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  1. StudyEvent: AMC-045 Concomitant Medication Form (MED)
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Ccrr Module For Concomitant Antiretroviral Medications - Rf08
C2347852 (UMLS CUI-1)
Agent
Item
Agent Name
text
C25364 (NCI Thesaurus Property)
C1708 (NCI Thesaurus ObjectClass)
C1708 (NCI Thesaurus ValueDomain)
C42614 (NCI Thesaurus ValueDomain)
C1372955 (UMLS CUI-1)
AgentDoseLevelBeginDate
Item
Dose Level Start Date
date
C1708 (NCI Thesaurus ObjectClass)
C0450442 (UMLS 2011AA ObjectClass)
C25488 (NCI Thesaurus Property)
C0178602 (UMLS 2011AA Property)
C25554 (NCI Thesaurus Property)
C0441889 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25431 (NCI Thesaurus ValueDomain)
C0439659 (UMLS 2011AA ValueDomain)
DailyAgentTotalDose
Item
Total Daily Dose of Agent (or Drug)
double
C25473 (NCI Thesaurus ObjectClass)
C0332173 (UMLS 2011AA ObjectClass)
C1708 (NCI Thesaurus ObjectClass)
C0450442 (UMLS 2011AA ObjectClass)
C25304 (NCI Thesaurus Property)
C0439810 (UMLS 2011AA Property)
C25256 (NCI Thesaurus Property)
C1265611 (UMLS 2011AA Property)
C25488 (NCI Thesaurus ValueDomain)
C0178602 (UMLS 2011AA ValueDomain)
C1708 (NCI Thesaurus ValueDomain)
C0450442 (UMLS 2011AA ValueDomain)
Item
Units
text
C1708 (NCI Thesaurus ObjectClass)
C25730 (NCI Thesaurus Property)
C25409 (NCI Thesaurus Property)
C25709 (NCI Thesaurus ValueDomain)
C1519795 (UMLS CUI-1)
Code List
Units
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
CL Item
Milligram (mg)
CL Item
Microgram (µg)
CL Item
Milliliter (ml)
CL Item
Unit (U)
CL Item
International Unit (IU)
CL Item
Capsules (Caps)
CL Item
Tablets (Tabl)
CL Item
Drops (Dr)
AgentConcomitantAdministrationSpecify
Item
Other, specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C1708 (NCI Thesaurus ObjectClass)
C0450442 (UMLS 2011AA ObjectClass)
C25730 (NCI Thesaurus Property)
C0521115 (UMLS 2011AA Property)
C25409 (NCI Thesaurus Property)
C1533734 (UMLS 2011AA Property)
Item
Frequency
text
C1708 (NCI Thesaurus ObjectClass)
C0450442 (UMLS 2011AA ObjectClass)
C25515 (NCI Thesaurus ValueDomain)
C0439603 (UMLS 2011AA ValueDomain)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
Code List
Frequency
CL Item
Once A Day (q.d.) (Once a day (Q.D.))
CL Item
Twice A Day (b.i.d) (twice a day (B.I.D))
CL Item
Three Times A Day (t.i.d) (three times a day (T.I.D))
CL Item
Four Times A Day (q.i.d) (four times a day (Q.I.D))
CL Item
>4x/day (>4X/day)
CL Item
Every 4 Hours (q4hr) (every 4 hours (Q4hr))
CL Item
Every 6 Hours (q6hr) (every 6 hours (Q6hr))
CL Item
Every 8 Hours (q8hr) (every 8 hours (Q8hr))
CL Item
Every 12 Hours (q12hr) (every 12 hours (Q12hr))
CL Item
At Bedtime Or Hour Of Sleep (h.s.) (at bedtime or hour of sleep (H.S.))
CL Item
Every Other Day (q.o.d.) (every other day (Q.O.D.))
CL Item
Weekly (Weekly)
CL158132 (NCI Metathesaurus)
CL Item
Monthly (Monthly)
CL Item
As Needed (p.r.n) (as needed (P.R.N))
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
AgentAdministeredFrequencySpecify
Item
Other, specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C1708 (NCI Thesaurus ObjectClass)
C0450442 (UMLS 2011AA ObjectClass)
C25409 (NCI Thesaurus ObjectClass)
C1533734 (UMLS 2011AA ObjectClass)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
Anti-RetroviralAgentsAdministeredInd-2
Item
Is this an antiretroviral agent
boolean
C38147 (NCI Thesaurus ValueDomain)
C25382 (NCI Thesaurus Property)
C0599685 (NCI Metathesaurus ObjectClass)
C1512698 (UMLS CUI-1)
C1521801 (UMLS CUI-2)
Anti-RetroviralAgentsNotAdministeredReason
Item
Please provide indication (If "no")
text
C25638 (NCI Thesaurus ValueDomain)
C0392360 (UMLS 2011AA ValueDomain)
C25594 (NCI Thesaurus Property)
C1518422 (UMLS 2011AA Property)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
C0599685 (NCI Metathesaurus ObjectClass)
ConcomitantMedicationAdministrationCurrentInd-3
Item
Is use of this agent ongoing
boolean
C459 (NCI Thesaurus ObjectClass)
C25730 (NCI Thesaurus ObjectClass)
C25409 (NCI Thesaurus Property)
C38148 (NCI Thesaurus ValueDomain)
C25471 (NCI Thesaurus ValueDomain)
C0013227 (UMLS CUI-1)
C0521115 (UMLS CUI-2)
C1533734 (UMLS CUI-3)
C1512699 (UMLS CUI-4)
C0521116 (UMLS CUI-5)
ConcomitantMedicationAdministrationLastDate
Item
Date last taken (If "no" mm/dd/yyyy)
date
C459 (NCI Thesaurus ObjectClass)
C0013227 (UMLS 2011AA ObjectClass)
C25730 (NCI Thesaurus ObjectClass)
C0521115 (UMLS 2011AA ObjectClass)
C25409 (NCI Thesaurus Property)
C1533734 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25551 (NCI Thesaurus ValueDomain)
C1517741 (UMLS 2011AA ValueDomain)
Item Group
Comments
C0947611 (UMLS CUI-1)
ResearchCommentsText
Item
Comments
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C0282411 (UMLS 2011AA Property)

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