ID

9699

Description

AMC-052 Vaccine Administration Form Human Papillomavirus Vaccine Therapy in Treating Men With HIV-1 Infection NCT00513526 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=39520C70-99B3-4542-E044-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=39520C70-99B3-4542-E044-0003BA3F9857

Keywords

Versions (2)
  1. 9/19/12 9/19/12 -
  2. 1/16/15 1/16/15 - Martin Dugas
Uploaded on

January 16, 2015

DOI

To request one please log in.

License

Creative Commons BY-NC 3.0 Legacy
Model comments :

You can comment on the data model here. Via the speech bubbles at the itemgroups and items you can add comments to those specificially.

Back to model comments
Itemgroup comments for :

Item comments for :

In order to download data models you must be logged in. Please log in or register for free.

Vaccine Administration Form (NCT00513526)

German English

Vaccine Administration Form (NCT00513526)

1 forms  
  1. StudyEvent: AMC-052 Vaccine Administration Form
    1. Vaccine Administration Form (NCT00513526)
Impfung
Description

Impfung

Alias
UMLS CUI-1
C0042196
Vaccination Date
Description

Vaccination Date

Data type

date

Measurement units
  • MM DD YYYY
Alias
NCI Thesaurus ValueDomain
C25164
NCI Thesaurus ValueDomain-2
C25367
NCI Thesaurus ObjectClass
C923
NCI Thesaurus Property
C25382
UMLS CUI-1
C1115436
MM DD YYYY
Vaccination Site
Description

Vaccination Site

Data type

text

Alias
NCI Thesaurus ValueDomain
C13717
NCI Thesaurus ObjectClass
C923
NCI Thesaurus Property
C25382
UMLS CUI-1
C1116171
Vaccine amount
Description

Vaccine amount

Data type

float

Measurement units
  • ml
Alias
NCI Thesaurus ObjectClass
C923
NCI Thesaurus Property
C25382
NCI Thesaurus ValueDomain
C25417
UMLS CUI-1
C0042210
UMLS CUI-2
C1265611
ml
Vaccination Time
Description

Vaccination Time

Data type

time

Measurement units
  • hh:mm (24 hour clock)
Alias
NCI Thesaurus ObjectClass
C923
NCI Thesaurus ValueDomain
C25207
NCI Thesaurus Property
C25382
UMLS CUI-1
C1115436
hh:mm (24 hour clock)
Dose deferred
Description

Dose deferred

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C38148
NCI Thesaurus Property
C25477
NCI Thesaurus ObjectClass
C25488
UMLS CUI-1
C0178602
UMLS CUI-2
C0205421
Delay Duration
Description

Delay Duration

Data type

durationDatetime

Alias
NCI Thesaurus Property
C25477
NCI Thesaurus ObjectClass
C1708
NCI Thesaurus Property-2
C25409
NCI Thesaurus ValueDomain
C25330
UMLS CUI-1
C2985752
Syncope following vaccination
Description

Syncope following vaccination

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C38147
NCI Thesaurus ObjectClass
C41331
NCI Thesaurus ObjectClass-2
C15346
NCI Thesaurus Property
C35053
UMLS CUI-1
C0039070
UMLS CUI-2
C0042196
Back to the top of the page

Similar models

Vaccine Administration Form (NCT00513526)

1 forms
  1. StudyEvent: AMC-052 Vaccine Administration Form
    1. Vaccine Administration Form (NCT00513526)
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Impfung
C0042196 (UMLS CUI-1)
Vaccination Date
Item
date
C25164 (NCI Thesaurus ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
C923 (NCI Thesaurus ObjectClass)
C25382 (NCI Thesaurus Property)
C1115436 (UMLS CUI-1)
Item
text
C13717 (NCI Thesaurus ValueDomain)
C923 (NCI Thesaurus ObjectClass)
C25382 (NCI Thesaurus Property)
C1116171 (UMLS CUI-1)
CL.1
Code List
Vaccination Site
CL Item
 (Dominant arm)
CL Item
 (Nondominant arm)
CL Item
 (Right thigh)
CL Item
 (Left thigh)
Vaccine amount
Item
float
C923 (NCI Thesaurus ObjectClass)
C25382 (NCI Thesaurus Property)
C25417 (NCI Thesaurus ValueDomain)
C0042210 (UMLS CUI-1)
C1265611 (UMLS CUI-2)
Vaccination Time
Item
time
C923 (NCI Thesaurus ObjectClass)
C25207 (NCI Thesaurus ValueDomain)
C25382 (NCI Thesaurus Property)
C1115436 (UMLS CUI-1)
Dose deferred
Item
boolean
C38148 (NCI Thesaurus ValueDomain)
C25477 (NCI Thesaurus Property)
C25488 (NCI Thesaurus ObjectClass)
C0178602 (UMLS CUI-1)
C0205421 (UMLS CUI-2)
Delay Duration
Item
durationDatetime
C25477 (NCI Thesaurus Property)
C1708 (NCI Thesaurus ObjectClass)
C25409 (NCI Thesaurus Property-2)
C25330 (NCI Thesaurus ValueDomain)
C2985752 (UMLS CUI-1)
Syncope following vaccination
Item
boolean
C38147 (NCI Thesaurus ValueDomain)
C41331 (NCI Thesaurus ObjectClass)
C15346 (NCI Thesaurus ObjectClass-2)
C35053 (NCI Thesaurus Property)
C0039070 (UMLS CUI-1)
C0042196 (UMLS CUI-2)
Back to the top of the page 

Contact

Please use this form for feedback, questions and suggestions for improvements.

Fields marked with * are required.

Help

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