ID
43252
Descrição
E2905 Follow Up Disease Evaluation Form Lenalidomide With or Without Epoetin Alfa in Treating Patients With Myelodysplastic Syndrome and Anemia NCT00843882 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=0F12A9EE-8D74-6165-E044-0003BA3F9857
Link
Palavras-chave
Versões (4)
- 18/12/2014 18/12/2014 - Martin Dugas
- 08/01/2015 08/01/2015 - Martin Dugas
- 23/01/2015 23/01/2015 - Martin Dugas
- 20/09/2021 20/09/2021 -
Transferido a
20 de setembro de 2021
DOI
Para um pedido faça login.
Licença
Creative Commons BY-NC 3.0 Legacy
Comentários do modelo :
Aqui pode comentar o modelo. Pode comentá-lo especificamente através dos balões de texto nos grupos de itens e itens.
Comentários do grupo de itens para :
Comentários do item para :
Para descarregar formulários, precisa de ter uma sessão iniciada. Por favor faça login ou registe-se gratuitamente.
Follow Up Disease Evaluation Form (E2905 NCT00843882)
INSTRUCTIONS: Complete this form and submit original to the ECOG Coordinating Center within one week of registration. Keep a copy for your files
- StudyEvent: E2905 Follow Up Disease Evaluation Form
Descrição
On Treatment
Descrição
Cycle number
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS CUI-1
- C2045829
- NCI Thesaurus Property
- C25214
- NCI Thesaurus Property-2
- C25616
- NCI Thesaurus ObjectClass
- C15368
Descrição
Chemotherapy cycle
Tipo de dados
text
Alias
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus Property
- C25214
- UMLS CUI-1
- C1302181
- NCI Thesaurus Property-2
- C25616
- NCI Thesaurus ValueDomain
- C25685
- NCI Thesaurus ValueDomain-2
- C25472
- NCI Thesaurus ValueDomain-3
- C25275
Descrição
Off Treatment
Descrição
PersonOff-TreatmentTimePeriodType
Tipo de dados
text
Alias
- NCI Thesaurus ObjectClass
- C25190
- UMLS 2011AA ObjectClass
- C0027361
- NCI Thesaurus Property
- C25616
- UMLS 2011AA Property
- C1948053
- NCI Thesaurus Property-2
- C25601
- UMLS 2011AA Property-2
- C1518544
- NCI Thesaurus Property-3
- C25207
- UMLS 2011AA Property-3
- C0040223
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
Descrição
Unnamed5
Descrição
MyelodysplasticSyndromeWorldHealthOrganizationClassificationCategory
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25372
- NCI Thesaurus ObjectClass
- C3247
- NCI Thesaurus Property
- C25161
- NCI Thesaurus Property-2
- C75419
- UMLS CUI-1
- C3463824
- UMLS CUI-2
- C0008902
Descrição
BoneMarrowBiopsyInd
Tipo de dados
boolean
Alias
- NCI Thesaurus ValueDomain
- C25180
- NCI Thesaurus Property
- C15189
- NCI Thesaurus ObjectClass
- C12431
- UMLS CUI-1
- C0005954
Descrição
BoneMarrowBiopsyDate
Tipo de dados
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- NCI Thesaurus ValueDomain-2
- C25367
- NCI Thesaurus Property
- C15189
- NCI Thesaurus ObjectClass
- C12431
- UMLS CUI-1
- C0005954
- UMLS CUI-2
- C0011008
Descrição
LaboratoryProcedureBoneMarrowBlastCellOutcomePercentageValue
Tipo de dados
float
Unidades de medida
- %
Alias
- NCI Thesaurus ObjectClass
- C25294
- NCI Thesaurus Property
- C12431
- NCI Thesaurus Property-2
- C20200
- NCI Thesaurus Property-3
- C12918
- NCI Thesaurus ValueDomain
- C25613
- NCI Thesaurus ValueDomain-2
- C25712
- UMLS CUI-1
- C1982687
Descrição
LaboratoryProcedureBoneMarrowCellularityOutcomePercentageValue
Tipo de dados
float
Unidades de medida
- %
Alias
- NCI Thesaurus ObjectClass
- C25294
- NCI Thesaurus Property
- C12431
- NCI Thesaurus Property-2
- C20200
- NCI Thesaurus Property-3
- C37923
- NCI Thesaurus ValueDomain
- C25613
- NCI Thesaurus ValueDomain-2
- C25712
- UMLS CUI-1
- C1561532
Descrição
LaboratoryProcedureBoneMarrowCellularityNegationReportOutcomeReason
Tipo de dados
text
Alias
- NCI Thesaurus ObjectClass
- C25294
- NCI Thesaurus Property
- C25594
- NCI Thesaurus Property-2
- C12431
- NCI Thesaurus Property-3
- C25375
- NCI Thesaurus Property-4
- C20200
- NCI Thesaurus Property-5
- C37923
- NCI Thesaurus ValueDomain
- C25638
- UMLS CUI-1
- C1561532
- UMLS CUI-2
- C1546437
Descrição
DysplasiaPresentInd-3
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C38148
- NCI Thesaurus Property
- C25626
- NCI Thesaurus ObjectClass
- C4086
- UMLS CUI-1
- C0334044
Descrição
DysplasiaHistologyType
Tipo de dados
integer
Alias
- NCI Thesaurus ValueDomain
- C25284
- NCI Thesaurus Property
- C16681
- NCI Thesaurus ObjectClass
- C4086
- UMLS CUI-1
- C0334044
- UMLS CUI-2
- C0683312
Descrição
CytogeneticAbnormalityPresentIndicator
Tipo de dados
text
Alias
- NCI Thesaurus Property
- C25626
- NCI Thesaurus ObjectClass
- C2950
- NCI Metathesaurus ValueDomain
- C0021212
- UMLS CUI-1
- C0008625
Descrição
Section Ii
Descrição
PackedRedBloodCellTransfusionRequirementInd-3
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
- NCI Thesaurus ObjectClass
- C15409
- UMLS 2011AA ObjectClass
- C0199962
- NCI Thesaurus Property
- C25382
- UMLS 2011AA Property
- C1521801
Descrição
PackedRedBloodCellTransfusionReceivedUnitCount
Tipo de dados
float
Alias
- NCI Thesaurus ValueDomain
- C44278
- UMLS 2011AA ValueDomain
- C0439148
- NCI Thesaurus Property
- C25639
- UMLS 2011AA Property
- C1514756
- NCI Thesaurus ValueDomain-2
- C25463
- UMLS 2011AA ValueDomain-2
- C0750480
- NCI Thesaurus ObjectClass
- C15409
- UMLS 2011AA ObjectClass
- C0199962
Descrição
PackedRedBloodCellTransfusionReceivedFirstDate
Tipo de dados
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus Property
- C25639
- UMLS 2011AA Property
- C1514756
- NCI Thesaurus ValueDomain-2
- C25509
- UMLS 2011AA ValueDomain-2
- C1279901
- NCI Thesaurus ObjectClass
- C15409
- UMLS 2011AA ObjectClass
- C0199962
Descrição
PackedRedBloodCellTransfusionReceivedMostRecentDate
Tipo de dados
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus Property
- C25639
- UMLS 2011AA Property
- C1514756
- NCI Thesaurus ObjectClass
- C15409
- UMLS 2011AA ObjectClass
- C0199962
- NCI Thesaurus ValueDomain-2
- C25577
- UMLS 2011AA ValueDomain-2
- C1513491
Descrição
Mds Response
Descrição
MyelodysplasticSyndromeResponseType
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus Property
- C25755
- UMLS 2011AA Property
- C0871261
- NCI Thesaurus ObjectClass
- C3247
- UMLS 2011AA ObjectClass
- C3463824
Descrição
MyelodysplasticSyndromeResponseFirstDate
Tipo de dados
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus Property
- C25755
- UMLS 2011AA Property
- C0871261
- NCI Thesaurus ObjectClass
- C3247
- UMLS 2011AA ObjectClass
- C3463824
- NCI Thesaurus ValueDomain-2
- C25509
- UMLS 2011AA ValueDomain-2
- C1279901
Descrição
MyelodysplasticSyndromeResponseDiagnosisDate
Tipo de dados
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus Property
- C25755
- UMLS 2011AA Property
- C0871261
- NCI Thesaurus ObjectClass
- C3247
- UMLS 2011AA ObjectClass
- C3463824
- NCI Thesaurus ValueDomain-2
- C15220
- UMLS 2011AA ValueDomain-2
- C0011900
Descrição
DiseaseRelapseInd-3
Tipo de dados
boolean
Alias
- NCI Thesaurus ValueDomain
- C38148
- NCI Thesaurus Property
- C18265
- NCI Thesaurus ObjectClass
- C2991
- UMLS CUI-1
- C0277556
Descrição
DiseaseRelapseDate
Tipo de dados
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- NCI Thesaurus Property
- C18265
- NCI Thesaurus ObjectClass
- C2991
- UMLS CUI-1
- C0035020
- UMLS CUI-2
- C0011008
Descrição
DiseaseMyelodysplasticSyndromeHematologyResponseType
Tipo de dados
text
Alias
- NCI Thesaurus ObjectClass
- C2991
- NCI Thesaurus Property
- C3247
- NCI Thesaurus Property-2
- C16673
- NCI Thesaurus Property-3
- C50995
- NCI Thesaurus ValueDomain
- C25284
- UMLS CUI-1
- C0012634
- UMLS CUI-2
- C3463824
- UMLS CUI-3
- C0018943
- UMLS CUI-4
- C1704632
- UMLS CUI-5
- C0332307
Descrição
DiseaseMyelodysplasticSyndromeHematologyResponseFirstDate
Tipo de dados
date
Alias
- NCI Thesaurus ObjectClass
- C2991
- NCI Thesaurus Property
- C3247
- NCI Thesaurus Property-2
- C16673
- NCI Thesaurus Property-3
- C50995
- NCI Thesaurus ValueDomain
- C25164
- NCI Thesaurus ValueDomain-2
- C25509
- UMLS CUI-1
- C0012634
- UMLS CUI-2
- C3463824
- UMLS CUI-3
- C0018943
- UMLS CUI-4
- C1704632
- UMLS CUI-5
- C0011008
- UMLS CUI-6
- C1279901
Descrição
DiseaseMyelodysplasticSyndromeHematologyResponseDiagnosisDate
Tipo de dados
date
Alias
- NCI Thesaurus ObjectClass
- C2991
- NCI Thesaurus Property
- C3247
- NCI Thesaurus Property-2
- C16673
- NCI Thesaurus Property-3
- C50995
- NCI Thesaurus ValueDomain
- C25164
- NCI Thesaurus ValueDomain-2
- C15220
- UMLS CUI-1
- C0012634
- UMLS CUI-2
- C3463824
- UMLS CUI-3
- C0018943
- UMLS CUI-4
- C1704632
- UMLS CUI-5
- C0011008
- UMLS CUI-6
- C0011900
Descrição
CytogeneticResponseType
Tipo de dados
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus Property
- C50995
- UMLS 2011AA Property
- C1704632
- NCI Thesaurus ObjectClass
- C17938
- UMLS 2011AA ObjectClass
- C0314603
Similar models
INSTRUCTIONS: Complete this form and submit original to the ECOG Coordinating Center within one week of registration. Keep a copy for your files
- StudyEvent: E2905 Follow Up Disease Evaluation Form
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1512162 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25491 (NCI Thesaurus Property-2)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1512162 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25491 (NCI Thesaurus Property-2)
C3242750 (UMLS CUI-1)
C19464 (NCI Thesaurus Property)
C25474 (NCI Thesaurus ObjectClass)
C25452 (NCI Thesaurus ObjectClass-2)
C1514821 (UMLS CUI-1)
C25646 (NCI Thesaurus ObjectClass)
C0237753 (UMLS CUI-2)
C16154 (NCI Thesaurus Property)
C16154 (NCI Thesaurus ValueDomain-2)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C25191 (NCI Thesaurus ValueDomain)
C21541 (NCI Thesaurus ValueDomain-2)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C0011008 (UMLS CUI-2)
C25416 (NCI Thesaurus Property)
C25367 (NCI Thesaurus ValueDomain-2)
C2346576 (UMLS CUI-1)
C25678 (NCI Thesaurus Property)
C17089 (NCI Thesaurus ObjectClass)
C2346576 (UMLS CUI-1)
C25678 (NCI Thesaurus Property)
C0011008 (UMLS CUI-2)
C25367 (NCI Thesaurus ValueDomain-2)
C17089 (NCI Thesaurus ObjectClass)
C2045829 (UMLS CUI-1)
C25214 (NCI Thesaurus Property)
C25616 (NCI Thesaurus Property-2)
C15368 (NCI Thesaurus ObjectClass)
C25214 (NCI Thesaurus Property)
C1302181 (UMLS CUI-1)
C25616 (NCI Thesaurus Property-2)
C25685 (NCI Thesaurus ValueDomain)
C25472 (NCI Thesaurus ValueDomain-2)
C25275 (NCI Thesaurus ValueDomain-3)
C0027361 (UMLS 2011AA ObjectClass)
C25616 (NCI Thesaurus Property)
C1948053 (UMLS 2011AA Property)
C25601 (NCI Thesaurus Property-2)
C1518544 (UMLS 2011AA Property-2)
C25207 (NCI Thesaurus Property-3)
C0040223 (UMLS 2011AA Property-3)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C3247 (NCI Thesaurus ObjectClass)
C25161 (NCI Thesaurus Property)
C75419 (NCI Thesaurus Property-2)
C3463824 (UMLS CUI-1)
C0008902 (UMLS CUI-2)
C1292779 (UMLS 2011AA)
C0796466 (UMLS 2011AA)
C1301356 (UMLS 2011AA)
C15189 (NCI Thesaurus Property)
C12431 (NCI Thesaurus ObjectClass)
C0005954 (UMLS CUI-1)
C25367 (NCI Thesaurus ValueDomain-2)
C15189 (NCI Thesaurus Property)
C12431 (NCI Thesaurus ObjectClass)
C0005954 (UMLS CUI-1)
C0011008 (UMLS CUI-2)
C12431 (NCI Thesaurus Property)
C20200 (NCI Thesaurus Property-2)
C12918 (NCI Thesaurus Property-3)
C25613 (NCI Thesaurus ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)
C1982687 (UMLS CUI-1)
C12431 (NCI Thesaurus Property)
C20200 (NCI Thesaurus Property-2)
C37923 (NCI Thesaurus Property-3)
C25613 (NCI Thesaurus ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)
C1561532 (UMLS CUI-1)
C25594 (NCI Thesaurus Property)
C12431 (NCI Thesaurus Property-2)
C25375 (NCI Thesaurus Property-3)
C20200 (NCI Thesaurus Property-4)
C37923 (NCI Thesaurus Property-5)
C25638 (NCI Thesaurus ValueDomain)
C1561532 (UMLS CUI-1)
C1546437 (UMLS CUI-2)
C25626 (NCI Thesaurus Property)
C4086 (NCI Thesaurus ObjectClass)
C0334044 (UMLS CUI-1)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C16681 (NCI Thesaurus Property)
C4086 (NCI Thesaurus ObjectClass)
C0334044 (UMLS CUI-1)
C0683312 (UMLS CUI-2)
C2950 (NCI Thesaurus ObjectClass)
C0021212 (NCI Metathesaurus ValueDomain)
C0008625 (UMLS CUI-1)
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C1512699 (UMLS 2011AA ValueDomain)
C15409 (NCI Thesaurus ObjectClass)
C0199962 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
C1298908 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0439148 (UMLS 2011AA ValueDomain)
C25639 (NCI Thesaurus Property)
C1514756 (UMLS 2011AA Property)
C25463 (NCI Thesaurus ValueDomain-2)
C0750480 (UMLS 2011AA ValueDomain-2)
C15409 (NCI Thesaurus ObjectClass)
C0199962 (UMLS 2011AA ObjectClass)
C0011008 (UMLS 2011AA ValueDomain)
C25639 (NCI Thesaurus Property)
C1514756 (UMLS 2011AA Property)
C25509 (NCI Thesaurus ValueDomain-2)
C1279901 (UMLS 2011AA ValueDomain-2)
C15409 (NCI Thesaurus ObjectClass)
C0199962 (UMLS 2011AA ObjectClass)
C0011008 (UMLS 2011AA ValueDomain)
C25639 (NCI Thesaurus Property)
C1514756 (UMLS 2011AA Property)
C15409 (NCI Thesaurus ObjectClass)
C0199962 (UMLS 2011AA ObjectClass)
C25577 (NCI Thesaurus ValueDomain-2)
C1513491 (UMLS 2011AA ValueDomain-2)
C0332307 (UMLS 2011AA ValueDomain)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
C3247 (NCI Thesaurus ObjectClass)
C3463824 (UMLS 2011AA ObjectClass)
C0677874 (UMLS 2011AA)
C1521726 (UMLS 2011AA)
C0677946 (UMLS 2011AA)
C0205488 (UMLS 2011AA)
C71685 (NCI Thesaurus-3)
C0332272 (UMLS 2011AA-4)
C1335499 (UMLS 2011AA)
C0011008 (UMLS 2011AA ValueDomain)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
C3247 (NCI Thesaurus ObjectClass)
C3463824 (UMLS 2011AA ObjectClass)
C25509 (NCI Thesaurus ValueDomain-2)
C1279901 (UMLS 2011AA ValueDomain-2)
C0011008 (UMLS 2011AA ValueDomain)
C25755 (NCI Thesaurus Property)
C0871261 (UMLS 2011AA Property)
C3247 (NCI Thesaurus ObjectClass)
C3463824 (UMLS 2011AA ObjectClass)
C15220 (NCI Thesaurus ValueDomain-2)
C0011900 (UMLS 2011AA ValueDomain-2)
C18265 (NCI Thesaurus Property)
C2991 (NCI Thesaurus ObjectClass)
C0277556 (UMLS CUI-1)
C18265 (NCI Thesaurus Property)
C2991 (NCI Thesaurus ObjectClass)
C0035020 (UMLS CUI-1)
C0011008 (UMLS CUI-2)
C3247 (NCI Thesaurus Property)
C16673 (NCI Thesaurus Property-2)
C50995 (NCI Thesaurus Property-3)
C25284 (NCI Thesaurus ValueDomain)
C0012634 (UMLS CUI-1)
C3463824 (UMLS CUI-2)
C0018943 (UMLS CUI-3)
C1704632 (UMLS CUI-4)
C0332307 (UMLS CUI-5)
C3247 (NCI Thesaurus Property)
C16673 (NCI Thesaurus Property-2)
C50995 (NCI Thesaurus Property-3)
C25164 (NCI Thesaurus ValueDomain)
C25509 (NCI Thesaurus ValueDomain-2)
C0012634 (UMLS CUI-1)
C3463824 (UMLS CUI-2)
C0018943 (UMLS CUI-3)
C1704632 (UMLS CUI-4)
C0011008 (UMLS CUI-5)
C1279901 (UMLS CUI-6)
C3247 (NCI Thesaurus Property)
C16673 (NCI Thesaurus Property-2)
C50995 (NCI Thesaurus Property-3)
C25164 (NCI Thesaurus ValueDomain)
C15220 (NCI Thesaurus ValueDomain-2)
C0012634 (UMLS CUI-1)
C3463824 (UMLS CUI-2)
C0018943 (UMLS CUI-3)
C1704632 (UMLS CUI-4)
C0011008 (UMLS CUI-5)
C0011900 (UMLS CUI-6)
C0332307 (UMLS 2011AA ValueDomain)
C50995 (NCI Thesaurus Property)
C1704632 (UMLS 2011AA Property)
C17938 (NCI Thesaurus ObjectClass)
C0314603 (UMLS 2011AA ObjectClass)
Sem comentários