ID

373

Descrizione

E1900 Cover Page for Adverse Event Form Combination Chemotherapy With or Without Monoclonal Antibody Therapy Followed by Stem Cell Transplant in Treating Patients With Acute Myeloid Leukemia Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=B19AAD35-91C7-25DB-E034-0003BA12F5E7

collegamento

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=B19AAD35-91C7-25DB-E034-0003BA12F5E7

Keywords

  1. 25/05/12 25/05/12 -
  2. 09/01/15 09/01/15 - Martin Dugas
Caricato su

25 maggio 2012

DOI

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Licenza

Creative Commons BY-NC 3.0 Legacy

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Leukemia NCT00049517 Toxicity - E1900 Cover Page for Adverse Event Form - 2075062v3.0

No Instruction available.

  1. StudyEvent: E1900 Cover Page for Adverse Event Form
    1. No Instruction available.
Unnamed1
Descrizione

Unnamed1

DCI Name
Descrizione

CollectedDataFormName

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus Property
C19464
UMLS 2011AA Property
C0376315
NCI Thesaurus ObjectClass
C25474
UMLS 2011AA ObjectClass
C1511726
NCI Thesaurus ObjectClass
C25452
Patient Initials
Descrizione

PatientInitialsName

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25536
UMLS 2011AA Property
C1555582
ECOG Protocol Number
Descrizione

ECOGProtocolNumber

Tipo di dati

text

ECOG Protocol Number
Descrizione

ECOGProtocolNumber

Tipo di dati

text

ECOG Protocol Number
Descrizione

ECOGProtocolNumber

Tipo di dati

text

ECOG Patient ID
Descrizione

ECOGPatientID

Tipo di dati

text

ECOG Patient ID
Descrizione

ECOGPatientID

Tipo di dati

text

Participating Group Protocol No.
Descrizione

ParticipatingGroupProtocolNo.

Tipo di dati

text

Participating Group Patient ID
Descrizione

ParticipatingGroupPatientID

Tipo di dati

text

Institution/Affiliate
Descrizione

MainMemberInstitution/Affiliate

Tipo di dati

text

On Treatment
Descrizione

On Treatment

On Treatment Time Period
Descrizione

OnTreatmentTimePeriod

Tipo di dati

text

Off Treatment
Descrizione

Off Treatment

Off Treatment Time Period
Descrizione

OffTreatmentTimePeriod

Tipo di dati

text

Alias
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C25616
UMLS 2011AA Property
C1948053
NCI Thesaurus Property
C25601
UMLS 2011AA Property
C1518544
NCI Thesaurus Property
C25207
UMLS 2011AA Property
C0040223
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Ccrr Module For E1900 Cover Page For Adverse Event Form
Descrizione

Ccrr Module For E1900 Cover Page For Adverse Event Form

Similar models

No Instruction available.

  1. StudyEvent: E1900 Cover Page for Adverse Event Form
    1. No Instruction available.
Name
genere
Description | Question | Decode (Coded Value)
Tipo di dati
Alias
Item Group
Unnamed1
CollectedDataFormName
Item
DCI Name
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C19464 (NCI Thesaurus Property)
C0376315 (UMLS 2011AA Property)
C25474 (NCI Thesaurus ObjectClass)
C1511726 (UMLS 2011AA ObjectClass)
C25452 (NCI Thesaurus ObjectClass)
PatientInitialsName
Item
Patient Initials
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25536 (NCI Thesaurus Property)
C1555582 (UMLS 2011AA Property)
ECOGProtocolNumber
Item
ECOG Protocol Number
text
ECOGProtocolNumber
Item
ECOG Protocol Number
text
ECOGProtocolNumber
Item
ECOG Protocol Number
text
ECOGPatientID
Item
ECOG Patient ID
text
ECOGPatientID
Item
ECOG Patient ID
text
ParticipatingGroupProtocolNo.
Item
Participating Group Protocol No.
text
ParticipatingGroupPatientID
Item
Participating Group Patient ID
text
MainMemberInstitution/Affiliate
Item
Institution/Affiliate
text
Item Group
On Treatment
Item
On Treatment Time Period
text
Code List
On Treatment Time Period
CL Item
Induction (Induction)
CL042203 (NCI Metathesaurus)
CL Item
Induction, Additional Forms (Induction, additional Forms)
CL Item
Consolidation (Consolidation)
CL Item
Post-transplant (Post-Transplant)
Item Group
Off Treatment
Item
Off Treatment Time Period
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25616 (NCI Thesaurus Property)
C1948053 (UMLS 2011AA Property)
C25601 (NCI Thesaurus Property)
C1518544 (UMLS 2011AA Property)
C25207 (NCI Thesaurus Property)
C0040223 (UMLS 2011AA Property)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
Off Treatment Time Period
CL Item
3 Months (3 months)
CL Item
6 Months (6 months)
CL Item
9 Months (9 months)
CL Item
12 Months (12 months)
CL Item
15 Months (15 months)
CL Item
18 Months (18 months)
CL Item
24 Months (24 months)
CL Item
30 Months (30 months)
CL Item
36 Months (36 months)
CL Item
42 Months (42 months)
CL Item
48 Months (48 months)
CL Item
54 Months (54 months)
CL Item
60 Months (60 months)
CL Item
2 Years (2 years)
CL Item
3 Years (3 years)
CL Item
4 Years (4 years)
CL Item
5 Years (5 years)
CL Item
6 Years (6 years)
CL Item
7 Years (7 years)
CL Item
8 Years (8 years)
CL Item
9 Years (9 years)
CL Item
10 Years (10 years)
Item Group
Ccrr Module For E1900 Cover Page For Adverse Event Form

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