ID

599

Description

NCI Cooperative Group Clinical Chemistry Laboratory Test Form (CALGB-90104) Combination Chemotherapy in Treating Patients With Bladder Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A9C02D4A-83A3-26C1-E034-0003BA12F5E7

Lien

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A9C02D4A-83A3-26C1-E034-0003BA12F5E7

Mots-clés

  1. 26/08/2012 26/08/2012 -
  2. 08/01/2015 08/01/2015 - Martin Dugas
Téléchargé le

26 août 2012

DOI

Pour une demande vous connecter.

Licence

Creative Commons BY-NC 3.0 Legacy

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Bladder Cancer NCT00014534 Lab - NCI Cooperative Group Clinical Chemistry Laboratory Test Form (CALGB-90104) - 2056328v3.0

No Instruction available.

  1. StudyEvent: NCI Cooperative Group Clinical Chemistry Laboratory Test Form (CALGB-90104)
    1. No Instruction available.
Mskcc 00-138; Calgb-90104; Ecog
Description

Mskcc 00-138; Calgb-90104; Ecog

Coordinating Group Protocol Number
Description

CoordinatingGroupProtocolNumber

Type de données

text

Coordinating Group Code
Description

CoordinatingGroupCode

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25162
UMLS 2011AA ValueDomain
C0805701
Protocol Title
Description

ProtocolTitle

Type de données

text

Alias
NCI Thesaurus ObjectClass
C25320
UMLS 2011AA ObjectClass
C1507394
NCI Thesaurus Property
C42774
UMLS 2011AA Property
C1705823
Patient Study ID, Coordinating Group
Description

PatientStudyID,CoordinatingGroup

Type de données

text

Patient Study ID, Participating Group
Description

PatientStudyID,ParticipatingGroup

Type de données

text

Participating Group Code
Description

ParticipatingGroupCode

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25162
UMLS 2011AA ValueDomain
C0805701
Institution Name
Description

InstitutionName

Type de données

text

Affiliate
Description

AffiliateName

Type de données

text

Patient Last Name (initials acceptable)
Description

PatientName,Last

Type de données

text

Patient First Name (initials acceptable)
Description

PatientName,First

Type de données

text

Patient Middle Name (initials acceptable)
Description

PatientName,Middle

Type de données

text

Form Administration
Description

Form Administration

Person Completing Form, Last Name
Description

PersonCompletingForm,LastName

Type de données

text

Person Completing Form, First Name
Description

PersonCompletingForm,FirstName

Type de données

text

Alias
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Are data amended?
Description

AmendedDataInd

Type de données

text

Alias
NCI Thesaurus ObjectClass
C25474
UMLS 2011AA ObjectClass
C1511726
NCI Thesaurus Property
C25416
UMLS 2011AA Property
C1691222
BUN
Description

Lab,Renal,BUN

Type de données

double

Calcium
Description

Lab,Electrolytes,Calcium

Type de données

double

Bilirubin
Description

Lab,Hepatic,Bilirubin

Type de données

double

Total Protein
Description

TotalProtein

Type de données

text

Albumin
Description

Lab,Chemistry,Albumin

Type de données

double

Alkaline Phosphatase
Description

Lab,Hepatic,AlkalinePhosphatase

Type de données

double

SGOT (AST)
Description

Lab,Hepatic,SGOT

Type de données

double

Glucose
Description

Glucose

Type de données

text

Creatinine
Description

Lab,Renal,Creatinine

Type de données

double

Sodium
Description

Lab,Electrolytes,Sodium

Type de données

double

Potassium
Description

Lab,Electrolytes,Potassium

Type de données

double

Chloride
Description

Lab,Electrolytes,Chloride

Type de données

double

Carbon Dioxide
Description

CarbonDioxide

Type de données

text

Magnesium
Description

LaboratoryProcedureMagnesiumResultSpecifiedValue

Type de données

double

Unités de mesure
  • mmol/L
Alias
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus Property
C29239
UMLS 2011AA Property
C0024467
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
NCI Thesaurus ValueDomain
C38024
UMLS 2011AA ValueDomain
C0205369
mmol/L
SGPT (ALT)
Description

Lab,Hepatic,SGPT

Type de données

double

Unit (Normal Range)
Description

Lab,UnitsofMeasure

Type de données

text

Normal Range-BUN
Description

LaboratoryProcedureBloodUreaNitrogenResultUpperLimitNormalValue

Type de données

double

Alias
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus Property
C61019
UMLS 2011AA Property
C0005845
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
NCI Thesaurus ValueDomain
C25706
UMLS 2011AA ValueDomain
C1519815
Normal Range-Calcium
Description

LaboratoryProcedureCalciumElectrolytesOutcomeLowerLimitofNormalValue

Type de données

double

Alias
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property
C331
UMLS 2011AA Property
C0006675
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus Property
C464
UMLS 2011AA Property
C0013832
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
NCI Thesaurus ValueDomain
C25555
UMLS 2011AA ValueDomain
C1518030
Normal Range-Bilirubin
Description

HepaticBilirubinLabUpperLimitNormalValue

Type de données

double

Alias
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus Property
C305
UMLS 2011AA Property
C0005437
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
NCI Thesaurus ValueDomain
C25706
UMLS 2011AA ValueDomain
C1519815
Normal Range-Total Protein
Description

NormalRange-TotalProtein

Type de données

text

Normal Range-Albumin
Description

LaboratoryProcedureAlbuminResultLowerLimitofNormalValue

Type de données

double

Alias
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus Property
C214
UMLS 2011AA Property
C0001924
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
NCI Thesaurus ValueDomain
C25555
UMLS 2011AA ValueDomain
C1518030
Normal Range-Alkaline Phosphatase
Description

LaboratoryProcedureAlkalinePhosphataseResultUpperLimitNormalValue

Type de données

double

Alias
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus Property
C16276
UMLS 2011AA Property
C0002059
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
NCI Thesaurus ValueDomain
C25706
UMLS 2011AA ValueDomain
C1519815
Normal Range-SGOT (AST)
Description

SGOTLabUpperLimitNormalValue

Type de données

double

Alias
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
NCI Thesaurus ValueDomain
C25706
UMLS 2011AA ValueDomain
C1519815
Normal Range-Glucose
Description

NormalRange-Glucose

Type de données

text

Normal Range-Creatinine
Description

LaboratoryProcedureCreatinineResultUpperLimitNormalValue

Type de données

double

Alias
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus Property
C399
UMLS 2011AA Property
C0010294
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
NCI Thesaurus ValueDomain
C25706
UMLS 2011AA ValueDomain
C1519815
Normal Range-Sodium
Description

LaboratoryProcedureSodiumElectrolytesOutcomeLowerLimitofNormalValue

Type de données

double

Alias
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus Property
C830
UMLS 2011AA Property
C0037473
NCI Thesaurus Property
C464
UMLS 2011AA Property
C0013832
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
NCI Thesaurus ValueDomain
C25555
UMLS 2011AA ValueDomain
C1518030
Normal Range-Potassium
Description

LaboratoryProcedurePotassiumElectrolytesOutcomeLowerLimitNormalValue

Type de données

double

Alias
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus Property
C464
UMLS 2011AA Property
C0013832
NCI Thesaurus Property
C765
UMLS 2011AA Property
C0032821
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
NCI Thesaurus ValueDomain
C25555
UMLS 2011AA ValueDomain
C1518030
Normal Range-Chloride
Description

LaboratoryProcedureChlorideIonElectrolytesOutcomeLowerLimitofNormalValue

Type de données

double

Alias
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus Property
C464
UMLS 2011AA Property
C0013832
NCI Thesaurus Property
C1741
UMLS 2011AA Property
C0596019
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
NCI Thesaurus ValueDomain
C25555
UMLS 2011AA ValueDomain
C1518030
Normal Range-Carbon Dioxide
Description

NormalRange-CarbonDioxide

Type de données

text

Normal Range-Magnesium
Description

NormalRange-Magnesium

Type de données

text

Normal Range-SGPT (ALT)
Description

SGPTLabUpperLimitNormalValue

Type de données

double

Alias
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
NCI Thesaurus ValueDomain
C25706
UMLS 2011AA ValueDomain
C1519815
Labs, Sample Collection Dates
Description

Labs,SampleCollectionDate

Type de données

date

Comments
Description

Comments

Comments
Description

Comments

Type de données

text

Ccrr Module For Nci Cooperative Group Clinical Chemistry Laboratory Test Form (calgb-90104)
Description

Ccrr Module For Nci Cooperative Group Clinical Chemistry Laboratory Test Form (calgb-90104)

Similar models

No Instruction available.

  1. StudyEvent: NCI Cooperative Group Clinical Chemistry Laboratory Test Form (CALGB-90104)
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Type de données
Alias
Item Group
Mskcc 00-138; Calgb-90104; Ecog
CoordinatingGroupProtocolNumber
Item
Coordinating Group Protocol Number
text
CoordinatingGroupCode
Item
Coordinating Group Code
text
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
ProtocolTitle
Item
Protocol Title
text
C25320 (NCI Thesaurus ObjectClass)
C1507394 (UMLS 2011AA ObjectClass)
C42774 (NCI Thesaurus Property)
C1705823 (UMLS 2011AA Property)
PatientStudyID,CoordinatingGroup
Item
Patient Study ID, Coordinating Group
text
PatientStudyID,ParticipatingGroup
Item
Patient Study ID, Participating Group
text
ParticipatingGroupCode
Item
Participating Group Code
text
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
InstitutionName
Item
Institution Name
text
AffiliateName
Item
Affiliate
text
PatientName,Last
Item
Patient Last Name (initials acceptable)
text
PatientName,First
Item
Patient First Name (initials acceptable)
text
PatientName,Middle
Item
Patient Middle Name (initials acceptable)
text
Item Group
Form Administration
PersonCompletingForm,LastName
Item
Person Completing Form, Last Name
text
PersonCompletingForm,FirstName
Item
Person Completing Form, First Name
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
Item
Are data amended?
text
C25474 (NCI Thesaurus ObjectClass)
C1511726 (UMLS 2011AA ObjectClass)
C25416 (NCI Thesaurus Property)
C1691222 (UMLS 2011AA Property)
Code List
Are data amended?
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Lab,Renal,BUN
Item
BUN
double
Lab,Electrolytes,Calcium
Item
Calcium
double
Lab,Hepatic,Bilirubin
Item
Bilirubin
double
TotalProtein
Item
Total Protein
text
Lab,Chemistry,Albumin
Item
Albumin
double
Lab,Hepatic,AlkalinePhosphatase
Item
Alkaline Phosphatase
double
Lab,Hepatic,SGOT
Item
SGOT (AST)
double
Glucose
Item
Glucose
text
Lab,Renal,Creatinine
Item
Creatinine
double
Lab,Electrolytes,Sodium
Item
Sodium
double
Lab,Electrolytes,Potassium
Item
Potassium
double
Lab,Electrolytes,Chloride
Item
Chloride
double
CarbonDioxide
Item
Carbon Dioxide
text
LaboratoryProcedureMagnesiumResultSpecifiedValue
Item
Magnesium
double
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C29239 (NCI Thesaurus Property)
C0024467 (UMLS 2011AA Property)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C38024 (NCI Thesaurus ValueDomain)
C0205369 (UMLS 2011AA ValueDomain)
Lab,Hepatic,SGPT
Item
SGPT (ALT)
double
Item
Unit (Normal Range)
text
Code List
Unit (Normal Range)
CL Item
Mg/dl (mg/dL)
CL Item
G/dl (g/dL)
CL Item
U/l (U/L)
CL Item
Mmol/l (mmol/L)
CL Item
Meq/l (mEq/L)
CL Item
Units (Units)
LaboratoryProcedureBloodUreaNitrogenResultUpperLimitNormalValue
Item
Normal Range-BUN
double
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C61019 (NCI Thesaurus Property)
C0005845 (UMLS 2011AA Property)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25706 (NCI Thesaurus ValueDomain)
C1519815 (UMLS 2011AA ValueDomain)
LaboratoryProcedureCalciumElectrolytesOutcomeLowerLimitofNormalValue
Item
Normal Range-Calcium
double
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C331 (NCI Thesaurus Property)
C0006675 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C464 (NCI Thesaurus Property)
C0013832 (UMLS 2011AA Property)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25555 (NCI Thesaurus ValueDomain)
C1518030 (UMLS 2011AA ValueDomain)
HepaticBilirubinLabUpperLimitNormalValue
Item
Normal Range-Bilirubin
double
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C305 (NCI Thesaurus Property)
C0005437 (UMLS 2011AA Property)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25706 (NCI Thesaurus ValueDomain)
C1519815 (UMLS 2011AA ValueDomain)
NormalRange-TotalProtein
Item
Normal Range-Total Protein
text
LaboratoryProcedureAlbuminResultLowerLimitofNormalValue
Item
Normal Range-Albumin
double
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C214 (NCI Thesaurus Property)
C0001924 (UMLS 2011AA Property)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25555 (NCI Thesaurus ValueDomain)
C1518030 (UMLS 2011AA ValueDomain)
LaboratoryProcedureAlkalinePhosphataseResultUpperLimitNormalValue
Item
Normal Range-Alkaline Phosphatase
double
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C16276 (NCI Thesaurus Property)
C0002059 (UMLS 2011AA Property)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25706 (NCI Thesaurus ValueDomain)
C1519815 (UMLS 2011AA ValueDomain)
SGOTLabUpperLimitNormalValue
Item
Normal Range-SGOT (AST)
double
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25706 (NCI Thesaurus ValueDomain)
C1519815 (UMLS 2011AA ValueDomain)
NormalRange-Glucose
Item
Normal Range-Glucose
text
LaboratoryProcedureCreatinineResultUpperLimitNormalValue
Item
Normal Range-Creatinine
double
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C399 (NCI Thesaurus Property)
C0010294 (UMLS 2011AA Property)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25706 (NCI Thesaurus ValueDomain)
C1519815 (UMLS 2011AA ValueDomain)
LaboratoryProcedureSodiumElectrolytesOutcomeLowerLimitofNormalValue
Item
Normal Range-Sodium
double
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C830 (NCI Thesaurus Property)
C0037473 (UMLS 2011AA Property)
C464 (NCI Thesaurus Property)
C0013832 (UMLS 2011AA Property)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25555 (NCI Thesaurus ValueDomain)
C1518030 (UMLS 2011AA ValueDomain)
LaboratoryProcedurePotassiumElectrolytesOutcomeLowerLimitNormalValue
Item
Normal Range-Potassium
double
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C464 (NCI Thesaurus Property)
C0013832 (UMLS 2011AA Property)
C765 (NCI Thesaurus Property)
C0032821 (UMLS 2011AA Property)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25555 (NCI Thesaurus ValueDomain)
C1518030 (UMLS 2011AA ValueDomain)
LaboratoryProcedureChlorideIonElectrolytesOutcomeLowerLimitofNormalValue
Item
Normal Range-Chloride
double
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C464 (NCI Thesaurus Property)
C0013832 (UMLS 2011AA Property)
C1741 (NCI Thesaurus Property)
C0596019 (UMLS 2011AA Property)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25555 (NCI Thesaurus ValueDomain)
C1518030 (UMLS 2011AA ValueDomain)
NormalRange-CarbonDioxide
Item
Normal Range-Carbon Dioxide
text
NormalRange-Magnesium
Item
Normal Range-Magnesium
text
SGPTLabUpperLimitNormalValue
Item
Normal Range-SGPT (ALT)
double
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25706 (NCI Thesaurus ValueDomain)
C1519815 (UMLS 2011AA ValueDomain)
Labs,SampleCollectionDate
Item
Labs, Sample Collection Dates
date
Item Group
Comments
Comments
Item
Comments
text
Item Group
Ccrr Module For Nci Cooperative Group Clinical Chemistry Laboratory Test Form (calgb-90104)

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