Información:
Error:
ID
10011
Descripción
Cidofovir in Treating HIV-Infected Patients With High-Grade Squamous Intraepithelial Lesions of the Skin Near the Anus NCT00550589 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=3BC16E2A-1509-2256-E044-0003BA3F9857
Link
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Versiones (2)
- 26/8/12 26/8/12 -
- 14/3/15 14/3/15 - Martin Dugas
Subido en
14 de marzo de 2015
DOI
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Licencia
Creative Commons BY-NC 3.0 Legacy
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Anal Cancer NCT00550589 Registration - AMC-046 Enrollment Form (ENR) Segment A - 2685912v1.0
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- StudyEvent: AMC-046 Enrollment Form (ENR) Segment A
Similar models
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- StudyEvent: AMC-046 Enrollment Form (ENR) Segment A
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Principal Investigator
Item
Principal Investigator
text
C25191 (NCI Thesaurus ValueDomain)
C25364 (NCI Thesaurus Property)
C19924 (NCI Thesaurus ObjectClass)
C1521895 (UMLS CUI-1)
C25364 (NCI Thesaurus Property)
C19924 (NCI Thesaurus ObjectClass)
C1521895 (UMLS CUI-1)
Age
Item
Age
integer
C16960 (NCI Thesaurus ObjectClass)
C29848 (NCI Thesaurus ValueDomain)
C25463 (NCI Thesaurus ValueDomain-2)
C25150 (NCI Thesaurus Property)
C0001779 (UMLS CUI-1)
C29848 (NCI Thesaurus ValueDomain)
C25463 (NCI Thesaurus ValueDomain-2)
C25150 (NCI Thesaurus Property)
C0001779 (UMLS CUI-1)
Informed Consent Date
Item
Date Informed Consent Signed
date
C25164 (NCI Thesaurus ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
C16468 (NCI Thesaurus ObjectClass)
C25679 (NCI Thesaurus Property)
C2985782 (UMLS CUI-1)
C25367 (NCI Thesaurus ValueDomain-2)
C16468 (NCI Thesaurus ObjectClass)
C25679 (NCI Thesaurus Property)
C2985782 (UMLS CUI-1)
ResearchCommentsText
Item
Comments
text
C25704 (NCI Thesaurus ValueDomain)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C0947611 (UMLS CUI-1)
Item
Inclusion Criteria
text
C16960 (NCI Thesaurus ObjectClass)
C19707 (NCI Thesaurus ObjectClass-2)
C16112 (NCI Thesaurus Property)
C25532 (NCI Thesaurus Property-2)
C25284 (NCI Thesaurus ValueDomain)
C1512693 (UMLS CUI-1)
C19707 (NCI Thesaurus ObjectClass-2)
C16112 (NCI Thesaurus Property)
C25532 (NCI Thesaurus Property-2)
C25284 (NCI Thesaurus ValueDomain)
C1512693 (UMLS CUI-1)
CL Item
Date Of Informed Consent (Date of informed consent)
CL Item
Does The Investigator Believe That The Participant Is Capable Of Complying With The Protocol (Does the investigator believe that the participant is capable of complying with the protocol)
CL Item
Does The Participant Have Documentation Of Hiv-1 Infection By Any Licensed Elisa Test Kit And Confirmed By Western Blot At Any Time Prior To Study Entry (Does the participant have documentation of HIV-1 infection by any licensed ELISA test kit and confirmed by Western blot at any time prior to study entry)
CL Item
Does The Participant Have The Ability And Willingness To Give Informed Consent (Does the participant have the ability and willingness to give informed consent)
CL Item
If Female, And Of Childbearing Potential, Has The Participant Had A Negative Urine Pregnancy Test Within The Past 7 Days (If female, and of childbearing potential, has the participant had a negative urine pregnancy test within the past 7 days)
CL Item
Participant's Age (in Years) (Participant's age (in years))
CL Item
3 months (Does the participant have a life expectancy >)
Item
Exclusion Criteria
text
C16960 (NCI Thesaurus ObjectClass)
C19707 (NCI Thesaurus ObjectClass-2)
C16112 (NCI Thesaurus Property)
C25370 (NCI Thesaurus Property-2)
C25284 (NCI Thesaurus ValueDomain)
C0680251 (UMLS CUI-1)
C19707 (NCI Thesaurus ObjectClass-2)
C16112 (NCI Thesaurus Property)
C25370 (NCI Thesaurus Property-2)
C25284 (NCI Thesaurus ValueDomain)
C0680251 (UMLS CUI-1)
CL Item
Does The Participant Have Concurrent Neoplasia Requiring Cytotoxic Therapy (Does the participant have concurrent neoplasia requiring cytotoxic therapy)
CL Item
Does The Participant Have Untreated Invasive Cancer Of The Lower Genital Tract (Does the participant have untreated invasive cancer of the lower genital tract)
CL Item
Is The Participant Pregnant Or Breast-feeding (Is the participant pregnant or breast-feeding)
CL Item
Is The Participant Receiving Corticosteroid Treatment, Other Than Replacement Doses (Is the participant receiving corticosteroid treatment, other than replacement doses)