ID

17650

Beschreibung

Sponsor: OSI Pharmaceuticals Information provided by (Responsible Party): Astellas Pharma Inc (OSI Pharmaceuticals) A multicenter, randomized, double-blind, placebo-controlled, phase 3 study of single-agent Tarceva® (erlotinib) following complete tumor resection with or without adjuvant chemotherapy in patients with stage IB-IIIA non-small cell lung carcinoma who have EGFR-positive tumors. See https://clinicaltrials.gov/ct2/show/NCT00373425 Part of study: Open-label Baseline Assessments

Link

https://clinicaltrials.gov/ct2/show/NCT00373425

Stichworte

Versionen (2)
  1. 02.08.16 02.08.16 -
  2. 27.09.16 27.09.16 -
Hochgeladen am

27. September 2016

DOI

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Lizenz

Creative Commons BY 4.0
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Open-label Baseline Assessments, Tarceva in NSCLC patients who have EGFR-positive tumors DRKS00001485 NCT00373425

Englisch

Open-label Baseline Assessments, Tarceva in NSCLC patients who have EGFR-positive tumors NCT00373425

1 Formulare  
Vital Assessment
Beschreibung

Vital Assessment

Date
Beschreibung

Assessment Date

Datentyp

date

Alias
UMLS CUI [1]
C2985720
Weight
Beschreibung

Weight

Datentyp

float

Maßeinheiten
  • kg
Alias
UMLS CUI [1]
C0005910
kg
ECOG performance status:
Beschreibung

ECOG

Datentyp

integer

Alias
UMLS CUI [1]
C1520224
Physical Examination
Beschreibung

Physical Examination

Date Physical Examination performed:
Beschreibung

Date of Examination

Datentyp

date

Alias
UMLS CUI [1]
C2826643
Pregnancy Test
Beschreibung

Pregnancy Test

Pregnancy Test: Not Applicable
Beschreibung

Pregnancy Test

Datentyp

boolean

Alias
UMLS CUI [1]
C0032976
Was pregnancy test performed?
Beschreibung

If applicable: Was pregnancy test performed?

Datentyp

boolean

Alias
UMLS CUI [1]
C0032976
Date of Collection
Beschreibung

Date of Collection

Datentyp

date

Alias
UMLS CUI [1,1]
C1516698
UMLS CUI [1,2]
C0032976
UMLS CUI [1,3]
C0011008
Accession Number
Beschreibung

Accession Number

Datentyp

text

Alias
UMLS CUI [1]
C2826726
Hematology
Beschreibung

Hematology

Date of Collection
Beschreibung

Date of Collection

Datentyp

date

Alias
UMLS CUI [1,1]
C0005834
UMLS CUI [1,2]
C0011008
Accession Number
Beschreibung

Accession Number

Datentyp

text

Alias
UMLS CUI [1]
C2826726
Biochemistry/Proteomics
Beschreibung

Biochemistry/Proteomics

Date of Collection
Beschreibung

Date of collection

Datentyp

date

Alias
UMLS CUI [1,1]
C0005834
UMLS CUI [1,2]
C0011008
Accession Number
Beschreibung

Accession Number

Datentyp

text

Alias
UMLS CUI [1]
C2826726
Cigarette Smoking Status
Beschreibung

Cigarette Smoking Status

Date of evaluation:
Beschreibung

Assessment Date

Datentyp

date

Alias
UMLS CUI [1]
C2985720
Cigarette Smoking Status
Beschreibung

Cigarette Smoking Status

Datentyp

integer

Alias
UMLS CUI [1,1]
C0543414
UMLS CUI [1,2]
C0677453
If patient is currently smoking cigarettes, indicate average number of cigarettes smoked per day:
Beschreibung

Number of cigarettes smoked per day

Datentyp

integer

Alias
UMLS CUI [1]
C3694146
Other Tobacco/Nicotine Use Status
Beschreibung

Other Tobacco/Nicotine Use Status

Other Tobacco/Nicotine Use
Beschreibung

Other Tobacco/Nicotine Use

Datentyp

integer

Alias
UMLS CUI [1]
C0543414
Cigars and/or Pipes: Not Applicable
Beschreibung

Cigars and Pipes

Datentyp

boolean

Alias
UMLS CUI [1]
C0337666
UMLS CUI [2]
C0240766
If a current user of cigars and/or pipes, indicate frequency used:
Beschreibung

Cigars and Pipes Frequency used

Datentyp

integer

Alias
UMLS CUI [1,1]
C0337666
UMLS CUI [1,2]
C0439603
UMLS CUI [2,1]
C0240766
UMLS CUI [2,2]
C0439603
Oral Tobacco Products: Not Applicable
Beschreibung

Oral Tobacco Products

Datentyp

boolean

Alias
UMLS CUI [1]
C0008038
If a current user of oral tobacco products, indicate frequency used:
Beschreibung

Oral Tobacco Products Frequency used

Datentyp

integer

Alias
UMLS CUI [1,1]
C0008038
UMLS CUI [1,2]
C0439603
Nicotine replacement therapy: Applicable?
Beschreibung

Nicotine Replacement Therapy

Datentyp

boolean

Alias
UMLS CUI [1]
C1278444
If a current user of nicotine replacement therapy, indicate frequency used:
Beschreibung

Nicotine Replacement Therapy Frequency used

Datentyp

integer

Alias
UMLS CUI [1,1]
C1278444
UMLS CUI [1,2]
C0439603
Other: Not Applicable
Beschreibung

Other tobacco/nicotine products

Datentyp

boolean

Alias
UMLS CUI [1]
C0543414
Other, please specify:
Beschreibung

Other tobacco/nicotine products

Datentyp

text

Alias
UMLS CUI [1]
C0543414
If a current user of other tobacco/nicotine products, indicate frequency used:
Beschreibung

Other tobacco/nicotine products frequency used

Datentyp

integer

Alias
UMLS CUI [1,1]
C0543414
UMLS CUI [1,2]
C0439603
Open-Label Tarceva Dispensed for Month 1
Beschreibung

Open-Label Tarceva Dispensed for Month 1

Date dispensed
Beschreibung

Open-label Tarceva: Date dispensed

Datentyp

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C0947323
UMLS CUI [1,3]
C1135136
Bottle number
Beschreibung

Bottle number

Datentyp

integer

Alias
UMLS CUI [1]
C1300638
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Ähnliche Modelle

Open-label Baseline Assessments, Tarceva in NSCLC patients who have EGFR-positive tumors NCT00373425

1 Formulare
Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
Alias
Item Group
Vital Assessment
Assessment Date
Item
Date
date
C2985720 (UMLS CUI [1])
Weight
Item
Weight
float
C0005910 (UMLS CUI [1])
ECOG
Item
ECOG performance status:
integer
C1520224 (UMLS CUI [1])
Item Group
Physical Examination
Date of Examination
Item
Date Physical Examination performed:
date
C2826643 (UMLS CUI [1])
Item Group
Pregnancy Test
Pregnancy Test
Item
Pregnancy Test: Not Applicable
boolean
C0032976 (UMLS CUI [1])
Pregnancy test
Item
Was pregnancy test performed?
boolean
C0032976 (UMLS CUI [1])
Date of Collection
Item
Date of Collection
date
C1516698 (UMLS CUI [1,1])
C0032976 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
Accession Number
Item
Accession Number
text
C2826726 (UMLS CUI [1])
Item Group
Hematology
Date of Collection
Item
Date of Collection
date
C0005834 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Accession Number
Item
Accession Number
text
C2826726 (UMLS CUI [1])
Item Group
Biochemistry/Proteomics
Date of collection
Item
Date of Collection
date
C0005834 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Accession Number
Item
Accession Number
text
C2826726 (UMLS CUI [1])
Item Group
Cigarette Smoking Status
Assessment Date
Item
Date of evaluation:
date
C2985720 (UMLS CUI [1])
Item
Cigarette Smoking Status
integer
C0543414 (UMLS CUI [1,1])
C0677453 (UMLS CUI [1,2])
Cigarette Smoking History
Code List
Cigarette Smoking Status
CL Item
Patient not currently smoking cigarettes. (1)
CL Item
Patient is currently smoking cigarettes. (2)
Number of cigarettes smoked per day
Item
If patient is currently smoking cigarettes, indicate average number of cigarettes smoked per day:
integer
C3694146 (UMLS CUI [1])
Item Group
Other Tobacco/Nicotine Use Status
Item
Other Tobacco/Nicotine Use
integer
C0543414 (UMLS CUI [1])
Other Tobacco/Nicotine History
Code List
Other Tobacco/Nicotine Use
CL Item
Patient not currently using other tobacco or nicotine products. Do not complete next questions. (1)
CL Item
Patient currently using other tobacco or nicotine products. Complete next questions. (2)
Cigars and Pipes
Item
Cigars and/or Pipes: Not Applicable
boolean
C0337666 (UMLS CUI [1])
C0240766 (UMLS CUI [2])
Item
If a current user of cigars and/or pipes, indicate frequency used:
integer
C0337666 (UMLS CUI [1,1])
C0439603 (UMLS CUI [1,2])
C0240766 (UMLS CUI [2,1])
C0439603 (UMLS CUI [2,2])
Cigar and Pipe Smoking
Code List
If a current user of cigars and/or pipes, indicate frequency used:
CL Item
at least once daily (1)
CL Item
at least once weekly (2)
CL Item
at least once monthly (3)
CL Item
< once monthly (4)
Oral Tobacco Products
Item
Oral Tobacco Products: Not Applicable
boolean
C0008038 (UMLS CUI [1])
Item
If a current user of oral tobacco products, indicate frequency used:
integer
C0008038 (UMLS CUI [1,1])
C0439603 (UMLS CUI [1,2])
Cigar and Pipe Smoking
Code List
If a current user of oral tobacco products, indicate frequency used:
CL Item
at least once daily (1)
CL Item
at least once weekly (2)
CL Item
at least once monthly (3)
CL Item
< once monthly (4)
Nicotine Replacement Therapy
Item
Nicotine replacement therapy: Applicable?
boolean
C1278444 (UMLS CUI [1])
Item
If a current user of nicotine replacement therapy, indicate frequency used:
integer
C1278444 (UMLS CUI [1,1])
C0439603 (UMLS CUI [1,2])
Cigar and Pipe Smoking
Code List
If a current user of nicotine replacement therapy, indicate frequency used:
CL Item
at least once daily (1)
CL Item
at least once weekly (2)
CL Item
at least once monthly (3)
CL Item
< once monthly (4)
Other tobacco/nicotine products
Item
Other: Not Applicable
boolean
C0543414 (UMLS CUI [1])
Other tobacco/nicotine products
Item
Other, please specify:
text
C0543414 (UMLS CUI [1])
Item
If a current user of other tobacco/nicotine products, indicate frequency used:
integer
C0543414 (UMLS CUI [1,1])
C0439603 (UMLS CUI [1,2])
Cigar and Pipe Smoking
Code List
If a current user of other tobacco/nicotine products, indicate frequency used:
CL Item
at least once daily (1)
CL Item
at least once weekly (2)
CL Item
at least once monthly (3)
CL Item
< once monthly (4)
Item Group
Open-Label Tarceva Dispensed for Month 1
Open-label Tarceva: Date dispensed
Item
Date dispensed
date
C0011008 (UMLS CUI [1,1])
C0947323 (UMLS CUI [1,2])
C1135136 (UMLS CUI [1,3])
Bottle number
Item
Bottle number
integer
C1300638 (UMLS CUI [1])
Zum Seitenanfang zurückkehren 

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