ID

2844

Description

AMC-063 Interventions Form (RK5) 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-B8CA-35E0-E040-BB89AD435080

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=8163A333-B8CA-35E0-E040-BB89AD435080

Keywords

Versions (3)
  1. 9/19/12 9/19/12 -
  2. 9/20/17 9/20/17 -
  3. 9/20/21 9/20/21 -
Uploaded on

September 19, 2012

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Creative Commons BY-NC 3.0 Legacy
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Sarcoma NCT01016730 Treatment - AMC-063 Interventions Form (RK5) - 3020573v1.0

English

No Instruction available.

1 forms  
  1. StudyEvent: AMC-063 Interventions Form (RK5)
    1. No Instruction available.
Header Module
Description

Header Module

Visit number
Description

HospitalAdmissionOrdinalNumber

Data type

double

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C16696
UMLS 2011AA ObjectClass
C0019994
NCI Thesaurus Property
C25385
UMLS 2011AA Property
C0809949
Unnamed1
Description

Unnamed1

Interventions for Oral Cavity Lesions
Description

KaposiSarcomaRelatedOralCavityDisorderInterventionType

Data type

text

Alias
NCI Thesaurus ObjectClass
C25648
UMLS 2011AA ObjectClass
C0439849
NCI Thesaurus ObjectClass
C9087
UMLS 2011AA ObjectClass
C0036220
NCI Thesaurus ObjectClass
C27641
UMLS 2011AA ObjectClass
C0026636
NCI Thesaurus Property
C16197
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Other, specify
Description

KaposiSarcomaRelatedOralCavityDisorderInterventionSpecify

Data type

text

Alias
NCI Thesaurus ObjectClass
C25648
UMLS 2011AA ObjectClass
C0439849
NCI Thesaurus ObjectClass
C9087
UMLS 2011AA ObjectClass
C0036220
NCI Thesaurus ObjectClass
C27641
UMLS 2011AA ObjectClass
C0026636
NCI Thesaurus Property
C16197
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ValueDomain
C25382
UMLS 2011AA ValueDomain
C1521801
Interventions for gastrointestinal (GI) lesions
Description

GastricKaposiSarcomaInterventionType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C5529
UMLS 2011AA ObjectClass
C1333776
NCI Thesaurus Property
C16197
Other, specify
Description

GastricKaposiSarcomaInterventionSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ValueDomain
C25382
UMLS 2011AA ValueDomain
C1521801
NCI Thesaurus ObjectClass
C5529
UMLS 2011AA ObjectClass
C1333776
NCI Thesaurus Property
C16197
Interventions for Pulmonary Lesions
Description

LungKaposiSarcomaInterventionType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C3551
UMLS 2011AA ObjectClass
C0153564
NCI Thesaurus Property
C16197
Other, specify
Description

LungKaposiSarcomaInterventionSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ValueDomain
C25382
UMLS 2011AA ValueDomain
C1521801
NCI Thesaurus ObjectClass
C3551
UMLS 2011AA ObjectClass
C0153564
NCI Thesaurus Property
C16197
Interventions for Extremity Edema
Description

KaposiSarcomaRelatedLimbEdemaInterventionType

Data type

text

Alias
NCI Thesaurus ObjectClass
C25648
UMLS 2011AA ObjectClass
C0439849
NCI Thesaurus ObjectClass
C3002
UMLS 2011AA ObjectClass
C0013604
NCI Thesaurus ObjectClass
C9087
UMLS 2011AA ObjectClass
C0036220
NCI Thesaurus ObjectClass
C12429
UMLS 2011AA ObjectClass
C0015385
NCI Thesaurus Property
C16197
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Other, specify
Description

KaposiSarcomaRelatedLimbEdemaInterventionSpecify

Data type

text

Alias
NCI Thesaurus ObjectClass
C25648
UMLS 2011AA ObjectClass
C0439849
NCI Thesaurus ObjectClass
C3002
UMLS 2011AA ObjectClass
C0013604
NCI Thesaurus ObjectClass
C9087
UMLS 2011AA ObjectClass
C0036220
NCI Thesaurus ObjectClass
C12429
UMLS 2011AA ObjectClass
C0015385
NCI Thesaurus Property
C16197
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ValueDomain
C25382
UMLS 2011AA ValueDomain
C1521801
Interventions for Periorbital Edema
Description

KaposiSarcomaRelatedOrbitEdemaInterventionType

Data type

text

Alias
NCI Thesaurus ObjectClass
C25648
UMLS 2011AA ObjectClass
C0439849
NCI Thesaurus ObjectClass
C3002
UMLS 2011AA ObjectClass
C0013604
NCI Thesaurus ObjectClass
C9087
UMLS 2011AA ObjectClass
C0036220
NCI Thesaurus ObjectClass
C12347
UMLS 2011AA ObjectClass
C0029180
NCI Thesaurus Property
C16197
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Other, specify
Description

KaposiSarcomaRelatedOrbitEdemaInterventionSpecify

Data type

text

Alias
NCI Thesaurus ObjectClass
C25648
UMLS 2011AA ObjectClass
C0439849
NCI Thesaurus ObjectClass
C3002
UMLS 2011AA ObjectClass
C0013604
NCI Thesaurus ObjectClass
C9087
UMLS 2011AA ObjectClass
C0036220
NCI Thesaurus ObjectClass
C12347
UMLS 2011AA ObjectClass
C0029180
NCI Thesaurus Property
C16197
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ValueDomain
C25382
UMLS 2011AA ValueDomain
C1521801
Interventions for Scrotal/Genital Edema
Description

KaposiSarcomaRelatedGenitaliaEdemaInterventionType

Data type

text

Alias
NCI Thesaurus ObjectClass
C25648
UMLS 2011AA ObjectClass
C0439849
NCI Thesaurus ObjectClass
C3002
UMLS 2011AA ObjectClass
C0013604
NCI Thesaurus ObjectClass
C25177
UMLS 2011AA ObjectClass
C0017420
NCI Thesaurus ObjectClass
C9087
UMLS 2011AA ObjectClass
C0036220
NCI Thesaurus Property
C16197
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Other, specify
Description

KaposiSarcomaRelatedGenitaliaEdemaInterventionSpecify

Data type

text

Alias
NCI Thesaurus ObjectClass
C25648
UMLS 2011AA ObjectClass
C0439849
NCI Thesaurus ObjectClass
C3002
UMLS 2011AA ObjectClass
C0013604
NCI Thesaurus ObjectClass
C25177
UMLS 2011AA ObjectClass
C0017420
NCI Thesaurus ObjectClass
C9087
UMLS 2011AA ObjectClass
C0036220
NCI Thesaurus Property
C16197
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ValueDomain
C25382
UMLS 2011AA ValueDomain
C1521801
Interventions for Foot Kaposi's Sarcoma (KS)
Description

KaposiSarcomaRelatedFootDiseaseInterventionType

Data type

text

Alias
NCI Thesaurus ObjectClass
C25648
UMLS 2011AA ObjectClass
C0439849
NCI Thesaurus ObjectClass
C2991
UMLS 2011AA ObjectClass
C0012634
NCI Thesaurus ObjectClass
C9087
UMLS 2011AA ObjectClass
C0036220
NCI Thesaurus ObjectClass
C32622
UMLS 2011AA ObjectClass
C0016504
NCI Thesaurus Property
C16197
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Other, specify
Description

KaposiSarcomaRelatedFootDiseaseInterventionSpecify

Data type

text

Alias
NCI Thesaurus ObjectClass
C25648
UMLS 2011AA ObjectClass
C0439849
NCI Thesaurus ObjectClass
C2991
UMLS 2011AA ObjectClass
C0012634
NCI Thesaurus ObjectClass
C9087
UMLS 2011AA ObjectClass
C0036220
NCI Thesaurus ObjectClass
C32622
UMLS 2011AA ObjectClass
C0016504
NCI Thesaurus Property
C16197
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ValueDomain
C25382
UMLS 2011AA ValueDomain
C1521801
Footer Module
Description

Footer Module

Comments
Description

ResearchCommentsText

Data type

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus ObjectClass
C15319
NCI Thesaurus Property
C25393
UMLS 2011AA Property
C0282411
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Similar models

No Instruction available.

1 forms
  1. StudyEvent: AMC-063 Interventions Form (RK5)
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Header Module
HospitalAdmissionOrdinalNumber
Item
Visit number
double
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C16696 (NCI Thesaurus ObjectClass)
C0019994 (UMLS 2011AA ObjectClass)
C25385 (NCI Thesaurus Property)
C0809949 (UMLS 2011AA Property)
Item Group
Unnamed1
Item
Interventions for Oral Cavity Lesions
text
C25648 (NCI Thesaurus ObjectClass)
C0439849 (UMLS 2011AA ObjectClass)
C9087 (NCI Thesaurus ObjectClass)
C0036220 (UMLS 2011AA ObjectClass)
C27641 (NCI Thesaurus ObjectClass)
C0026636 (UMLS 2011AA ObjectClass)
C16197 (NCI Thesaurus Property)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.1
Code List
Interventions for Oral Cavity Lesions
CL Item
Local Anesthetic/analgesic (Local anesthetic/analgesic)
CL Item
Local Intervention To Ks Lesions (Local intervention to KS lesions)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
KaposiSarcomaRelatedOralCavityDisorderInterventionSpecify
Item
Other, specify
text
C25648 (NCI Thesaurus ObjectClass)
C0439849 (UMLS 2011AA ObjectClass)
C9087 (NCI Thesaurus ObjectClass)
C0036220 (UMLS 2011AA ObjectClass)
C27641 (NCI Thesaurus ObjectClass)
C0026636 (UMLS 2011AA ObjectClass)
C16197 (NCI Thesaurus Property)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C25382 (NCI Thesaurus ValueDomain)
C1521801 (UMLS 2011AA ValueDomain)
Item
Interventions for gastrointestinal (GI) lesions
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C5529 (NCI Thesaurus ObjectClass)
C1333776 (UMLS 2011AA ObjectClass)
C16197 (NCI Thesaurus Property)
CL.2
Code List
Interventions for gastrointestinal (GI) lesions
CL Item
Antiemetics (Antiemetics)
CL Item
Blood Transfusion (Blood transfusions)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
GastricKaposiSarcomaInterventionSpecify
Item
Other, specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C25382 (NCI Thesaurus ValueDomain)
C1521801 (UMLS 2011AA ValueDomain)
C5529 (NCI Thesaurus ObjectClass)
C1333776 (UMLS 2011AA ObjectClass)
C16197 (NCI Thesaurus Property)
Item
Interventions for Pulmonary Lesions
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C3551 (NCI Thesaurus ObjectClass)
C0153564 (UMLS 2011AA ObjectClass)
C16197 (NCI Thesaurus Property)
CL.3
Code List
Interventions for Pulmonary Lesions
CL Item
Bronchodilators (Bronchodilators)
CL Item
Cough Suppressant (Cough suppressant)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
CL Item
Oxygen (Oxygen)
CL Item
Steroids (Steroids)
LungKaposiSarcomaInterventionSpecify
Item
Other, specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C25382 (NCI Thesaurus ValueDomain)
C1521801 (UMLS 2011AA ValueDomain)
C3551 (NCI Thesaurus ObjectClass)
C0153564 (UMLS 2011AA ObjectClass)
C16197 (NCI Thesaurus Property)
Item
Interventions for Extremity Edema
text
C25648 (NCI Thesaurus ObjectClass)
C0439849 (UMLS 2011AA ObjectClass)
C3002 (NCI Thesaurus ObjectClass)
C0013604 (UMLS 2011AA ObjectClass)
C9087 (NCI Thesaurus ObjectClass)
C0036220 (UMLS 2011AA ObjectClass)
C12429 (NCI Thesaurus ObjectClass)
C0015385 (UMLS 2011AA ObjectClass)
C16197 (NCI Thesaurus Property)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.4
Code List
Interventions for Extremity Edema
CL Item
Diuretic (Diuretics)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
KaposiSarcomaRelatedLimbEdemaInterventionSpecify
Item
Other, specify
text
C25648 (NCI Thesaurus ObjectClass)
C0439849 (UMLS 2011AA ObjectClass)
C3002 (NCI Thesaurus ObjectClass)
C0013604 (UMLS 2011AA ObjectClass)
C9087 (NCI Thesaurus ObjectClass)
C0036220 (UMLS 2011AA ObjectClass)
C12429 (NCI Thesaurus ObjectClass)
C0015385 (UMLS 2011AA ObjectClass)
C16197 (NCI Thesaurus Property)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C25382 (NCI Thesaurus ValueDomain)
C1521801 (UMLS 2011AA ValueDomain)
Item
Interventions for Periorbital Edema
text
C25648 (NCI Thesaurus ObjectClass)
C0439849 (UMLS 2011AA ObjectClass)
C3002 (NCI Thesaurus ObjectClass)
C0013604 (UMLS 2011AA ObjectClass)
C9087 (NCI Thesaurus ObjectClass)
C0036220 (UMLS 2011AA ObjectClass)
C12347 (NCI Thesaurus ObjectClass)
C0029180 (UMLS 2011AA ObjectClass)
C16197 (NCI Thesaurus Property)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.5
Code List
Interventions for Periorbital Edema
CL Item
Analgesics (Analgesics)
CL Item
Local Therapy (Local therapy)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
KaposiSarcomaRelatedOrbitEdemaInterventionSpecify
Item
Other, specify
text
C25648 (NCI Thesaurus ObjectClass)
C0439849 (UMLS 2011AA ObjectClass)
C3002 (NCI Thesaurus ObjectClass)
C0013604 (UMLS 2011AA ObjectClass)
C9087 (NCI Thesaurus ObjectClass)
C0036220 (UMLS 2011AA ObjectClass)
C12347 (NCI Thesaurus ObjectClass)
C0029180 (UMLS 2011AA ObjectClass)
C16197 (NCI Thesaurus Property)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C25382 (NCI Thesaurus ValueDomain)
C1521801 (UMLS 2011AA ValueDomain)
Item
Interventions for Scrotal/Genital Edema
text
C25648 (NCI Thesaurus ObjectClass)
C0439849 (UMLS 2011AA ObjectClass)
C3002 (NCI Thesaurus ObjectClass)
C0013604 (UMLS 2011AA ObjectClass)
C25177 (NCI Thesaurus ObjectClass)
C0017420 (UMLS 2011AA ObjectClass)
C9087 (NCI Thesaurus ObjectClass)
C0036220 (UMLS 2011AA ObjectClass)
C16197 (NCI Thesaurus Property)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.6
Code List
Interventions for Scrotal/Genital Edema
CL Item
Analgesics (Analgesics)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
KaposiSarcomaRelatedGenitaliaEdemaInterventionSpecify
Item
Other, specify
text
C25648 (NCI Thesaurus ObjectClass)
C0439849 (UMLS 2011AA ObjectClass)
C3002 (NCI Thesaurus ObjectClass)
C0013604 (UMLS 2011AA ObjectClass)
C25177 (NCI Thesaurus ObjectClass)
C0017420 (UMLS 2011AA ObjectClass)
C9087 (NCI Thesaurus ObjectClass)
C0036220 (UMLS 2011AA ObjectClass)
C16197 (NCI Thesaurus Property)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C25382 (NCI Thesaurus ValueDomain)
C1521801 (UMLS 2011AA ValueDomain)
Item
Interventions for Foot Kaposi's Sarcoma (KS)
text
C25648 (NCI Thesaurus ObjectClass)
C0439849 (UMLS 2011AA ObjectClass)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C9087 (NCI Thesaurus ObjectClass)
C0036220 (UMLS 2011AA ObjectClass)
C32622 (NCI Thesaurus ObjectClass)
C0016504 (UMLS 2011AA ObjectClass)
C16197 (NCI Thesaurus Property)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.7
Code List
Interventions for Foot Kaposi's Sarcoma (KS)
CL Item
Analgesics (Analgesics)
CL Item
Uses Cane, Wheelchair (Uses cane, wheelchair)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
KaposiSarcomaRelatedFootDiseaseInterventionSpecify
Item
Other, specify
text
C25648 (NCI Thesaurus ObjectClass)
C0439849 (UMLS 2011AA ObjectClass)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C9087 (NCI Thesaurus ObjectClass)
C0036220 (UMLS 2011AA ObjectClass)
C32622 (NCI Thesaurus ObjectClass)
C0016504 (UMLS 2011AA ObjectClass)
C16197 (NCI Thesaurus Property)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C25382 (NCI Thesaurus ValueDomain)
C1521801 (UMLS 2011AA ValueDomain)
Item Group
Footer Module
ResearchCommentsText
Item
Comments
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C0282411 (UMLS 2011AA Property)
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