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Long NameVital Signs NCI Standard Template
DefinitionThe collection of CDEs used in the vital signs modules.
ContextcaBIG
Protocol Long NameNCI Standard Template Forms
WorkflowDRAFT NEW
TypeCRF
Public ID3476772
Version1.0
Module Long NameModule InstructionsQuestionCDECDE Public IDCDE VersionQuestion InstructionsValue Domain Data TypeValue Domain Unit of MeasureDisplay FormatValid ValueForm Value Meaning TextForm Value Meaning Desc.
Optional Vital Signs QuestionsThere is no requirement for inclusion of these elements on the case report form. If the design and scientific questions posed in the study dictate the need to collect this type of data, these elements should be included.
Date of MeasurementMeasurement Vital Signs Occurrence Date28298081.0DATE
Time of MeasurementMeasurement Vital Signs Occurrence Time28298121.0NUMBER
Participant PositionParticipant Position Type20084322.0CHARACTER
ProneProne PositionAn anterior recumbent body position whereby the person lies on its stomach and faces downward.
SemiproneSemiproneLying on side, lateral recumbent
SittingSittingThe state or act of one who sits; the posture of one who occupies a seat.
StandingStandingThe act of assuming or maintaining an erect upright position.
SupineSupine PositionA posterior recumbent body position whereby the person lies on its back and faces upward.
UnknownUnknownNot known, not observed, not recorded, or refused.
UprightUprightErect, perpendicular position
Performance Status (Karnofsky)Karnofsky Performance Status Score20038534.2CHARACTER
0DeadDead
10Moribund, fatal processes progressing rapidlyMoribund, fatal processes progressing rapidly
20Very sick, hospitalization indicated. Death not imminentVery sick, hospitalization indicated. Death not imminent
30Severely disabled, hospitalization indicated. Death not imminentSeverely disabled, hospitalization indicated. Death not imminent
40Disabled, requires special care and assistanceDisabled, requires special care and assistance
50Requires considerable assistance and frequent medical careRequires considerable assistance and frequent medical care
60Requires occasional assistance, but is able to care for most of his/her needsRequires occasional assistance, but is able to care for most of his/her needs
70Cares for self, unable to carry on normal activity or to do active workCares for self, unable to carry on normal activity or to do active work
80Normal activity with effort; some signs or symptoms of diseaseNormal activity with effort; some signs or symptoms of disease
90Able to carry on normal activity; minor signs or symptoms of diseaseAble to carry on normal activity; minor signs or symptoms of disease
100Normal, no complaints, no evidence of diseaseNormal, no complaints, no evidence of disease
Performance Status (Zubrod)Zubrod Performance Status Score20033154.2CHARACTER
0Normal ActivityNormal Activity
1Symptoms, but nearly fully ambulatorySymptoms, but nearly fully ambulatory
2Some bed time, but needs to be in bed <50% of normal daytimeSome bed time, but needs to be in bed <50% of normal daytime
3Needs to be in bed > 50% of normal daytimeNeeds to be in bed > 50% of normal daytime
4Unable to get out of bedUnable to get out of bed
Performance Status (Lansky)Lansky Performance Status Score21801581.1CHARACTER
0UnresponsiveUnresponsive, according to the Lansky performance scale
10No play; does not get out of bed.No play; does not get out of bed. (Lansky Performance Status Scale)
20Often sleeping; play entirely limited to very passive activities. Often sleeping; play entirely limited to very passive activities. (Lansky Performance Status Scale)
30In bed; needs assistance even for quiet play.In bed; needs assistance even for quiet play. (Lansky Performance Status Scale)
40Mostly in bed; participates in quiet activities. Mostly in bed; participates in quiet activities. (Lansky Performance Status Scale)
50Gets dressed, but lies around much of the day; no active play, able to participate in all quiet play and activities.Gets dressed, but lies around much of the day; no active play, able to participate in all quiet play and activities. (Lansky Performance Status Scale)
60Up and around, but minimal active play; keeps busy with quieter activities.Up and around, but minimal active play; keeps busy with quieter activities. (Lansky performance status scale)
70Both greater restriction of and less time spent in play activityBoth greater restriction of and less time spent in play activity according to the Lansky scale.
80Active, but tires more quicklyActive, but tires more quickly according to the Lansky scale.
90Minor restrictions in physically strenuous activityMinor restrictions in physically strenuous activity according to the Lansky scale.
100Fully active, normalFull active, normal according to the Lansky scale
Performance Status (ECOG)Performance Status Assessment Eastern Cooperative Oncology Group Scale885.1CHARACTER
0Fully active, able to carry on all pre-disease performance without restriction.Fully active, able to carry on all pre-disease performance without restriction.
1Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature, e.g., light housework, office work.Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature, e.g., light housework, office work.
2Ambulatory and capable of all selfcare but unable to carry out any work activities. Up and about more than 50% of waking hours.Ambulatory and capable of all selfcare but unable to carry out any work activities. Up and about more than 50% of waking hours.
3Capable of only limited selfcare, confined to bed or chair more than 50% of waking hours.Capable of only limited selfcare, confined to bed or chair more than 50% of waking hours.
4Completely disabled. Cannot carry on any selfcare. Totally confined to bed or chair.Completely disabled. Cannot carry on any selfcare. Totally confined to bed or chair.
5DeadDead
WeightPerson Weight Value21796894.0NUMBER
Ideal WeightPerson Ideal Body Weight Value29562481.0NUMBER
Weight Unit of Measure UCUM CodePerson Weight Unit of Measure Unified Code for Units of Measure Code26302001.0CHARACTER
[lb_av]PoundA traditional unit of mass. By international agreement, one avoirdupois pound is equal to exactly 0.453 592 37 kilogram, 16 ounces, or 1.215 28 troy pounds.
[oz_av]OunceThe traditional unit of mass. The avoirdupois ounce is equal to 1/16 pound, or 28.3495 grams, or 0.911 457 troy ounce.
ggramgram
kgkilogramkilogram
HeightPerson Height Value21796434.0NUMBER
Height Unit of Measure UCUM CodePerson Height Unit of Measure Unified Code for Units of Measure Code25389201.0CHARACTER
[ft_i][ft_i]Foot (International customary units) UCUM Code
[in_i][in_i]inch (International Customary Units) UCUM Code
cmCENTIMETERA centimeter is a basic unit of length in the former CGS version of metric system, equal to one hundredth of a meter or approximately 0.393 700 787 inch.
mMeterThe unit of linear measure in the metric system, one of the seven base units of the International System of Units (Systeme International d'Unites, SI). Meter is defined as the length of the path traveled by light in a vacuum during a time interval of 1/299 792 458 of a second and is equal to 1.093 61 yards.
BSAPerson Body Surface Area Value6536.0NUMBERm2
Body Mass Index (BMI)Person Body Mass Index Value20064103.0NUMBERkg/m2
Body TemperaturePerson Vital Signs Temperature Physical Examination Value26444011.0NUMBER999.9
Temperature Unit of Measure UCUM CodePerson Temperature Unified Code for Units of Measure Code29562671.0CHARACTER
CELCelsiusCelsius (International customary units) UCUM Code
[degF]FahrenheitFahrenheit (International customary units) UCUM Code
PulsePulse Rate Measurement Value27670731.0NUMBER
Pulse OxPulse Oximetry Value21862141.0NUMBER%
Respiratory RatePerson Vital Signs Respiratory Rate Physical Examination Value26443991.0NUMBER
Systolic BPSystolic Blood Pressure Value20042891.0NUMBERmmHg
Diastolic BPDiastolic Blood Pressure Value20042911.0NUMBERmmHg
CommentsResearch Comments Text7975.0CHARACTER
Comments DateComment Created Date29562531.0DATEMM/DD/YYYY