ID

27711

Description

Study part: Medical History Visit 03. A Randomized Phase II Trial of Transarterial Radioembolisation With Yttrium-90 (SIRT) in Comparison to Transarterial Chemoembolisation With Cisplatin (TACE) in Patients With Liver Metastases From Uveal Melanoma. Provided by Prof. Dr. Ulrich Keilholz, Charité – University of medicine Berlin. EudraCT-Nummer: 2014-002439-32. NCT02936388.

Keywords

Versions (1)
  1. 11/26/17 11/26/17 -
Copyright Holder

Charité – University of medicine Berlin

Uploaded on

November 26, 2017

DOI

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License

Creative Commons BY-NC 3.0
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Medical History Visit 03 SirTac NCT02936388

German

Medical History Visit 03

1 forms  
Visite 03 (Woche 03 nach Behandlung)
Description

Visite 03 (Woche 03 nach Behandlung)

Alias
UMLS CUI-1
C0545082 (Visit)
Patienten-ID:
Description

Patienten-ID

Data type

text

Alias
UMLS CUI [1]
C2348585 (Clinical Trial Subject Unique Identifier)
Random. Nr.:
Description

randomization number

Data type

text

Alias
UMLS CUI [1,1]
C1300638 (Identification number)
SNOMED
396278008
UMLS CUI [1,2]
C0034656 (Randomization)
Visite durchgeführt am
Description

date of visit

Data type

date

Alias
UMLS CUI [1]
C1320303 (Date of visit)
SNOMED
406543005
Krankheitszeichen und –symptome:
Description

symptoms

Data type

text

Alias
UMLS CUI [1]
C1457887 (Symptoms)
LOINC
MTHU021540
Klinischer Anhalt für Progress?
Description

wenn ja, Bildgebung zur Bestätigung durchführen

Data type

boolean

Alias
UMLS CUI [1]
C0242656 (Disease Progression)
SNOMED
246453008
LOINC
LP121764-7
Unerwünschtes Ereignis
Description

Adverse event

Data type

boolean

Alias
UMLS CUI [1]
C0877248 (Adverse event)
LOINC
MTHU014542
Befragung zur Lebensqualität nach EORTC QLQ-C30 Version 3 und EORTC QLQ-LMC21
Description

Befragung zur Lebensqualität nach EORTC QLQ-C30 Version 3 und EORTC QLQ-LMC21

Alias
UMLS CUI-1
C0034380 (Quality of life)
Hat der/die Patient/in den Fragebogen EORTC QLQ-30 ausgefüllt?
Description

EORTC QLQ-30

Data type

boolean

Alias
UMLS CUI [1,1]
C0451149 (EORTC - Quality of life questionnaire)
SNOMED
273446001
UMLS CUI [1,2]
C4055104 (EORTC QLQ-C30 Health and Quality of Life Rating Scale)
Hat der/die Patient/in den Fragebogen EORTC QLQ-LMC21 ausgefüllt?
Description

EORTC QLQ-LMC21

Data type

boolean

Alias
UMLS CUI [1,1]
C0451149 (EORTC - Quality of life questionnaire)
SNOMED
273446001
UMLS CUI [1,2]
C4055104 (EORTC QLQ-C30 Health and Quality of Life Rating Scale)
Ausgefüllt/bestätigt am:
Description

date

Data type

date

Alias
UMLS CUI [1]
C0011008 (Date in time)
SNOMED
410671006
Name Prüfarzt
Description

Investigator name

Data type

text

Alias
UMLS CUI [1]
C2826892 (Investigator Name)
Unterschrift Prüfarzt
Description

Investigator signature

Data type

text

Alias
UMLS CUI [1]
C2346576 (Investigator Signature)
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Similar models

Medical History Visit 03

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Visite 03 (Woche 03 nach Behandlung)
C0545082 (UMLS CUI-1)
Patienten-ID
Item
Patienten-ID:
text
C2348585 (UMLS CUI [1])
randomization number
Item
Random. Nr.:
text
C1300638 (UMLS CUI [1,1])
C0034656 (UMLS CUI [1,2])
date of visit
Item
Visite durchgeführt am
date
C1320303 (UMLS CUI [1])
symptoms
Item
Krankheitszeichen und –symptome:
text
C1457887 (UMLS CUI [1])
disease progression
Item
Klinischer Anhalt für Progress?
boolean
C0242656 (UMLS CUI [1])
Adverse event
Item
Unerwünschtes Ereignis
boolean
C0877248 (UMLS CUI [1])
Item Group
Befragung zur Lebensqualität nach EORTC QLQ-C30 Version 3 und EORTC QLQ-LMC21
C0034380 (UMLS CUI-1)
EORTC QLQ-30
Item
Hat der/die Patient/in den Fragebogen EORTC QLQ-30 ausgefüllt?
boolean
C0451149 (UMLS CUI [1,1])
C4055104 (UMLS CUI [1,2])
EORTC QLQ-LMC21
Item
Hat der/die Patient/in den Fragebogen EORTC QLQ-LMC21 ausgefüllt?
boolean
C0451149 (UMLS CUI [1,1])
C4055104 (UMLS CUI [1,2])
date
Item
Ausgefüllt/bestätigt am:
date
C0011008 (UMLS CUI [1])
Investigator name
Item
Name Prüfarzt
text
C2826892 (UMLS CUI [1])
Investigator signature
Item
Unterschrift Prüfarzt
text
C2346576 (UMLS CUI [1])
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