ID

575

Description

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

Lien

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

Mots-clés

Versions (6)
  1. 26/08/2012 26/08/2012 -
  2. 22/12/2014 22/12/2014 - Martin Dugas
  3. 08/01/2015 08/01/2015 - Martin Dugas
  4. 22/01/2015 22/01/2015 - Martin Dugas
  5. 22/01/2015 22/01/2015 - Martin Dugas
  6. 22/01/2015 22/01/2015 - Martin Dugas
Téléchargé le

26 août 2012

DOI

Pour une demande vous connecter.

Licence

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

Anglais

No Instruction available.

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

Mskcc 00-138; Calgb-90104; Ecog

Coordinating Group Protocol Number
Description

CoordinatingGroupProtocolNumber

Type de données

text

Coordinating Group Code
Description

CoordinatingGroupCode

Type de données

text

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

ProtocolTitle

Type de données

text

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

PatientStudyID,CoordinatingGroup

Type de données

text

Patient Study ID, Participating Group
Description

PatientStudyID,ParticipatingGroup

Type de données

text

Participating Group Code
Description

ParticipatingGroupCode

Type de données

text

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

InstitutionName

Type de données

text

Affiliate
Description

AffiliateName

Type de données

text

Patient Last Name (initials acceptable)
Description

PatientName,Last

Type de données

text

Patient First Name (initials acceptable)
Description

PatientName,First

Type de données

text

Patient Middle Name (initials acceptable)
Description

PatientName,Middle

Type de données

text

Form Administration
Description

Form Administration

Person Completing Form, Last Name
Description

PersonCompletingForm,LastName

Type de données

text

Person Completing Form, First Name
Description

PersonCompletingForm,FirstName

Type de données

text

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

AmendedDataInd

Type de données

text

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

Hematology Laboratory Tests

Peripheral WBC Count
Description

Lab,Hematology,WBC

Type de données

double

Hemoglobin
Description

Lab,Hematology,Hemoglobin

Type de données

double

Peripheral Hematocrit Count (%)
Description

PeripheralHematocritCount(%)

Type de données

text

Peripheral Platelet Count
Description

Lab,Hematology,Platelets

Type de données

double

Peripheral Neutrophils (%)
Description

Lab,Hematology,Neutrophils,CellPercentage

Type de données

double

Peripheral Neutrophil Count
Description

Lab,Hematology,NeutrophilCount

Type de données

double

Unit (Normal Range)
Description

Lab,UnitsofMeasure

Type de données

text

Normal Range-Peripheral WBC Count
Description

WBCcount(x1000),LLN

Type de données

text

Normal Range-Hemoglobin
Description

Hemoglobin(g/dl),LLN

Type de données

text

Normal Range-Peripheral Hematocrit Count (%)
Description

NormalRange-PeripheralHematocritCount(%)

Type de données

text

Normal Range-Peripheral Platelet Count
Description

Plateletscount(x1000),LLN

Type de données

double

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

NormalRange-PeripheralNeutrophils(%)

Type de données

text

Normal Range-Peripheral Neutrophil Count
Description

NormalRange-PeripheralNeutrophilCount

Type de données

text

Dates
Description

Labs,SampleCollectionDate

Type de données

date

Comments
Description

Comments

Comments
Description

Comments

Type de données

text

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

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

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Similar models

No Instruction available.

1 Formulaires
  1. StudyEvent: NCI Cooperative Group Hematology Laboratory Test Form (CALGB-90104)
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Type de données
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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