ID

575

Descripción

NCI Cooperative Group Hematology Laboratory Test Form (CALGB-90104) Combination Chemotherapy in Treating Patients With Bladder Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A9C02B5C-8C97-26B5-E034-0003BA12F5E7

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A9C02B5C-8C97-26B5-E034-0003BA12F5E7

Palabras clave

Versiones (6)
  1. 26/8/12 26/8/12 -
  2. 22/12/14 22/12/14 - Martin Dugas
  3. 8/1/15 8/1/15 - Martin Dugas
  4. 22/1/15 22/1/15 - Martin Dugas
  5. 22/1/15 22/1/15 - Martin Dugas
  6. 22/1/15 22/1/15 - Martin Dugas
Subido en

26 de agosto de 2012

DOI

Para solicitar uno, por favor iniciar sesión.

Licencia

Creative Commons BY-NC 3.0 Legacy
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Bladder Cancer NCT00014534 Lab - NCI Cooperative Group Hematology Laboratory Test Form (CALGB-90104) - 2056366v3.0

Inglés

No Instruction available.

1 formularios  
  1. StudyEvent: NCI Cooperative Group Hematology Laboratory Test Form (CALGB-90104)
    1. No Instruction available.
Mskcc 00-138; Calgb-90104; Ecog
Descripción

Mskcc 00-138; Calgb-90104; Ecog

Coordinating Group Protocol Number
Descripción

CoordinatingGroupProtocolNumber

Tipo de datos

text

Coordinating Group Code
Descripción

CoordinatingGroupCode

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25162
UMLS 2011AA ValueDomain
C0805701
Protocol Title
Descripción

ProtocolTitle

Tipo de datos

text

Alias
NCI Thesaurus ObjectClass
C25320
UMLS 2011AA ObjectClass
C1507394
NCI Thesaurus Property
C42774
UMLS 2011AA Property
C1705823
Patient Study ID, Coordinating Group
Descripción

PatientStudyID,CoordinatingGroup

Tipo de datos

text

Patient Study ID, Participating Group
Descripción

PatientStudyID,ParticipatingGroup

Tipo de datos

text

Participating Group Code
Descripción

ParticipatingGroupCode

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25162
UMLS 2011AA ValueDomain
C0805701
Institution Name
Descripción

InstitutionName

Tipo de datos

text

Affiliate
Descripción

AffiliateName

Tipo de datos

text

Patient Last Name (initials acceptable)
Descripción

PatientName,Last

Tipo de datos

text

Patient First Name (initials acceptable)
Descripción

PatientName,First

Tipo de datos

text

Patient Middle Name (initials acceptable)
Descripción

PatientName,Middle

Tipo de datos

text

Form Administration
Descripción

Form Administration

Person Completing Form, Last Name
Descripción

PersonCompletingForm,LastName

Tipo de datos

text

Person Completing Form, First Name
Descripción

PersonCompletingForm,FirstName

Tipo de datos

text

Alias
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Are data amended?
Descripción

AmendedDataInd

Tipo de datos

text

Alias
NCI Thesaurus ObjectClass
C25474
UMLS 2011AA ObjectClass
C1511726
NCI Thesaurus Property
C25416
UMLS 2011AA Property
C1691222
Hematology Laboratory Tests
Descripción

Hematology Laboratory Tests

Peripheral WBC Count
Descripción

Lab,Hematology,WBC

Tipo de datos

double

Hemoglobin
Descripción

Lab,Hematology,Hemoglobin

Tipo de datos

double

Peripheral Hematocrit Count (%)
Descripción

PeripheralHematocritCount(%)

Tipo de datos

text

Peripheral Platelet Count
Descripción

Lab,Hematology,Platelets

Tipo de datos

double

Peripheral Neutrophils (%)
Descripción

Lab,Hematology,Neutrophils,CellPercentage

Tipo de datos

double

Peripheral Neutrophil Count
Descripción

Lab,Hematology,NeutrophilCount

Tipo de datos

double

Unit (Normal Range)
Descripción

Lab,UnitsofMeasure

Tipo de datos

text

Normal Range-Peripheral WBC Count
Descripción

WBCcount(x1000),LLN

Tipo de datos

text

Normal Range-Hemoglobin
Descripción

Hemoglobin(g/dl),LLN

Tipo de datos

text

Normal Range-Peripheral Hematocrit Count (%)
Descripción

NormalRange-PeripheralHematocritCount(%)

Tipo de datos

text

Normal Range-Peripheral Platelet Count
Descripción

Plateletscount(x1000),LLN

Tipo de datos

double

Alias
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
NCI Thesaurus ValueDomain
C25555
UMLS 2011AA ValueDomain
C1518030
Normal Range-Peripheral Neutrophils (%)
Descripción

NormalRange-PeripheralNeutrophils(%)

Tipo de datos

text

Normal Range-Peripheral Neutrophil Count
Descripción

NormalRange-PeripheralNeutrophilCount

Tipo de datos

text

Dates
Descripción

Labs,SampleCollectionDate

Tipo de datos

date

Comments
Descripción

Comments

Comments
Descripción

Comments

Tipo de datos

text

Ccrr Module For Nci Cooperative Group Hematology Laboratory Test Form (calgb-90104)
Descripción

Ccrr Module For Nci Cooperative Group Hematology Laboratory Test Form (calgb-90104)

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Similar models

No Instruction available.

1 formularios
  1. StudyEvent: NCI Cooperative Group Hematology Laboratory Test Form (CALGB-90104)
    1. No Instruction available.
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
Mskcc 00-138; Calgb-90104; Ecog
CoordinatingGroupProtocolNumber
Item
Coordinating Group Protocol Number
text
CoordinatingGroupCode
Item
Coordinating Group Code
text
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
ProtocolTitle
Item
Protocol Title
text
C25320 (NCI Thesaurus ObjectClass)
C1507394 (UMLS 2011AA ObjectClass)
C42774 (NCI Thesaurus Property)
C1705823 (UMLS 2011AA Property)
PatientStudyID,CoordinatingGroup
Item
Patient Study ID, Coordinating Group
text
PatientStudyID,ParticipatingGroup
Item
Patient Study ID, Participating Group
text
ParticipatingGroupCode
Item
Participating Group Code
text
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
InstitutionName
Item
Institution Name
text
AffiliateName
Item
Affiliate
text
PatientName,Last
Item
Patient Last Name (initials acceptable)
text
PatientName,First
Item
Patient First Name (initials acceptable)
text
PatientName,Middle
Item
Patient Middle Name (initials acceptable)
text
Item Group
Form Administration
PersonCompletingForm,LastName
Item
Person Completing Form, Last Name
text
PersonCompletingForm,FirstName
Item
Person Completing Form, First Name
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
Item
Are data amended?
text
C25474 (NCI Thesaurus ObjectClass)
C1511726 (UMLS 2011AA ObjectClass)
C25416 (NCI Thesaurus Property)
C1691222 (UMLS 2011AA Property)
CL.1
Code List
Are data amended?
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Item Group
Hematology Laboratory Tests
Lab,Hematology,WBC
Item
Peripheral WBC Count
double
Lab,Hematology,Hemoglobin
Item
Hemoglobin
double
PeripheralHematocritCount(%)
Item
Peripheral Hematocrit Count (%)
text
Lab,Hematology,Platelets
Item
Peripheral Platelet Count
double
Lab,Hematology,Neutrophils,CellPercentage
Item
Peripheral Neutrophils (%)
double
Lab,Hematology,NeutrophilCount
Item
Peripheral Neutrophil Count
double
Item
Unit (Normal Range)
text
CL.2
Code List
Unit (Normal Range)
CL Item
K/uL (K/uL)
CL Item
G/dl (g/dL)
CL Item
% (%)
WBCcount(x1000),LLN
Item
Normal Range-Peripheral WBC Count
text
Hemoglobin(g/dl),LLN
Item
Normal Range-Hemoglobin
text
NormalRange-PeripheralHematocritCount(%)
Item
Normal Range-Peripheral Hematocrit Count (%)
text
Plateletscount(x1000),LLN
Item
Normal Range-Peripheral Platelet Count
double
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25555 (NCI Thesaurus ValueDomain)
C1518030 (UMLS 2011AA ValueDomain)
NormalRange-PeripheralNeutrophils(%)
Item
Normal Range-Peripheral Neutrophils (%)
text
NormalRange-PeripheralNeutrophilCount
Item
Normal Range-Peripheral Neutrophil Count
text
Labs,SampleCollectionDate
Item
Dates
date
Item Group
Comments
Comments
Item
Comments
text
Item Group
Ccrr Module For Nci Cooperative Group Hematology Laboratory Test Form (calgb-90104)
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