ID
44339
Description
LOCALIZED PROSTATE CANCER DATA COLLECTION Version 2.0.5 Revised: April 7th , 2017 www.ichom.org Notice: This work was conducted using resources from ICHOM, the International Consortium for Health Outcomes Measurement (www.ICHOM.org). The content is solely the responsibility of the authors and does not necessarily represent the official views of ICHOM. Conditions: Localized prostate cancer Treatment Approaches: Active Surveillance | Watchful Waiting | Radical Prostatectomy* | External Beam Radiation Therapy* | Androgen Deprivation Therapy (ADT)* | Focal Therapy* | Other* * These should also be collected as salvage treatments where necessary This ODM-file contains a Clinical Form to be used 6 months after primary treatment initiation. Surveys used: Expanded Prostate Cancer Index Composite (EPIC-26): The EPIC-26 is free for all health care organizations, and a license is not needed. The scoring guide may be found at http://www.med.umich.edu/urology/research/EPIC/EPIC-26-Scoring-1.2007.pdf ; Wei J, Dunn R, Litwin M, Sandler H, and Sanda M. "Development and Validation of the Expanded Prostate Cancer Index Composite (EPIC) for Comprehensive Assessment of Health-Related Quality of Life in Men with Prostate Cancer", Urology. 56: 899-905, 2000. For registries choosing to implement the EPIC-CP rather than the EPIC-26, we recommend using the same variable IDs as the corresponding EPIC-26 questions. This means that only questions 2, 3, 4a, 4b, 4d, 4e, 5, 6e, 6b, 7, 8b, 9, 12, 13a, 13c, and 13d of the EPIC-26 are administered. Utilization of Sexual Medications/Devices: The Utilization of Sexual Medications/Devices is free for all health care organizations, and a license is not needed. Refer to http://dx.doi.org/10.1016/j.urology.2006.01.077 for more information European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ- PR25): The EORTC QLQ-PR25 is free for all health care organizations, but a license is needed for use. Therefore it will not be integrated in this Version of the questionnaire. For more information, please visit http://groups.eortc.be/qol/eortc-qlq-c30 . ICHOM was supported for the Localized Prostate Cancer Standard Set by the Movember Foundation. For this version of the standard set, semantic annotation with UMLS CUIs has been added.
Link
Keywords
Versions (4)
- 8/22/18 8/22/18 - Sarah Riepenhausen
- 8/22/18 8/22/18 - Sarah Riepenhausen
- 4/30/20 4/30/20 - Sarah Riepenhausen
- 9/20/21 9/20/21 -
Copyright Holder
ICHOM
Uploaded on
September 20, 2021
DOI
To request one please log in.
License
Creative Commons BY-NC 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.
Itemgroup comments for :
Item comments for :
In order to download data models you must be logged in. Please log in or register for free.
ICHOM Localized Prostate Cancer
Clinical Form within 6 months after treatment initiation
- StudyEvent: ODM
Description
Treatment Variables
Alias
- UMLS CUI-1
- C0087111
Description
INCLUSION CRITERIA: All patients TIMING: Within 6 months after primary treatment initiation REPORTING SOURCE: Clinical TYPE: Multiple answer
Data type
boolean
Alias
- UMLS CUI [1]
- C1298659
Description
INCLUSION CRITERIA: All patients TIMING: Within 6 months after primary treatment initiation REPORTING SOURCE: Clinical TYPE: Multiple answer
Data type
boolean
Alias
- UMLS CUI [1,1]
- C0920425
- UMLS CUI [1,2]
- C1827061
Description
INCLUSION CRITERIA: All patients TIMING: Within 6 months after primary treatment initiation REPORTING SOURCE: Clinical TYPE: Multiple answer
Data type
boolean
Alias
- UMLS CUI [1,1]
- C0920425
- UMLS CUI [1,2]
- C0194810
Description
INCLUSION CRITERIA: All patients TIMING: Within 6 months after primary treatment initiation REPORTING SOURCE: Clinical TYPE: Multiple answer
Data type
boolean
Alias
- UMLS CUI [1,1]
- C0920425
- UMLS CUI [1,2]
- C1517033
Description
INCLUSION CRITERIA: All patients TIMING: Within 6 months after primary treatment initiation REPORTING SOURCE: Clinical TYPE: Multiple answer
Data type
boolean
Alias
- UMLS CUI [1,1]
- C0920425
- UMLS CUI [1,2]
- C0006098
Description
INCLUSION CRITERIA: All patients TIMING: Within 6 months after primary treatment initiation REPORTING SOURCE: Clinical TYPE: Multiple answer
Data type
boolean
Alias
- UMLS CUI [1,1]
- C0920425
- UMLS CUI [1,2]
- C0279492
Description
INCLUSION CRITERIA: All patients TIMING: Within 6 months after primary treatment initiation REPORTING SOURCE: Clinical TYPE: Multiple answer
Data type
boolean
Alias
- UMLS CUI [1,1]
- C0920425
- UMLS CUI [1,2]
- C0205234
Description
INCLUSION CRITERIA: All patients TIMING: Within 6 months after primary treatment initiation REPORTING SOURCE: Clinical TYPE: Multiple answer
Data type
boolean
Alias
- UMLS CUI [1,1]
- C0920425
- UMLS CUI [1,2]
- C0205394
Description
INCLUSION CRITERIA: All patients If answered '7 = Focal therapy' on primary treatment modalities used (PRIMARYTX) TIMING: Within 6 months after primary treatment initiation REPORTING SOURCE: Clinical TYPE: Free text
Data type
text
Alias
- UMLS CUI [1,1]
- C0920425
- UMLS CUI [1,2]
- C0205234
Description
INCLUSION CRITERIA: All patients, If answered 'Watchful waiting' (PRIMARYTX) TIMING: Within 6 months after primary treatment initiation REPORTING SOURCE: Clinical TYPE: Date by DD/MM/YYYY
Data type
date
Measurement units
- DD/MM/YYYY
Alias
- UMLS CUI [1,1]
- C1298659
- UMLS CUI [1,2]
- C0808070
Description
INCLUSION CRITERIA: All patients, If answered 'Active surveillance' (PRIMARYTX) TIMING: Within 6 months after primary treatment initiation REPORTING SOURCE: Clinical TYPE: Date by DD/MM/YYYY
Data type
date
Measurement units
- DD/MM/YYYY
Alias
- UMLS CUI [1,1]
- C1827061
- UMLS CUI [1,2]
- C0808070
Description
INCLUSION CRITERIA: All patients, If answered 'Radical prostatectomy' (PRIMARYTX) TIMING: Within 6 months after primary treatment initiation REPORTING SOURCE: Clinical TYPE: Date by DD/MM/YYYY
Data type
date
Measurement units
- DD/MM/YYYY
Alias
- UMLS CUI [1,1]
- C0194810
- UMLS CUI [1,2]
- C0011008
Description
INCLUSION CRITERIA: All patients, If answered '3 = Radical prostatectomy' on primary treatment modalities (PRIMARYTX) TIMING: Within 6 months after primary treatment initiation REPORTING SOURCE: Clinical TYPE: Single Answer
Data type
integer
Alias
- UMLS CUI [1,1]
- C1514120
- UMLS CUI [1,2]
- C1512698
Description
INCLUSION CRITERIA: All patients, If answered '4 = External beam radiation therapy (primary treatment or adjuvant following surgery)' on primary treatment modalities (PRIMARYTX) TIMING: Within 6 months after primary treatment initiation REPORTING SOURCE: Clinical TYPE: Numerical value
Data type
integer
Measurement units
- Gy
Alias
- UMLS CUI [1,1]
- C1517033
- UMLS CUI [1,2]
- C2986497
Description
INCLUSION CRITERIA: All patients, If answered '4 = External beam radiation therapy (primary treatment or adjuvant following surgery)' on primary treatment modalities (PRIMARYTX) TIMING: Within 6 months after primary treatment initiation REPORTING SOURCE: Clinical TYPE: Numerical value
Data type
float
Measurement units
- Gy
Alias
- UMLS CUI [1,1]
- C0860348
- UMLS CUI [1,2]
- C0178602
- UMLS CUI [1,3]
- C1264633
Description
INCLUSION CRITERIA: All patients, If answered 'External beam radiation therapy' (PRIMARYTX) TIMING: Within 6 months after primary treatment initiation REPORTING SOURCE: Clinical TYPE: Date by DD/MM/YYYY
Data type
date
Measurement units
- DD/MM/YYYY
Alias
- UMLS CUI [1,1]
- C1517033
- UMLS CUI [1,2]
- C0808070
Description
INCLUSION CRITERIA: All patients, If answered 'External beam radiation therapy' (PRIMARYTX) TIMING: Within 6 months after primary treatment initiation REPORTING SOURCE: Clinical TYPE: Date by DD/MM/YYYY
Data type
date
Measurement units
- DD/MM/YYYY
Alias
- UMLS CUI [1,1]
- C1517033
- UMLS CUI [1,2]
- C0806020
Description
INCLUSION CRITERIA: All patients, If answered 'External beam radiation therapy' (PRIMARYTX), and no end date is entered (PREBRTTXSTOPDATE) TIMING: Within 6 months after primary treatment initiation REPORTING SOURCE: Clinical TYPE: Single answer
Data type
text
Alias
- UMLS CUI [1,1]
- C1517033
- UMLS CUI [1,2]
- C0549178
Description
INCLUSION CRITERIA: All patients, If answered 'Brachytherapy' (PRIMARYTX) TIMING: Within 6 months after primary treatment initiation REPORTING SOURCE: Clinical TYPE: Date by DD/MM/YYYY
Data type
date
Measurement units
- DD/MM/YYYY
Alias
- UMLS CUI [1,1]
- C0006098
- UMLS CUI [1,2]
- C0808070
Description
INCLUSION CRITERIA: All patients, If answered 'Brachytherapy' (PRIMARYTX) TIMING: Within 6 months after primary treatment initiation REPORTING SOURCE: Clinical TYPE: Date by DD/MM/YYYY
Data type
date
Measurement units
- DD/MM/YYYY
Alias
- UMLS CUI [1,1]
- C0006098
- UMLS CUI [1,2]
- C0806020
Description
INCLUSION CRITERIA: All patients, If answered 'Brachytherapy' (PRIMARYTX), and no end date is entered (PRBRACHYTXSTOPDATE) TIMING: Within 6 months after primary treatment initiation REPORTING SOURCE: Clinical TYPE: Single answer
Data type
integer
Alias
- UMLS CUI [1,1]
- C0006098
- UMLS CUI [1,2]
- C0549178
Description
INCLUSION CRITERIA: All patients, If answered '3 = Brachytherapy' on primary treatment modalities (PRIMARYTX) TIMING: Within 6 months after primary treatment initiation REPORTING SOURCE: Clinical TYPE: Single answer
Data type
integer
Alias
- UMLS CUI [1,1]
- C0006098
- UMLS CUI [1,2]
- C0178602
Description
INCLUSION CRITERIA: All patients, If answered 'Androgen deprivation therapy' (PRIMARYTX) TIMING: Within 6 months after primary treatment initiation REPORTING SOURCE: Clinical TYPE: Date by DD/MM/YYYY
Data type
date
Measurement units
- DD/MM/YYYY
Alias
- UMLS CUI [1,1]
- C0279492
- UMLS CUI [1,2]
- C0808070
Description
INCLUSION CRITERIA: All patients, If answered 'Androgen deprivation therapy' (PRIMARYTX) TIMING: Within 6 months after primary treatment initiation REPORTING SOURCE: Clinical TYPE: Date by DD/MM/YYYY
Data type
date
Measurement units
- DD/MM/YYYY
Alias
- UMLS CUI [1,1]
- C0279492
- UMLS CUI [1,2]
- C0806020
Description
INCLUSION CRITERIA: All patients, If answered 'Androgen deprivation therapy' (PRIMARYTX), and no end date is entered (PRADTTXSTOPDATE) TIMING: Within 6 months after primary treatment initiation REPORTING SOURCE: Clinical TYPE: Single answer
Data type
integer
Alias
- UMLS CUI [1,1]
- C0279492
- UMLS CUI [1,2]
- C0549178
Description
INCLUSION CRITERIA: All patients, If answered 'Focal therapy' (PRIMARYTX) TIMING: Within 6 months after primary treatment initiation REPORTING SOURCE: Clinical TYPE: Date by DD/MM/YYYY
Data type
date
Measurement units
- DD/MM/YYYY
Alias
- UMLS CUI [1,1]
- C0920425
- UMLS CUI [1,2]
- C0205234
- UMLS CUI [1,3]
- C0808070
Description
INCLUSION CRITERIA: All patients, If answered 'Focal therapy' (PRIMARYTX) TIMING: Within 6 months after primary treatment initiation REPORTING SOURCE: Clinical TYPE: Date by DD/MM/YYYY
Data type
date
Measurement units
- DD/MM/YYYY
Alias
- UMLS CUI [1,1]
- C0920425
- UMLS CUI [1,2]
- C0205234
- UMLS CUI [1,3]
- C0806020
Description
INCLUSION CRITERIA: All patients, If answered 'Focal therapy' (PRIMARYTX) TIMING: Within 6 months after primary treatment initiation REPORTING SOURCE: Clinical TYPE: Single answer
Data type
integer
Alias
- UMLS CUI [1,1]
- C0920425
- UMLS CUI [1,2]
- C0205234
- UMLS CUI [1,3]
- C0549178
Description
INCLUSION CRITERIA: All patients, If answered '888 = Other' on primary treatment modalities used (PRIMARYTX) TIMING: Within 6 months after primary treatment initiation REPORTING SOURCE: Clinical TYPE: Free text
Data type
text
Alias
- UMLS CUI [1,1]
- C0920425
- UMLS CUI [1,2]
- C0205394
Description
INCLUSION CRITERIA: All patients, If answered '888 = Other' on primary treatment modalities used (PRIMARYTX) TIMING: Within 6 months after primary treatment initiation REPORTING SOURCE: Clinical TYPE: Date by DD/MM/YYYY
Data type
date
Measurement units
- DD/MM/YYYY
Alias
- UMLS CUI [1,1]
- C0920425
- UMLS CUI [1,2]
- C0205394
- UMLS CUI [1,3]
- C0808070
Description
INCLUSION CRITERIA: All patients, If answered '888 = Other' on primary treatment modalities used (PRIMARYTX) TIMING: Within 6 months after primary treatment initiation REPORTING SOURCE: Clinical TYPE: Date by DD/MM/YYYY
Data type
date
Measurement units
- DD/MM/YYYY
Alias
- UMLS CUI [1,1]
- C0920425
- UMLS CUI [1,2]
- C0205394
- UMLS CUI [1,3]
- C0806020
Description
INCLUSION CRITERIA: All patients, If answered '888 = Other' on primary treatment modalities used (PRIMARYTX) TIMING: Within 6 months after primary treatment initiation REPORTING SOURCE: Clinical TYPE: Single answer
Data type
integer
Alias
- UMLS CUI [1,1]
- C0920425
- UMLS CUI [1,2]
- C0205394
- UMLS CUI [1,3]
- C0549178
Description
Acute Complications of Treatment
Alias
- UMLS CUI-1
- C0679861
Description
INCLUSION CRITERIA: Patients who undergo surgical interventions TIMING: Occurring within 6 months after primary or salvage radical prostatectomy REPORTING SOURCE: Clinical TYPE: Single answer
Data type
integer
Alias
- UMLS CUI [1,1]
- C0009566
- UMLS CUI [1,2]
- C4524868
Description
INCLUSION CRITERIA: All patients undergoing primary or salvage radiation therapy TIMING: During primary or salvage radiation therapy treatment and the 6 months following completion of therapy REPORTING SOURCE: Clinical TYPE: Single answer
Data type
integer
Alias
- UMLS CUI [1]
- C1516728
Description
The CTCAE defines Grade 3 and 4 complications for the following categories as follows: Fatigue - Grade 1: Fatigue relieved by rest - Grade 2: Fatigue not relieved by rest; limiting instrumental ADL - Grade 3: Fatigue not relieved by rest, limiting self care ADL - Grade 4: N/A Dermatitis radiation - Grade 1: Faint erythema or dry desquamation - Grade 2: Moderate to brisk erythema; patchy moist desquamation, mostly confined to skin folds and creases; moderate edema - Grade 3: Moist desquamation in areas other than skin folds and creases; bleeding induced by minor trauma or abrasion - Grade 4: Life-threatening consequences; skin necrosis or ulceration of full thickness dermis; spontaneous bleeding from involved site; skin graft indicated Diarrhea - Grade 1: Increase of less than 4 stools per day over baseline; mild increase in ostomy output compared to baseline - Grade 2: Increase of 4 - 6 stools per day over baseline; moderate increase in ostomy output compared to baseline - Grade 3: Increase of 7 or more stools per day over baseline; incontinence; hospitalization indicated; severe increase in ostomy output compared to baseline; limiting self care ADL - Grade 4: Life-threatening consequences; urgent intervention indicated Abdominal pain - Grade 1: Mild pain - Grade 2: Moderate pain; limiting instrumental ADL - Grade 3: Severe pain; limiting self care ADL - Grade 4: N/A Rectal mucositis - Grade 1: Asymptomatic or mild symptoms; intervention not indicated - Grade 2: Symptomatic; medical intervention indicated; limiting instrumental ADL - Grade 3: Severe symptoms; limiting self care ADL - Grade 4: Life-threatening consequences; urgent operative intervention indicated Proctitis - Grade 1: Rectal discomfort, intervention not indicated - Grade 2: Symptoms (e.g., rectal discomfort, passing blood or mucus); medical intervention indicated; limiting instrumental ADL - Grade 3: Severe symptoms; fecal urgency or stool incontinence; limiting self care ADL - Grade 4: Life-threatening consequences; urgent intervention indicated Hot flashes - Grade 1: Mild symptoms; intervention not indicated - Grade 2: Moderate symptoms; limiting instrumental ADL - Grade 3: Severe symptoms; limiting self care ADL - Grade 4: N/A Cystitis non-infective - Grade 1: Microscopic hematuria; minimal increase in frequency, urgency, dysuria, or nocturia; new onset of incontinence - Grade 2: Moderate hematuria; moderate increase in frequency, urgency, dysuria, nocturia or incontinence; urinary catheter placement or bladder irrigation indicated; limiting instrumental ADL - Grade 3: Gross hematuria; transfusion, IV medications or hospitalization indicated; elective endoscopic, radiologic or operative intervention indicated - Grade 4: Life-threatening consequences; urgent radiologic or operative intervention indicated Urinary retention - Grade 1: Urinary, suprapubic or intermittent catheter placement not indicated; able to void with some residual - Grade 2: Placement of urinary, suprapubic or intermittent catheter placement indicated; medication indicated - Grade 3: Elective operative or radiologic intervention indicated; substantial loss of affected kidney function or mass - Grade 4: Life-threatening consequences; organ failure; urgent operative intervention indicated INCLUSION CRITERIA: All patients undergoing primary or salvage radiation therapy TIMING: During primary or salvage radiation therapy treatment and the 6 months following completion of therapy REPORTING SOURCE: Clinical TYPE: Multiple answer, Arrange as array (see sample questionnaire)
Data type
boolean
Alias
- UMLS CUI [1,1]
- C1516728
- UMLS CUI [1,2]
- C0549184
Description
The CTCAE defines Grade 3 and 4 complications for the following categories as follows: Fatigue - Grade 1: Fatigue relieved by rest - Grade 2: Fatigue not relieved by rest; limiting instrumental ADL - Grade 3: Fatigue not relieved by rest, limiting self care ADL - Grade 4: N/A INCLUSION CRITERIA: All patients undergoing primary or salvage radiation therapy TIMING: During primary or salvage radiation therapy treatment and the 6 months following completion of therapy REPORTING SOURCE: Clinical TYPE: Multiple answer, Arrange as array (see sample questionnaire)
Data type
integer
Alias
- UMLS CUI [1,1]
- C1516728
- UMLS CUI [1,2]
- C0015672
Description
The CTCAE defines Grade 3 and 4 complications for the following categories as follows: Dermatitis radiation - Grade 1: Faint erythema or dry desquamation - Grade 2: Moderate to brisk erythema; patchy moist desquamation, mostly confined to skin folds and creases; moderate edema - Grade 3: Moist desquamation in areas other than skin folds and creases; bleeding induced by minor trauma or abrasion - Grade 4: Life-threatening consequences; skin necrosis or ulceration of full thickness dermis; spontaneous bleeding from involved site; skin graft indicated INCLUSION CRITERIA: All patients undergoing primary or salvage radiation therapy TIMING: During primary or salvage radiation therapy treatment and the 6 months following completion of therapy REPORTING SOURCE: Clinical TYPE: Multiple answer, Arrange as array (see sample questionnaire)
Data type
integer
Alias
- UMLS CUI [1,1]
- C1516728
- UMLS CUI [1,2]
- C0034561
Description
The CTCAE defines Grade 3 and 4 complications for the following categories as follows: Diarrhea - Grade 1: Increase of less than 4 stools per day over baseline; mild increase in ostomy output compared to baseline - Grade 2: Increase of 4 - 6 stools per day over baseline; moderate increase in ostomy output compared to baseline - Grade 3: Increase of 7 or more stools per day over baseline; incontinence; hospitalization indicated; severe increase in ostomy output compared to baseline; limiting self care ADL - Grade 4: Life-threatening consequences; urgent intervention indicated INCLUSION CRITERIA: All patients undergoing primary or salvage radiation therapy TIMING: During primary or salvage radiation therapy treatment and the 6 months following completion of therapy REPORTING SOURCE: Clinical TYPE: Multiple answer, Arrange as array (see sample questionnaire)
Data type
integer
Alias
- UMLS CUI [1,1]
- C1516728
- UMLS CUI [1,2]
- C0011991
Description
The CTCAE defines Grade 3 and 4 complications for the following categories as follows: Abdominal pain - Grade 1: Mild pain - Grade 2: Moderate pain; limiting instrumental ADL - Grade 3: Severe pain; limiting self care ADL - Grade 4: N/A INCLUSION CRITERIA: All patients undergoing primary or salvage radiation therapy TIMING: During primary or salvage radiation therapy treatment and the 6 months following completion of therapy REPORTING SOURCE: Clinical TYPE: Multiple answer, Arrange as array (see sample questionnaire)
Data type
integer
Alias
- UMLS CUI [1,1]
- C1516728
- UMLS CUI [1,2]
- C0000737
Description
The CTCAE defines Grade 3 and 4 complications for the following categories as follows: Rectal mucositis - Grade 1: Asymptomatic or mild symptoms; intervention not indicated - Grade 2: Symptomatic; medical intervention indicated; limiting instrumental ADL - Grade 3: Severe symptoms; limiting self care ADL - Grade 4: Life-threatening consequences; urgent operative intervention indicated INCLUSION CRITERIA: All patients undergoing primary or salvage radiation therapy TIMING: During primary or salvage radiation therapy treatment and the 6 months following completion of therapy REPORTING SOURCE: Clinical TYPE: Multiple answer, Arrange as array (see sample questionnaire)
Data type
integer
Alias
- UMLS CUI [1,1]
- C1516728
- UMLS CUI [1,2]
- C1328588
Description
The CTCAE defines Grade 3 and 4 complications for the following categories as follows: Proctitis - Grade 1: Rectal discomfort, intervention not indicated - Grade 2: Symptoms (e.g., rectal discomfort, passing blood or mucus); medical intervention indicated; limiting instrumental ADL - Grade 3: Severe symptoms; fecal urgency or stool incontinence; limiting self care ADL - Grade 4: Life-threatening consequences; urgent intervention indicated INCLUSION CRITERIA: All patients undergoing primary or salvage radiation therapy TIMING: During primary or salvage radiation therapy treatment and the 6 months following completion of therapy REPORTING SOURCE: Clinical TYPE: Multiple answer, Arrange as array (see sample questionnaire)
Data type
integer
Alias
- UMLS CUI [1,1]
- C1516728
- UMLS CUI [1,2]
- C0033246
Description
The CTCAE defines Grade 3 and 4 complications for the following categories as follows: Hot flashes - Grade 1: Mild symptoms; intervention not indicated - Grade 2: Moderate symptoms; limiting instrumental ADL - Grade 3: Severe symptoms; limiting self care ADL - Grade 4: N/A INCLUSION CRITERIA: All patients undergoing primary or salvage radiation therapy TIMING: During primary or salvage radiation therapy treatment and the 6 months following completion of therapy REPORTING SOURCE: Clinical TYPE: Multiple answer, Arrange as array (see sample questionnaire)
Data type
integer
Alias
- UMLS CUI [1,1]
- C1516728
- UMLS CUI [1,2]
- C0600142
Description
The CTCAE defines Grade 3 and 4 complications for the following categories as follows: Cystitis non-infective - Grade 1: Microscopic hematuria; minimal increase in frequency, urgency, dysuria, or nocturia; new onset of incontinence - Grade 2: Moderate hematuria; moderate increase in frequency, urgency, dysuria, nocturia or incontinence; urinary catheter placement or bladder irrigation indicated; limiting instrumental ADL - Grade 3: Gross hematuria; transfusion, IV medications or hospitalization indicated; elective endoscopic, radiologic or operative intervention indicated - Grade 4: Life-threatening consequences; urgent radiologic or operative intervention indicated INCLUSION CRITERIA: All patients undergoing primary or salvage radiation therapy TIMING: During primary or salvage radiation therapy treatment and the 6 months following completion of therapy REPORTING SOURCE: Clinical TYPE: Multiple answer, Arrange as array (see sample questionnaire)
Data type
integer
Alias
- UMLS CUI [1,1]
- C1516728
- UMLS CUI [1,2]
- C0010692
Description
The CTCAE defines Grade 3 and 4 complications for the following categories as follows: Urinary retention - Grade 1: Urinary, suprapubic or intermittent catheter placement not indicated; able to void with some residual - Grade 2: Placement of urinary, suprapubic or intermittent catheter placement indicated; medication indicated - Grade 3: Elective operative or radiologic intervention indicated; substantial loss of affected kidney function or mass - Grade 4: Life-threatening consequences; organ failure; urgent operative intervention indicated INCLUSION CRITERIA: All patients undergoing primary or salvage radiation therapy TIMING: During primary or salvage radiation therapy treatment and the 6 months following completion of therapy REPORTING SOURCE: Clinical TYPE: Multiple answer, Arrange as array (see sample questionnaire)
Data type
integer
Alias
- UMLS CUI [1,1]
- C1516728
- UMLS CUI [1,2]
- C0080274
Description
INCLUSION CRITERIA: All patients undergoing primary or salvage radiation therapy TIMING: During primary or salvage radiation therapy treatment and the 6 months following completion of therapy REPORTING SOURCE: Clinical TYPE: Multiple answer, Arrange as array (see sample questionnaire)
Data type
integer
Alias
- UMLS CUI [1,1]
- C1516728
- UMLS CUI [1,2]
- C0205394
Description
INCLUSION CRITERIA: All patients undergoing primary or salvage radiation therapy, If answered '19 = Other grade 3' or '20 = Other grade 4' on CTCAE domain and grade (COMPLRADDOMGRA) TIMING: During primary or salvage radiation therapy treatment and the 6 months following completion of therapy REPORTING SOURCE: Clinical TYPE: Free text
Data type
text
Alias
- UMLS CUI [1,1]
- C1516728
- UMLS CUI [1,2]
- C0205394
- UMLS CUI [1,3]
- C2699044
Similar models
Clinical Form within 6 months after treatment initiation
- StudyEvent: ODM
C1442488 (UMLS CUI [1,2])
C1827061 (UMLS CUI [1,2])
C0194810 (UMLS CUI [1,2])
C1517033 (UMLS CUI [1,2])
C0006098 (UMLS CUI [1,2])
C0279492 (UMLS CUI [1,2])
C0205234 (UMLS CUI [1,2])
C0205394 (UMLS CUI [1,2])
C0205234 (UMLS CUI [1,2])
C0808070 (UMLS CUI [1,2])
C0808070 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,2])
C1512698 (UMLS CUI [1,2])
C0445089 (UMLS CUI-2)
(Comment:en)
(Comment:en)
C2986497 (UMLS CUI [1,2])
C0178602 (UMLS CUI [1,2])
C1264633 (UMLS CUI [1,3])
C0808070 (UMLS CUI [1,2])
C0806020 (UMLS CUI [1,2])
C0549178 (UMLS CUI [1,2])
C0549178 (UMLS CUI-2)
(Comment:en)
C0808070 (UMLS CUI [1,2])
C0806020 (UMLS CUI [1,2])
C0549178 (UMLS CUI [1,2])
C0549178 (UMLS CUI-2)
(Comment:en)
C0178602 (UMLS CUI [1,2])
(Comment:en)
(Comment:en)
(Comment:en)
C0808070 (UMLS CUI [1,2])
C0806020 (UMLS CUI [1,2])
C0549178 (UMLS CUI [1,2])
C0549178 (UMLS CUI-2)
(Comment:en)
C0205234 (UMLS CUI [1,2])
C0808070 (UMLS CUI [1,3])
C0205234 (UMLS CUI [1,2])
C0806020 (UMLS CUI [1,3])
C0205234 (UMLS CUI [1,2])
C0549178 (UMLS CUI [1,3])
C0205234 (UMLS CUI-2)
C0549178 (UMLS CUI-3)
(Comment:en)
C0205394 (UMLS CUI [1,2])
C0205394 (UMLS CUI [1,2])
C0808070 (UMLS CUI [1,3])
C0205394 (UMLS CUI [1,2])
C0806020 (UMLS CUI [1,3])
C0205394 (UMLS CUI [1,2])
C0549178 (UMLS CUI [1,3])
C0205394 (UMLS CUI-2)
C0549178 (UMLS CUI-3)
(Comment:en)
C4524868 (UMLS CUI [1,2])
(Comment:en)
(Comment:en)
(Comment:en)
(Comment:en)
(Comment:en)
C0549184 (UMLS CUI [1,2])
C0015672 (UMLS CUI [1,2])
C1556364 (UMLS CUI-2)
C1298908 (UMLS CUI-3)
(Comment:en)
(Comment:en)
(Comment:en)
C0034561 (UMLS CUI [1,2])
C1519275 (UMLS CUI-2)
C1517874 (UMLS CUI-3)
C0011603 (UMLS CUI-4)
(Comment:en)
C0011603 (UMLS CUI-2)
(Comment:en)
C0011603 (UMLS CUI-2)
(Comment:en)
C0011991 (UMLS CUI [1,2])
C1559311 (UMLS CUI-2)
C1298908 (UMLS CUI-3)
(Comment:en)
(Comment:en)
(Comment:en)
C0000737 (UMLS CUI [1,2])
C1557400 (UMLS CUI-2)
C1298908 (UMLS CUI-3)
(Comment:en)
(Comment:en)
(Comment:en)
C1328588 (UMLS CUI [1,2])
C1298908 (UMLS CUI-2)
(Comment:en)
(Comment:en)
(Comment:en)
C0033246 (UMLS CUI [1,2])
C1559354 (UMLS CUI-2)
C1298908 (UMLS CUI-3)
(Comment:en)
(Comment:en)
(Comment:en)
C0600142 (UMLS CUI [1,2])
C1517874 (UMLS CUI-2)
C0600142 (UMLS CUI-3)
C1298908 (UMLS CUI-4)
(Comment:en)
(Comment:en)
C0600142 (UMLS CUI-2)
(Comment:en)
C0010692 (UMLS CUI [1,2])
C1557814 (UMLS CUI-2)
C1298908 (UMLS CUI-3)
(Comment:en)
(Comment:en)
(Comment:en)
C0080274 (UMLS CUI [1,2])
C1558144 (UMLS CUI-2)
C1298908 (UMLS CUI-3)
(Comment:en)
(Comment:en)
(Comment:en)
C0205394 (UMLS CUI [1,2])
C1517874 (UMLS CUI-2)
C0205394 (UMLS CUI-3)
C1298908 (UMLS CUI-4)
(Comment:en)
C0205394 (UMLS CUI-2)
(Comment:en)
C0205394 (UMLS CUI-2)
(Comment:en)
C0205394 (UMLS CUI [1,2])
C2699044 (UMLS CUI [1,3])
No comments