Open raw ↗{
"version": "1.0",
"description": "CTCAE v5.0 grading rules for common treatment-related adverse events",
"categories": {
"gastrointestinal": {
"nausea": {
"symptom_id": "nausea",
"display_name": "Nausea",
"category": "gastrointestinal",
"grades": {
"1": {
"criteria": "Loss of appetite without alteration in eating habits",
"intervention": "Observation; dietary modification",
"thresholds": {
"severity_score": [
1,
3
]
}
},
"2": {
"criteria": "Decreased oral intake without significant weight loss, dehydration, or malnutrition",
"intervention": "Oral antiemetics indicated",
"thresholds": {
"severity_score": [
4,
6
]
}
},
"3": {
"criteria": "Inadequate oral caloric or fluid intake; tube feeding or TPN indicated",
"intervention": "IV fluids, tube feeding, or TPN indicated",
"thresholds": {
"severity_score": [
7,
8
]
}
},
"4": {
"criteria": "Life-threatening consequences; urgent intervention indicated",
"intervention": "Life-threatening; hospitalization required",
"thresholds": {
"severity_score": [
9,
10
]
}
},
"5": {
"criteria": "Death",
"intervention": "N/A",
"thresholds": {
"severity_score": [
11,
11
]
}
}
}
},
"vomiting": {
"symptom_id": "vomiting",
"display_name": "Vomiting",
"category": "gastrointestinal",
"grades": {
"1": {
"criteria": "1-2 episodes per 24 hours",
"intervention": "Observation",
"thresholds": {
"episodes_per_24h": [
1,
2
]
}
},
"2": {
"criteria": "3-5 episodes per 24 hours; IV fluids indicated < 24h",
"intervention": "Oral antiemetics; IV fluids if needed",
"thresholds": {
"episodes_per_24h": [
3,
5
]
}
},
"3": {
"criteria": ">=6 episodes per 24 hours; tube feeding or TPN indicated",
"intervention": "IV antiemetics; IV fluids",
"thresholds": {
"episodes_per_24h": [
6,
9
]
}
},
"4": {
"criteria": "Life-threatening consequences; urgent intervention indicated",
"intervention": "Life-threatening; hospitalization",
"thresholds": {
"episodes_per_24h": [
10,
99
]
}
},
"5": {
"criteria": "Death",
"intervention": "N/A",
"thresholds": {
"episodes_per_24h": [
100,
999
]
}
}
}
},
"diarrhea": {
"symptom_id": "diarrhea",
"display_name": "Diarrhea",
"category": "gastrointestinal",
"grades": {
"1": {
"criteria": "Increase of <4 stools per day over baseline",
"intervention": "Dietary modification; observation",
"thresholds": {
"stools_increase_per_day": [
1,
3
]
}
},
"2": {
"criteria": "Increase of 4-6 stools per day over baseline",
"intervention": "Oral antidiarrheal agents indicated",
"thresholds": {
"stools_increase_per_day": [
4,
6
]
}
},
"3": {
"criteria": "Increase of >=7 stools per day; hospitalization indicated",
"intervention": "IV fluids; hospitalization",
"thresholds": {
"stools_increase_per_day": [
7,
9
]
}
},
"4": {
"criteria": "Life-threatening consequences; urgent intervention indicated",
"intervention": "Life-threatening; ICU care",
"thresholds": {
"stools_increase_per_day": [
10,
99
]
}
},
"5": {
"criteria": "Death",
"intervention": "N/A",
"thresholds": {
"stools_increase_per_day": [
100,
999
]
}
}
}
}
},
"hematologic": {
"neutropenia": {
"symptom_id": "neutropenia",
"display_name": "Neutropenia",
"category": "hematologic",
"grades": {
"1": {
"criteria": "ANC < LLN - 1500/mm3",
"intervention": "Monitoring",
"thresholds": {
"anc_mm3": [
1000,
1500
]
}
},
"2": {
"criteria": "ANC 1000 - <1500/mm3 with single-site infection",
"intervention": "Growth factor consideration; antibiotics if febrile",
"thresholds": {
"anc_mm3": [
500,
999
]
}
},
"3": {
"criteria": "ANC 500 - <1000/mm3 with IV antibiotics/antifungals",
"intervention": "Growth factor; IV antibiotics indicated",
"thresholds": {
"anc_mm3": [
200,
499
]
}
},
"4": {
"criteria": "ANC <500/mm3 with life-threatening infection",
"intervention": "Life-threatening; immediate hospitalization",
"thresholds": {
"anc_mm3": [
50,
199
]
}
},
"5": {
"criteria": "Death",
"intervention": "N/A",
"thresholds": {
"anc_mm3": [
0,
49
]
}
}
}
},
"anemia": {
"symptom_id": "anemia",
"display_name": "Anemia",
"category": "hematologic",
"grades": {
"1": {
"criteria": "Hgb < LLN - 10.0 g/dL",
"intervention": "Monitoring",
"thresholds": {
"hemoglobin_gdl": [
10.0,
12.0
]
}
},
"2": {
"criteria": "Hgb 8.0 - <10.0 g/dL",
"intervention": "Consider transfusion; erythropoiesis agents",
"thresholds": {
"hemoglobin_gdl": [
8.0,
9.9
]
}
},
"3": {
"criteria": "Hgb 6.5 - <8.0 g/dL; transfusion indicated",
"intervention": "Transfusion indicated",
"thresholds": {
"hemoglobin_gdl": [
6.5,
7.9
]
}
},
"4": {
"criteria": "Life-threatening; urgent intervention indicated",
"intervention": "Life-threatening; immediate transfusion",
"thresholds": {
"hemoglobin_gdl": [
0.0,
6.4
]
}
},
"5": {
"criteria": "Death",
"intervention": "N/A",
"thresholds": {
"hemoglobin_gdl": [
0.0,
0.0
]
}
}
}
},
"thrombocytopenia": {
"symptom_id": "thrombocytopenia",
"display_name": "Thrombocytopenia",
"category": "hematologic",
"grades": {
"1": {
"criteria": "Platelets < LLN - 75,000/mm3",
"intervention": "Monitoring",
"thresholds": {
"platelets_mm3": [
50000,
75000
]
}
},
"2": {
"criteria": "Platelets 50,000 - <75,000/mm3",
"intervention": "Monitoring; avoid invasive procedures",
"thresholds": {
"platelets_mm3": [
25000,
49999
]
}
},
"3": {
"criteria": "Platelets 25,000 - <50,000/mm3",
"intervention": "Transfusion indicated",
"thresholds": {
"platelets_mm3": [
10000,
24999
]
}
},
"4": {
"criteria": "Platelets <25,000/mm3; life-threatening bleeding",
"intervention": "Life-threatening; immediate transfusion",
"thresholds": {
"platelets_mm3": [
0,
9999
]
}
},
"5": {
"criteria": "Death",
"intervention": "N/A",
"thresholds": {
"platelets_mm3": [
0,
0
]
}
}
}
}
},
"dermatologic": {
"rash": {
"symptom_id": "rash",
"display_name": "Rash / Dermatitis",
"category": "dermatologic",
"grades": {
"1": {
"criteria": "Macules/papules covering <10% BSA with or without symptoms",
"intervention": "Topical emollients; observation",
"thresholds": {
"bsa_percent": [
0,
10
]
}
},
"2": {
"criteria": "Macules/papules covering 10-30% BSA with limiting ADLs",
"intervention": "Topical corticosteroids; oral antihistamines",
"thresholds": {
"bsa_percent": [
11,
30
]
}
},
"3": {
"criteria": ">30% BSA with limiting self-care ADLs",
"intervention": "Systemic corticosteroids; dermatology consult",
"thresholds": {
"bsa_percent": [
31,
60
]
}
},
"4": {
"criteria": "Skin necrosis or ulceration covering >30% BSA",
"intervention": "Hospitalization; IV corticosteroids",
"thresholds": {
"bsa_percent": [
61,
100
]
}
},
"5": {
"criteria": "Death",
"intervention": "N/A",
"thresholds": {
"bsa_percent": [
0,
0
]
}
}
}
},
"alopecia": {
"symptom_id": "alopecia",
"display_name": "Alopecia",
"category": "dermatologic",
"grades": {
"1": {
"criteria": "Hair thinning but not obvious from appearance",
"intervention": "Reassurance; scalp care",
"thresholds": {
"hair_loss_percent": [
0,
25
]
}
},
"2": {
"criteria": "Moderate hair loss; obvious hair loss on examination",
"intervention": "Wig/head covering; emotional support",
"thresholds": {
"hair_loss_percent": [
26,
75
]
}
},
"3": {
"criteria": "Complete hair loss",
"intervention": "Complete hair covering; psychological support",
"thresholds": {
"hair_loss_percent": [
76,
100
]
}
}
}
}
},
"neurologic": {
"peripheral_neuropathy": {
"symptom_id": "peripheral_neuropathy",
"display_name": "Peripheral Neuropathy",
"category": "neurologic",
"grades": {
"1": {
"criteria": "Mild paresthesia; mild loss of deep tendon reflexes",
"intervention": "Monitoring; vitamin supplementation",
"thresholds": {
"severity_score": [
1,
3
]
}
},
"2": {
"criteria": "Moderate paresthesia; limiting instrumental ADLs",
"intervention": "Dose modification; duloxetine consideration",
"thresholds": {
"severity_score": [
4,
6
]
}
},
"3": {
"criteria": "Severe paresthesia; limiting self-care ADLs",
"intervention": "Dose reduction or discontinuation; gabapentin/pregabalin",
"thresholds": {
"severity_score": [
7,
8
]
}
},
"4": {
"criteria": "Life-threatening consequences; urgent intervention indicated",
"intervention": "Permanent discontinuation; ICU care",
"thresholds": {
"severity_score": [
9,
10
]
}
},
"5": {
"criteria": "Death",
"intervention": "N/A",
"thresholds": {
"severity_score": [
11,
11
]
}
}
}
}
},
"constitutional": {
"fatigue": {
"symptom_id": "fatigue",
"display_name": "Fatigue",
"category": "constitutional",
"grades": {
"1": {
"criteria": "Mild fatigue over baseline",
"intervention": "Lifestyle modification; exercise",
"thresholds": {
"severity_score": [
1,
3
]
}
},
"2": {
"criteria": "Moderate fatigue; limiting instrumental ADLs",
"intervention": "Activity modification; consider stimulants",
"thresholds": {
"severity_score": [
4,
6
]
}
},
"3": {
"criteria": "Severe fatigue; limiting self-care ADLs",
"intervention": "Medical evaluation; erythropoiesis agents if anemic",
"thresholds": {
"severity_score": [
7,
8
]
}
},
"4": {
"criteria": "Disabling; life-threatening if cardiac/respiratory",
"intervention": "Hospitalization if life-threatening",
"thresholds": {
"severity_score": [
9,
10
]
}
},
"5": {
"criteria": "Death",
"intervention": "N/A",
"thresholds": {
"severity_score": [
11,
11
]
}
}
}
},
"fever": {
"symptom_id": "fever",
"display_name": "Fever (without neutropenia)",
"category": "constitutional",
"grades": {
"1": {
"criteria": "Temperature 38.0-39.0C (100.4-102.2F)",
"intervention": "Antipyretics; monitoring",
"thresholds": {
"temp_celsius": [
38.0,
39.0
]
}
},
"2": {
"criteria": "Temperature >39.0-40.0C (102.2-104.0F)",
"intervention": "Antipyretics; blood cultures; infection workup",
"thresholds": {
"temp_celsius": [
39.1,
40.0
]
}
},
"3": {
"criteria": "Temperature >40.0C (>104F) for <=24 hours",
"intervention": "IV fluids; IV antibiotics; hospitalization",
"thresholds": {
"temp_celsius": [
40.1,
41.0
]
}
},
"4": {
"criteria": "Temperature >40.0C (>104F) for >24 hours; life-threatening",
"intervention": "Life-threatening; ICU admission",
"thresholds": {
"temp_celsius": [
41.1,
42.0
]
}
},
"5": {
"criteria": "Death",
"intervention": "N/A",
"thresholds": {
"temp_celsius": [
42.1,
99.0
]
}
}
}
},
"febrile_neutropenia": {
"symptom_id": "febrile_neutropenia",
"display_name": "Febrile Neutropenia",
"category": "constitutional",
"grades": {
"3": {
"criteria": "ANC <1000/mm3 with single temperature >=38.3C or >=38.0C for >1 hour",
"intervention": "Empiric broad-spectrum antibiotics; hospitalization",
"thresholds": {
"anc_mm3": [
0,
999
],
"temp_celsius": [
38.0,
99.0
]
}
},
"4": {
"criteria": "Life-threatening consequences; urgent intervention indicated",
"intervention": "Life-threatening; ICU admission",
"thresholds": {
"anc_mm3": [
0,
499
],
"temp_celsius": [
38.0,
99.0
]
}
},
"5": {
"criteria": "Death",
"intervention": "N/A",
"thresholds": {
"anc_mm3": [
0,
0
]
}
}
}
}
}
}
}