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1 forms
  1. StudyEvent: VEGF-AS Administration Form for Protocol 043
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Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Administration Form
Cycle Number
Item
Course number
integer
C25337 (NCI Thesaurus ValueDomain)
C2045829 (UMLS CUI-1)
C15368 (NCI Thesaurus ObjectClass)
C25379 (NCI Thesaurus Property)
Treatment Begin Date
Item
Treatment start date for this course
date
C15368 (NCI Thesaurus ObjectClass)
C25431 (NCI Thesaurus Property)
C3173309 (UMLS CUI-1)
C25275 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25431 (NCI Thesaurus ValueDomain-2)
Medication Dose
Item
Dose administered
float
C25488 (NCI Thesaurus ValueDomain)
C3174092 (UMLS CUI-1)
C1708 (NCI Thesaurus ObjectClass)
C1708 (NCI Thesaurus ValueDomain-2)
C25382 (NCI Thesaurus Property)
Item
Has the patient received a dose escalation or dose reduction of this agent during this administration
text
C25180 (NCI Thesaurus ValueDomain)
C1707811 (UMLS CUI-1)
C25256 (NCI Thesaurus ObjectClass)
C25572 (NCI Thesaurus Property)
C25572 (NCI Thesaurus ValueDomain-2)
CL.2
Code List
Has the patient received a dose escalation or dose reduction of this agent during this administration
CL Item
Yes, Planned (i.e., The Treatment Was Changed According To Protocol Guidelines) (Yes, planned)
CL Item
Yes, Unplanned (i.e., The Treatment Change Was Not Part Of Protocol Guidelines) (Yes, unplanned)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
AdverseEventOccurrenceIndicator
Item
Did the patient experience any adverse events
boolean
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
CL209504 (NCI Metathesaurus Property)
Item
Dose assigned
text
CL.1
Code List
Dose assigned
CL Item
50 mg (50 mg)
CL Item
100 mg (100 mg)
CL Item
150 mg (150 mg)
CL Item
200 mg (200 mg)
havealladverseeventsbeenreportedontheAdverseEventForm
Item
have all adverse events been reported on the Adverse Event Form
boolean
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