCI Thesaurus ObjectClass
C25755
NCI Thesaurus ObjectClass-2
C25378
NCI Thesaurus Property
C25458
NCI Thesaurus ValueDomain
C38148
NCI Thesaurus ValueDomain-2
C25755
UMLS CUI [1,1]
C1521726
UMLS CUI [1,2]
C0750484
Partial Response Confirmed Date
Description

PartialResponseConfirmedDate (If Yes,)

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
NCI Thesaurus ObjectClass
C25755
NCI Thesaurus Property
C25458
NCI Thesaurus ObjectClass-2
C25378
UMLS CUI [1,1]
C1521726
UMLS CUI [1,2]
C0750484
UMLS CUI [1,3]
C0011008
Is progression confirmed
Description

progression confirmed

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C38147
NCI Thesaurus Property
C25458
NCI Thesaurus ObjectClass
C25331
UMLS CUI [1,1]
C0242656
UMLS CUI [1,2]
C0750484
Progressive Disease Confirmed Date
Description

ProgressionConfirmedDate

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
NCI Thesaurus Property
C25458
NCI Thesaurus ObjectClass
C25331
UMLS CUI [1,1]
C0242656
UMLS CUI [1,2]
C0750484
UMLS CUI [1,3]
C0011008
Comments
Description

Comments

Alias
UMLS CUI-1
C0947611
UMLS CUI-2
C0276535
UMLS CUI-3
C0521982
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
UMLS CUI [1,3]
C0521982
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Similar models

No Instruction available.

1 forms
  1. StudyEvent: AMC-051 Overall Assessment Form (RK6)
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Header - Overall Assessment Form
C1320722 (UMLS CUI-1)
C0276535 (UMLS CUI-2)
C0521982 (UMLS CUI-3)
C1144149 (UMLS CUI-4)
Visit number
Item
Visit number
float
C25337 (NCI Thesaurus ValueDomain)
C16696 (NCI Thesaurus ObjectClass)
C25385 (NCI Thesaurus Property)
C1549755 (UMLS CUI-1)
Item Group
Overall Assessment
C0276535 (UMLS CUI-1)
C0521982 (UMLS CUI-2)
C0220825 (UMLS CUI-3)
C1144149 (UMLS CUI-4)
Item
Best Response
integer
C25284 (NCI Thesaurus ValueDomain)
C25755 (NCI Thesaurus Property)
C9087 (NCI Thesaurus ObjectClass)
C25432 (NCI Thesaurus Property-2)
C2986560 (UMLS CUI [1])
C0276535 (UMLS CUI [2])
CL.1
Code List
Best Response
CL Item
Clinical Complete Response (1)
CL Item
Complete Response (2)
CL Item
Partial Response (3)
CL Item
Progressive Disease (4)
CL Item
Stable Disease (5)
CL Item
Unevaluable (6)
CL Item
Unknown (7)
Item
What is the present status of the best response
integer
C25755 (NCI Thesaurus Property)
C9087 (NCI Thesaurus ObjectClass)
C25688 (NCI Thesaurus ValueDomain)
C25432 (NCI Thesaurus Property-2)
C2986560 (UMLS CUI [1,1])
C0449438 (UMLS CUI [1,2])
C0276535 (UMLS CUI [2])
CL.2
Code List
What is the present status of the best response
CL Item
No Relapse Observed, But Patent Died (1)
CL Item
Not Applicable (2)
CL Item
Relapse Occurred After A Response Was Achieved (3)
CL Item
Response Continuing Or First Time At This Response (4)
Date of Relapse
Item
Date of Relapse or Progression
date
C2991 (NCI Thesaurus ObjectClass)
C38155 (NCI Thesaurus Property)
C15220 (NCI Thesaurus Property-2)
C19987 (NCI Thesaurus Property-3)
C25164 (NCI Thesaurus ValueDomain)
C0242656 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C0035020 (UMLS CUI [2])
C0276535 (UMLS CUI [3])
Item Group
Disease Response
C1704632 (UMLS CUI-1)
C0276535 (UMLS CUI-2)
C0521982 (UMLS CUI-3)
comcomplete response confirmed
Item
Is complete response confirmed
boolean
C38148 (NCI Thesaurus ValueDomain)
C25755 (NCI Thesaurus ObjectClass)
C25250 (NCI Thesaurus ObjectClass-2)
C25458 (NCI Thesaurus Property)
C0677874 (UMLS CUI [1,1])
C0750484 (UMLS CUI [1,2])
Complete Response Confirmed Date
Item
Complete Response Confirmed Date
date
C25164 (NCI Thesaurus ValueDomain)
C25755 (NCI Thesaurus ObjectClass)
C25250 (NCI Thesaurus ObjectClass-2)
C25458 (NCI Thesaurus Property)
C0677874 (UMLS CUI [1,1])
C0750484 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
clinical complete response confirmed
Item
Is clinical complete response confirmed
boolean
C25755 (NCI Thesaurus ObjectClass)
C25250 (NCI Thesaurus ObjectClass-2)
CL035092 (NCI Metathesaurus ObjectClass)
C25458 (NCI Thesaurus Property)
C38147 (NCI Thesaurus ValueDomain)
C4055223 (UMLS CUI [1,1])
C0677874 (UMLS CUI [1,2])
C0750484 (UMLS CUI [1,3])
Clinical Complete Response Confirmed Date
Item
Clinical Complete Response Confirmed Date
date
C25755 (NCI Thesaurus ObjectClass)
C25250 (NCI Thesaurus ObjectClass-2)
CL035092 (NCI Metathesaurus ObjectClass)
C25458 (NCI Thesaurus Property)
C25164 (NCI Thesaurus ValueDomain)
C4055223 (UMLS CUI [1,1])
C0677874 (UMLS CUI [1,2])
C0750484 (UMLS CUI [1,3])
C0011008 (UMLS CUI [1,4])
partial response confirmed
Item
Is partial response confirmed
boolean
C25755 (NCI Thesaurus ObjectClass)
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])
Partial Response Confirmed Date
Item
Partial Response Confirmed Date
date
C25164 (NCI Thesaurus ValueDomain)
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])
progression confirmed
Item
Is progression confirmed
boolean
C38147 (NCI Thesaurus ValueDomain)
C25458 (NCI Thesaurus Property)
C25331 (NCI Thesaurus ObjectClass)
C0242656 (UMLS CUI [1,1])
C0750484 (UMLS CUI [1,2])
ProgressionConfirmedDate
Item
Progressive Disease Confirmed Date
date
C25164 (NCI Thesaurus ValueDomain)
C25458 (NCI Thesaurus Property)
C25331 (NCI Thesaurus ObjectClass)
C0242656 (UMLS CUI [1,1])
C0750484 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
Item Group
Comments
C0947611 (UMLS CUI-1)
C0276535 (UMLS CUI-2)
C0521982 (UMLS CUI-3)
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])
C0521982 (UMLS CUI [1,3])
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