0 Ratings
ID

7082

Description

The Division of Cancer Prevention's pharmacokinetics results tissue case report form (CRF) template. Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=5C37C68E-37F3-2ED2-E044-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=5C37C68E-37F3-2ED2-E044-0003BA3F9857

Keywords

Versions (2)
  1. 9/19/12 9/19/12 -
  2. 1/9/15 1/9/15 - Martin Dugas
Uploaded on

January 9, 2015

DOI

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License

Creative Commons BY-NC 3.0 Legacy
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    On-Study - Pharmacokinetics Results Tissue - 2804379v1.0

    English

    No Instruction available.

    1 forms  
    1. StudyEvent: Pharmacokinetics Results Tissue
      1. No Instruction available.
    Screening
    Description

    Screening

    DCP Protocol #
    Description

    Protocol ID NCI

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C3274381
    NCI Thesaurus ObjectClass
    C25320
    UMLS CUI-2
    C1513882
    NCI Thesaurus Property
    C25364
    NCI Thesaurus Property-2
    C19202
    Institution Code
    Description

    NationalCancerInstituteInstituteCode

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25162
    UMLS 2011AA ValueDomain
    C0805701
    NCI Thesaurus ObjectClass
    C21541
    UMLS 2011AA ObjectClass
    C0018704
    NCI Thesaurus Property
    C25364
    UMLS 2011AA Property
    C0600091
    Participant ID
    Description

    ParticipantIdentifier

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C25364
    UMLS 2011AA Property
    C0600091
    NCI Thesaurus ValueDomain
    C25364
    UMLS 2011AA ValueDomain
    C0600091
    Visit Type
    Description

    VisitTypeText

    Data type

    text

    Alias
    NCI Thesaurus Property
    C25284
    UMLS 2011AA Property
    C0332307
    NCI Thesaurus ValueDomain
    C25704
    UMLS 2011AA ValueDomain
    C1527021
    NCI Thesaurus ObjectClass
    C25716
    UMLS 2011AA ObjectClass
    C0545082
    Visit Date
    Description

    VisitDate

    Data type

    date

    Alias
    NCI Thesaurus Property
    C25164
    UMLS 2011AA Property
    C0011008
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ValueDomain-2
    C25367
    NCI Thesaurus ObjectClass
    C25716
    UMLS 2011AA ObjectClass
    C0545082
    Pharmacokinetics Results Blood
    Description

    Pharmacokinetics Results Blood

    Specimen Number
    Description

    SpecimenIdentifierNumber

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS 2011AA ValueDomain
    C0237753
    NCI Thesaurus Property
    C25364
    UMLS 2011AA Property
    C0600091
    NCI Thesaurus ObjectClass
    C19157
    UMLS 2011AA ObjectClass
    C0370003
    Not Obtained
    Description

    NotObtainedIndicator

    Data type

    text

    Alias
    NCI Thesaurus Property
    C25180
    UMLS 2011AA Property
    C1522602
    NCI Metathesaurus ObjectClass
    CL310460
    NCI Metathesaurus ObjectClass-2
    CL052458
    NCI Metathesaurus ValueDomain
    C0021212
    Date Sample Collected (MM/DD/YYYY)
    Description

    SpecimenCollectedDate

    Data type

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ObjectClass
    C19157
    UMLS 2011AA ObjectClass
    C0370003
    NCI Thesaurus Property
    C25452
    NCI Thesaurus Property-2
    C25275
    UMLS 2011AA Property
    C2745955
    Time Specimen Collected (hr:mm per 24 hour clock - if unknown report UNK)
    Description

    SpecimenCollectedTime

    Data type

    time

    Alias
    NCI Thesaurus ValueDomain
    C25207
    UMLS 2011AA ValueDomain
    C0040223
    NCI Thesaurus ObjectClass
    C19157
    UMLS 2011AA ObjectClass
    C0370003
    NCI Thesaurus Property
    C25452
    NCI Thesaurus Property-2
    C25275
    UMLS 2011AA Property
    C2745955
    Result
    Description

    LaboratoryTestResultNumericValue

    Data type

    float

    Alias
    NCI Thesaurus ObjectClass
    C37984
    UMLS 2011AA ObjectClass
    C0022877
    NCI Thesaurus Property
    C25294
    UMLS 2011AA Property
    C0022885
    NCI Thesaurus ValueDomain
    C25712
    UMLS 2011AA ValueDomain
    C1522609
    Units
    Description

    LabTestResultUnitofMeasureCode

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25162
    UMLS 2011AA ValueDomain
    C0805701
    NCI Thesaurus Property
    C37984
    UMLS 2011AA Property
    C0022877
    NCI Thesaurus ObjectClass
    C25709
    UMLS 2011AA ObjectClass
    C1519795
    Other Result
    Description

    OtherResultIndicatorResultIndicator

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C17649
    UMLS 2011AA ObjectClass
    C0205394
    NCI Thesaurus Property
    C25180
    UMLS 2011AA Property
    C1522602
    NCI Metathesaurus ObjectClass
    CL282989
    NCI Metathesaurus ValueDomain
    C0021212
    Date Specimen Analyzed (MM/DD/YYYY)
    Description

    SpecimenAnalyzedDate

    Data type

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Metathesaurus ObjectClass
    C0370003
    NCI Thesaurus Property
    C25420
    Dcp Template Footer
    Description

    Dcp Template Footer

    Protocol Title
    Description

    Protocol Title

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS CUI-1
    C2986303
    NCI Thesaurus ObjectClass
    C25320
    NCI Thesaurus Property
    C42774
    Protocol Version
    Description

    Protocol Version

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704
    UMLS CUI-1
    C2985700
    NCI Thesaurus ObjectClass
    C25320
    NCI Thesaurus Property
    C25364
    Protocol Date
    Description

    Protocol Version Date

    Data type

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS CUI-1
    C2985700
    NCI Thesaurus ObjectClass
    C25320
    UMLS CUI-2
    C0011008
    NCI Thesaurus Property
    C25364
    NCI Thesaurus ValueDomain-2
    C25367
    Page #
    Description

    PageNumber

    Data type

    float

    Alias
    NCI Thesaurus Property
    C25337
    UMLS 2011AA Property
    C0237753
    NCI Thesaurus ValueDomain
    C25337
    UMLS 2011AA ValueDomain
    C0237753
    NCI Metathesaurus ObjectClass
    C0439643
    Total Page Number
    Description

    CaseReportFormTotalPageNumber

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C40988
    UMLS 2011AA ObjectClass
    C1516308
    NCI Thesaurus Property
    C25337
    UMLS 2011AA Property
    C0237753
    NCI Thesaurus Property-2
    C25304
    UMLS 2011AA Property-2
    C0439810
    NCI Thesaurus Property-3
    C42783
    UMLS 2011AA Property-3
    C1704732
    NCI Thesaurus ValueDomain
    C25337
    UMLS 2011AA ValueDomain
    C0237753
    DCP Template Version
    Description

    DCPTemplateVersionText

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704
    UMLS 2011AA ValueDomain
    C1527021
    NCI Metathesaurus ObjectClass
    C0728990
    NCI Thesaurus Property
    C25714
    UMLS 2011AA Property
    C0333052
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    Similar models

    No Instruction available.

    1 forms
    1. StudyEvent: Pharmacokinetics Results Tissue
      1. No Instruction available.
    Name
    Type
    Description | Question | Decode (Coded Value)
    Data type
    Alias
    Item Group
    Screening
    Protocol ID NCI
    Item
    DCP Protocol #
    text
    C25337 (NCI Thesaurus ValueDomain)
    C3274381 (UMLS CUI-1)
    C25320 (NCI Thesaurus ObjectClass)
    C1513882 (UMLS CUI-2)
    C25364 (NCI Thesaurus Property)
    C19202 (NCI Thesaurus Property-2)
    NationalCancerInstituteInstituteCode
    Item
    Institution Code
    text
    C25162 (NCI Thesaurus ValueDomain)
    C0805701 (UMLS 2011AA ValueDomain)
    C21541 (NCI Thesaurus ObjectClass)
    C0018704 (UMLS 2011AA ObjectClass)
    C25364 (NCI Thesaurus Property)
    C0600091 (UMLS 2011AA Property)
    ParticipantIdentifier
    Item
    Participant ID
    text
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C25364 (NCI Thesaurus Property)
    C0600091 (UMLS 2011AA Property)
    C25364 (NCI Thesaurus ValueDomain)
    C0600091 (UMLS 2011AA ValueDomain)
    VisitTypeText
    Item
    Visit Type
    text
    C25284 (NCI Thesaurus Property)
    C0332307 (UMLS 2011AA Property)
    C25704 (NCI Thesaurus ValueDomain)
    C1527021 (UMLS 2011AA ValueDomain)
    C25716 (NCI Thesaurus ObjectClass)
    C0545082 (UMLS 2011AA ObjectClass)
    VisitDate
    Item
    Visit Date
    date
    C25164 (NCI Thesaurus Property)
    C0011008 (UMLS 2011AA Property)
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C25367 (NCI Thesaurus ValueDomain-2)
    C25716 (NCI Thesaurus ObjectClass)
    C0545082 (UMLS 2011AA ObjectClass)
    Item Group
    Pharmacokinetics Results Blood
    SpecimenIdentifierNumber
    Item
    Specimen Number
    text
    C25337 (NCI Thesaurus ValueDomain)
    C0237753 (UMLS 2011AA ValueDomain)
    C25364 (NCI Thesaurus Property)
    C0600091 (UMLS 2011AA Property)
    C19157 (NCI Thesaurus ObjectClass)
    C0370003 (UMLS 2011AA ObjectClass)
    NotObtainedIndicator
    Item
    Not Obtained
    text
    C25180 (NCI Thesaurus Property)
    C1522602 (UMLS 2011AA Property)
    CL310460 (NCI Metathesaurus ObjectClass)
    CL052458 (NCI Metathesaurus ObjectClass-2)
    C0021212 (NCI Metathesaurus ValueDomain)
    SpecimenCollectedDate
    Item
    Date Sample Collected (MM/DD/YYYY)
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C19157 (NCI Thesaurus ObjectClass)
    C0370003 (UMLS 2011AA ObjectClass)
    C25452 (NCI Thesaurus Property)
    C25275 (NCI Thesaurus Property-2)
    C2745955 (UMLS 2011AA Property)
    SpecimenCollectedTime
    Item
    Time Specimen Collected (hr:mm per 24 hour clock - if unknown report UNK)
    time
    C25207 (NCI Thesaurus ValueDomain)
    C0040223 (UMLS 2011AA ValueDomain)
    C19157 (NCI Thesaurus ObjectClass)
    C0370003 (UMLS 2011AA ObjectClass)
    C25452 (NCI Thesaurus Property)
    C25275 (NCI Thesaurus Property-2)
    C2745955 (UMLS 2011AA Property)
    LaboratoryTestResultNumericValue
    Item
    Result
    float
    C37984 (NCI Thesaurus ObjectClass)
    C0022877 (UMLS 2011AA ObjectClass)
    C25294 (NCI Thesaurus Property)
    C0022885 (UMLS 2011AA Property)
    C25712 (NCI Thesaurus ValueDomain)
    C1522609 (UMLS 2011AA ValueDomain)
    LabTestResultUnitofMeasureCode
    Item
    Units
    text
    C25162 (NCI Thesaurus ValueDomain)
    C0805701 (UMLS 2011AA ValueDomain)
    C37984 (NCI Thesaurus Property)
    C0022877 (UMLS 2011AA Property)
    C25709 (NCI Thesaurus ObjectClass)
    C1519795 (UMLS 2011AA ObjectClass)
    Item
    Other Result
    text
    C17649 (NCI Thesaurus ObjectClass)
    C0205394 (UMLS 2011AA ObjectClass)
    C25180 (NCI Thesaurus Property)
    C1522602 (UMLS 2011AA Property)
    CL282989 (NCI Metathesaurus ObjectClass)
    C0021212 (NCI Metathesaurus ValueDomain)
    CL.1
    Code List
    Other Result
    CL Item
    Not Assayed (Not assayed)
    CL Item
    Below Limit Of Detection (Below limit of detection)
    SpecimenAnalyzedDate
    Item
    Date Specimen Analyzed (MM/DD/YYYY)
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C0370003 (NCI Metathesaurus ObjectClass)
    C25420 (NCI Thesaurus Property)
    Item Group
    Dcp Template Footer
    Protocol Title
    Item
    Protocol Title
    text
    C25191 (NCI Thesaurus ValueDomain)
    C2986303 (UMLS CUI-1)
    C25320 (NCI Thesaurus ObjectClass)
    C42774 (NCI Thesaurus Property)
    Protocol Version
    Item
    Protocol Version
    text
    C25704 (NCI Thesaurus ValueDomain)
    C2985700 (UMLS CUI-1)
    C25320 (NCI Thesaurus ObjectClass)
    C25364 (NCI Thesaurus Property)
    Protocol Version Date
    Item
    Protocol Date
    date
    C25164 (NCI Thesaurus ValueDomain)
    C2985700 (UMLS CUI-1)
    C25320 (NCI Thesaurus ObjectClass)
    C0011008 (UMLS CUI-2)
    C25364 (NCI Thesaurus Property)
    C25367 (NCI Thesaurus ValueDomain-2)
    PageNumber
    Item
    Page #
    float
    C25337 (NCI Thesaurus Property)
    C0237753 (UMLS 2011AA Property)
    C25337 (NCI Thesaurus ValueDomain)
    C0237753 (UMLS 2011AA ValueDomain)
    C0439643 (NCI Metathesaurus ObjectClass)
    CaseReportFormTotalPageNumber
    Item
    Total Page Number
    text
    C40988 (NCI Thesaurus ObjectClass)
    C1516308 (UMLS 2011AA ObjectClass)
    C25337 (NCI Thesaurus Property)
    C0237753 (UMLS 2011AA Property)
    C25304 (NCI Thesaurus Property-2)
    C0439810 (UMLS 2011AA Property-2)
    C42783 (NCI Thesaurus Property-3)
    C1704732 (UMLS 2011AA Property-3)
    C25337 (NCI Thesaurus ValueDomain)
    C0237753 (UMLS 2011AA ValueDomain)
    DCPTemplateVersionText
    Item
    DCP Template Version
    text
    C25704 (NCI Thesaurus ValueDomain)
    C1527021 (UMLS 2011AA ValueDomain)
    C0728990 (NCI Metathesaurus ObjectClass)
    C25714 (NCI Thesaurus Property)
    C0333052 (UMLS 2011AA Property)
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