ID

9741

Descripción

E1900 Hematology Form Combination Chemotherapy With or Without Monoclonal Antibody Therapy Followed by Stem Cell Transplant in Treating Patients With Acute Myeloid Leukemia NCT00049517 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A729522D-1C90-2FD4-E034-0003BA0B1A09

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A729522D-1C90-2FD4-E034-0003BA0B1A09

Palabras clave

Versiones (2)
  1. 19/9/12 19/9/12 -
  2. 21/1/15 21/1/15 - Martin Dugas
Subido en

21 de enero de 2015

DOI

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Licencia

Creative Commons BY-NC 3.0 Legacy
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Hematology Form AML (E1900, NCT00049517)

Alemán Inglés

No Instruction available.

1 formularios  
  1. StudyEvent: E1900 Hematology Form
    1. No Instruction available.
Header
Descripción

Header

ECOG Protocol No.
Descripción

ECOGProtocolNo.

Tipo de datos

text

Alias
UMLS CUI-1
C3274381
UMLS CUI-2
C1512162
ECOG Patient ID
Descripción

ECOGPatientID

Tipo de datos

text

Alias
UMLS CUI-1
C2348585
UMLS CUI-2
C1512162
Registration Step
Descripción

RegistrationStep

Tipo de datos

text

Alias
UMLS CUI-1
C1514821
Reporting period
Descripción

TreatmentPhase

Tipo de datos

text

Alias
UMLS CUI-1
C3538994
Patient's Name
Descripción

Patient Name

Tipo de datos

text

Alias
UMLS CUI-1
C1299487
Participating Group Protocol No.
Descripción

Participating Group ProtocolNo.

Tipo de datos

text

Alias
UMLS CUI-1
C3274381
UMLS CUI-2
C2347449
Participating Group Patient ID
Descripción

ParticipatingGroupPatientID

Tipo de datos

text

Alias
UMLS CUI-1
C2348585
UMLS CUI-2
C2347449
Institution/Affiliate
Descripción

MainMemberInstitution/Affiliate

Tipo de datos

text

Alias
UMLS CUI-1
C1301943
Are data amended? (If yes, please circle amended items in red)
Descripción

AmendedDataInd

Tipo de datos

boolean

Alias
NCI Thesaurus ObjectClass
C25474
NCI Thesaurus Property
C25416
UMLS CUI-1
C0680532
Comments
Descripción

Comments

Tipo de datos

text

Investigator Signature
Descripción

InvestigatorSignature

Tipo de datos

text

Alias
NCI Thesaurus Property
C25678
UMLS 2011AA Property
C1519316
NCI Thesaurus ObjectClass
C17089
UMLS 2011AA ObjectClass
C0035173
Date
Descripción

InvestigatorSignatureDate

Tipo de datos

date

Hematology lab
Descripción

Hematology lab

Alias
UMLS CUI-1
C0474523
Laboratory Name
Descripción

SpecimenLabIdentifierName

Tipo de datos

text

Alias
NCI Thesaurus ValueDomain
C25191
NCI Thesaurus Property
C25364
NCI Thesaurus ObjectClass
C37984
NCI Thesaurus ObjectClass-2
C19157
UMLS CUI-1
C1882331
Date obtained
Descripción

Lab,Hematology,SampleCollectionDate

Tipo de datos

date

Unidades de medida
  • M D Y
Alias
UMLS CUI-1
C1317250
M D Y
Peripheral WBC count (x1000), LLN
Descripción

WBCcount(x1000),LLN

Tipo de datos

float

Alias
UMLS CUI-1
C0023508
UMLS CUI-2
C1518030
Peripheral WBC count (x1000), Value
Descripción

Lab,Hematology,WBC

Tipo de datos

float

Alias
UMLS CUI-1
C0023508
Granulocyte count AGC/ANC
Descripción

Lab,Hematology,GranulocyteCount

Tipo de datos

float

Alias
UMLS CUI-1
C0857490
Peripheral Platelet count (x1000), LLN (Peripheral Platelet count x1000, Value)
Descripción

Plateletscount(x1000),LLN

Tipo de datos

float

Alias
NCI Thesaurus ValueDomain
C25712
NCI Thesaurus ValueDomain-2
C25555
UMLS CUI-1
C0005821
UMLS CUI-2
C1518030
Platelets
Descripción

Platelets

Tipo de datos

float

Alias
UMLS CUI-1
C0005821
Hemoglobin LLN
Descripción

Hemoglobin(g/dl),LLN

Tipo de datos

float

Unidades de medida
  • g/dl
Alias
UMLS CUI-1
C0019046
UMLS CUI-2
C1518030
g/dl
Hemoglobin Value
Descripción

Lab,Hematology,Hemoglobin

Tipo de datos

float

Unidades de medida
  • g/dl
Alias
UMLS CUI-1
C0019046
g/dl
Blasts
Descripción

Lab,Hematology,Blasts,CellPercentage

Tipo de datos

float

Unidades de medida
  • %
Alias
UMLS CUI-1
C1982687
%
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Similar models

No Instruction available.

1 formularios
  1. StudyEvent: E1900 Hematology Form
    1. No Instruction available.
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
Header
ECOG Protocol Number
Item
ECOG Protocol No.
text
C3274381 (UMLS CUI-1)
C1512162 (UMLS CUI-2)
ECOG Patient ID
Item
ECOG Patient ID
text
C2348585 (UMLS CUI-1)
C1512162 (UMLS CUI-2)
Registration Step
Item
Registration Step
text
C1514821 (UMLS CUI-1)
Item
Reporting period
text
C3538994 (UMLS CUI-1)
CL.1
Code List
Reporting period
CL Item
Current Phase Of Leukemia Treatment For Patient Is Induction (induction)
CL Item
Current Phase Of Leukemia Treatment For Patient Is Consolidation (consolidation)
CL Item
post transplant (post transplant)
Patient Name
Item
Patient's Name
text
C1299487 (UMLS CUI-1)
Participating Group Protocol Number
Item
Participating Group Protocol No.
text
C3274381 (UMLS CUI-1)
C2347449 (UMLS CUI-2)
Participating Group Patient ID
Item
Participating Group Patient ID
text
C2348585 (UMLS CUI-1)
C2347449 (UMLS CUI-2)
Institution
Item
Institution/Affiliate
text
C1301943 (UMLS CUI-1)
Data amended
Item
Are data amended? (If yes, please circle amended items in red)
boolean
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
C0680532 (UMLS CUI-1)
Comments
Item
Comments
text
InvestigatorSignature
Item
Investigator Signature
text
C25678 (NCI Thesaurus Property)
C1519316 (UMLS 2011AA Property)
C17089 (NCI Thesaurus ObjectClass)
C0035173 (UMLS 2011AA ObjectClass)
InvestigatorSignatureDate
Item
Date
date
Item Group
Hematology lab
C0474523 (UMLS CUI-1)
Laboratory Name
Item
Laboratory Name
text
C25191 (NCI Thesaurus ValueDomain)
C25364 (NCI Thesaurus Property)
C37984 (NCI Thesaurus ObjectClass)
C19157 (NCI Thesaurus ObjectClass-2)
C1882331 (UMLS CUI-1)
Sample Collection Date
Item
Date obtained
date
C1317250 (UMLS CUI-1)
WBC LLN
Item
Peripheral WBC count (x1000), LLN
float
C0023508 (UMLS CUI-1)
C1518030 (UMLS CUI-2)
WBC count
Item
Peripheral WBC count (x1000), Value
float
C0023508 (UMLS CUI-1)
Granulocyte count
Item
Granulocyte count AGC/ANC
float
C0857490 (UMLS CUI-1)
Platelets LLN
Item
Peripheral Platelet count (x1000), LLN (Peripheral Platelet count x1000, Value)
float
C25712 (NCI Thesaurus ValueDomain)
C25555 (NCI Thesaurus ValueDomain-2)
C0005821 (UMLS CUI-1)
C1518030 (UMLS CUI-2)
Platelets
Item
Platelets
float
C0005821 (UMLS CUI-1)
Hemoglobin LLN
Item
Hemoglobin LLN
float
C0019046 (UMLS CUI-1)
C1518030 (UMLS CUI-2)
Hemoglobin
Item
Hemoglobin Value
float
C0019046 (UMLS CUI-1)
Blasts
Item
Blasts
float
C1982687 (UMLS CUI-1)
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