ID

7485

Description

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

Lien

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

Mots-clés

Versions (4)
  1. 19/09/2012 19/09/2012 - Philipp Bruland
  2. 26/11/2014 26/11/2014 - Martin Dugas
  3. 26/11/2014 26/11/2014 - Martin Dugas
  4. 09/01/2015 09/01/2015 - Martin Dugas
Téléchargé le

9 janvier 2015

DOI

Pour une demande vous connecter.

Licence

Creative Commons BY-NC 3.0 Legacy
Modèle Commentaires :

Ici, vous pouvez faire des commentaires sur le modèle. À partir des bulles de texte, vous pouvez laisser des commentaires spécifiques sur les groupes Item et les Item.

Retour au modèle Commentaires
Groupe Item commentaires pour :

Item commentaires pour :

Vous devez être connecté pour pouvoir télécharger des formulaires. Veuillez vous connecter ou s’inscrire gratuitement.

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

Anglais

No Instruction available.

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

Administrative documentation

Alias
UMLS CUI-1
C1320722
SWOG Patient ID
Description

Trial subject ID SWOG

Type de données

float

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C2348585
NCI Thesaurus ObjectClass
C16960
UMLS CUI-2
C1519429
NCI Thesaurus Property
C25364
NCI Thesaurus Property-2
C25699
SWOG Study No.
Description

Protocol ID SWOG

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C3274381
NCI Thesaurus ObjectClass
C25320
UMLS CUI-2
C1519429
NCI Thesaurus Property
C25364
NCI Thesaurus Property-2
C25699
Registration Step
Description

Registration Number

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C1514821
NCI Thesaurus ObjectClass
C25646
UMLS CUI-2
C0237753
NCI Thesaurus Property
C16154
NCI Thesaurus ValueDomain-2
C16154
Patient Initials (L, F M)
Description

Patient Initials

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C2986440
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25536
Institution/Affiliate
Description

Institution Name

Type de données

text

Alias
NCI Thesaurus ObjectClass
C25454
UMLS CUI-1
C1301943
NCI Thesaurus ObjectClass-2
C21541
NCI Thesaurus Property
C25364
NCI Thesaurus ValueDomain
C25191
NCI Thesaurus ValueDomain-2
C21541
Physician
Description

Investigator Name

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C2826892
NCI Thesaurus Property
C25364
NCI Thesaurus ObjectClass
C17089
NCI Thesaurus ObjectClass-2
C25644
Treatment Number
Description

PlannedAssessmentPeriodType

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus Property
C25616
UMLS 2011AA Property
C1948053
Date Log Started
Description

DiaryMedicationPainBeginDate

Type de données

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus Property
C3303
UMLS 2011AA Property
C0030193
NCI Thesaurus ObjectClass
C459
UMLS 2011AA ObjectClass
C0013227
Analgesics
Description

Analgesics

Alias
UMLS CUI-1
C0002771
Name of Pain Medication (Nurse and Patient)
Description

Analgesics

Type de données

text

Alias
NCI Thesaurus Property
C3303
UMLS CUI-1
C0002771
NCI Thesaurus ObjectClass
C459
NCI Thesaurus ValueDomain
C42614
Medication Type
Description

MedicationPainAdministeredType

Type de données

integer

Alias
NCI Thesaurus ValueDomain
C25284
NCI Thesaurus Property
C3303
NCI Thesaurus ObjectClass
C459
UMLS CUI-1
C0332307
UMLS CUI-2
C0030193
UMLS CUI-3
C0013227
Analgesic Code (+)
Description

AnalgesicsMedicationPainType

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus Property
C3303
UMLS 2011AA Property
C0030193
NCI Thesaurus ObjectClass
C459
UMLS 2011AA ObjectClass
C0013227
Dose (Units ^)
Description

Medication Dose

Type de données

float

Alias
NCI Thesaurus ValueDomain
C25488
UMLS CUI-1
C3174092
NCI Thesaurus ObjectClass
C1708
NCI Thesaurus ValueDomain-2
C1708
NCI Thesaurus Property
C25382
Number of pain meds taken at this dose Tallies (/)
Description

TotalMedicationPainText

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus Property
C3303
UMLS 2011AA Property
C0030193
NCI Thesaurus ObjectClass
C459
UMLS 2011AA ObjectClass
C0013227
Number of pain meds taken at this dose Total
Description

TotalMedicationPainCount

Type de données

float

Alias
NCI Thesaurus Property
C3303
UMLS 2011AA Property
C0030193
NCI Thesaurus ObjectClass
C459
UMLS 2011AA ObjectClass
C0013227
NCI Thesaurus ValueDomain
C25463
UMLS 2011AA ValueDomain
C0750480
Retour au début de la page

Similar models

No Instruction available.

1 Formulaires
  1. StudyEvent: S0205 PAIN MEDICATION LOG
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Type de données
Alias
Item Group
Administrative documentation
C1320722 (UMLS CUI-1)
Trial subject ID SWOG
Item
SWOG Patient ID
float
C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1519429 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25699 (NCI Thesaurus Property-2)
Protocol ID SWOG
Item
SWOG Study No.
text
C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1519429 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25699 (NCI Thesaurus Property-2)
Registration Number
Item
Registration Step
text
C25337 (NCI Thesaurus ValueDomain)
C1514821 (UMLS CUI-1)
C25646 (NCI Thesaurus ObjectClass)
C0237753 (UMLS CUI-2)
C16154 (NCI Thesaurus Property)
C16154 (NCI Thesaurus ValueDomain-2)
Patient Initials
Item
Patient Initials (L, F M)
text
C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
Institution Name
Item
Institution/Affiliate
text
C25454 (NCI Thesaurus ObjectClass)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C25191 (NCI Thesaurus ValueDomain)
C21541 (NCI Thesaurus ValueDomain-2)
Investigator Name
Item
Physician
text
C25191 (NCI Thesaurus ValueDomain)
C2826892 (UMLS CUI-1)
C25364 (NCI Thesaurus Property)
C17089 (NCI Thesaurus ObjectClass)
C25644 (NCI Thesaurus ObjectClass-2)
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)
CL.1
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)
CL.2
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)
CL.3
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)
Medication Dose
Item
Dose (Units ^)
float
C25488 (NCI Thesaurus ValueDomain)
C3174092 (UMLS CUI-1)
C1708 (NCI Thesaurus ObjectClass)
C1708 (NCI Thesaurus ValueDomain-2)
C25382 (NCI Thesaurus 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
float
C3303 (NCI Thesaurus Property)
C0030193 (UMLS 2011AA Property)
C459 (NCI Thesaurus ObjectClass)
C0013227 (UMLS 2011AA ObjectClass)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
Retour au début de la page 

Contact

Utilisez ce formulaire pour les retours, les questions et les améliorations suggérées.

Les champs marqués d’un * sont obligatoires.

Aide

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial