ID

28021

Beschrijving

NCT02499003 The GOAL Trial: Rescue Treatment With the Monoclonal Anti CD20-antibody Obinutuzumab (GA101) in Combination With Pixantrone for the Treatment of Patients With Relapsed Aggressive B-cell Lymphoma. Visit: All visits. Source: Prof. Dr. med. Georg Heß Universitätsmedizin Mainz

Trefwoorden

  1. 10-12-17 10-12-17 -
  2. 02-01-18 02-01-18 -
Houder van rechten

Prof. Dr. med. Georg Heß

Geüploaded op

10 december 2017

DOI

Voor een aanvraag inloggen.

Licentie

Creative Commons BY-NC 3.0

Model Commentaren :

Hier kunt u commentaar leveren op het model. U kunt de tekstballonnen bij de itemgroepen en items gebruiken om er specifiek commentaar op te geven.

Itemgroep Commentaren voor :

Item Commentaren voor :


Geen commentaren

U moet ingelogd zijn om formulieren te downloaden. AUB inloggen of schrijf u gratis in.

Adverse events GOAL Trial B-cell Lymphoma NCT02499003

Adverse events GOAL Trial B-cell Lymphoma NCT02499003

Admininstrative data
Beschrijving

Admininstrative data

Subject ID
Beschrijving

Subject ID

Datatype

text

Alias
UMLS CUI [1]
C2348585
Page
Beschrijving

Page

Datatype

integer

Adverse events
Beschrijving

Adverse events

No.
Beschrijving

adverse event number

Datatype

integer

AE Term (based on CTCAE 4.0)
Beschrijving

Adverse event

Datatype

text

SAE?
Beschrijving

Serious adverse event

Datatype

text

Study termination
Beschrijving

Study termination

Datatype

text

Start date
Beschrijving

Start date

Datatype

date

Stop date
Beschrijving

Stop date

Datatype

date

Ongoing at End of Treatment?
Beschrijving

Ongoing adverse event at End of Treatment

Datatype

boolean

Max. CTCAE grade
Beschrijving

Maximum CTCAE grade

Datatype

integer

Causality with Obinutuzumab
Beschrijving

Causality with Obinutuzumab

Datatype

integer

Causality with Pixantrone
Beschrijving

Causality with Pixantrone

Datatype

integer

Action taken with Obinutuzumab
Beschrijving

Action taken with Obinutuzumab

Datatype

integer

Action taken with Pixantrone
Beschrijving

Action taken with Pixantrone

Datatype

integer

Treatment given?
Beschrijving

Treatment

Datatype

text

Outcome
Beschrijving

Treatment Outcome

Datatype

integer

I have reviewed the AEs on this page and have assessed them for seriousness, causality, severity and outcome and confirm that, to the best of my knowledge, they accurately reflect the study information obtained for this patient.
Beschrijving

I have reviewed the AEs on this page and have assessed them for seriousness, causality, severity and outcome and confirm that, to the best of my knowledge, they accurately reflect the study information obtained for this patient.

Data correct?
Beschrijving

Data correct

Datatype

boolean

Date of signature
Beschrijving

Date of signature

Datatype

date

Name of investigator
Beschrijving

Name of investigator

Datatype

text

Similar models

Adverse events GOAL Trial B-cell Lymphoma NCT02499003

Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
Admininstrative data
Subject ID
Item
Subject ID
text
C2348585 (UMLS CUI [1])
Page
Item
Page
integer
Item Group
Adverse events
Item
No.
integer
CL Item
01 (1)
CL Item
02 (2)
CL Item
03 (3)
CL Item
04 (4)
CL Item
05 (5)
CL Item
06 (6)
CL Item
07 (7)
CL Item
08 (8)
CL Item
09 (9)
CL Item
10 (10)
Adverse event
Item
AE Term (based on CTCAE 4.0)
text
CL Item
Yes (Y)
CL Item
No (N)
Item
Study termination
text
Code List
Study termination
CL Item
Yes (Y)
CL Item
No (N)
Start date
Item
Start date
date
Stop date
Item
Stop date
date
Ongoing adverse event at End of Treatment
Item
Ongoing at End of Treatment?
boolean
Maximum CTCAE grade
Item
Max. CTCAE grade
integer
Item
Causality with Obinutuzumab
integer
Code List
Causality with Obinutuzumab
CL Item
Not related (1)
CL Item
Related (2)
Item
Causality with Pixantrone
integer
Code List
Causality with Pixantrone
CL Item
Not related (1)
CL Item
Related (2)
Item
Action taken with Obinutuzumab
integer
Code List
Action taken with Obinutuzumab
CL Item
Unchanged (1)
CL Item
Reduced (2)
CL Item
Interrupted (3)
CL Item
Discontinued (4)
CL Item
Not applicable (5)
Item
Action taken with Pixantrone
integer
Code List
Action taken with Pixantrone
CL Item
Unchanged (1)
CL Item
Reduced (2)
CL Item
Interrupted (3)
CL Item
Discontinued (4)
CL Item
Not applicable (5)
Item
Treatment given?
text
Code List
Treatment given?
CL Item
Yes (Y)
CL Item
No (N)
Item
Outcome
integer
Code List
Outcome
CL Item
Recovered (1)
CL Item
Recovered with sequelae (2)
CL Item
Recovering (3)
CL Item
Not recovered (4)
CL Item
Fatal (5)
CL Item
Unknown (6)
Item Group
I have reviewed the AEs on this page and have assessed them for seriousness, causality, severity and outcome and confirm that, to the best of my knowledge, they accurately reflect the study information obtained for this patient.
Data correct
Item
Data correct?
boolean
Date of signature
Item
Date of signature
date
Name of investigator
Item
Name of investigator
text

Gebruik dit formulier voor feedback, vragen en verbeteringsvoorstellen.

Velden gemarkeerd met een * zijn verplicht.

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial