ID
6286
Description
GOG-0241 Cycle Dose Drug Form (D2R) Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=
Link
https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=
Keywords
Versions (2)
- 12/18/14 12/18/14 - Martin Dugas
- 8/22/15 8/22/15 - Martin Dugas
Uploaded on
December 18, 2014
DOI
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License
Creative Commons BY-NC 3.0 Legacy
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GOG-0241 Cycle Dose Drug Form (D2R) - 3126715v1.0
No Instruction available.
- StudyEvent: SE.0000
Description
Treatment Cycle And Modification
Description
TreatmentCurrentCourseNumber
Data type
double
Description
TreatmentDelayedCycleInd-3
Data type
text
Description
TreatmentDelayDayCount
Data type
double
Description
TreatmentDelayedCycleReason
Data type
text
Description
TreatmentCourseBeginDate
Data type
date
Description
AgentName
Data type
text
Description
AgentDoseLevelValue
Data type
text
Description
DoseModificationStatus
Data type
text
Description
DoseModificationInd
Data type
text
Description
DoseModificationReason
Data type
text
Description
DoseAdverseEventModificationReason
Data type
text
Description
AgentCourseTotalDose
Data type
double
Description
AgentDoseUOM
Data type
text
Description
PatientWeightMeasurement
Data type
double
Measurement units
- Kg
Description
PersonBodySurfaceAreaValue
Data type
double
Measurement units
- m2
Description
PerformanceStatusAssessmentEasternCooperativeOncologyGroupScale
Data type
text
Description
Pretreatment Hematology And Chemistry Values
Description
LesionAssessmentDate
Data type
date
Description
LaboratoryProcedureHemoglobinResultSpecifiedValue
Data type
double
Measurement units
- g/dL
Description
LaboratoryProcedureErythrocyteResultCount
Data type
double
Description
LaboratoryProcedureLeukocyteResultSpecifiedValue
Data type
double
Measurement units
- 1000/uL
Description
LaboratoryProcedureGranulocyteResultCount
Data type
double
Measurement units
- 1000/uL
Description
LaboratoryProcedurePlateletResultSpecifiedValue
Data type
double
Measurement units
- 1000/uL
Description
LaboratoryProcedureProthrombinTimeResultValue
Data type
double
Measurement units
- seconds
Description
LaboratoryProcedurePartialThromboplastinTimeResultValue
Data type
double
Description
UrinaryCreatinineProteinAssessmentValue
Data type
double
Description
LaboratoryProcedureBloodUreaNitrogenResultUnspecifiedValue
Data type
double
Description
LaboratoryProcedureCreatinineResultSpecifiedValue
Data type
double
Measurement units
- mg/dL
Description
LaboratoryProcedureCreatinineClearanceOutcomeValue
Data type
double
Description
LaboratoryProcedureSerumGlutamicOxaloaceticTransferaseResultUnspecifiedValue
Data type
double
Description
LaboratoryProcedureTotalBilirubinResultValue
Data type
double
Measurement units
- mg/dL
Description
LaboratoryProcedureAlkalinePhosphataseResultValue
Data type
double
Description
LaboratoryProcedureCA-125AntigenTumorMarkerResultValue
Data type
double
Description
LaboratoryProcedureInternationalNormalizationRatioResultValue
Data type
double
Description
LaboratoryProcedureSecondOptionalPerformedSpecify
Data type
text
Description
LaboratoryProcedurePerformedValue
Data type
double
Description
Comments
Similar models
No Instruction available.
- StudyEvent: SE.0000