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ID

6037

Descrizione

S0205 PAIN MEDICATION LOG S0205 Gemcitabine With or Without Cetuximab as First-Line Therapy in Treating Patients With Locally Advanced Unresectable or Metastatic Adenocarcinoma of the Pancreas Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=E30D7C36-2312-0722-E034-0003BA12F5E7

collegamento

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=E30D7C36-2312-0722-E034-0003BA12F5E7

Keywords

  1. 19/09/12 19/09/12 -
  2. 26/11/14 26/11/14 - Martin Dugas
  3. 26/11/14 26/11/14 - Martin Dugas
  4. 09/01/15 09/01/15 - Martin Dugas
Caricato su

26 novembre 2014

DOI

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Licenza

Creative Commons BY-NC 3.0 Legacy

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    Pancreatic Cancer NCT00075686 Treatment - S0205 PAIN MEDICATION LOG - 2291766v3.0

    No Instruction available.

    1. StudyEvent: S0205 PAIN MEDICATION LOG
      1. No Instruction available.
    Administrative documentation
    Descrizione

    Administrative documentation

    Alias
    UMLS CUI-1
    C1320722 (Administrative documentation)
    SNOMED
    405624007
    SWOG Patient ID
    Descrizione

    PatientSouthwestOncologyGroupIdentifierNumber

    Tipo di dati

    double

    Alias
    NCI Thesaurus ValueDomain
    C25337 (undefined)
    UMLS 2011AA ValueDomain
    C0237753 (Numbers)
    SNOMED
    260299005
    LOINC
    LP6841-3
    NCI Thesaurus ObjectClass
    C16960 (undefined)
    UMLS 2011AA ObjectClass
    C0030705 (Patients)
    SNOMED
    116154003
    NCI Thesaurus Property
    C25364 (undefined)
    UMLS 2011AA Property
    C0600091 (Identifier)
    SNOMED
    118522005
    LOINC
    LP31795-5
    NCI Thesaurus Property
    C25699 (undefined)
    UMLS 2011AA Property
    C1519429 (SWOG)
    LOINC
    LA4458-1
    SWOG Study No.
    Descrizione

    ProtocolSWOGIdentifierNumber

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337 (undefined)
    UMLS 2011AA ValueDomain
    C0237753 (Numbers)
    SNOMED
    260299005
    LOINC
    LP6841-3
    NCI Thesaurus ObjectClass
    C25320 (undefined)
    UMLS 2011AA ObjectClass
    C1507394 (Clinical trial protocol document)
    LOINC
    LP33258-2
    NCI Thesaurus Property
    C25364 (undefined)
    UMLS 2011AA Property
    C0600091 (Identifier)
    SNOMED
    118522005
    LOINC
    LP31795-5
    NCI Thesaurus Property
    C25699 (undefined)
    UMLS 2011AA Property
    C1519429 (SWOG)
    LOINC
    LA4458-1
    Registration Step
    Descrizione

    RegistrationStepNumber

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337 (undefined)
    UMLS 2011AA ValueDomain
    C0237753 (Numbers)
    SNOMED
    260299005
    LOINC
    LP6841-3
    NCI Thesaurus ObjectClass
    C25646 (undefined)
    UMLS 2011AA ObjectClass
    C1514821 (Registration)
    NCI Thesaurus Property
    C16154 (undefined)
    UMLS 2011AA Property
    C1704379 (Treatment Step)
    NCI Thesaurus ValueDomain
    C16154 (undefined)
    UMLS 2011AA ValueDomain
    C1704379 (Treatment Step)
    Patient Initials (L, F M)
    Descrizione

    PatientInitialsName

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191 (undefined)
    UMLS 2011AA ValueDomain
    C1547383 (Person Name)
    SNOMED
    734006007
    NCI Thesaurus ObjectClass
    C16960 (undefined)
    UMLS 2011AA ObjectClass
    C0030705 (Patients)
    SNOMED
    116154003
    NCI Thesaurus Property
    C25536 (undefined)
    UMLS 2011AA Property
    C1555582 (Initial (abbreviation))
    Institution/Affiliate
    Descrizione

    CombinedInstitutionName

    Tipo di dati

    text

    Alias
    NCI Thesaurus ObjectClass
    C25454 (undefined)
    UMLS 2011AA ObjectClass
    C0205195 (Combined)
    SNOMED
    89780004
    LOINC
    LA30596-3
    NCI Thesaurus ObjectClass
    C21541 (undefined)
    UMLS 2011AA ObjectClass
    C0018704 (Health care facility)
    SNOMED
    257622000
    LOINC
    LA30302-6
    NCI Thesaurus Property
    C25364 (undefined)
    UMLS 2011AA Property
    C0600091 (Identifier)
    SNOMED
    118522005
    LOINC
    LP31795-5
    NCI Thesaurus ValueDomain
    C25191 (undefined)
    UMLS 2011AA ValueDomain
    C1547383 (Person Name)
    SNOMED
    734006007
    NCI Thesaurus ValueDomain
    C21541 (undefined)
    UMLS 2011AA ValueDomain
    C0018704 (Health care facility)
    SNOMED
    257622000
    LOINC
    LA30302-6
    Physician
    Descrizione

    RegisteredInvestigatorName

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191 (undefined)
    UMLS 2011AA ValueDomain
    C1547383 (Person Name)
    SNOMED
    734006007
    NCI Thesaurus Property
    C25364 (undefined)
    UMLS 2011AA Property
    C0600091 (Identifier)
    SNOMED
    118522005
    LOINC
    LP31795-5
    NCI Thesaurus ObjectClass
    C17089 (undefined)
    UMLS 2011AA ObjectClass
    C0035173 (Research Personnel)
    SNOMED
    769038007
    LOINC
    LA23773-7
    NCI Thesaurus ObjectClass
    C25644 (undefined)
    Treatment Number
    Descrizione

    PlannedAssessmentPeriodType

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25284 (undefined)
    UMLS 2011AA ValueDomain
    C0332307 (Type - attribute)
    SNOMED
    261664005
    NCI Thesaurus ObjectClass
    C20989 (undefined)
    UMLS 2011AA ObjectClass
    C0031809 (Physical Examination)
    SNOMED
    5880005
    LOINC
    MTHU028014
    NCI Thesaurus Property
    C25616 (undefined)
    UMLS 2011AA Property
    C1948053 (Period (temporal qualifier))
    SNOMED
    272117007
    Date Log Started
    Descrizione

    DiaryMedicationPainBeginDate

    Tipo di dati

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164 (undefined)
    UMLS 2011AA ValueDomain
    C0011008 (Date in time)
    SNOMED
    410671006
    NCI Thesaurus Property
    C3303 (undefined)
    UMLS 2011AA Property
    C0030193 (Pain)
    SNOMED
    22253000
    LOINC
    MTHU029813
    NCI Thesaurus ObjectClass
    C459 (undefined)
    UMLS 2011AA ObjectClass
    C0013227 (Pharmaceutical Preparations)
    SNOMED
    763158003
    LOINC
    LP100609-9
    Analgesics
    Descrizione

    Analgesics

    Alias
    UMLS CUI-1
    C0002771 (Analgesics)
    SNOMED
    53009005
    LOINC
    LP31483-8
    Name of Pain Medication (Nurse and Patient)
    Descrizione

    Analgesics

    Tipo di dati

    text

    Alias
    NCI Thesaurus Property
    C3303 (undefined)
    UMLS CUI-1
    C0002771 (Analgesics)
    SNOMED
    53009005
    LOINC
    LP31483-8
    NCI Thesaurus ObjectClass
    C459 (undefined)
    NCI Thesaurus ValueDomain
    C42614 (undefined)
    Medication Type
    Descrizione

    MedicationPainAdministeredType

    Tipo di dati

    integer

    Alias
    NCI Thesaurus ValueDomain
    C25284 (undefined)
    NCI Thesaurus Property
    C3303 (undefined)
    NCI Thesaurus ObjectClass
    C459 (undefined)
    UMLS CUI-1
    C0332307 (Type - attribute)
    SNOMED
    261664005
    UMLS CUI-2
    C0030193 (Pain)
    SNOMED
    22253000
    LOINC
    MTHU029813
    UMLS CUI-3
    C0013227 (Pharmaceutical Preparations)
    SNOMED
    763158003
    LOINC
    LP100609-9
    Analgesic Code (+)
    Descrizione

    AnalgesicsMedicationPainType

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25284 (undefined)
    UMLS 2011AA ValueDomain
    C0332307 (Type - attribute)
    SNOMED
    261664005
    NCI Thesaurus Property
    C3303 (undefined)
    UMLS 2011AA Property
    C0030193 (Pain)
    SNOMED
    22253000
    LOINC
    MTHU029813
    NCI Thesaurus ObjectClass
    C459 (undefined)
    UMLS 2011AA ObjectClass
    C0013227 (Pharmaceutical Preparations)
    SNOMED
    763158003
    LOINC
    LP100609-9
    Dose (Units ^)
    Descrizione

    AgentAdministeredDose

    Tipo di dati

    double

    Alias
    NCI Thesaurus ValueDomain
    C25488 (undefined)
    UMLS 2011AA ValueDomain
    C0178602 (Dosage)
    SNOMED
    260911001
    LOINC
    LP7180-5
    NCI Thesaurus ObjectClass
    C1708 (undefined)
    UMLS 2011AA ObjectClass
    C0450442 (Agent)
    SNOMED
    260872001
    NCI Thesaurus ValueDomain
    C1708 (undefined)
    UMLS 2011AA ValueDomain
    C0450442 (Agent)
    SNOMED
    260872001
    NCI Thesaurus Property
    C25382 (undefined)
    UMLS 2011AA Property
    C1521801 (Having administered)
    Number of pain meds taken at this dose Tallies (/)
    Descrizione

    TotalMedicationPainText

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704 (undefined)
    UMLS 2011AA ValueDomain
    C1527021 (Text)
    LOINC
    LP6885-0
    NCI Thesaurus Property
    C3303 (undefined)
    UMLS 2011AA Property
    C0030193 (Pain)
    SNOMED
    22253000
    LOINC
    MTHU029813
    NCI Thesaurus ObjectClass
    C459 (undefined)
    UMLS 2011AA ObjectClass
    C0013227 (Pharmaceutical Preparations)
    SNOMED
    763158003
    LOINC
    LP100609-9
    Number of pain meds taken at this dose Total
    Descrizione

    TotalMedicationPainCount

    Tipo di dati

    double

    Alias
    NCI Thesaurus Property
    C3303 (undefined)
    UMLS 2011AA Property
    C0030193 (Pain)
    SNOMED
    22253000
    LOINC
    MTHU029813
    NCI Thesaurus ObjectClass
    C459 (undefined)
    UMLS 2011AA ObjectClass
    C0013227 (Pharmaceutical Preparations)
    SNOMED
    763158003
    LOINC
    LP100609-9
    NCI Thesaurus ValueDomain
    C25463 (undefined)
    UMLS 2011AA ValueDomain
    C0750480 (Count)

    Similar models

    No Instruction available.

    1. StudyEvent: S0205 PAIN MEDICATION LOG
      1. No Instruction available.
    Name
    genere
    Description | Question | Decode (Coded Value)
    Tipo di dati
    Alias
    Item Group
    Administrative documentation
    C1320722 (UMLS CUI-1)
    PatientSouthwestOncologyGroupIdentifierNumber
    Item
    SWOG Patient ID
    double
    C25337 (NCI Thesaurus ValueDomain)
    C0237753 (UMLS 2011AA ValueDomain)
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C25364 (NCI Thesaurus Property)
    C0600091 (UMLS 2011AA Property)
    C25699 (NCI Thesaurus Property)
    C1519429 (UMLS 2011AA Property)
    ProtocolSWOGIdentifierNumber
    Item
    SWOG Study No.
    text
    C25337 (NCI Thesaurus ValueDomain)
    C0237753 (UMLS 2011AA ValueDomain)
    C25320 (NCI Thesaurus ObjectClass)
    C1507394 (UMLS 2011AA ObjectClass)
    C25364 (NCI Thesaurus Property)
    C0600091 (UMLS 2011AA Property)
    C25699 (NCI Thesaurus Property)
    C1519429 (UMLS 2011AA Property)
    RegistrationStepNumber
    Item
    Registration Step
    text
    C25337 (NCI Thesaurus ValueDomain)
    C0237753 (UMLS 2011AA ValueDomain)
    C25646 (NCI Thesaurus ObjectClass)
    C1514821 (UMLS 2011AA ObjectClass)
    C16154 (NCI Thesaurus Property)
    C1704379 (UMLS 2011AA Property)
    C16154 (NCI Thesaurus ValueDomain)
    C1704379 (UMLS 2011AA ValueDomain)
    PatientInitialsName
    Item
    Patient Initials (L, F M)
    text
    C25191 (NCI Thesaurus ValueDomain)
    C1547383 (UMLS 2011AA ValueDomain)
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C25536 (NCI Thesaurus Property)
    C1555582 (UMLS 2011AA Property)
    CombinedInstitutionName
    Item
    Institution/Affiliate
    text
    C25454 (NCI Thesaurus ObjectClass)
    C0205195 (UMLS 2011AA ObjectClass)
    C21541 (NCI Thesaurus ObjectClass)
    C0018704 (UMLS 2011AA ObjectClass)
    C25364 (NCI Thesaurus Property)
    C0600091 (UMLS 2011AA Property)
    C25191 (NCI Thesaurus ValueDomain)
    C1547383 (UMLS 2011AA ValueDomain)
    C21541 (NCI Thesaurus ValueDomain)
    C0018704 (UMLS 2011AA ValueDomain)
    RegisteredInvestigatorName
    Item
    Physician
    text
    C25191 (NCI Thesaurus ValueDomain)
    C1547383 (UMLS 2011AA ValueDomain)
    C25364 (NCI Thesaurus Property)
    C0600091 (UMLS 2011AA Property)
    C17089 (NCI Thesaurus ObjectClass)
    C0035173 (UMLS 2011AA ObjectClass)
    C25644 (NCI Thesaurus ObjectClass)
    Item
    Treatment Number
    text
    C25284 (NCI Thesaurus ValueDomain)
    C0332307 (UMLS 2011AA ValueDomain)
    C20989 (NCI Thesaurus ObjectClass)
    C0031809 (UMLS 2011AA ObjectClass)
    C25616 (NCI Thesaurus Property)
    C1948053 (UMLS 2011AA Property)
    Code List
    Treatment Number
    CL Item
    Prestudy (Prestudy)
    CL Item
    Week 5 (Week 5)
    CL Item
    Week 9 (Week 9)
    CL Item
    Week 13 (Week 13)
    CL Item
    Week 17 (Week 17)
    DiaryMedicationPainBeginDate
    Item
    Date Log Started
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C3303 (NCI Thesaurus Property)
    C0030193 (UMLS 2011AA Property)
    C459 (NCI Thesaurus ObjectClass)
    C0013227 (UMLS 2011AA ObjectClass)
    Item Group
    Analgesics
    C0002771 (UMLS CUI-1)
    Analgesics
    Item
    Name of Pain Medication (Nurse and Patient)
    text
    C3303 (NCI Thesaurus Property)
    C0002771 (UMLS CUI-1)
    C459 (NCI Thesaurus ObjectClass)
    C42614 (NCI Thesaurus ValueDomain)
    Item
    Medication Type
    integer
    C25284 (NCI Thesaurus ValueDomain)
    C3303 (NCI Thesaurus Property)
    C459 (NCI Thesaurus ObjectClass)
    C0332307 (UMLS CUI-1)
    C0030193 (UMLS CUI-2)
    C0013227 (UMLS CUI-3)
    Code List
    Medication Type
    CL Item
    Pill (1)
    CL Item
    Liquid (2)
    CL Item
    Pump (3)
    CL Item
    Patch (4)
    Item
    Analgesic Code (+)
    text
    C25284 (NCI Thesaurus ValueDomain)
    C0332307 (UMLS 2011AA ValueDomain)
    C3303 (NCI Thesaurus Property)
    C0030193 (UMLS 2011AA Property)
    C459 (NCI Thesaurus ObjectClass)
    C0013227 (UMLS 2011AA ObjectClass)
    Code List
    Analgesic Code (+)
    CL Item
    No Analgesic (No analgesic)
    CL Item
    Non-narcotic (Non-narcotic)
    CL Item
    Weak Opioid (Weak opioid)
    CL Item
    Strong Opioid (Strong opioid)
    AgentAdministeredDose
    Item
    Dose (Units ^)
    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)
    TotalMedicationPainText
    Item
    Number of pain meds taken at this dose Tallies (/)
    text
    C25704 (NCI Thesaurus ValueDomain)
    C1527021 (UMLS 2011AA ValueDomain)
    C3303 (NCI Thesaurus Property)
    C0030193 (UMLS 2011AA Property)
    C459 (NCI Thesaurus ObjectClass)
    C0013227 (UMLS 2011AA ObjectClass)
    TotalMedicationPainCount
    Item
    Number of pain meds taken at this dose Total
    double
    C3303 (NCI Thesaurus Property)
    C0030193 (UMLS 2011AA Property)
    C459 (NCI Thesaurus ObjectClass)
    C0013227 (UMLS 2011AA ObjectClass)
    C25463 (NCI Thesaurus ValueDomain)
    C0750480 (UMLS 2011AA ValueDomain)

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