ID
2700
Beschrijving
AMC-075 Pregnancy Report Form (PRF) Vorinostat and Combination Chemotherapy With Rituximab in Treating Patients With Previously Untreated HIV-Related Diffuse Large B-Cell Non-Hodgkin Lymphoma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A0F9B852-8D06-8306-E040-BB89AD434EB4
Link
Trefwoorden
Versies (2)
- 19-09-12 19-09-12 -
- 29-08-17 29-08-17 -
Geüploaded op
19 september 2012
DOI
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Licentie
Creative Commons BY-NC 3.0 Legacy
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Lymphoma NCT01193842 On-Study - AMC-075 Pregnancy Report Form (PRF) - 3228000v1.0
For date fields, if the month and year are known, but the exact date is not, please enter "15" for the day.
- StudyEvent: AMC-075 Pregnancy Report Form (PRF)
Beschrijving
Current Pregnancy Information
Beschrijving
PatientMostRecentPregnancyTestDate
Datatype
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Metathesaurus Property
- C0032976
- NCI Thesaurus Property
- C25577
- UMLS 2011AA Property
- C1513491
Beschrijving
PregnancyLaboratoryProcedurePerformedType
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus Property
- C38000
- UMLS 2011AA Property
- C0884358
- NCI Thesaurus ObjectClass
- C25742
- UMLS 2011AA ObjectClass
- C0032961
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
Beschrijving
PatientSerumPregnancyTestInd-3
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C13325
- UMLS 2011AA Property
- C0229671
- NCI Thesaurus Property
- C92949
Beschrijving
PatientSerumPregnancyTestDate
Datatype
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C13325
- UMLS 2011AA Property
- C0229671
- NCI Thesaurus Property
- C92949
Beschrijving
LastMenstrualCycleOccurrenceDate
Datatype
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C25551
- UMLS 2011AA ObjectClass
- C1517741
- NCI Thesaurus Property
- C25275
- UMLS 2011AA Property
- C2745955
- NCI Thesaurus ObjectClass
- C16838
- UMLS 2011AA ObjectClass
- C0025329
Beschrijving
PatientEstimatedConceptionDate
Datatype
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C25498
- UMLS 2011AA Property
- C0750572
- NCI Thesaurus Property
- C16465
- UMLS 2011AA Property
- C0009637
Beschrijving
PregnancyDeliveryDate
Datatype
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C25742
- UMLS 2011AA ObjectClass
- C0032961
- NCI Thesaurus Property
- C61560
Beschrijving
Previous Pregnancy Information
Beschrijving
PatientPregnancyCount
Datatype
double
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus ValueDomain
- C25463
- UMLS 2011AA ValueDomain
- C0750480
- NCI Thesaurus Property
- C25742
- UMLS 2011AA Property
- C0032961
Beschrijving
PregnancyLiveBirthCount
Datatype
double
Alias
- NCI Thesaurus ValueDomain
- C25463
- UMLS 2011AA ValueDomain
- C0750480
Beschrijving
PatientPregnancySpontaneousAbortionCount
Datatype
double
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus ValueDomain
- C25463
- UMLS 2011AA ValueDomain
- C0750480
- NCI Thesaurus Property
- C25742
- UMLS 2011AA Property
- C0032961
Beschrijving
PatientPregnancyTherapeuticAbortionCount
Datatype
double
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus ValueDomain
- C25463
- UMLS 2011AA ValueDomain
- C0750480
- NCI Thesaurus Property
- C25742
- UMLS 2011AA Property
- C0032961
Beschrijving
DataUnknownText
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus ObjectClass
- C25474
- UMLS 2011AA ObjectClass
- C1511726
- NCI Thesaurus Property
- C17998
- UMLS 2011AA Property
- C0439673
Beschrijving
PersonPreviousPregnancyComplicationInd-3
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
- NCI Thesaurus Property
- C25627
- UMLS 2011AA Property
- C0205156
- NCI Thesaurus Property
- C34941
- UMLS 2011AA Property
- C0032962
Beschrijving
PersonPreviousPregnancyComplicationSpecify
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus Property
- C25627
- UMLS 2011AA Property
- C0205156
- NCI Thesaurus Property
- C34941
- UMLS 2011AA Property
- C0032962
Beschrijving
PersonCongenitalAbnormalityPregnancyInd-3
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
- NCI Thesaurus Property
- C25742
- UMLS 2011AA Property
- C0032961
- NCI Thesaurus Property
- C2849
- UMLS 2011AA Property
- C0000768
Beschrijving
PatientCongenitalAbnormalitySpecify
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
- NCI Thesaurus ObjectClass
- C16960
- UMLS 2011AA ObjectClass
- C0030705
- NCI Thesaurus Property
- C2849
- UMLS 2011AA Property
- C0000768
Beschrijving
Relevant Medical History
Beschrijving
PersonPersonalMedicalHistoryPregnancyText
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus Property
- C25742
- UMLS 2011AA Property
- C0032961
- NCI Thesaurus Property
- C18772
- UMLS 2011AA Property
- C0262926
Beschrijving
PersonFatherKnownIndicator
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus ValueDomain
- C25180
- UMLS 2011AA ValueDomain
- C1522602
- NCI Thesaurus Property
- C25174
- UMLS 2011AA Property
- C0015671
- NCI Thesaurus Property
- C80137
- UMLS 2011AA Property
- C0205309
Beschrijving
FatherPersonChildCount
Datatype
double
Alias
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus ObjectClass
- C25174
- UMLS 2011AA ObjectClass
- C0015671
- NCI Thesaurus ValueDomain
- C25463
- UMLS 2011AA ValueDomain
- C0750480
- NCI Thesaurus Property
- C42708
- UMLS 2011AA Property
- C0680063
Beschrijving
FatherAgeValue
Datatype
double
Maateenheden
- year
Alias
- NCI Thesaurus ObjectClass
- C25174
- UMLS 2011AA ObjectClass
- C0015671
- NCI Thesaurus Property
- C25150
- UMLS 2011AA Property
- C0001779
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
Beschrijving
DataUnknownText
Datatype
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus ObjectClass
- C25474
- UMLS 2011AA ObjectClass
- C1511726
- NCI Thesaurus Property
- C17998
- UMLS 2011AA Property
- C0439673
Beschrijving
ConcomitantDiseaseOrganSystemPersonalMedicalHistorySpecify
Datatype
text
Alias
- NCI Thesaurus ObjectClass
- C2991
- UMLS 2011AA ObjectClass
- C0012634
- NCI Thesaurus ObjectClass
- C25730
- UMLS 2011AA ObjectClass
- C0521115
- NCI Thesaurus Property
- C18772
- UMLS 2011AA Property
- C0262926
- NCI Thesaurus Property
- C12919
- UMLS 2011AA Property
- C0460002
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
Beschrijving
Comments
Similar models
For date fields, if the month and year are known, but the exact date is not, please enter "15" for the day.
- StudyEvent: AMC-075 Pregnancy Report Form (PRF)
C0376315 (UMLS 2011AA ObjectClass)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
C49153 (NCI Thesaurus ObjectClass)
C1705294 (UMLS 2011AA ObjectClass)
C25694 (NCI Thesaurus Property)
C1515022 (UMLS 2011AA Property)
C0011008 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C0032976 (NCI Metathesaurus Property)
C25577 (NCI Thesaurus Property)
C1513491 (UMLS 2011AA Property)
C0332307 (UMLS 2011AA ValueDomain)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C25742 (NCI Thesaurus ObjectClass)
C0032961 (UMLS 2011AA ObjectClass)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C1512699 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C13325 (NCI Thesaurus Property)
C0229671 (UMLS 2011AA Property)
C92949 (NCI Thesaurus Property)
C1705108 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C0011008 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C13325 (NCI Thesaurus Property)
C0229671 (UMLS 2011AA Property)
C92949 (NCI Thesaurus Property)
C0011008 (UMLS 2011AA ValueDomain)
C25551 (NCI Thesaurus ObjectClass)
C1517741 (UMLS 2011AA ObjectClass)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
C16838 (NCI Thesaurus ObjectClass)
C0025329 (UMLS 2011AA ObjectClass)
C0011008 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25498 (NCI Thesaurus Property)
C0750572 (UMLS 2011AA Property)
C16465 (NCI Thesaurus Property)
C0009637 (UMLS 2011AA Property)
C0011008 (UMLS 2011AA ValueDomain)
C25742 (NCI Thesaurus ObjectClass)
C0032961 (UMLS 2011AA ObjectClass)
C61560 (NCI Thesaurus Property)
C0030705 (UMLS 2011AA ObjectClass)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
C25742 (NCI Thesaurus Property)
C0032961 (UMLS 2011AA Property)
C0750480 (UMLS 2011AA ValueDomain)
C0030705 (UMLS 2011AA ObjectClass)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
C25742 (NCI Thesaurus Property)
C0032961 (UMLS 2011AA Property)
C0030705 (UMLS 2011AA ObjectClass)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
C25742 (NCI Thesaurus Property)
C0032961 (UMLS 2011AA Property)
C1527021 (UMLS 2011AA ValueDomain)
C25474 (NCI Thesaurus ObjectClass)
C1511726 (UMLS 2011AA ObjectClass)
C17998 (NCI Thesaurus Property)
C0439673 (UMLS 2011AA Property)
C0027361 (UMLS 2011AA ObjectClass)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25627 (NCI Thesaurus Property)
C0205156 (UMLS 2011AA Property)
C34941 (NCI Thesaurus Property)
C0032962 (UMLS 2011AA Property)
C1705108 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C1521902 (UMLS 2011AA ValueDomain)
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25627 (NCI Thesaurus Property)
C0205156 (UMLS 2011AA Property)
C34941 (NCI Thesaurus Property)
C0032962 (UMLS 2011AA Property)
C0027361 (UMLS 2011AA ObjectClass)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25742 (NCI Thesaurus Property)
C0032961 (UMLS 2011AA Property)
C2849 (NCI Thesaurus Property)
C0000768 (UMLS 2011AA Property)
C1705108 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C1521902 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C2849 (NCI Thesaurus Property)
C0000768 (UMLS 2011AA Property)
C1527021 (UMLS 2011AA ValueDomain)
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25742 (NCI Thesaurus Property)
C0032961 (UMLS 2011AA Property)
C18772 (NCI Thesaurus Property)
C0262926 (UMLS 2011AA Property)
C0027361 (UMLS 2011AA ObjectClass)
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C25174 (NCI Thesaurus Property)
C0015671 (UMLS 2011AA Property)
C80137 (NCI Thesaurus Property)
C0205309 (UMLS 2011AA Property)
C1705108 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
C0027361 (UMLS 2011AA ObjectClass)
C25174 (NCI Thesaurus ObjectClass)
C0015671 (UMLS 2011AA ObjectClass)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
C42708 (NCI Thesaurus Property)
C0680063 (UMLS 2011AA Property)
C0015671 (UMLS 2011AA ObjectClass)
C25150 (NCI Thesaurus Property)
C0001779 (UMLS 2011AA Property)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C25474 (NCI Thesaurus ObjectClass)
C1511726 (UMLS 2011AA ObjectClass)
C17998 (NCI Thesaurus Property)
C0439673 (UMLS 2011AA Property)
C0012634 (UMLS 2011AA ObjectClass)
C25730 (NCI Thesaurus ObjectClass)
C0521115 (UMLS 2011AA ObjectClass)
C18772 (NCI Thesaurus Property)
C0262926 (UMLS 2011AA Property)
C12919 (NCI Thesaurus Property)
C0460002 (UMLS 2011AA Property)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C0282411 (UMLS 2011AA Property)