ID

5540

Descrizione

NCIC MA.32 Serious Adverse Event Folder A Phase III Randomized Trial of Metformin vs Placebo in Early Stage Breast Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=81E4E526-5F38-E26A-E040-BB89AD43175C

collegamento

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=81E4E526-5F38-E26A-E040-BB89AD43175C

Keywords

  1. 08/08/14 08/08/14 - Martin Dugas
  2. 09/01/15 09/01/15 - Martin Dugas
  3. 09/01/15 09/01/15 - Martin Dugas
  4. 17/09/21 17/09/21 -
Caricato su

8 agosto 2014

DOI

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Licenza

Creative Commons BY-NC 3.0 Legacy

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Breast Cancer NCT01101438 Toxicity - NCIC MA.32 Serious Adverse Event Folder - 3027655v1.0

No Instruction available.

  1. StudyEvent: NCIC MA.32 Serious Adverse Event Folder
    1. No Instruction available.
Date Of Event/reporting Period
Descrizione

Date Of Event/reporting Period

Start Date of Primary AE
Descrizione

PrimaryAdverseEventBeginDate

Tipo di dati

date

Alias
NCI Thesaurus ObjectClass
C25251
UMLS 2011AA ObjectClass
C0205225
NCI Thesaurus ObjectClass
C41331
UMLS 2011AA ObjectClass
C0877248
NCI Thesaurus Property
C25431
UMLS 2011AA Property
C0439659
NCI Thesaurus Property
C25275
UMLS 2011AA Property
C2745955
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ValueDomain
C25431
UMLS 2011AA ValueDomain
C0439659
SAE Reported to Investigator Date
Descrizione

SeriousAdverseEventReportedtoInvestigatorDate

Tipo di dati

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C41331
UMLS 2011AA ObjectClass
C0877248
NCI Metathesaurus Property
CL124429
Temporal relation to SAE to protocol treatment
Descrizione

ReportSeriousAdverseEventPeriodType

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus Property
C25616
UMLS 2011AA Property
C1948053
NCI Thesaurus ObjectClass
C25375
UMLS 2011AA ObjectClass
C0684224
NCI Thesaurus Property
C41335
UMLS 2011AA Property
C1519255
Reporting period at which SAE occurred
Descrizione

ReportSeriousAdverseEventPeriodText

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus Property
C25616
UMLS 2011AA Property
C1948053
NCI Thesaurus ObjectClass
C25375
UMLS 2011AA ObjectClass
C0684224
NCI Thesaurus Property
C41335
UMLS 2011AA Property
C1519255
Event Description
Descrizione

Event Description

Event Description
Descrizione

AdverseEventTreatingDescriptionText

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus ObjectClass
C41331
UMLS 2011AA ObjectClass
C0877248
NCI Thesaurus Property
C25705
UMLS 2011AA Property
C1522326
NCI Thesaurus Property
C25365
UMLS 2011AA Property
C0678257
Serious Adverse Events
Descrizione

Serious Adverse Events

CTC Adverse Event Term
Descrizione

AdverseEventCommonTerminologyforAdverseEventsVersion4TermName

Tipo di dati

text

Alias
NCI Thesaurus ObjectClass
C41331
UMLS 2011AA ObjectClass
C0877248
NCI Thesaurus Property
C49704
UMLS 2011AA Property
C1516728
NCI Thesaurus Property
C45559
UMLS 2011AA Property
C1705313
NCI Thesaurus ValueDomain
C45255
UMLS 2011AA ValueDomain
C1708523
NCI Thesaurus ValueDomain
C49704
UMLS 2011AA ValueDomain
C1516728
NCI Thesaurus ValueDomain
C42614
UMLS 2011AA ValueDomain
C0027365
NCI Thesaurus ValueDomain
C45559
UMLS 2011AA ValueDomain
C1705313
NCI Thesaurus ValueDomain
C25714
UMLS 2011AA ValueDomain
C0333052
Event Onset Time
Descrizione

AdverseEventOnsetTime

Tipo di dati

time

Alias
NCI Thesaurus ObjectClass
C41331
UMLS 2011AA ObjectClass
C0877248
NCI Thesaurus ValueDomain
C25207
UMLS 2011AA ValueDomain
C0040223
NCI Thesaurus Property
C25279
UMLS 2011AA Property
C0332162
Event End Time
Descrizione

AdverseEventEndTime

Tipo di dati

time

Alias
NCI Thesaurus ObjectClass
C41331
UMLS 2011AA ObjectClass
C0877248
NCI Thesaurus ValueDomain
C25207
UMLS 2011AA ValueDomain
C0040223
NCI Thesaurus Property
C25496
UMLS 2011AA Property
C2746065
Grade
Descrizione

AdverseEventSeverityGrade

Tipo di dati

text

Alias
NCI Thesaurus ObjectClass
C41331
UMLS 2011AA ObjectClass
C0877248
NCI Thesaurus Property
C48309
UMLS 2011AA Property
C0441800
NCI Thesaurus Property
C49705
UMLS 2011AA Property
C1710065
NCI Thesaurus Property
C25676
UMLS 2011AA Property
C0439793
NCI Thesaurus ValueDomain
C41331
UMLS 2011AA ValueDomain
C0877248
NCI Thesaurus ValueDomain
C48309
UMLS 2011AA ValueDomain
C0441800
NCI Thesaurus ValueDomain
C25676
UMLS 2011AA ValueDomain
C0439793
Attribution (to Metformin/Placebo)
Descrizione

CTCAdverseEventAttributionScale

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
NCI Thesaurus ObjectClass
C49704
UMLS 2011AA ObjectClass
C1516728
NCI Thesaurus Property
C25358
UMLS 2011AA Property
C0596130
Action Taken at Time of Adverse Event
Descrizione

AdverseEventActionType

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C41331
UMLS 2011AA ObjectClass
C0877248
NCI Thesaurus Property
C25404
UMLS 2011AA Property
C0441472
AE Outcome
Descrizione

AdverseEventPresentStatus

Tipo di dati

text

Alias
NCI Thesaurus Property
C25626
UMLS 2011AA Property
C0150312
NCI Thesaurus ObjectClass
C41331
UMLS 2011AA ObjectClass
C0877248
NCI Thesaurus ValueDomain
C25688
UMLS 2011AA ValueDomain
C0449438
Seriousness Attributed to Adverse Event
Descrizione

AdverseEventSeriousnessAttributionScale

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
NCI Thesaurus ObjectClass
C41331
UMLS 2011AA ObjectClass
C0877248
NCI Thesaurus Property
C25358
UMLS 2011AA Property
C0596130
Laboratory Tests - Question
Descrizione

Laboratory Tests - Question

Are there any relevant laboratory or physical exam tests to report
Descrizione

AbnormalPhysicalExaminationLaboratoryProcedureOutcomeInd-2

Tipo di dati

text

Alias
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus ObjectClass
C25401
UMLS 2011AA ObjectClass
C0205161
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
Laboratory Test
Descrizione

Laboratory Test

Diagnostic Test
Descrizione

LaboratoryProcedurePhysicalExaminationAssessmentType

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property
C25367
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
Specify
Descrizione

LaboratoryProcedurePerformedSpecify

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus Property
C38000
UMLS 2011AA Property
C0884358
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
Nadir/Worst Value
Descrizione

AdverseEventWorstSymptomValue

Tipo di dati

double

Alias
NCI Thesaurus ObjectClass
C41331
UMLS 2011AA ObjectClass
C0877248
NCI Thesaurus Property
C4876
UMLS 2011AA Property
C1457887
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
NCI Thesaurus Property
C25719
UMLS 2011AA Property
C1522166
Nadir/Worst Date (at Time of SAE)
Descrizione

AdverseEventWorstSymptomDate

Tipo di dati

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C41331
UMLS 2011AA ObjectClass
C0877248
NCI Thesaurus Property
C4876
UMLS 2011AA Property
C1457887
NCI Thesaurus Property
C25719
UMLS 2011AA Property
C1522166
Nadir/Worst Unit of Measure
Descrizione

AdverseEventWorstSymptomUOM

Tipo di dati

text

Alias
NCI Thesaurus ObjectClass
C41331
UMLS 2011AA ObjectClass
C0877248
NCI Thesaurus Property
C4876
UMLS 2011AA Property
C1457887
NCI Thesaurus ValueDomain
C25709
UMLS 2011AA ValueDomain
C1519795
NCI Thesaurus Property
C25719
UMLS 2011AA Property
C1522166
LLN
Descrizione

LaboratoryProcedurePerformedLowerLimitofNormalValue

Tipo di dati

double

Alias
NCI Thesaurus Property
C38000
UMLS 2011AA Property
C0884358
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
NCI Thesaurus ValueDomain
C25555
UMLS 2011AA ValueDomain
C1518030
ULN
Descrizione

LaboratoryProcedurePerformedUpperLimitofNormalValue

Tipo di dati

double

Alias
NCI Thesaurus Property
C38000
UMLS 2011AA Property
C0884358
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
NCI Thesaurus ValueDomain
C25706
UMLS 2011AA ValueDomain
C1519815
Has the patient recovered
Descrizione

LaboratoryFindingRecoveryInd-2

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus ObjectClass
C38470
NCI Thesaurus Property
C70827
UMLS 2011AA Property
C0237820
Recovery or Latest Value
Descrizione

AdverseEventMostRecentRecoveryValue

Tipo di dati

text

Alias
NCI Thesaurus ObjectClass
C41331
UMLS 2011AA ObjectClass
C0877248
NCI Thesaurus Property
C25746
UMLS 2011AA Property
C2004454
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
NCI Thesaurus Property
C25577
UMLS 2011AA Property
C1513491
Date of Recovery or Death
Descrizione

AdverseEventMostRecentRecoveryDate

Tipo di dati

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C41331
UMLS 2011AA ObjectClass
C0877248
NCI Thesaurus Property
C25746
UMLS 2011AA Property
C2004454
NCI Thesaurus Property
C25577
UMLS 2011AA Property
C1513491
Name of Laboratory (where tests were completed)
Descrizione

PathologyCoreFacilityLaboratoryIdentifierName

Tipo di dati

text

Alias
NCI Thesaurus ObjectClass
C37984
UMLS 2011AA ObjectClass
C0022877
NCI Thesaurus ObjectClass
C18189
UMLS 2011AA ObjectClass
C0030664
NCI Thesaurus ObjectClass
C15896
UMLS 2011AA ObjectClass
C1511521
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus ValueDomain
C42614
UMLS 2011AA ValueDomain
C0027365
Blood Pressure - Question
Descrizione

Blood Pressure - Question

Are there any relevant blood pressure results to report
Descrizione

AbnormalBloodPressureLaboratoryProcedureOutcomeInd-2

Tipo di dati

text

Alias
NCI Thesaurus ObjectClass
C25401
UMLS 2011AA ObjectClass
C0205161
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus ObjectClass
C54706
UMLS 2011AA ObjectClass
C0005823
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
Blood Pressure
Descrizione

Blood Pressure

Nadir/Worst Date (at Time of SAE)
Descrizione

AdverseEventWorstSymptomDate

Tipo di dati

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C41331
UMLS 2011AA ObjectClass
C0877248
NCI Thesaurus Property
C4876
UMLS 2011AA Property
C1457887
NCI Thesaurus Property
C25719
UMLS 2011AA Property
C1522166
Blood Pressure, Systolic (mmHg, Recovery Value)
Descrizione

Systolic blood pressure

Tipo di dati

double

Alias
NCI Thesaurus ValueDomain
C25209
UMLS CUI-1
C0871470
NCI Thesaurus Property
C25214
NCI Thesaurus ObjectClass
C25298
Blood Pressure, Systolic (mmHg, Recovery Value)
Descrizione

Systolic blood pressure

Tipo di dati

double

Alias
NCI Thesaurus ValueDomain
C25209
UMLS CUI-1
C0871470
NCI Thesaurus Property
C25214
NCI Thesaurus ObjectClass
C25298
Blood pressure, Diastolic (mmHg, Recovery Value)
Descrizione

Diastolic blood pressure

Tipo di dati

double

Alias
NCI Thesaurus ValueDomain
C25209
UMLS CUI-1
C0428883
NCI Thesaurus Property
C25214
NCI Thesaurus ObjectClass
C25299
Blood pressure, Diastolic (mmHg, Recovery Value)
Descrizione

Diastolic blood pressure

Tipo di dati

double

Alias
NCI Thesaurus ValueDomain
C25209
UMLS CUI-1
C0428883
NCI Thesaurus Property
C25214
NCI Thesaurus ObjectClass
C25299
Has the patient recovered
Descrizione

LaboratoryFindingRecoveryInd-2

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus ObjectClass
C38470
NCI Thesaurus Property
C70827
UMLS 2011AA Property
C0237820
Date of Recovery or Death
Descrizione

AdverseEventMostRecentRecoveryDate

Tipo di dati

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C41331
UMLS 2011AA ObjectClass
C0877248
NCI Thesaurus Property
C25746
UMLS 2011AA Property
C2004454
NCI Thesaurus Property
C25577
UMLS 2011AA Property
C1513491
Other Investigations - Question
Descrizione

Other Investigations - Question

Are there any other relevant investigations to report
Descrizione

AbnormalOtherLaboratoryProcedureOutcomeInd-2

Tipo di dati

text

Alias
NCI Thesaurus ObjectClass
C17649
UMLS 2011AA ObjectClass
C0205394
NCI Thesaurus ObjectClass
C25401
UMLS 2011AA ObjectClass
C0205161
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
Other Investigations - Question
Descrizione

Other Investigations - Question

Diagnostic Test
Descrizione

LaboratoryProcedurePhysicalExaminationAssessmentType

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property
C25367
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
Specify
Descrizione

LaboratoryProcedurePerformedSpecify

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus Property
C38000
UMLS 2011AA Property
C0884358
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
Date
Descrizione

LaboratoryProcedureEvaluationPerformedDate

Tipo di dati

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus Property
C25214
UMLS 2011AA Property
C0220825
NCI Thesaurus Property
C38000
UMLS 2011AA Property
C0884358
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
Results
Descrizione

AdverseEventAssessmentText

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus ObjectClass
C41331
UMLS 2011AA ObjectClass
C0877248
Protocol Treatment
Descrizione

Protocol Treatment

Treatment Assignment Code
Descrizione

TreatmentAssignmentCode

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C25162
UMLS 2011AA ValueDomain
C0805701
NCI Thesaurus ObjectClass
C15368
NCI Thesaurus Property
C25426
UMLS 2011AA Property
C1516050
Actual dose
Descrizione

AgentAdministeredDose

Tipo di dati

double

Alias
NCI Thesaurus ValueDomain
C25488
UMLS 2011AA ValueDomain
C0178602
NCI Thesaurus ObjectClass
C1708
UMLS 2011AA ObjectClass
C0450442
NCI Thesaurus ValueDomain
C1708
UMLS 2011AA ValueDomain
C0450442
NCI Thesaurus Property
C25382
UMLS 2011AA Property
C1521801
Units
Descrizione

UnitsText

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus Property
C37984
UMLS 2011AA Property
C0022877
NCI Thesaurus ObjectClass
C25709
UMLS 2011AA ObjectClass
C1519795
Route of Administration
Descrizione

AgentAdministrationType

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Metathesaurus ObjectClass
CL111054
NCI Thesaurus Property
C25409
UMLS 2011AA Property
C1533734
Schedule
Descrizione

AgentAdministeredFrequency

Tipo di dati

text

Alias
NCI Thesaurus ObjectClass
C1708
UMLS 2011AA ObjectClass
C0450442
NCI Thesaurus ValueDomain
C25515
UMLS 2011AA ValueDomain
C0439603
NCI Thesaurus Property
C25382
UMLS 2011AA Property
C1521801
Randomization Date
Descrizione

PatientRandomizationDate

Tipo di dati

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25196
UMLS 2011AA Property
C0034656
Last Administered Date (Prior to SAE)
Descrizione

TreatmentLastAdministeredDate

Tipo di dati

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C15368
NCI Thesaurus Property
C25551
UMLS 2011AA Property
C1517741
NCI Thesaurus Property
C25382
UMLS 2011AA Property
C1521801
Agent Source
Descrizione

AgentSourceText

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus ObjectClass
C1708
UMLS 2011AA ObjectClass
C0450442
NCI Thesaurus Property
C25683
UMLS 2011AA Property
C0449416
Patient rechallenged with agent
Descrizione

PatientRetreatmentInd

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C54055
UMLS 2011AA Property
C0376495
Did event reoccur
Descrizione

SeriousAdverseEventRepeatOccurrenceInd-2

Tipo di dati

text

Alias
NCI Thesaurus ObjectClass
C41331
UMLS 2011AA ObjectClass
C0877248
NCI Thesaurus ObjectClass
C54035
UMLS 2011AA ObjectClass
C0205404
NCI Thesaurus Property
C25275
UMLS 2011AA Property
C2745955
NCI Thesaurus Property
C47886
UMLS 2011AA Property
C0205341
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
Prior Systemic Therapy - Question
Descrizione

Prior Systemic Therapy - Question

Has the patient received systemic therapy?
Descrizione

SystemicTherapyAdministeredInd-3

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C15698
UMLS 2011AA ObjectClass
C1515119
NCI Thesaurus Property
C25382
UMLS 2011AA Property
C1521801
Prior Radiation Therapy - Question
Descrizione

Prior Radiation Therapy - Question

Has the patient received adjuvant RT
Descrizione

AdjuvantRadiationTherapyAdministeredInd-3

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C15313
UMLS 2011AA ObjectClass
C1522449
NCI Thesaurus ObjectClass
C2140
UMLS 2011AA ObjectClass
C0001552
NCI Thesaurus Property
C25382
UMLS 2011AA Property
C1521801
Relevant Major Medical Problems - Question
Descrizione

Relevant Major Medical Problems - Question

Significant Medical History, Concomitant Diseases and/or Relevant Medical Conditions
Descrizione

ConcomitantDiseasePersonalMedicalHistoryInd-2

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus ObjectClass
C2991
UMLS 2011AA ObjectClass
C0012634
NCI Thesaurus ObjectClass
C25730
UMLS 2011AA ObjectClass
C0521115
NCI Thesaurus Property
C18772
UMLS 2011AA Property
C0262926
Relevant Major Medical Problems
Descrizione

Relevant Major Medical Problems

Date Documented
Descrizione

PatientMedicalConditionDate

Tipo di dati

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25261
UMLS 2011AA Property
C0205476
NCI Thesaurus Property
C25457
UMLS 2011AA Property
C0348080
Relevant major medical problems
Descrizione

ConcomitantDiseaseOrganSystemPersonalMedicalHistoryType

Tipo di dati

text

Alias
NCI Thesaurus ObjectClass
C2991
UMLS 2011AA ObjectClass
C0012634
NCI Thesaurus ObjectClass
C25730
UMLS 2011AA ObjectClass
C0521115
NCI Thesaurus Property
C18772
UMLS 2011AA Property
C0262926
NCI Thesaurus Property
C12919
UMLS 2011AA Property
C0460002
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Specify other disease/condition
Descrizione

ConcomitantDiseaseOrganSystemPersonalMedicalHistorySpecify

Tipo di dati

text

Alias
NCI Thesaurus ObjectClass
C2991
UMLS 2011AA ObjectClass
C0012634
NCI Thesaurus ObjectClass
C25730
UMLS 2011AA ObjectClass
C0521115
NCI Thesaurus Property
C18772
UMLS 2011AA Property
C0262926
NCI Thesaurus Property
C12919
UMLS 2011AA Property
C0460002
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
Other Relevant Details
Descrizione

PatientHistoryText

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C18772
UMLS 2011AA Property
C0262926
Concomitant Medications - Question
Descrizione

Concomitant Medications - Question

Did the participant report taking any concomitant medication
Descrizione

ConcomitantMedicationUseInd-3

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C459
UMLS 2011AA ObjectClass
C0013227
NCI Thesaurus ObjectClass
C25730
UMLS 2011AA ObjectClass
C0521115
NCI Thesaurus Property
C25340
UMLS 2011AA Property
C0457083
Concomitant Medications
Descrizione

Concomitant Medications

Concomitant Medication (335 permissible values)
Descrizione

ConcomitantMedicationReceivedText

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus ObjectClass
C459
UMLS 2011AA ObjectClass
C0013227
NCI Thesaurus Property
C25639
UMLS 2011AA Property
C1514756
NCI Thesaurus ObjectClass
C25730
UMLS 2011AA ObjectClass
C0521115
Agent Type (116 permissible values not coded)
Descrizione

ConcomitantMedicationAdministeredReasonText

Tipo di dati

text

Alias
NCI Thesaurus ObjectClass
C459
UMLS 2011AA ObjectClass
C0013227
NCI Thesaurus ObjectClass
C25730
UMLS 2011AA ObjectClass
C0521115
NCI Thesaurus Property
C25382
UMLS 2011AA Property
C1521801
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus ValueDomain
C25638
UMLS 2011AA ValueDomain
C0392360
Was this medication used to treat the SAE
Descrizione

SeriousAdverseEventTherapyInd-2

Tipo di dati

text

Alias
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
NCI Thesaurus Property
C15368
NCI Thesaurus ObjectClass
C41335
UMLS 2011AA ObjectClass
C1519255
Start date
Descrizione

AgentBeginDate

Tipo di dati

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ValueDomain
C25431
UMLS 2011AA ValueDomain
C0439659
NCI Thesaurus ObjectClass
C1708
UMLS 2011AA ObjectClass
C0450442
NCI Thesaurus Property
C25275
UMLS 2011AA Property
C2745955
Stop date
Descrizione

AgentEndDate

Tipo di dati

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C1708
UMLS 2011AA ObjectClass
C0450442
NCI Thesaurus Property
C25275
UMLS 2011AA Property
C2745955
Sae Notification Form
Descrizione

Sae Notification Form

Similar models

No Instruction available.

  1. StudyEvent: NCIC MA.32 Serious Adverse Event Folder
    1. No Instruction available.
Name
genere
Description | Question | Decode (Coded Value)
Tipo di dati
Alias
Item Group
Date Of Event/reporting Period
PrimaryAdverseEventBeginDate
Item
Start Date of Primary AE
date
C25251 (NCI Thesaurus ObjectClass)
C0205225 (UMLS 2011AA ObjectClass)
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
C25431 (NCI Thesaurus Property)
C0439659 (UMLS 2011AA Property)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25431 (NCI Thesaurus ValueDomain)
C0439659 (UMLS 2011AA ValueDomain)
SeriousAdverseEventReportedtoInvestigatorDate
Item
SAE Reported to Investigator Date
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
CL124429 (NCI Metathesaurus Property)
Item
Temporal relation to SAE to protocol treatment
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C25616 (NCI Thesaurus Property)
C1948053 (UMLS 2011AA Property)
C25375 (NCI Thesaurus ObjectClass)
C0684224 (UMLS 2011AA ObjectClass)
C41335 (NCI Thesaurus Property)
C1519255 (UMLS 2011AA Property)
Code List
Temporal relation to SAE to protocol treatment
CL Item
During Protocol Treatment (during protocol treatment)
CL Item
Within 30 Days After Completion Of Protocol Treatment (within 30 days after completion of protocol treatment)
CL Item
More Than 30 Days After Completion Of Protocol Treatment (more than 30 days after completion of protocol treatment)
ReportSeriousAdverseEventPeriodText
Item
Reporting period at which SAE occurred
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C25616 (NCI Thesaurus Property)
C1948053 (UMLS 2011AA Property)
C25375 (NCI Thesaurus ObjectClass)
C0684224 (UMLS 2011AA ObjectClass)
C41335 (NCI Thesaurus Property)
C1519255 (UMLS 2011AA Property)
Item Group
Event Description
AdverseEventTreatingDescriptionText
Item
Event Description
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
C25705 (NCI Thesaurus Property)
C1522326 (UMLS 2011AA Property)
C25365 (NCI Thesaurus Property)
C0678257 (UMLS 2011AA Property)
Item Group
Serious Adverse Events
AdverseEventCommonTerminologyforAdverseEventsVersion4TermName
Item
CTC Adverse Event Term
text
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
C49704 (NCI Thesaurus Property)
C1516728 (UMLS 2011AA Property)
C45559 (NCI Thesaurus Property)
C1705313 (UMLS 2011AA Property)
C45255 (NCI Thesaurus ValueDomain)
C1708523 (UMLS 2011AA ValueDomain)
C49704 (NCI Thesaurus ValueDomain)
C1516728 (UMLS 2011AA ValueDomain)
C42614 (NCI Thesaurus ValueDomain)
C0027365 (UMLS 2011AA ValueDomain)
C45559 (NCI Thesaurus ValueDomain)
C1705313 (UMLS 2011AA ValueDomain)
C25714 (NCI Thesaurus ValueDomain)
C0333052 (UMLS 2011AA ValueDomain)
AdverseEventOnsetTime
Item
Event Onset Time
time
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
C25207 (NCI Thesaurus ValueDomain)
C0040223 (UMLS 2011AA ValueDomain)
C25279 (NCI Thesaurus Property)
C0332162 (UMLS 2011AA Property)
AdverseEventEndTime
Item
Event End Time
time
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
C25207 (NCI Thesaurus ValueDomain)
C0040223 (UMLS 2011AA ValueDomain)
C25496 (NCI Thesaurus Property)
C2746065 (UMLS 2011AA Property)
Item
Grade
text
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
C48309 (NCI Thesaurus Property)
C0441800 (UMLS 2011AA Property)
C49705 (NCI Thesaurus Property)
C1710065 (UMLS 2011AA Property)
C25676 (NCI Thesaurus Property)
C0439793 (UMLS 2011AA Property)
C41331 (NCI Thesaurus ValueDomain)
C0877248 (UMLS 2011AA ValueDomain)
C48309 (NCI Thesaurus ValueDomain)
C0441800 (UMLS 2011AA ValueDomain)
C25676 (NCI Thesaurus ValueDomain)
C0439793 (UMLS 2011AA ValueDomain)
Code List
Grade
CL Item
Absent Adverse Event (0)
C75533 (NCI Thesaurus)
C2699517 (UMLS 2011AA)
CL Item
Mild Adverse Event (1)
C84263 (NCI Thesaurus)
C1513302 (UMLS 2011AA)
CL Item
Moderate Adverse Event (2)
C84264 (NCI Thesaurus)
C1513374 (UMLS 2011AA)
CL Item
Severe Adverse Event (3)
C84265 (NCI Thesaurus)
C2919019 (UMLS 2011AA)
CL Item
Life Threatening Adverse Event (4)
C84266 (NCI Thesaurus)
C1517874 (UMLS 2011AA)
CL Item
Death Related To Adverse Event (5)
C48275 (NCI Thesaurus)
C1705232 (UMLS 2011AA)
Item
Attribution (to Metformin/Placebo)
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C25358 (NCI Thesaurus Property)
C0596130 (UMLS 2011AA Property)
Code List
Attribution (to Metformin/Placebo)
CL Item
Definite (Definite)
CL209464 (NCI Metathesaurus)
CL Item
Possible (Possible)
C0332149 (NCI Metathesaurus)
CL Item
Probable (Probable)
C0332148 (NCI Metathesaurus)
CL Item
Unlikely (Unlikely)
CL Item
Unrelated (Unrelated)
C25328 (NCI Thesaurus)
C0445356 (UMLS 2011AA)
Item
Action Taken at Time of Adverse Event
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
C25404 (NCI Thesaurus Property)
C0441472 (UMLS 2011AA Property)
Code List
Action Taken at Time of Adverse Event
CL Item
There Was No Action Taken Based On The Adverse Event (none)
CL Item
Study Dose Was Reduced As A Result Of The Adverse Event (study dose reduced)
CL Item
Protocol Treatment Was Delayed As A Result Of The Adverse Event (protocol treatment delayed)
CL Item
Protocol Treatment Was Discontinued As A Result Of The Adverse Event (protocol treatment discontinued)
Item
AE Outcome
text
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
Code List
AE Outcome
CL Item
Recovered Or Resolved Without Sequelae (Recovered/Resolved without Sequelae)
C85257 (NCI Thesaurus)
C2827606 (UMLS 2011AA)
CL Item
Not Recovered Or Not Resolved (Not recovered/Not resolved)
C49494 (NCI Thesaurus)
C1709277 (UMLS 2011AA)
CL Item
Recovered Or Resolved With Sequelae (Recovered/Resolved with Sequelae)
C49495 (NCI Thesaurus)
C1709862 (UMLS 2011AA)
CL Item
Fatal Or Died (Fatal/Died)
Item
Seriousness Attributed to Adverse Event
text
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
C25358 (NCI Thesaurus Property)
C0596130 (UMLS 2011AA Property)
Code List
Seriousness Attributed to Adverse Event
CL Item
Not Serious (Not serious)
CL Item
Death (Death)
C28554 (NCI Thesaurus)
C0011065 (UMLS 2011AA)
CL Item
Life Threatening (Life threatening)
CL Item
Hospitalized (Hospitalization, initial or prolonged)
CL Item
Disability (Disability/incapacity)
C21007 (NCI Thesaurus)
C0231170 (UMLS 2011AA)
CL Item
Congenital Anomaly (Congenital anomaly)
CL Item
Intervention Required (Required intervention to prevent permanent impairment/damage)
Item Group
Laboratory Tests - Question
Item
Are there any relevant laboratory or physical exam tests to report
text
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C25401 (NCI Thesaurus ObjectClass)
C0205161 (UMLS 2011AA ObjectClass)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
Code List
Are there any relevant laboratory or physical exam tests to report
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Item Group
Laboratory Test
Item
Diagnostic Test
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25367 (NCI Thesaurus Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
Code List
Diagnostic Test
CL Item
Activated Partial Thromboplastin Time (Activated partial thromboplastin time (APTT))
CL Item
Albumin (Albumin - blood)
C214 (NCI Thesaurus)
C0001924 (UMLS 2011AA)
CL Item
Alkaline Phosphatase (Alkaline phosphatase NOS)
CL Item
Alkaline Phosphatase (Alkaline phosphates NOS)
CL Item
Amylase (Amylase - blood)
CL Item
Absolute Neutrophil Count (ANC)
CL Item
Bacterial Infection (Bacterial infection NOS)
CL Item
Direct Bilirubin (Bilirubin direct - blood)
CL Item
Total Bilirubin (Bilirubin total - blood)
C38037 (NCI Thesaurus)
C0201913 (UMLS 2011AA)
CL Item
Blood Bicarbonate (Blood bicarbonate)
CL Item
Blood Carbon Dioxide (Blood carbon dioxide)
CL Item
Anc (Blood neutrophils (ANC))
CL Item
Bun (Blood urea nitrogen (BUN))
CL Item
Bone Marrow Blasts (Bone Marrow Blasts)
CL Item
Bone Marrow Cellularity (Bone Marrow Cellularity)
C12431 (NCI Thesaurus)
C0005953 (UMLS 2011AA)
C37923 (NCI Thesaurus)
C1516377 (UMLS 2011AA)
CL Item
Calcium (Calcium - blood (Ca))
CL Item
Blood Carbon Dioxide (Carbon dioxide - blood (CO2))
CL Item
Chloride (Chloride - blood)
CL Item
Cholesterol (Cholesterol - blood)
CL Item
Creatine Phosphokinase (Creatine phosphokinase - blood (CK))
CL Item
Creatinine (Creatinine - serum (Cr))
CL Item
Creatinine Clearance (Creatinine clearance (CrCl))
CL Item
Fibrin D-dimer (Fibrin D-dimer)
CL Item
Fibrin Degradation Products (Fibrin degradation products (FDP))
CL Item
Fibrinogen (Fibrinogen - blood)
C25736 (NCI Thesaurus)
C0016006 (UMLS 2011AA)
CL Item
Fungal Infection (Fungal infection NOS)
CL Item
Glucose (Glucose - blood)
CL Item
Glutamic-oxaloacetic Transferase (ast, Sgot) (Glutamic-oxaloacetic transferase (AST, SGOT))
CL Item
Glutamic-pyruvate Transferase (alt, Sgpt) (Glutamic-pyruvate transferase (ALT, SGPT))
CL Item
Hematocrit (Hematocrit (Hct))
CL Item
Hemoglobin (hgb) (Hemoglobin (Hb))
CL Item
International Normalized Ratio (International normalised ratio (INR))
CL Item
Ldh (Lactate dehydrogenase - blood (LDH))
CL Item
Lipase (Lipase)
C37988 (NCI Thesaurus)
C0023764 (UMLS 2011AA)
CL Item
Magnesium (Magnesium - blood (Mg))
CL Item
Oxygen Saturation (Oxygen saturation)
C0483415 (NCI Metathesaurus)
CL Item
Peripheral Blasts (Peripheral Blasts)
CL Item
Ph Nos (pH NOS)
CL Item
Phosphorus (Phosphorus)
CL Item
Platelet Count (Platelet count (PLT))
C0032181 (NCI Metathesaurus)
CL Item
Po2 (pO2)
C0483414 (NCI Metathesaurus)
CL Item
Potassium (Potassium - blood (K))
CL Item
Total Protein (Protein NOS (Total))
CL Item
Prothrombin Time (Prothrombin time (PT))
C0033707 (NCI Metathesaurus)
CL Item
Sodium (Sodium - blood)
C830 (NCI Thesaurus)
C0037473 (UMLS 2011AA)
CL Item
Triglycerides (Triglycerides)
C906 (NCI Thesaurus)
C0041004 (UMLS 2011AA)
CL Item
Urinalysis (Urine analysis)
C17241 (NCI Thesaurus)
C0042014 (UMLS 2011AA)
CL Item
Viral Infection (Viral infection NOS)
CL Item
Wbc (White blood cell count (WBC))
LaboratoryProcedurePerformedSpecify
Item
Specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
AdverseEventWorstSymptomValue
Item
Nadir/Worst Value
double
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
C4876 (NCI Thesaurus Property)
C1457887 (UMLS 2011AA Property)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25719 (NCI Thesaurus Property)
C1522166 (UMLS 2011AA Property)
AdverseEventWorstSymptomDate
Item
Nadir/Worst Date (at Time of SAE)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
C4876 (NCI Thesaurus Property)
C1457887 (UMLS 2011AA Property)
C25719 (NCI Thesaurus Property)
C1522166 (UMLS 2011AA Property)
Item
Nadir/Worst Unit of Measure
text
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
C4876 (NCI Thesaurus Property)
C1457887 (UMLS 2011AA Property)
C25709 (NCI Thesaurus ValueDomain)
C1519795 (UMLS 2011AA ValueDomain)
C25719 (NCI Thesaurus Property)
C1522166 (UMLS 2011AA Property)
Code List
Nadir/Worst Unit of Measure
CL Item
Percent (%)
C48570 (NCI Thesaurus)
C0439165 (UMLS 2011AA)
CL Item
1000 Per Cubic Millimiter (1000/mm3)
CL Item
1000 Per Microliter (1000/uL)
CL Item
Cubic Centimeters Per Minute (cc/min)
CL Item
Cells Per Liter (cells/L)
CL Item
Grams Per Deciliter (g/dL)
CL Item
Grams Per Liter (g/L)
CL Item
Gram (gm)
C0439208 (NCI Metathesaurus)
CL Item
Grams Per Deciliter (gm/dl)
CL Item
International Units Per Liter (iU/L)
CL Item
Kilopascals (kPa)
CL Item
Milliequivalents Per Liter (mEq/L)
CL Item
Milligrams Per Deciliter (mg/dL)
CL Item
Milligrams Per Liter (mg/L)
CL Item
Minutes (min)
CL Item
Ml/min/1.73m^2 (mL/min/1.73m2)
CL Item
Cubic Millimeters (mm3)
CL Item
Millimeters Of Mercury (mmHg)
CL Item
Millimole Per Liter (mmol/L)
CL Item
Not Applicable (n/a)
C48660 (NCI Thesaurus)
C1272460 (UMLS 2011AA)
CL Item
Number (number)
C25337 (NCI Thesaurus)
C0237753 (UMLS 2011AA)
CL Item
Seconds (seconds)
CL Item
Units Per Liter (U/L)
CL Item
Micrograms Per Milliliter (ug/mL)
CL Item
Microliter (ul)
C48153 (NCI Thesaurus)
C0439243 (UMLS 2011AA)
CL Item
Micromole Per Liter (umol/L)
CL Item
Volume Fraction (Vol Frac)
C67469 (NCI Thesaurus)
C1264666 (UMLS 2011AA)
LaboratoryProcedurePerformedLowerLimitofNormalValue
Item
LLN
double
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25555 (NCI Thesaurus ValueDomain)
C1518030 (UMLS 2011AA ValueDomain)
LaboratoryProcedurePerformedUpperLimitofNormalValue
Item
ULN
double
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25706 (NCI Thesaurus ValueDomain)
C1519815 (UMLS 2011AA ValueDomain)
Item
Has the patient recovered
text
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C38470 (NCI Thesaurus ObjectClass)
C70827 (NCI Thesaurus Property)
C0237820 (UMLS 2011AA Property)
Code List
Has the patient recovered
CL Item
Yes (yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (no)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
AdverseEventMostRecentRecoveryValue
Item
Recovery or Latest Value
text
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
C25746 (NCI Thesaurus Property)
C2004454 (UMLS 2011AA Property)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25577 (NCI Thesaurus Property)
C1513491 (UMLS 2011AA Property)
AdverseEventMostRecentRecoveryDate
Item
Date of Recovery or Death
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
C25746 (NCI Thesaurus Property)
C2004454 (UMLS 2011AA Property)
C25577 (NCI Thesaurus Property)
C1513491 (UMLS 2011AA Property)
PathologyCoreFacilityLaboratoryIdentifierName
Item
Name of Laboratory (where tests were completed)
text
C37984 (NCI Thesaurus ObjectClass)
C0022877 (UMLS 2011AA ObjectClass)
C18189 (NCI Thesaurus ObjectClass)
C0030664 (UMLS 2011AA ObjectClass)
C15896 (NCI Thesaurus ObjectClass)
C1511521 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C42614 (NCI Thesaurus ValueDomain)
C0027365 (UMLS 2011AA ValueDomain)
Item Group
Blood Pressure - Question
Item
Are there any relevant blood pressure results to report
text
C25401 (NCI Thesaurus ObjectClass)
C0205161 (UMLS 2011AA ObjectClass)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C54706 (NCI Thesaurus ObjectClass)
C0005823 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
Code List
Are there any relevant blood pressure results to report
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Item Group
Blood Pressure
AdverseEventWorstSymptomDate
Item
Nadir/Worst Date (at Time of SAE)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
C4876 (NCI Thesaurus Property)
C1457887 (UMLS 2011AA Property)
C25719 (NCI Thesaurus Property)
C1522166 (UMLS 2011AA Property)
Systolic blood pressure
Item
Blood Pressure, Systolic (mmHg, Recovery Value)
double
C25209 (NCI Thesaurus ValueDomain)
C0871470 (UMLS CUI-1)
C25214 (NCI Thesaurus Property)
C25298 (NCI Thesaurus ObjectClass)
Systolic blood pressure
Item
Blood Pressure, Systolic (mmHg, Recovery Value)
double
C25209 (NCI Thesaurus ValueDomain)
C0871470 (UMLS CUI-1)
C25214 (NCI Thesaurus Property)
C25298 (NCI Thesaurus ObjectClass)
Diastolic blood pressure
Item
Blood pressure, Diastolic (mmHg, Recovery Value)
double
C25209 (NCI Thesaurus ValueDomain)
C0428883 (UMLS CUI-1)
C25214 (NCI Thesaurus Property)
C25299 (NCI Thesaurus ObjectClass)
Diastolic blood pressure
Item
Blood pressure, Diastolic (mmHg, Recovery Value)
double
C25209 (NCI Thesaurus ValueDomain)
C0428883 (UMLS CUI-1)
C25214 (NCI Thesaurus Property)
C25299 (NCI Thesaurus ObjectClass)
Item
Has the patient recovered
text
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C38470 (NCI Thesaurus ObjectClass)
C70827 (NCI Thesaurus Property)
C0237820 (UMLS 2011AA Property)
Code List
Has the patient recovered
CL Item
Yes (yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (no)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
AdverseEventMostRecentRecoveryDate
Item
Date of Recovery or Death
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
C25746 (NCI Thesaurus Property)
C2004454 (UMLS 2011AA Property)
C25577 (NCI Thesaurus Property)
C1513491 (UMLS 2011AA Property)
Item Group
Other Investigations - Question
Item
Are there any other relevant investigations to report
text
C17649 (NCI Thesaurus ObjectClass)
C0205394 (UMLS 2011AA ObjectClass)
C25401 (NCI Thesaurus ObjectClass)
C0205161 (UMLS 2011AA ObjectClass)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
Code List
Are there any other relevant investigations to report
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Item Group
Other Investigations - Question
Item
Diagnostic Test
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25367 (NCI Thesaurus Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
Code List
Diagnostic Test
CL Item
Activated Partial Thromboplastin Time (Activated partial thromboplastin time (APTT))
CL Item
Albumin (Albumin - blood)
C214 (NCI Thesaurus)
C0001924 (UMLS 2011AA)
CL Item
Alkaline Phosphatase (Alkaline phosphatase NOS)
CL Item
Alkaline Phosphatase (Alkaline phosphates NOS)
CL Item
Amylase (Amylase - blood)
CL Item
Absolute Neutrophil Count (ANC)
CL Item
Bacterial Infection (Bacterial infection NOS)
CL Item
Direct Bilirubin (Bilirubin direct - blood)
CL Item
Total Bilirubin (Bilirubin total - blood)
C38037 (NCI Thesaurus)
C0201913 (UMLS 2011AA)
CL Item
Blood Bicarbonate (Blood bicarbonate)
CL Item
Blood Carbon Dioxide (Blood carbon dioxide)
CL Item
Anc (Blood neutrophils (ANC))
CL Item
Bun (Blood urea nitrogen (BUN))
CL Item
Bone Marrow Blasts (Bone Marrow Blasts)
CL Item
Bone Marrow Cellularity (Bone Marrow Cellularity)
C12431 (NCI Thesaurus)
C0005953 (UMLS 2011AA)
C37923 (NCI Thesaurus)
C1516377 (UMLS 2011AA)
CL Item
Calcium (Calcium - blood (Ca))
CL Item
Blood Carbon Dioxide (Carbon dioxide - blood (CO2))
CL Item
Chloride (Chloride - blood)
CL Item
Cholesterol (Cholesterol - blood)
CL Item
Creatine Phosphokinase (Creatine phosphokinase - blood (CK))
CL Item
Creatinine (Creatinine - serum (Cr))
CL Item
Creatinine Clearance (Creatinine clearance (CrCl))
CL Item
Fibrin D-dimer (Fibrin D-dimer)
CL Item
Fibrin Degradation Products (Fibrin degradation products (FDP))
CL Item
Fibrinogen (Fibrinogen - blood)
C25736 (NCI Thesaurus)
C0016006 (UMLS 2011AA)
CL Item
Fungal Infection (Fungal infection NOS)
CL Item
Glucose (Glucose - blood)
CL Item
Glutamic-oxaloacetic Transferase (ast, Sgot) (Glutamic-oxaloacetic transferase (AST, SGOT))
CL Item
Glutamic-pyruvate Transferase (alt, Sgpt) (Glutamic-pyruvate transferase (ALT, SGPT))
CL Item
Hematocrit (Hematocrit (Hct))
CL Item
Hemoglobin (hgb) (Hemoglobin (Hb))
CL Item
International Normalized Ratio (International normalised ratio (INR))
CL Item
Ldh (Lactate dehydrogenase - blood (LDH))
CL Item
Lipase (Lipase)
C37988 (NCI Thesaurus)
C0023764 (UMLS 2011AA)
CL Item
Magnesium (Magnesium - blood (Mg))
CL Item
Oxygen Saturation (Oxygen saturation)
C0483415 (NCI Metathesaurus)
CL Item
Peripheral Blasts (Peripheral Blasts)
CL Item
Ph Nos (pH NOS)
CL Item
Phosphorus (Phosphorus)
CL Item
Platelet Count (Platelet count (PLT))
C0032181 (NCI Metathesaurus)
CL Item
Po2 (pO2)
C0483414 (NCI Metathesaurus)
CL Item
Potassium (Potassium - blood (K))
CL Item
Total Protein (Protein NOS (Total))
CL Item
Prothrombin Time (Prothrombin time (PT))
C0033707 (NCI Metathesaurus)
CL Item
Sodium (Sodium - blood)
C830 (NCI Thesaurus)
C0037473 (UMLS 2011AA)
CL Item
Triglycerides (Triglycerides)
C906 (NCI Thesaurus)
C0041004 (UMLS 2011AA)
CL Item
Urinalysis (Urine analysis)
C17241 (NCI Thesaurus)
C0042014 (UMLS 2011AA)
CL Item
Viral Infection (Viral infection NOS)
CL Item
Wbc (White blood cell count (WBC))
LaboratoryProcedurePerformedSpecify
Item
Specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
LaboratoryProcedureEvaluationPerformedDate
Item
Date
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25214 (NCI Thesaurus Property)
C0220825 (UMLS 2011AA Property)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
AdverseEventAssessmentText
Item
Results
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
Item Group
Protocol Treatment
TreatmentAssignmentCode
Item
Treatment Assignment Code
text
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
C15368 (NCI Thesaurus ObjectClass)
C25426 (NCI Thesaurus Property)
C1516050 (UMLS 2011AA Property)
AgentAdministeredDose
Item
Actual dose
double
C25488 (NCI Thesaurus ValueDomain)
C0178602 (UMLS 2011AA ValueDomain)
C1708 (NCI Thesaurus ObjectClass)
C0450442 (UMLS 2011AA ObjectClass)
C1708 (NCI Thesaurus ValueDomain)
C0450442 (UMLS 2011AA ValueDomain)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
UnitsText
Item
Units
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C37984 (NCI Thesaurus Property)
C0022877 (UMLS 2011AA Property)
C25709 (NCI Thesaurus ObjectClass)
C1519795 (UMLS 2011AA ObjectClass)
Item
Route of Administration
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL111054 (NCI Metathesaurus ObjectClass)
C25409 (NCI Thesaurus Property)
C1533734 (UMLS 2011AA Property)
Code List
Route of Administration
CL Item
Oral Administration Of Drug (PO)
Item
Schedule
text
C1708 (NCI Thesaurus ObjectClass)
C0450442 (UMLS 2011AA ObjectClass)
C25515 (NCI Thesaurus ValueDomain)
C0439603 (UMLS 2011AA ValueDomain)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
Code List
Schedule
CL Item
Daily (Daily)
C25473 (NCI Thesaurus)
C0332173 (UMLS 2011AA)
PatientRandomizationDate
Item
Randomization Date
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25196 (NCI Thesaurus Property)
C0034656 (UMLS 2011AA Property)
TreatmentLastAdministeredDate
Item
Last Administered Date (Prior to SAE)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C15368 (NCI Thesaurus ObjectClass)
C25551 (NCI Thesaurus Property)
C1517741 (UMLS 2011AA Property)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
AgentSourceText
Item
Agent Source
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C1708 (NCI Thesaurus ObjectClass)
C0450442 (UMLS 2011AA ObjectClass)
C25683 (NCI Thesaurus Property)
C0449416 (UMLS 2011AA Property)
Item
Patient rechallenged with agent
text
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C54055 (NCI Thesaurus Property)
C0376495 (UMLS 2011AA Property)
Code List
Patient rechallenged with agent
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Decision Pending (Decision Pending)
Item
Did event reoccur
text
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
C54035 (NCI Thesaurus ObjectClass)
C0205404 (UMLS 2011AA ObjectClass)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
C47886 (NCI Thesaurus Property)
C0205341 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
Code List
Did event reoccur
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Item Group
Prior Systemic Therapy - Question
Item
Has the patient received systemic therapy?
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C15698 (NCI Thesaurus ObjectClass)
C1515119 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
Code List
Has the patient received systemic therapy?
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Item Group
Prior Radiation Therapy - Question
Item
Has the patient received adjuvant RT
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C15313 (NCI Thesaurus ObjectClass)
C1522449 (UMLS 2011AA ObjectClass)
C2140 (NCI Thesaurus ObjectClass)
C0001552 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
Code List
Has the patient received adjuvant RT
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Item Group
Relevant Major Medical Problems - Question
Item
Significant Medical History, Concomitant Diseases and/or Relevant Medical Conditions
text
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C25730 (NCI Thesaurus ObjectClass)
C0521115 (UMLS 2011AA ObjectClass)
C18772 (NCI Thesaurus Property)
C0262926 (UMLS 2011AA Property)
Code List
Significant Medical History, Concomitant Diseases and/or Relevant Medical Conditions
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Item Group
Relevant Major Medical Problems
PatientMedicalConditionDate
Item
Date Documented
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25261 (NCI Thesaurus Property)
C0205476 (UMLS 2011AA Property)
C25457 (NCI Thesaurus Property)
C0348080 (UMLS 2011AA Property)
Item
Relevant major medical problems
text
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C25730 (NCI Thesaurus ObjectClass)
C0521115 (UMLS 2011AA ObjectClass)
C18772 (NCI Thesaurus Property)
C0262926 (UMLS 2011AA Property)
C12919 (NCI Thesaurus Property)
C0460002 (UMLS 2011AA Property)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
Relevant major medical problems
CL Item
Acquired Immunodeficiency Syndrome (AIDS)
C2851 (NCI Thesaurus)
C0001175 (UMLS 2011AA)
CL Item
Immunology Hypersensitivity (Allergy/Immunology)
C3114 (NCI Thesaurus)
C0020517 (UMLS 2011AA)
C18011 (NCI Thesaurus)
C0152036 (UMLS 2011AA)
CL Item
Auditory (Auditory/Ear)
C37915 (NCI Thesaurus)
C0439825 (UMLS 2011AA)
CL Item
Bone Marrow Blood (Blood/Bone Marrow)
C12431 (NCI Thesaurus)
C0005953 (UMLS 2011AA)
C12434 (NCI Thesaurus)
C0229664 (UMLS 2011AA)
CL Item
Cardiac (Cardiac)
C13306 (NCI Thesaurus)
C1522601 (UMLS 2011AA)
CL Item
Coagulation (Coagulation)
C20812 (NCI Thesaurus)
C0005778 (UMLS 2011AA)
CL Item
Dermatologic (Dermatology/Skin)
C41128 (NCI Thesaurus)
C0205489 (UMLS 2011AA)
CL Item
Endocrine (Endocrine)
C41064 (NCI Thesaurus)
C0521425 (UMLS 2011AA)
CL Item
Gastrointestinal (Gastrointestinal)
C13359 (NCI Thesaurus)
C0521362 (UMLS 2011AA)
CL Item
Hepatobiliary System (Hepatobiliary/Pancreas)
C43612 (NCI Thesaurus)
C1711359 (UMLS 2011AA)
CL Item
Infection (Infection)
C26726 (NCI Thesaurus)
C0009450 (UMLS 2011AA)
CL Item
Metabolic (Metabolic/Laboratory)
C28240 (NCI Thesaurus)
C0311400 (UMLS 2011AA)
CL Item
Soft Tissue Musculoskeletal (Musculoskeletal/Soft Tissue)
C25348 (NCI Thesaurus)
C0497254 (UMLS 2011AA)
C12471 (NCI Thesaurus)
C0225317 (UMLS 2011AA)
CL Item
Neurology (Neurology)
C16908 (NCI Thesaurus)
C0027855 (UMLS 2011AA)
CL Item
Ocular (Ocular)
C87163 (NCI Thesaurus)
C1299003 (UMLS 2011AA)
C87163 (NCI Thesaurus)
C1299003 (UMLS 2011AA)
CL Item
Ocular (Ocular/Eye)
C87163 (NCI Thesaurus)
C1299003 (UMLS 2011AA)
C87163 (NCI Thesaurus)
C1299003 (UMLS 2011AA)
CL Item
Other (Other)
CL Item
Other Malignant Neoplasm (Other Malignancy)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
C9305 (NCI Thesaurus)
C0006826 (UMLS 2011AA)
CL Item
Pulmonary (Pulmonary/Upper Respiratory)
C13304 (NCI Thesaurus)
C2709248 (UMLS 2011AA)
CL Item
Genitourinary Renal (Renal/Genitourinary)
C25225 (NCI Thesaurus)
C0022646 (UMLS 2011AA)
C25350 (NCI Thesaurus)
C2709259 (UMLS 2011AA)
CL Item
Surgical Procedure (Surgical Procedure)
C15329 (NCI Thesaurus)
C0543467 (UMLS 2011AA)
ConcomitantDiseaseOrganSystemPersonalMedicalHistorySpecify
Item
Specify other disease/condition
text
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C25730 (NCI Thesaurus ObjectClass)
C0521115 (UMLS 2011AA ObjectClass)
C18772 (NCI Thesaurus Property)
C0262926 (UMLS 2011AA Property)
C12919 (NCI Thesaurus Property)
C0460002 (UMLS 2011AA Property)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
PatientHistoryText
Item
Other Relevant Details
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C18772 (NCI Thesaurus Property)
C0262926 (UMLS 2011AA Property)
Item Group
Concomitant Medications - Question
Item
Did the participant report taking any concomitant medication
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C459 (NCI Thesaurus ObjectClass)
C0013227 (UMLS 2011AA ObjectClass)
C25730 (NCI Thesaurus ObjectClass)
C0521115 (UMLS 2011AA ObjectClass)
C25340 (NCI Thesaurus Property)
C0457083 (UMLS 2011AA Property)
Code List
Did the participant report taking any concomitant medication
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Item Group
Concomitant Medications
ConcomitantMedicationReceivedText
Item
Concomitant Medication (335 permissible values)
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C459 (NCI Thesaurus ObjectClass)
C0013227 (UMLS 2011AA ObjectClass)
C25639 (NCI Thesaurus Property)
C1514756 (UMLS 2011AA Property)
C25730 (NCI Thesaurus ObjectClass)
C0521115 (UMLS 2011AA ObjectClass)
ConcomitantMedicationAdministeredReasonText
Item
Agent Type (116 permissible values not coded)
text
C459 (NCI Thesaurus ObjectClass)
C0013227 (UMLS 2011AA ObjectClass)
C25730 (NCI Thesaurus ObjectClass)
C0521115 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C25638 (NCI Thesaurus ValueDomain)
C0392360 (UMLS 2011AA ValueDomain)
Item
Was this medication used to treat the SAE
text
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C15368 (NCI Thesaurus Property)
C41335 (NCI Thesaurus ObjectClass)
C1519255 (UMLS 2011AA ObjectClass)
Code List
Was this medication used to treat the SAE
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
AgentBeginDate
Item
Start date
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25431 (NCI Thesaurus ValueDomain)
C0439659 (UMLS 2011AA ValueDomain)
C1708 (NCI Thesaurus ObjectClass)
C0450442 (UMLS 2011AA ObjectClass)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
AgentEndDate
Item
Stop date
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C1708 (NCI Thesaurus ObjectClass)
C0450442 (UMLS 2011AA ObjectClass)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
Item Group
Sae Notification Form

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