ID
10654
Descripción
CALGB 90601: Supplemental Adverse Event Form (Thromboembolic Events) NCT00942331 Gemcitabine Hydrochloride and Cisplatin With or Without Bevacizumab in Treating Patients With Advanced Urinary Tract Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=65940F04-CD97-54E2-E040-BB89AD435A8C
Link
Palabras clave
Versiones (3)
- 26/8/12 26/8/12 -
- 8/1/15 8/1/15 - Martin Dugas
- 3/6/15 3/6/15 -
Subido en
3 de junio de 2015
DOI
Para solicitar uno, por favor iniciar sesión.
Licencia
Creative Commons BY-NC 3.0 Legacy
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CALGB 90601: Supplemental Adverse Event Form (Thromboembolic Events) NCT00942331
INSTRUCTIONS: Complete and submit this form as required by the protocol. Information in the upper right box must be completed for this form to be accepted.
- StudyEvent: CALGB 90601: Supplemental Adverse Event Form (Thromboembolic Events)
Descripción
Patient demographics
Descripción
Patient Initials
Tipo de datos
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS CUI-1
- C2986440
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25536
Descripción
Medical Record Number
Tipo de datos
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C1301894
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C25261
- NCI Thesaurus Property-2
- C25198
Descripción
Institution Name
Tipo de datos
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
Descripción
Participating Group
Tipo de datos
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS CUI-1
- C2347449
- NCI Thesaurus ObjectClass
- C25608
- NCI Thesaurus ObjectClass-2
- C17005
- NCI Thesaurus Property
- C25364
Descripción
Study Number Participating Group
Tipo de datos
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C3274381
- NCI Thesaurus ObjectClass
- C25320
- UMLS CUI-2
- C2347449
- NCI Thesaurus Property
- C25608
- NCI Thesaurus Property-2
- C25364
Descripción
Trial subject ID Participating Group
Tipo de datos
text
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C2348585
- NCI Thesaurus ObjectClass
- C16960
- UMLS CUI-2
- C2347449
- NCI Thesaurus Property
- C25608
- NCI Thesaurus Property-2
- C25364
Descripción
Assessment of medication
Descripción
Cycle Number
Tipo de datos
integer
Alias
- NCI Thesaurus ValueDomain
- C25337
- UMLS CUI-1
- C2045829
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus Property
- C25379
Descripción
ReceivedMedicationReportingPeriodType
Tipo de datos
text
Alias
- NCI Thesaurus ObjectClass
- C459
- UMLS 2011AA ObjectClass
- C0013227
- NCI Thesaurus ObjectClass-2
- C25639
- UMLS 2011AA ObjectClass-2
- C1514756
- NCI Thesaurus Property
- C25616
- UMLS 2011AA Property
- C1948053
- NCI Thesaurus Property-2
- C25651
- UMLS 2011AA Property-2
- C0700287
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
Descripción
NonsteroidalAntiinflammatoryDrugMedicationReportingPeriodSpecify
Tipo de datos
text
Alias
- NCI Thesaurus ObjectClass
- C459
- UMLS 2011AA ObjectClass
- C0013227
- NCI Thesaurus ObjectClass-2
- C257
- UMLS 2011AA ObjectClass-2
- C0003211
- NCI Thesaurus Property
- C25616
- UMLS 2011AA Property
- C1948053
- NCI Thesaurus Property-2
- C25651
- UMLS 2011AA Property-2
- C0700287
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
Descripción
AntiplateletMedicationReportingPeriodSpecify
Tipo de datos
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
- NCI Thesaurus Property
- C25616
- UMLS 2011AA Property
- C1948053
- NCI Thesaurus ObjectClass
- C459
- UMLS 2011AA ObjectClass
- C0013227
- NCI Thesaurus Property-2
- C25651
- UMLS 2011AA Property-2
- C0700287
- NCI Thesaurus ObjectClass-2
- C1327
- UMLS 2011AA ObjectClass-2
- C0085826
Descripción
LipidLoweringMedicationReportingPeriodSpecify
Tipo de datos
text
Alias
- NCI Thesaurus ObjectClass
- C459
- UMLS 2011AA ObjectClass
- C0013227
- NCI Metathesaurus ObjectClass
- CL264271
- NCI Thesaurus Property
- C25616
- UMLS 2011AA Property
- C1948053
- NCI Thesaurus Property-2
- C25651
- UMLS 2011AA Property-2
- C0700287
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
Descripción
CardiacMedicationReportingPeriodSpecify
Tipo de datos
text
Alias
- NCI Thesaurus ObjectClass
- C13306
- UMLS 2011AA ObjectClass
- C1522601
- NCI Thesaurus ObjectClass-2
- C459
- UMLS 2011AA ObjectClass-2
- C0013227
- NCI Thesaurus Property
- C25616
- UMLS 2011AA Property
- C1948053
- NCI Thesaurus Property-2
- C25651
- UMLS 2011AA Property-2
- C0700287
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
Descripción
AnticoagulantMedicationReportingPeriodSpecify
Tipo de datos
text
Alias
- NCI Thesaurus ObjectClass
- C459
- UMLS 2011AA ObjectClass
- C0013227
- NCI Thesaurus ObjectClass-2
- C263
- UMLS 2011AA ObjectClass-2
- C0003280
- NCI Thesaurus Property
- C25616
- UMLS 2011AA Property
- C1948053
- NCI Thesaurus Property-2
- C25651
- UMLS 2011AA Property-2
- C0700287
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
Descripción
ArterialThrombosisReportingPeriodType
Tipo de datos
text
Alias
- NCI Thesaurus ObjectClass
- C26891
- UMLS 2011AA ObjectClass
- C0040053
- NCI Metathesaurus ObjectClass
- C0221464
- NCI Thesaurus Property
- C25616
- UMLS 2011AA Property
- C1948053
- NCI Thesaurus Property-2
- C25651
- UMLS 2011AA Property-2
- C0700287
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
Descripción
ArterialThrombosisReportingPeriodSpecify
Tipo de datos
text
Alias
- NCI Thesaurus ObjectClass
- C26891
- UMLS 2011AA ObjectClass
- C0040053
- NCI Metathesaurus ObjectClass
- C0221464
- NCI Thesaurus Property
- C25616
- UMLS 2011AA Property
- C1948053
- NCI Thesaurus Property-2
- C25651
- UMLS 2011AA Property-2
- C0700287
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
Descripción
ArterialThrombosisTherapyType
Tipo de datos
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus ObjectClass
- C26891
- UMLS 2011AA ObjectClass
- C0040053
- NCI Thesaurus Property
- C15368
- NCI Metathesaurus ObjectClass
- C0221464
Descripción
ArterialThrombosisOutcomeType
Tipo de datos
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus ObjectClass
- C26891
- UMLS 2011AA ObjectClass
- C0040053
- NCI Metathesaurus ObjectClass
- C0221464
- NCI Metathesaurus Property
- CL158230
Descripción
VenousThrombosisReportingPeriodType
Tipo de datos
text
Alias
- NCI Thesaurus ObjectClass
- C26891
- UMLS 2011AA ObjectClass
- C0040053
- NCI Thesaurus ObjectClass-2
- C25291
- UMLS 2011AA ObjectClass-2
- C0348013
- NCI Thesaurus Property
- C25616
- UMLS 2011AA Property
- C1948053
- NCI Thesaurus Property-2
- C25651
- UMLS 2011AA Property-2
- C0700287
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
Descripción
VenousThrombosisReportingPeriodSpecify
Tipo de datos
text
Alias
- NCI Thesaurus ObjectClass
- C26891
- UMLS 2011AA ObjectClass
- C0040053
- NCI Thesaurus ObjectClass-2
- C25291
- UMLS 2011AA ObjectClass-2
- C0348013
- NCI Thesaurus Property
- C25616
- UMLS 2011AA Property
- C1948053
- NCI Thesaurus Property-2
- C25651
- UMLS 2011AA Property-2
- C0700287
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
Descripción
VenousThrombosisReportingPeriodStatus
Tipo de datos
text
Alias
- NCI Thesaurus ObjectClass
- C26891
- UMLS 2011AA ObjectClass
- C0040053
- NCI Thesaurus ObjectClass-2
- C25291
- UMLS 2011AA ObjectClass-2
- C0348013
- NCI Thesaurus Property
- C25616
- UMLS 2011AA Property
- C1948053
- NCI Thesaurus Property-2
- C25651
- UMLS 2011AA Property-2
- C0700287
- NCI Thesaurus ValueDomain
- C25688
- UMLS 2011AA ValueDomain
- C0449438
Descripción
VenousThrombosisTreatmentType
Tipo de datos
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus ObjectClass
- C26891
- UMLS 2011AA ObjectClass
- C0040053
- NCI Thesaurus ObjectClass-2
- C25291
- UMLS 2011AA ObjectClass-2
- C0348013
- NCI Metathesaurus Property
- C0087111
Descripción
VenousThrombosisOutcomeType
Tipo de datos
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus ObjectClass
- C26891
- UMLS 2011AA ObjectClass
- C0040053
- NCI Thesaurus ObjectClass-2
- C25291
- UMLS 2011AA ObjectClass-2
- C0348013
- NCI Metathesaurus Property
- CL158230
Descripción
Person Completing Form
Tipo de datos
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS CUI-1
- C1550483
- NCI Thesaurus ObjectClass
- C25657
- NCI Thesaurus Property
- C25364
Descripción
Date Form Completed
Tipo de datos
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C1115437
- NCI Thesaurus ObjectClass
- C40988
- NCI Thesaurus Property
- C25250
- NCI Thesaurus ValueDomain-2
- C25367
Similar models
INSTRUCTIONS: Complete and submit this form as required by the protocol. Information in the upper right box must be completed for this form to be accepted.
- StudyEvent: CALGB 90601: Supplemental Adverse Event Form (Thromboembolic Events)
C3262252 (UMLS CUI-1)
C19464 (NCI Thesaurus ObjectClass)
C1516238 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25442 (NCI Thesaurus ObjectClass-2)
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C1516238 (UMLS CUI-2)
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C25442 (NCI Thesaurus Property-2)
C25616 (NCI Thesaurus Property)
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C2361259 (UMLS CUI-1)
C25616 (NCI Thesaurus Property)
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C25651 (NCI Thesaurus Property-2)
C0680532 (UMLS CUI-1)
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C25416 (NCI Thesaurus Property)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C1301894 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25261 (NCI Thesaurus Property)
C25198 (NCI Thesaurus Property-2)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C25191 (NCI Thesaurus ValueDomain)
C21541 (NCI Thesaurus ValueDomain-2)
C2347449 (UMLS CUI-1)
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C17005 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
C2045829 (UMLS CUI-1)
C15368 (NCI Thesaurus ObjectClass)
C25379 (NCI Thesaurus Property)
C0013227 (UMLS 2011AA ObjectClass)
C25639 (NCI Thesaurus ObjectClass-2)
C1514756 (UMLS 2011AA ObjectClass-2)
C25616 (NCI Thesaurus Property)
C1948053 (UMLS 2011AA Property)
C25651 (NCI Thesaurus Property-2)
C0700287 (UMLS 2011AA Property-2)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C0549184 (UMLS 2011AA)
C0013227 (UMLS 2011AA ObjectClass)
C257 (NCI Thesaurus ObjectClass-2)
C0003211 (UMLS 2011AA ObjectClass-2)
C25616 (NCI Thesaurus Property)
C1948053 (UMLS 2011AA Property)
C25651 (NCI Thesaurus Property-2)
C0700287 (UMLS 2011AA Property-2)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C25616 (NCI Thesaurus Property)
C1948053 (UMLS 2011AA Property)
C459 (NCI Thesaurus ObjectClass)
C0013227 (UMLS 2011AA ObjectClass)
C25651 (NCI Thesaurus Property-2)
C0700287 (UMLS 2011AA Property-2)
C1327 (NCI Thesaurus ObjectClass-2)
C0085826 (UMLS 2011AA ObjectClass-2)
C0013227 (UMLS 2011AA ObjectClass)
CL264271 (NCI Metathesaurus ObjectClass)
C25616 (NCI Thesaurus Property)
C1948053 (UMLS 2011AA Property)
C25651 (NCI Thesaurus Property-2)
C0700287 (UMLS 2011AA Property-2)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C1522601 (UMLS 2011AA ObjectClass)
C459 (NCI Thesaurus ObjectClass-2)
C0013227 (UMLS 2011AA ObjectClass-2)
C25616 (NCI Thesaurus Property)
C1948053 (UMLS 2011AA Property)
C25651 (NCI Thesaurus Property-2)
C0700287 (UMLS 2011AA Property-2)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C0013227 (UMLS 2011AA ObjectClass)
C263 (NCI Thesaurus ObjectClass-2)
C0003280 (UMLS 2011AA ObjectClass-2)
C25616 (NCI Thesaurus Property)
C1948053 (UMLS 2011AA Property)
C25651 (NCI Thesaurus Property-2)
C0700287 (UMLS 2011AA Property-2)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C0040053 (UMLS 2011AA ObjectClass)
C0221464 (NCI Metathesaurus ObjectClass)
C25616 (NCI Thesaurus Property)
C1948053 (UMLS 2011AA Property)
C25651 (NCI Thesaurus Property-2)
C0700287 (UMLS 2011AA Property-2)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C0549184 (UMLS 2011AA)
C0027051 (UMLS 2011AA)
C0002962 (UMLS 2011AA)
C0040053 (UMLS 2011AA ObjectClass)
C0221464 (NCI Metathesaurus ObjectClass)
C25616 (NCI Thesaurus Property)
C1948053 (UMLS 2011AA Property)
C25651 (NCI Thesaurus Property-2)
C0700287 (UMLS 2011AA Property-2)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C26891 (NCI Thesaurus ObjectClass)
C0040053 (UMLS 2011AA ObjectClass)
C15368 (NCI Thesaurus Property)
C0221464 (NCI Metathesaurus ObjectClass)
C0332307 (UMLS 2011AA ValueDomain)
C26891 (NCI Thesaurus ObjectClass)
C0040053 (UMLS 2011AA ObjectClass)
C0221464 (NCI Metathesaurus ObjectClass)
CL158230 (NCI Metathesaurus Property)
C1709863 (UMLS 2011AA)
C0040053 (UMLS 2011AA ObjectClass)
C25291 (NCI Thesaurus ObjectClass-2)
C0348013 (UMLS 2011AA ObjectClass-2)
C25616 (NCI Thesaurus Property)
C1948053 (UMLS 2011AA Property)
C25651 (NCI Thesaurus Property-2)
C0700287 (UMLS 2011AA Property-2)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C0549184 (UMLS 2011AA)
C0040053 (UMLS 2011AA ObjectClass)
C25291 (NCI Thesaurus ObjectClass-2)
C0348013 (UMLS 2011AA ObjectClass-2)
C25616 (NCI Thesaurus Property)
C1948053 (UMLS 2011AA Property)
C25651 (NCI Thesaurus Property-2)
C0700287 (UMLS 2011AA Property-2)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C0040053 (UMLS 2011AA ObjectClass)
C25291 (NCI Thesaurus ObjectClass-2)
C0348013 (UMLS 2011AA ObjectClass-2)
C25616 (NCI Thesaurus Property)
C1948053 (UMLS 2011AA Property)
C25651 (NCI Thesaurus Property-2)
C0700287 (UMLS 2011AA Property-2)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
C0231221 (UMLS 2011AA)
C0231220 (UMLS 2011AA)
C0332307 (UMLS 2011AA ValueDomain)
C26891 (NCI Thesaurus ObjectClass)
C0040053 (UMLS 2011AA ObjectClass)
C25291 (NCI Thesaurus ObjectClass-2)
C0348013 (UMLS 2011AA ObjectClass-2)
C0087111 (NCI Metathesaurus Property)
C0332307 (UMLS 2011AA ValueDomain)
C26891 (NCI Thesaurus ObjectClass)
C0040053 (UMLS 2011AA ObjectClass)
C25291 (NCI Thesaurus ObjectClass-2)
C0348013 (UMLS 2011AA ObjectClass-2)
CL158230 (NCI Metathesaurus Property)
C1709863 (UMLS 2011AA)
C1550483 (UMLS CUI-1)
C25657 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)
C1115437 (UMLS CUI-1)
C40988 (NCI Thesaurus ObjectClass)
C25250 (NCI Thesaurus Property)
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