ID

3270

Descrizione

AMC-051 Vital Signs Form (F20) Sirolimus in Treating Patients With HIV-Related Kaposi's Sarcoma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=2FF95103-FC90-6437-E044-0003BA3F9857

collegamento

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=2FF95103-FC90-6437-E044-0003BA3F9857

Keywords

versioni (3)
  1. 19/09/12 19/09/12 -
  2. 08/08/14 08/08/14 - Martin Dugas
  3. 09/01/15 09/01/15 - Martin Dugas
Caricato su

19 settembre 2012

DOI

Per favore, per richiedere un accesso.

Licenza

Creative Commons BY-NC 3.0 Legacy
Commenti del modello :

Puoi commentare il modello dati qui. Tramite i fumetti nei gruppi di articoli e articoli è possibile aggiungere commenti a quelli in modo specifico.

Torna ai commenti del modello
Commenti del gruppo di articoli per :

Commenti dell'articolo per :

Per scaricare i modelli di dati devi essere registrato. Per favore accesso o registrati GRATIS.

Sarcoma NCT00450320 On-Study - AMC-051 Vital Signs Form (F20) - 2636818v1.0

Inglese

No Instruction available.

1 moduli  
  1. StudyEvent: AMC-051 Vital Signs Form (F20)
    1. No Instruction available.
Header Module
Descrizione

Header Module

Visit number
Descrizione

HospitalAdmissionOrdinalNumber

Tipo di dati

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
Descrizione

Unnamed1

Date of evaluation
Descrizione

AssessmentPerformedDate

Tipo di dati

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C25367
NCI Thesaurus ValueDomain
C25367
NCI Thesaurus Property
C38000
UMLS 2011AA Property
C0884358
Time Test Completed
Descrizione

PatientCompleteVitalSignsPhysicalExaminationTime

Tipo di dati

time

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property
C25250
UMLS 2011AA Property
C0205197
NCI Metathesaurus Property
C0518766
NCI Thesaurus ValueDomain
C25207
UMLS 2011AA ValueDomain
C0040223
Unnamed2
Descrizione

Unnamed2

Height (cm in)
Descrizione

PatientHeightMeasurement

Tipo di dati

double

Unità di misura
  • cm
Alias
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25347
UMLS 2011AA Property
C0489786
cm
Weight (kg lb)
Descrizione

PatientWeightMeasurement

Tipo di dati

double

Unità di misura
  • Kg
Alias
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25208
UMLS 2011AA Property
C0043100
Kg
Body Surface Area (m^2)
Descrizione

PersonBodySurfaceAreaValue

Tipo di dati

double

Unità di misura
  • m2
Alias
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
NCI Thesaurus Property
C25157
UMLS 2011AA Property
C0005902
m2
Blood Pressure (mmHg)
Descrizione

BloodSystolicPressureMeasurement

Tipo di dati

double

Alias
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
NCI Thesaurus Property
C25214
UMLS 2011AA Property
C0220825
NCI Thesaurus ObjectClass
C25298
UMLS 2011AA ObjectClass
C0871470
Blood pressure (mmHg)
Descrizione

DiastolicBloodPressureEvaluationMeasurement

Tipo di dati

double

Alias
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
NCI Thesaurus Property
C25214
UMLS 2011AA Property
C0220825
NCI Thesaurus ObjectClass
C25299
UMLS 2011AA ObjectClass
C0428883
Heart Rate (beats/min)
Descrizione

PatientVitalSignsHeartRatePhysicalExaminationValue

Tipo di dati

double

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property
C49672
UMLS 2011AA Property
C1704752
NCI Thesaurus Property
C49677
UMLS 2011AA Property
C0018810
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
Respiratory Rate (breaths/min)
Descrizione

PersonVitalSignsRespiratoryRatePhysicalExaminationValue

Tipo di dati

double

Alias
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property
C49672
UMLS 2011AA Property
C1704752
NCI Thesaurus Property
C49678
UMLS 2011AA Property
C0231832
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
Body Temperature (C F)
Descrizione

PersonVitalSignsTemperaturePhysicalExaminationValue

Tipo di dati

double

Alias
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property
C25206
UMLS 2011AA Property
C0039476
NCI Thesaurus Property
C49672
UMLS 2011AA Property
C1704752
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
Karnofsky Performance Status Score (%)
Descrizione

KarnofskyPerformanceStatusScore

Tipo di dati

text

Alias
NCI Thesaurus Property
C25367
NCI Thesaurus ObjectClass
C20641
UMLS 2011AA ObjectClass
C1518965
NCI Thesaurus ValueDomain
C25338
UMLS 2011AA ValueDomain
C0449820
Units
Descrizione

PatientVitalSignsPhysicalExaminationUnitofMeasure

Tipo di dati

text

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Metathesaurus Property
C0518766
NCI Thesaurus ValueDomain
C25709
UMLS 2011AA ValueDomain
C1519795
Footer Module
Descrizione

Footer Module

Comments
Descrizione

ResearchCommentsText

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus ObjectClass
C15319
NCI Thesaurus Property
C25393
UMLS 2011AA Property
C0282411
Ritorna all'inizio della pagina

Similar models

No Instruction available.

1 moduli
  1. StudyEvent: AMC-051 Vital Signs Form (F20)
    1. No Instruction available.
Name
genere
Description | Question | Decode (Coded Value)
Tipo di dati
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
AssessmentPerformedDate
Item
Date of evaluation
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ObjectClass)
C25367 (NCI Thesaurus ValueDomain)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
PatientCompleteVitalSignsPhysicalExaminationTime
Item
Time Test Completed
time
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C0518766 (NCI Metathesaurus Property)
C25207 (NCI Thesaurus ValueDomain)
C0040223 (UMLS 2011AA ValueDomain)
Item Group
Unnamed2
PatientHeightMeasurement
Item
Height (cm in)
double
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25347 (NCI Thesaurus Property)
C0489786 (UMLS 2011AA Property)
PatientWeightMeasurement
Item
Weight (kg lb)
double
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25208 (NCI Thesaurus Property)
C0043100 (UMLS 2011AA Property)
PersonBodySurfaceAreaValue
Item
Body Surface Area (m^2)
double
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25157 (NCI Thesaurus Property)
C0005902 (UMLS 2011AA Property)
BloodSystolicPressureMeasurement
Item
Blood Pressure (mmHg)
double
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
C25214 (NCI Thesaurus Property)
C0220825 (UMLS 2011AA Property)
C25298 (NCI Thesaurus ObjectClass)
C0871470 (UMLS 2011AA ObjectClass)
DiastolicBloodPressureEvaluationMeasurement
Item
Blood pressure (mmHg)
double
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
C25214 (NCI Thesaurus Property)
C0220825 (UMLS 2011AA Property)
C25299 (NCI Thesaurus ObjectClass)
C0428883 (UMLS 2011AA ObjectClass)
PatientVitalSignsHeartRatePhysicalExaminationValue
Item
Heart Rate (beats/min)
double
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C49672 (NCI Thesaurus Property)
C1704752 (UMLS 2011AA Property)
C49677 (NCI Thesaurus Property)
C0018810 (UMLS 2011AA Property)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
PersonVitalSignsRespiratoryRatePhysicalExaminationValue
Item
Respiratory Rate (breaths/min)
double
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C49672 (NCI Thesaurus Property)
C1704752 (UMLS 2011AA Property)
C49678 (NCI Thesaurus Property)
C0231832 (UMLS 2011AA Property)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
PersonVitalSignsTemperaturePhysicalExaminationValue
Item
Body Temperature (C F)
double
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25206 (NCI Thesaurus Property)
C0039476 (UMLS 2011AA Property)
C49672 (NCI Thesaurus Property)
C1704752 (UMLS 2011AA Property)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
Item
Karnofsky Performance Status Score (%)
text
C25367 (NCI Thesaurus Property)
C20641 (NCI Thesaurus ObjectClass)
C1518965 (UMLS 2011AA ObjectClass)
C25338 (NCI Thesaurus ValueDomain)
C0449820 (UMLS 2011AA ValueDomain)
CL.1
Code List
Karnofsky Performance Status Score (%)
CL Item
Dead (0)
CL Item
Moribund, Fatal Processes Progressing Rapidly (10)
CL Item
Normal, No Complaints, No Evidence Of Disease (100)
CL Item
Very Sick, Hospitalization Indicated. Death Not Imminent (20)
CL Item
Severely Disabled, Hospitalization Indicated. Death Not Imminent (30)
CL Item
Disabled, Requires Special Care And Assistance (40)
CL Item
Requires Considerable Assistance And Frequent Medical Care (50)
CL Item
Requires Occasional Assistance, But Is Able To Care For Most Of His/her Needs (60)
CL Item
Cares For Self, Unable To Carry On Normal Activity Or To Do Active Work (70)
CL Item
Normal Activity With Effort; Some Signs Or Symptoms Of Disease (80)
CL Item
Able To Carry On Normal Activity; Minor Signs Or Symptoms Of Disease (90)
Item
Units
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C0518766 (NCI Metathesaurus Property)
C25709 (NCI Thesaurus ValueDomain)
C1519795 (UMLS 2011AA ValueDomain)
CL.2
Code List
Units
CL Item
Percentage (%)
C25613 (NCI Thesaurus)
C0439165 (UMLS 2011AA)
CL Item
Beats Per Minute:c49673 (beats/min)
C49673 (NCI Thesaurus)
C0439385 (UMLS 2011AA)
CL Item
Breaths Per Minute:c49674 (breaths/min)
C49674 (NCI Thesaurus)
C0439386 (UMLS 2011AA)
CL Item
Degree Celsius (C)
C42559 (NCI Thesaurus)
C0439237 (UMLS 2011AA)
CL Item
Centimeter (cm)
C49668 (NCI Thesaurus)
C0475210 (UMLS 2011AA)
CL Item
Degree Fahrenheit (F)
C44277 (NCI Thesaurus)
C0456628 (UMLS 2011AA)
CL Item
Inch (in)
C48500 (NCI Thesaurus)
C0439204 (UMLS 2011AA)
CL Item
Kilogram (kg)
C28252 (NCI Thesaurus)
C0439209 (UMLS 2011AA)
CL Item
Pound (lb)
C48531 (NCI Thesaurus)
C0439219 (UMLS 2011AA)
CL Item
Millimeter Of Mercury:c49670 (mmHg)
C49670 (NCI Thesaurus)
C0439475 (UMLS 2011AA)
CL Item
Square Meter (m^2)
C42569 (NCI Thesaurus)
C0457242 (UMLS 2011AA)
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)
Ritorna all'inizio della pagina 

Contatto

Si prega di utilizzare questo modulo per feedback, domande e suggerimenti per miglioramenti.

I campi contrassegnati da * sono obbligatori.

Aiuto

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