ID

3329

Description

Abnormal Liver Function Tests - RF29 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=CCE279E2-AE7F-404E-E034-0003BA12F5E7

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=CCE279E2-AE7F-404E-E034-0003BA12F5E7

Keywords

  1. 9/19/12 9/19/12 -
Uploaded on

September 19, 2012

DOI

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License

Creative Commons BY-NC 3.0 Legacy

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Sarcoma, Kaposi xxx Lab - Abnormal Liver Function Tests - RF29 - 2266098v3.0

No Instruction available.

  1. StudyEvent: Abnormal Liver Function Tests - RF29
    1. No Instruction available.
Ccrr Module For Abnormal Liver Function Tests - Rf29
Description

Ccrr Module For Abnormal Liver Function Tests - Rf29

ID#
Description

ID#

Data type

text

Cycle#
Description

Cycle#

Data type

text

Visit Date
Description

VisitDate

Data type

text

Which evaluation does this represent?
Description

Whichevaluationdoesthisrepresent?

Data type

text

Were any of the liver function tests outside of normal limits?
Description

Wereanyoftheliverfunctiontestsoutsideofnormallimits?

Data type

text

Check if abnormal
Description

Checkifabnormal

Data type

text

SGOT (AST) mU/ml Value
Description

SGOT(AST)mU/mlValue

Data type

text

SGOT (AST) mU/ml LLN
Description

SGOT(AST)mU/mlLLN

Data type

text

SGOT (AST) mU/ml ULN
Description

SGOT(AST)mU/mlULN

Data type

text

SGPT (ALT) (mU/ml) Value
Description

SGPT(ALT)(mU/ml)Value

Data type

text

SGPT (ALT) (mU/ml) LLN
Description

SGPT(ALT)(mU/ml)LLN

Data type

text

SGPT (ALT) (mU/ml) ULN
Description

SGPT(ALT)(mU/ml)ULN

Data type

text

Alkaline Phosphatase (mU/ml) Value
Description

AlkalinePhosphatase(mU/ml)Value

Data type

text

Alkaline Phosphatase (mU/ml) LLN
Description

AlkalinePhosphatase(mU/ml)LLN

Data type

text

Alkaline Phosphatase (mU/ml) ULN
Description

AlkalinePhosphatase(mU/ml)ULN

Data type

text

Total Bilirubin (mg/dl) Value
Description

TotalBilirubin(mg/dl)Value

Data type

text

Total Bilirubin (mg/dl) LLN
Description

TotalBilirubin(mg/dl)LLN

Data type

text

Total Bilirubin (mg/dl) ULN
Description

TotalBilirubin(mg/dl)ULN

Data type

text

Direct Bilirubin (mg/dl) Value
Description

DirectBilirubin(mg/dl)Value

Data type

text

Direct Bilirubin (mg/dl) LLN
Description

DirectBilirubin(mg/dl)LLN

Data type

text

Direct Bilirubin (mg/dl) ULN
Description

DirectBilirubin(mg/dl)ULN

Data type

text

Similar models

No Instruction available.

  1. StudyEvent: Abnormal Liver Function Tests - RF29
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Ccrr Module For Abnormal Liver Function Tests - Rf29
ID#
Item
ID#
text
Cycle#
Item
Cycle#
text
VisitDate
Item
Visit Date
text
Item
Which evaluation does this represent?
text
Code List
Which evaluation does this represent?
CL Item
Entry/Baseline (Entry/Baseline)
CL Item
On Treatment (On Treatment)
CL Item
Post Therapy Evaluation (Post Therapy Evaluation)
Item
Were any of the liver function tests outside of normal limits?
text
Code List
Were any of the liver function tests outside of normal limits?
CL Item
Yes (Yes)
CL Item
No (No)
Item
Check if abnormal
text
Code List
Check if abnormal
CL Item
SGOT (AST) mU/ml (SGOT (AST) mU/ml)
CL Item
SGPT (ALT) (mU/ml) (SGPT (ALT) (mU/ml))
CL Item
Alkaline Phosphatase (mU/ml) (Alkaline Phosphatase (mU/ml))
CL Item
Total Bilirubin (mg/dl) (Total Bilirubin (mg/dl))
CL Item
Direct Bilirubin (mg/dl) (Direct Bilirubin (mg/dl))
SGOT(AST)mU/mlValue
Item
SGOT (AST) mU/ml Value
text
SGOT(AST)mU/mlLLN
Item
SGOT (AST) mU/ml LLN
text
SGOT(AST)mU/mlULN
Item
SGOT (AST) mU/ml ULN
text
SGPT(ALT)(mU/ml)Value
Item
SGPT (ALT) (mU/ml) Value
text
SGPT(ALT)(mU/ml)LLN
Item
SGPT (ALT) (mU/ml) LLN
text
SGPT(ALT)(mU/ml)ULN
Item
SGPT (ALT) (mU/ml) ULN
text
AlkalinePhosphatase(mU/ml)Value
Item
Alkaline Phosphatase (mU/ml) Value
text
AlkalinePhosphatase(mU/ml)LLN
Item
Alkaline Phosphatase (mU/ml) LLN
text
AlkalinePhosphatase(mU/ml)ULN
Item
Alkaline Phosphatase (mU/ml) ULN
text
TotalBilirubin(mg/dl)Value
Item
Total Bilirubin (mg/dl) Value
text
TotalBilirubin(mg/dl)LLN
Item
Total Bilirubin (mg/dl) LLN
text
TotalBilirubin(mg/dl)ULN
Item
Total Bilirubin (mg/dl) ULN
text
DirectBilirubin(mg/dl)Value
Item
Direct Bilirubin (mg/dl) Value
text
DirectBilirubin(mg/dl)LLN
Item
Direct Bilirubin (mg/dl) LLN
text
DirectBilirubin(mg/dl)ULN
Item
Direct Bilirubin (mg/dl) ULN
text

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