ID

26136

Description

AMC-063 Physical Exam Form (RK2) Bortezomib in Treating Patients With Relapsed or Refractory AIDS-Related Kaposi Sarcoma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=8163A333-BC0C-35E0-E040-BB89AD435080

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=8163A333-BC0C-35E0-E040-BB89AD435080

Keywords

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

AIDS Malignancy Consortium

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October 9, 2017

DOI

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Creative Commons BY-NC 3.0
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AMC-063 Physical Exam Form (RK2)

English

This form represents the aggregate of initial and follow-up evaluation screens. Five questions are merged as a result: At entry, does the participant have >=50 lesions (2646194); Total Number New Lesions (2646313); Number of cutaneous lesions (2646435); Character of cutaneous lesions (2646439); and, Number of Marker Lesions (2646443)

1 forms  
Header - Physical Exam Form
Description

Header - Physical Exam Form

Alias
UMLS CUI-1
C1320722
UMLS CUI-2
C0031809
UMLS CUI-3
C0276535
UMLS CUI-4
C1176309
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
Evaluation of Cutaneous Lesions
Description

Evaluation of Cutaneous Lesions

Alias
UMLS CUI-1
C0037284
UMLS CUI-2
C0220825
At entry, does the participant have >=50 lesions
Description

KaposiSarcomaMalignantNeoplasmCutaneousAssessmentInd-2

Data type

boolean

Alias
NCI Thesaurus ObjectClass
C9305
NCI Thesaurus ObjectClass-2
C9087
NCI Thesaurus Property
C25367
NCI Thesaurus Property-2
C13316
NCI Thesaurus ValueDomain
C38147
UMLS CUI [1,1]
C0037284
UMLS CUI [1,2]
C0449788
Representative Area
Description

KaposiSarcomaMalignantNeoplasmCutaneousAnatomicSite

Data type

text

Alias
NCI Thesaurus ObjectClass
C9305
NCI Thesaurus ObjectClass-2
C9087
NCI Thesaurus Property
C25341
NCI Thesaurus Property-2
C13316
NCI Thesaurus Property-3
C25421
NCI Thesaurus ValueDomain
C37901
UMLS CUI [1,1]
C0450429
UMLS CUI [1,2]
C0037284
UMLS CUI [2]
C0276535
Total Number Raised Lesions
Description

KaposiSarcomaMalignantNeoplasmElevatedCount

Data type

integer

Alias
NCI Thesaurus ObjectClass
C9305
NCI Thesaurus ObjectClass-2
C9087
NCI Thesaurus Property
C25493
NCI Thesaurus Property-2
C25256
NCI Thesaurus ValueDomain
C25463
UMLS CUI [1,1]
C0748816
UMLS CUI [1,2]
C0449788
UMLS CUI [1,3]
C0276535
Total Number Flat Lesions
Description

KaposiSarcomaMalignantNeoplasmFlatCount

Data type

integer

Alias
NCI Thesaurus ObjectClass
C9305
NCI Thesaurus ObjectClass-2
C9087
NCI Thesaurus Property
C25256
NCI Metathesaurus Property
C0205324
NCI Thesaurus ValueDomain
C25463
UMLS CUI [1,1]
C0037284
UMLS CUI [1,2]
C1446350
UMLS CUI [1,3]
C0449788
UMLS CUI [1,4]
C0276535
Total Number New Lesions
Description

KaposiSarcomaMalignantNeoplasmNewCount

Data type

integer

Alias
NCI Thesaurus ObjectClass
C9305
NCI Thesaurus ObjectClass-2
C9087
NCI Thesaurus Property
C25586
NCI Thesaurus Property-2
C25256
NCI Thesaurus ValueDomain
C25463
UMLS CUI [1,1]
C0037284
UMLS CUI [1,2]
C0205314
UMLS CUI [1,3]
C0449788
UMLS CUI [1,4]
C0276535
Number of cutaneous lesions
Description

KaposiSarcomaNumberMalignantNeoplasmCutaneousAssessmentStatus

Data type

text

Alias
NCI Thesaurus ObjectClass
C25337
NCI Thesaurus ObjectClass-2
C9305
NCI Thesaurus ObjectClass-3
C9087
NCI Thesaurus Property
C25367
NCI Thesaurus Property-2
C13316
NCI Thesaurus ValueDomain
C25688
UMLS CUI [1,1]
C0037284
UMLS CUI [1,2]
C0449788
Character of cutaneous lesions
Description

KaposiSarcomaMalignantNeoplasmCutaneousAssessmentStatus (since baseline or best response)

Data type

text

Alias
NCI Thesaurus ObjectClass
C9305
NCI Thesaurus ObjectClass-2
C9087
NCI Thesaurus Property
C25367
NCI Thesaurus Property-2
C13316
NCI Thesaurus ValueDomain
C25688
UMLS CUI [1,1]
C0037284
UMLS CUI [1,2]
C1521970
Evaluation of Marker Lesions
Description

Evaluation of Marker Lesions

Alias
UMLS CUI-1
C0037284
UMLS CUI-2
C0220825
Representative Area
Description

KaposiSarcomaMalignantNeoplasmDiseaseMarkerAnatomicSite

Data type

text

Alias
NCI Thesaurus ObjectClass
C9305
NCI Thesaurus ObjectClass-2
C9087
NCI Thesaurus Property
C25341
NCI Thesaurus Property-2
C18329
NCI Thesaurus Property-3
C25421
NCI Thesaurus ValueDomain
C37901
UMLS CUI [1,1]
C0450429
UMLS CUI [1,2]
C0037284
UMLS CUI [2]
C0276535
Specify
Description

KaposiSarcomaMalignantNeoplasmDiseaseMarkerAnatomicLocationSpecify

Data type

text

Alias
NCI Thesaurus ObjectClass
C9305
NCI Thesaurus ObjectClass-2
C9087
NCI Thesaurus Property
C25341
NCI Thesaurus Property-2
C18329
NCI Thesaurus Property-3
C25421
NCI Thesaurus ValueDomain
C25685
UMLS CUI [1,1]
C0450429
UMLS CUI [1,2]
C0037284
UMLS CUI [2]
C0276535
Dimension 1
Description

TumorLargestDimensionMeasurement (cm)

Data type

float

Measurement units
  • cm
Alias
NCI Thesaurus ValueDomain
C25209
NCI Thesaurus ObjectClass
C3262
NCI Thesaurus Property
C25550
NCI Thesaurus Property-2
C25483
UMLS CUI [1,1]
C0037284
UMLS CUI [1,2]
C0439534
UMLS CUI [1,3]
C0276535
cm
Dimension 2
Description

TumorSecondDimensionMeasurement (cm)

Data type

float

Measurement units
  • cm
Alias
NCI Thesaurus ValueDomain
C25209
NCI Thesaurus ObjectClass
C3262
NCI Thesaurus Property
C25666
NCI Thesaurus Property-2
C25483
UMLS CUI [1,1]
C0037284
UMLS CUI [1,2]
C0439534
UMLS CUI [1,3]
C0276535
cm
Product of Diameters
Description

MalignantNeoplasmProductDimensionMeasurement

Data type

float

Alias
NCI Thesaurus ValueDomain
C25209
NCI Thesaurus ObjectClass
C9305
NCI Thesaurus Property
C25483
NCI Thesaurus Property-2
C40352
UMLS CUI [1,1]
C0037284
UMLS CUI [1,2]
C0439534
UMLS CUI [1,3]
C1704444
Photos Taken
Description

PatientPhotographMalignantNeoplasmAssessmentInd-2

Data type

boolean

Alias
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25367
NCI Thesaurus Property-2
C9305
NCI Thesaurus Property-3
C86035
NCI Thesaurus ValueDomain
C38147
UMLS CUI [1,1]
C0037284
UMLS CUI [1,2]
C0441468
Sum of Products of Greatest Diameters
Description

SumLesionDiameterProductMeasurement

Data type

float

Alias
NCI Thesaurus ObjectClass
C3824
NCI Thesaurus ObjectClass-2
C25697
NCI Thesaurus Property
C25285
NCI Thesaurus ValueDomain
C25209
NCI Thesaurus ValueDomain-2
C40352
UMLS CUI [1,1]
C0037284
UMLS CUI [1,2]
C0242485
Evaluation of Marker Lesions
Description

KaposiSarcomaMalignantNeoplasmDiseaseMarkerAssessmentStatus

Data type

text

Alias
NCI Thesaurus ObjectClass
C9305
NCI Thesaurus ObjectClass-2
C9087
NCI Thesaurus Property
C25367
NCI Thesaurus Property-2
C18329
NCI Thesaurus ValueDomain
C25688
UMLS CUI [1,1]
C0037284
UMLS CUI [1,2]
C0220825
Comments
Description

Comments

Alias
UMLS CUI-1
C0947611
UMLS CUI-2
C0037284
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]
C0037284
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Similar models

This form represents the aggregate of initial and follow-up evaluation screens. Five questions are merged as a result: At entry, does the participant have >=50 lesions (2646194); Total Number New Lesions (2646313); Number of cutaneous lesions (2646435); Character of cutaneous lesions (2646439); and, Number of Marker Lesions (2646443)

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Header - Physical Exam Form
C1320722 (UMLS CUI-1)
C0031809 (UMLS CUI-2)
C0276535 (UMLS CUI-3)
C1176309 (UMLS CUI-4)
Visit number
Item
Visit number
integer
C25337 (NCI Thesaurus ValueDomain)
C16696 (NCI Thesaurus ObjectClass)
C25385 (NCI Thesaurus Property)
C1549755 (UMLS CUI [1])
Item Group
Evaluation of Cutaneous Lesions
C0037284 (UMLS CUI-1)
C0220825 (UMLS CUI-2)
count of lesions
Item
At entry, does the participant have >=50 lesions
boolean
C9305 (NCI Thesaurus ObjectClass)
C9087 (NCI Thesaurus ObjectClass-2)
C25367 (NCI Thesaurus Property)
C13316 (NCI Thesaurus Property-2)
C38147 (NCI Thesaurus ValueDomain)
C0037284 (UMLS CUI [1,1])
C0449788 (UMLS CUI [1,2])
Item
Representative Area
text
C9305 (NCI Thesaurus ObjectClass)
C9087 (NCI Thesaurus ObjectClass-2)
C25341 (NCI Thesaurus Property)
C13316 (NCI Thesaurus Property-2)
C25421 (NCI Thesaurus Property-3)
C37901 (NCI Thesaurus ValueDomain)
C0450429 (UMLS CUI [1,1])
C0037284 (UMLS CUI [1,2])
C0276535 (UMLS CUI [2])
CL.2
Code List
Representative Area
CL Item
Abdomen (Abdomen)
C12664 (NCI Thesaurus)
C0230168 (UMLS 2011AA)
CL Item
Back (Back)
C13062 (NCI Thesaurus)
C0205095 (UMLS 2011AA)
CL Item
Chest (Chest)
C25389 (NCI Thesaurus)
C0817096 (UMLS 2011AA)
CL Item
Genital Area (Genital)
CL Item
Head (Head)
C12419 (NCI Thesaurus)
C0018670 (UMLS 2011AA)
CL Item
Left Arm (Left arm)
CL Item
Left Foot (Left foot)
CL Item
Left Hand (Left hand)
CL Item
Left Leg (Left leg)
CL Item
Neck (Neck)
C13063 (NCI Thesaurus)
C0027530 (UMLS 2011AA)
CL Item
Right Arm (Right arm)
CL Item
Right Foot (Right foot)
CL Item
Right Hand (Right hand)
CL Item
Right Leg (Right leg)
CL Item
Total Body (Total body)
Total Number Raised Lesions
Item
Total Number Raised Lesions
integer
C9305 (NCI Thesaurus ObjectClass)
C9087 (NCI Thesaurus ObjectClass-2)
C25493 (NCI Thesaurus Property)
C25256 (NCI Thesaurus Property-2)
C25463 (NCI Thesaurus ValueDomain)
C0748816 (UMLS CUI [1,1])
C0449788 (UMLS CUI [1,2])
C0276535 (UMLS CUI [1,3])
Total Number Flat Lesions
Item
Total Number Flat Lesions
integer
C9305 (NCI Thesaurus ObjectClass)
C9087 (NCI Thesaurus ObjectClass-2)
C25256 (NCI Thesaurus Property)
C0205324 (NCI Metathesaurus Property)
C25463 (NCI Thesaurus ValueDomain)
C0037284 (UMLS CUI [1,1])
C1446350 (UMLS CUI [1,2])
C0449788 (UMLS CUI [1,3])
C0276535 (UMLS CUI [1,4])
Total Number New Lesions
Item
Total Number New Lesions
integer
C9305 (NCI Thesaurus ObjectClass)
C9087 (NCI Thesaurus ObjectClass-2)
C25586 (NCI Thesaurus Property)
C25256 (NCI Thesaurus Property-2)
C25463 (NCI Thesaurus ValueDomain)
C0037284 (UMLS CUI [1,1])
C0205314 (UMLS CUI [1,2])
C0449788 (UMLS CUI [1,3])
C0276535 (UMLS CUI [1,4])
Item
Number of cutaneous lesions
text
C25337 (NCI Thesaurus ObjectClass)
C9305 (NCI Thesaurus ObjectClass-2)
C9087 (NCI Thesaurus ObjectClass-3)
C25367 (NCI Thesaurus Property)
C13316 (NCI Thesaurus Property-2)
C25688 (NCI Thesaurus ValueDomain)
C0037284 (UMLS CUI [1,1])
C0449788 (UMLS CUI [1,2])
CL.3
Code List
Number of cutaneous lesions
CL Item
Complete Resolution (Complete resolution)
CL Item
None Of The Above (None of the above)
CL Item
50% decrease in the number of lesions since baseline = >=50% Decrease In The Number Of Lesions Since Baseline (>)
CL Item
50% decrease in the number of lesions since baseline = >=50% Decrease In The Number Of Lesions Since Baseline (>)
Item
Character of cutaneous lesions
text
C9305 (NCI Thesaurus ObjectClass)
C9087 (NCI Thesaurus ObjectClass-2)
C25367 (NCI Thesaurus Property)
C13316 (NCI Thesaurus Property-2)
C25688 (NCI Thesaurus ValueDomain)
C0037284 (UMLS CUI [1,1])
C1521970 (UMLS CUI [1,2])
CL.4
Code List
Character of cutaneous lesions
CL Item
None Of The Above (None of the above)
CL Item
50% of raised have become flat = Since Baseline, >=50% Of Raised Have Become Flat (Since baseline, >)
CL Item
25% increase in the number of raised lesions = >=25% Increase In The Number Of Raised Lesions (>)
Item Group
Evaluation of Marker Lesions
C0037284 (UMLS CUI-1)
C0220825 (UMLS CUI-2)
Item
Representative Area
text
C9305 (NCI Thesaurus ObjectClass)
C9087 (NCI Thesaurus ObjectClass-2)
C25341 (NCI Thesaurus Property)
C18329 (NCI Thesaurus Property-2)
C25421 (NCI Thesaurus Property-3)
C37901 (NCI Thesaurus ValueDomain)
C0450429 (UMLS CUI [1,1])
C0037284 (UMLS CUI [1,2])
C0276535 (UMLS CUI [2])
CL.5
Code List
Representative Area
CL Item
Abdomen (Abdomen)
C12664 (NCI Thesaurus)
C0230168 (UMLS 2011AA)
CL Item
Back (Back)
C13062 (NCI Thesaurus)
C0205095 (UMLS 2011AA)
CL Item
Chest (Chest)
C25389 (NCI Thesaurus)
C0817096 (UMLS 2011AA)
CL Item
Genital Area (Genital)
CL Item
Head (Head)
C12419 (NCI Thesaurus)
C0018670 (UMLS 2011AA)
CL Item
Left Arm (Left arm)
CL Item
Left Foot (Left foot)
CL Item
Left Hand (Left hand)
CL Item
Left Leg (Left leg)
CL Item
Neck (Neck)
C13063 (NCI Thesaurus)
C0027530 (UMLS 2011AA)
CL Item
Right Arm (Right arm)
CL Item
Right Foot (Right foot)
CL Item
Right Hand (Right hand)
CL Item
Right Leg (Right leg)
CL Item
Total Body (Total body)
Specify
Item
Specify
text
C9305 (NCI Thesaurus ObjectClass)
C9087 (NCI Thesaurus ObjectClass-2)
C25341 (NCI Thesaurus Property)
C18329 (NCI Thesaurus Property-2)
C25421 (NCI Thesaurus Property-3)
C25685 (NCI Thesaurus ValueDomain)
C0450429 (UMLS CUI [1,1])
C0037284 (UMLS CUI [1,2])
C0276535 (UMLS CUI [2])
Dimension 1
Item
Dimension 1
float
C25209 (NCI Thesaurus ValueDomain)
C3262 (NCI Thesaurus ObjectClass)
C25550 (NCI Thesaurus Property)
C25483 (NCI Thesaurus Property-2)
C0037284 (UMLS CUI [1,1])
C0439534 (UMLS CUI [1,2])
C0276535 (UMLS CUI [1,3])
Dimension 2
Item
Dimension 2
float
C25209 (NCI Thesaurus ValueDomain)
C3262 (NCI Thesaurus ObjectClass)
C25666 (NCI Thesaurus Property)
C25483 (NCI Thesaurus Property-2)
C0037284 (UMLS CUI [1,1])
C0439534 (UMLS CUI [1,2])
C0276535 (UMLS CUI [1,3])
Product of Diameters
Item
Product of Diameters
float
C25209 (NCI Thesaurus ValueDomain)
C9305 (NCI Thesaurus ObjectClass)
C25483 (NCI Thesaurus Property)
C40352 (NCI Thesaurus Property-2)
C0037284 (UMLS CUI [1,1])
C0439534 (UMLS CUI [1,2])
C1704444 (UMLS CUI [1,3])
Photos Taken
Item
Photos Taken
boolean
C16960 (NCI Thesaurus ObjectClass)
C25367 (NCI Thesaurus Property)
C9305 (NCI Thesaurus Property-2)
C86035 (NCI Thesaurus Property-3)
C38147 (NCI Thesaurus ValueDomain)
C0037284 (UMLS CUI [1,1])
C0441468 (UMLS CUI [1,2])
Sum of Products of Greatest Diameters
Item
Sum of Products of Greatest Diameters
float
C3824 (NCI Thesaurus ObjectClass)
C25697 (NCI Thesaurus ObjectClass-2)
C25285 (NCI Thesaurus Property)
C25209 (NCI Thesaurus ValueDomain)
C40352 (NCI Thesaurus ValueDomain-2)
C0037284 (UMLS CUI [1,1])
C0242485 (UMLS CUI [1,2])
Item
Evaluation of Marker Lesions
text
C9305 (NCI Thesaurus ObjectClass)
C9087 (NCI Thesaurus ObjectClass-2)
C25367 (NCI Thesaurus Property)
C18329 (NCI Thesaurus Property-2)
C25688 (NCI Thesaurus ValueDomain)
C0037284 (UMLS CUI [1,1])
C0220825 (UMLS CUI [1,2])
CL.7
Code List
Evaluation of Marker Lesions
CL Item
Complete Resolution (Complete resolution)
CL Item
None Of The Above (None of the above)
CL Item
50% decrease in the sum of the products of the diameters of all marker lesions since baseline = >=50% Decrease In The Sum Of The Products Of The Diameters Of All Marker Lesions Since Baseline (>)
CL Item
25% inc in sum of the products of the diam of all marker lesions since baseline/best response = >=25% Inc In Sum Of The Products Of The Diam Of All Marker Lesions Since Baseline/best Response (>)
Item Group
Comments
C0947611 (UMLS CUI-1)
C0037284 (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])
C0037284 (UMLS CUI [1,2])
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