ID

38036

Description

Part II: Exercise in Hispanic Breast Cancer Survivors; ODM derived from: https://clinicaltrials.gov/show/NCT01504789

Link

https://clinicaltrials.gov/show/NCT01504789

Keywords

Versions (1)
  1. 9/10/19 9/10/19 -
Copyright Holder

See clinicaltrials.gov

Uploaded on

September 10, 2019

DOI

To request one please log in.

License

Creative Commons BY 4.0
Model comments :

You can comment on the data model here. Via the speech bubbles at the itemgroups and items you can add comments to those specificially.

Back to model comments
Itemgroup comments for :

Item comments for :

In order to download data models you must be logged in. Please log in or register for free.

Eligibility Breast Cancer NCT01504789

English

Eligibility Breast Cancer NCT01504789

1 forms  
Inclusion Criteria
Description

Inclusion Criteria

Alias
UMLS CUI
C1512693
1. be female and be 21 years of age or older. (pilot test and pretest criteria)
Description

Gender | Age

Data type

boolean

Alias
UMLS CUI [1]
C0079399
UMLS CUI [2]
C0001779
2. self-reported mexican-american ( for mexican-american participants) or puerto rican ethnicity. (pilot test and pretest criteria)
Description

Mexican Americans | Puerto Ricans

Data type

boolean

Alias
UMLS CUI [1]
C0025884
UMLS CUI [2]
C0034043
3. history of breast cancer (invasive or ductal carcinoma in situ). (pilot test criteria only)
Description

Invasive carcinoma of breast | DCIS

Data type

boolean

Alias
UMLS CUI [1]
C0853879
UMLS CUI [2]
C0007124
4. at least 3 months post treatment (surgery, chemotherapy, radiation). (pilot test criteria only)
Description

Status post Treatment | Operative Surgical Procedures | Chemotherapy | Therapeutic radiology procedure

Data type

boolean

Alias
UMLS CUI [1,1]
C0231290
UMLS CUI [1,2]
C0087111
UMLS CUI [2]
C0543467
UMLS CUI [3]
C0392920
UMLS CUI [4]
C1522449
5. not meeting current recommended physical activity guidelines. (pilot test and pretest criteria)
Description

Physical activity Recommended failed

Data type

boolean

Alias
UMLS CUI [1,1]
C0026606
UMLS CUI [1,2]
C0034866
UMLS CUI [1,3]
C0231175
6. able to read/write in either english or spanish. (pilot test and pretest criteria)
Description

Able to read English Language | Able to read Spanish Language | Able to write English Language | Able to write Spanish Language

Data type

boolean

Alias
UMLS CUI [1,1]
C0586740
UMLS CUI [1,2]
C0376245
UMLS CUI [2,1]
C0586740
UMLS CUI [2,2]
C0037750
UMLS CUI [3,1]
C0584993
UMLS CUI [3,2]
C0376245
UMLS CUI [4,1]
C0584993
UMLS CUI [4,2]
C0037750
7. reside in harris county, texas or one of the contiguous counties or metropolitan area of san juan, puerto rico. (pilot test and pretest criteria)
Description

Residence Texas | Residence Puerto Rico

Data type

boolean

Alias
UMLS CUI [1,1]
C0237096
UMLS CUI [1,2]
C0039711
UMLS CUI [2,1]
C0237096
UMLS CUI [2,2]
C0034044
8. be able to provide informed consent. (pilot test and pretest criteria)
Description

Informed Consent

Data type

boolean

Alias
UMLS CUI [1]
C0021430
9. be oriented to person, place, and time. (pilot test and pretest criteria)
Description

Oriented to person | Oriented to place | Oriented to time

Data type

boolean

Alias
UMLS CUI [1]
C1961030
UMLS CUI [2]
C1961028
UMLS CUI [3]
C1961029
Exclusion Criteria
Description

Exclusion Criteria

Alias
UMLS CUI
C0680251
1. currently receiving herceptin or non-hormonal treatment for cancer (hormonal treatment is allowed). (pilot test and pretest criteria)
Description

Herceptin | Cancer treatment Except Hormone Therapy | Hormone Therapy allowed

Data type

boolean

Alias
UMLS CUI [1]
C0338204
UMLS CUI [2,1]
C0920425
UMLS CUI [2,2]
C0332300
UMLS CUI [2,3]
C0279025
UMLS CUI [3,1]
C0279025
UMLS CUI [3,2]
C0683607
2. present with any of american college of sports medicine's absolute contraindications to exercise testing: (a recent significant change in the resting ecg suggesting significant ischemia, recent myocardial infarction (within 2 days), or other acute cardiac event; unstable angina; uncontrolled cardiac dysrhythmias causing symptoms or hemodynamic compromise; symptomatic severe aortic stenosis; uncontrolled symptomatic heart failure; acute pulmonary embolus or pulmonary infarction; acute myocarditis or pericarditis; suspected or known dissecting aneurysm acute systemic infection, accompanied by fever, body aches, or swollen lymph glands). ( pilot test and pretest criteria)
Description

Medical contraindication Exercise testing | Resting ECG Changes Suggestive of Ischemia | Myocardial Infarction | Cardiac event | Angina, Unstable | Symptoms Causing Cardiac Arrhythmia Uncontrolled | Impairment Hemodynamic | Aortic stenosis symptomatic Severe | Heart failure Symptomatic Uncontrolled | Pulmonary Embolism | Pulmonary Infarction | Myocarditis | Pericarditis | Aneurysm, Dissecting | Dissecting Aneurysm Suspected | Sepsis Associated with Fever | Sepsis Associated with BODY ACHE | Sepsis Associated with Lymphadenopathy

Data type

boolean

Alias
UMLS CUI [1,1]
C1301624
UMLS CUI [1,2]
C0015260
UMLS CUI [2,1]
C3897699
UMLS CUI [2,2]
C0332299
UMLS CUI [2,3]
C0022116
UMLS CUI [3]
C0027051
UMLS CUI [4]
C0741923
UMLS CUI [5]
C0002965
UMLS CUI [6,1]
C1457887
UMLS CUI [6,2]
C0678227
UMLS CUI [6,3]
C0003811
UMLS CUI [6,4]
C0205318
UMLS CUI [7,1]
C0221099
UMLS CUI [7,2]
C0019010
UMLS CUI [8,1]
C0741183
UMLS CUI [8,2]
C0205082
UMLS CUI [9,1]
C0018801
UMLS CUI [9,2]
C0231220
UMLS CUI [9,3]
C0205318
UMLS CUI [10]
C0034065
UMLS CUI [11]
C0034074
UMLS CUI [12]
C0027059
UMLS CUI [13]
C0031046
UMLS CUI [14]
C0002949
UMLS CUI [15,1]
C0002949
UMLS CUI [15,2]
C0750491
UMLS CUI [16,1]
C0243026
UMLS CUI [16,2]
C0332281
UMLS CUI [16,3]
C0015967
UMLS CUI [17,1]
C0243026
UMLS CUI [17,2]
C0332281
UMLS CUI [17,3]
C0741585
UMLS CUI [18,1]
C0243026
UMLS CUI [18,2]
C0332281
UMLS CUI [18,3]
C0497156
Back to the top of the page

Similar models

Eligibility Breast Cancer NCT01504789

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
C1512693 (UMLS CUI)
Gender | Age
Item
1. be female and be 21 years of age or older. (pilot test and pretest criteria)
boolean
C0079399 (UMLS CUI [1])
C0001779 (UMLS CUI [2])
Mexican Americans | Puerto Ricans
Item
2. self-reported mexican-american ( for mexican-american participants) or puerto rican ethnicity. (pilot test and pretest criteria)
boolean
C0025884 (UMLS CUI [1])
C0034043 (UMLS CUI [2])
Invasive carcinoma of breast | DCIS
Item
3. history of breast cancer (invasive or ductal carcinoma in situ). (pilot test criteria only)
boolean
C0853879 (UMLS CUI [1])
C0007124 (UMLS CUI [2])
Status post Treatment | Operative Surgical Procedures | Chemotherapy | Therapeutic radiology procedure
Item
4. at least 3 months post treatment (surgery, chemotherapy, radiation). (pilot test criteria only)
boolean
C0231290 (UMLS CUI [1,1])
C0087111 (UMLS CUI [1,2])
C0543467 (UMLS CUI [2])
C0392920 (UMLS CUI [3])
C1522449 (UMLS CUI [4])
Physical activity Recommended failed
Item
5. not meeting current recommended physical activity guidelines. (pilot test and pretest criteria)
boolean
C0026606 (UMLS CUI [1,1])
C0034866 (UMLS CUI [1,2])
C0231175 (UMLS CUI [1,3])
Able to read English Language | Able to read Spanish Language | Able to write English Language | Able to write Spanish Language
Item
6. able to read/write in either english or spanish. (pilot test and pretest criteria)
boolean
C0586740 (UMLS CUI [1,1])
C0376245 (UMLS CUI [1,2])
C0586740 (UMLS CUI [2,1])
C0037750 (UMLS CUI [2,2])
C0584993 (UMLS CUI [3,1])
C0376245 (UMLS CUI [3,2])
C0584993 (UMLS CUI [4,1])
C0037750 (UMLS CUI [4,2])
Residence Texas | Residence Puerto Rico
Item
7. reside in harris county, texas or one of the contiguous counties or metropolitan area of san juan, puerto rico. (pilot test and pretest criteria)
boolean
C0237096 (UMLS CUI [1,1])
C0039711 (UMLS CUI [1,2])
C0237096 (UMLS CUI [2,1])
C0034044 (UMLS CUI [2,2])
Informed Consent
Item
8. be able to provide informed consent. (pilot test and pretest criteria)
boolean
C0021430 (UMLS CUI [1])
Oriented to person | Oriented to place | Oriented to time
Item
9. be oriented to person, place, and time. (pilot test and pretest criteria)
boolean
C1961030 (UMLS CUI [1])
C1961028 (UMLS CUI [2])
C1961029 (UMLS CUI [3])
Item Group
C0680251 (UMLS CUI)
Herceptin | Cancer treatment Except Hormone Therapy | Hormone Therapy allowed
Item
1. currently receiving herceptin or non-hormonal treatment for cancer (hormonal treatment is allowed). (pilot test and pretest criteria)
boolean
C0338204 (UMLS CUI [1])
C0920425 (UMLS CUI [2,1])
C0332300 (UMLS CUI [2,2])
C0279025 (UMLS CUI [2,3])
C0279025 (UMLS CUI [3,1])
C0683607 (UMLS CUI [3,2])
Medical contraindication Exercise testing | Resting ECG Changes Suggestive of Ischemia | Myocardial Infarction | Cardiac event | Angina, Unstable | Symptoms Causing Cardiac Arrhythmia Uncontrolled | Impairment Hemodynamic | Aortic stenosis symptomatic Severe | Heart failure Symptomatic Uncontrolled | Pulmonary Embolism | Pulmonary Infarction | Myocarditis | Pericarditis | Aneurysm, Dissecting | Dissecting Aneurysm Suspected | Sepsis Associated with Fever | Sepsis Associated with BODY ACHE | Sepsis Associated with Lymphadenopathy
Item
2. present with any of american college of sports medicine's absolute contraindications to exercise testing: (a recent significant change in the resting ecg suggesting significant ischemia, recent myocardial infarction (within 2 days), or other acute cardiac event; unstable angina; uncontrolled cardiac dysrhythmias causing symptoms or hemodynamic compromise; symptomatic severe aortic stenosis; uncontrolled symptomatic heart failure; acute pulmonary embolus or pulmonary infarction; acute myocarditis or pericarditis; suspected or known dissecting aneurysm acute systemic infection, accompanied by fever, body aches, or swollen lymph glands). ( pilot test and pretest criteria)
boolean
C1301624 (UMLS CUI [1,1])
C0015260 (UMLS CUI [1,2])
C3897699 (UMLS CUI [2,1])
C0332299 (UMLS CUI [2,2])
C0022116 (UMLS CUI [2,3])
C0027051 (UMLS CUI [3])
C0741923 (UMLS CUI [4])
C0002965 (UMLS CUI [5])
C1457887 (UMLS CUI [6,1])
C0678227 (UMLS CUI [6,2])
C0003811 (UMLS CUI [6,3])
C0205318 (UMLS CUI [6,4])
C0221099 (UMLS CUI [7,1])
C0019010 (UMLS CUI [7,2])
C0741183 (UMLS CUI [8,1])
C0205082 (UMLS CUI [8,2])
C0018801 (UMLS CUI [9,1])
C0231220 (UMLS CUI [9,2])
C0205318 (UMLS CUI [9,3])
C0034065 (UMLS CUI [10])
C0034074 (UMLS CUI [11])
C0027059 (UMLS CUI [12])
C0031046 (UMLS CUI [13])
C0002949 (UMLS CUI [14])
C0002949 (UMLS CUI [15,1])
C0750491 (UMLS CUI [15,2])
C0243026 (UMLS CUI [16,1])
C0332281 (UMLS CUI [16,2])
C0015967 (UMLS CUI [16,3])
C0243026 (UMLS CUI [17,1])
C0332281 (UMLS CUI [17,2])
C0741585 (UMLS CUI [17,3])
C0243026 (UMLS CUI [18,1])
C0332281 (UMLS CUI [18,2])
C0497156 (UMLS CUI [18,3])
Back to the top of the page 

Contact

Please use this form for feedback, questions and suggestions for improvements.

Fields marked with * are required.

Help

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