ID

2975

Description

Urinalysis - RF25 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=CCE3C24A-B0A1-5094-E034-0003BA12F5E7

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=CCE3C24A-B0A1-5094-E034-0003BA12F5E7

Keywords

Versions (2)
  1. 9/19/12 9/19/12 -
  2. 1/9/15 1/9/15 - Martin Dugas
Uploaded on

September 19, 2012

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License

Creative Commons BY-NC 3.0 Legacy
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Sarcoma, Kaposi xxx Lab - Urinalysis - RF25 - 2267334v3.0

English

No Instruction available.

1 forms  
  1. StudyEvent: Urinalysis - RF25
    1. No Instruction available.
Ccrr Module For Urinalysis - Rf25
Description

Ccrr Module For Urinalysis - Rf25

Patient Initials
Description

PatientInitialsName

Data type

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25536
UMLS 2011AA Property
C1555582
Study#
Description

ProtocolCoordinatingIdentifierNumber

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C25320
UMLS 2011AA ObjectClass
C1507394
NCI Thesaurus Property
C25462
UMLS 2011AA Property
C0700114
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Site#
Description

NCIInstitutionIdentifierCode

Data type

text

Alias
NCI Thesaurus ValueDomain
C25162
UMLS 2011AA ValueDomain
C0805701
NCI Thesaurus ObjectClass
C21541
UMLS 2011AA ObjectClass
C0018704
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus ObjectClass
C19202
UMLS 2011AA ObjectClass
C1513882
ID#
Description

PatientCoordinatingIdentifierNumber

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25462
UMLS 2011AA Property
C0700114
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Cycle#
Description

TreatmentCurrentCourseNumber

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus Property
C25471
UMLS 2011AA Property
C0521116
NCI Thesaurus ObjectClass
C15368
NCI Thesaurus Property
C25379
UMLS 2011AA Property
C0750729
Date Specimen Obtained
Description

SpecimenCollectedDate

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C19157
UMLS 2011AA ObjectClass
C0370003
NCI Thesaurus Property
C25452
NCI Thesaurus Property
C25275
UMLS 2011AA Property
C2745955
Which evaluation does this represent?
Description

TimePeriod

Data type

text

Specific Grav
Description

LaboratoryProcedureUrineSpecificGravityOutcomeValue

Data type

double

Alias
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property
C13283
UMLS 2011AA Property
C0042036
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus Property
C64832
UMLS 2011AA Property
C0037786
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
Cycle Day
Description

CycleDay

Data type

text

Sequence #
Description

Sequence#

Data type

text

Appearance
Description

Appearance

Data type

text

Color
Description

Color

Data type

text

Ph
Description

Ph

Data type

text

Glucose
Description

Glucose

Data type

text

Ketones
Description

Ketones

Data type

text

Protein
Description

Protein

Data type

text

Urobilingogen
Description

Urobilingogen

Data type

text

WBC
Description

WBC

Data type

text

RBC
Description

RBC

Data type

text

Cast
Description

Cast

Data type

text

Crystals
Description

Crystals

Data type

text

Bacteria
Description

Bacteria

Data type

text

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Similar models

No Instruction available.

1 forms
  1. StudyEvent: Urinalysis - RF25
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Ccrr Module For Urinalysis - Rf25
PatientInitialsName
Item
Patient Initials
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25536 (NCI Thesaurus Property)
C1555582 (UMLS 2011AA Property)
ProtocolCoordinatingIdentifierNumber
Item
Study#
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C25320 (NCI Thesaurus ObjectClass)
C1507394 (UMLS 2011AA ObjectClass)
C25462 (NCI Thesaurus Property)
C0700114 (UMLS 2011AA Property)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
NCIInstitutionIdentifierCode
Item
Site#
text
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
C21541 (NCI Thesaurus ObjectClass)
C0018704 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C19202 (NCI Thesaurus ObjectClass)
C1513882 (UMLS 2011AA ObjectClass)
PatientCoordinatingIdentifierNumber
Item
ID#
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25462 (NCI Thesaurus Property)
C0700114 (UMLS 2011AA Property)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
TreatmentCurrentCourseNumber
Item
Cycle#
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C25471 (NCI Thesaurus Property)
C0521116 (UMLS 2011AA Property)
C15368 (NCI Thesaurus ObjectClass)
C25379 (NCI Thesaurus Property)
C0750729 (UMLS 2011AA Property)
SpecimenCollectedDate
Item
Date Specimen Obtained
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C25452 (NCI Thesaurus Property)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
Item
Which evaluation does this represent?
text
CL.1
Code List
Which evaluation does this represent?
CL Item
Entry/Baseline (Entry/Baseline)
CL Item
On Treatment (On Treatment)
CL Item
Post Therapy Evaluation (Post Therapy Evaluation)
LaboratoryProcedureUrineSpecificGravityOutcomeValue
Item
Specific Grav
double
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C13283 (NCI Thesaurus Property)
C0042036 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C64832 (NCI Thesaurus Property)
C0037786 (UMLS 2011AA Property)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
CycleDay
Item
Cycle Day
text
Sequence#
Item
Sequence #
text
Item
Appearance
text
CL.2
Code List
Appearance
CL Item
Clear (Clear)
CL Item
Hazy (Hazy)
CL Item
Cloudy (Cloudy)
CL Item
Opaque (Opaque)
Item
Color
text
CL.3
Code List
Color
CL Item
Clear (Clear)
CL Item
Straw (Straw)
CL Item
Yellow (Yellow)
CL Item
Amber (Amber)
CL Item
Brown (Brown)
Ph
Item
Ph
text
Glucose
Item
Glucose
text
Item
Ketones
text
CL.4
Code List
Ketones
CL Item
Negative/trace (Negative/trace)
CL Item
1+ (1+)
CL Item
2+ (2+)
CL Item
3+ (3+)
CL Item
4+ (4+)
Item
Protein
text
CL.5
Code List
Protein
CL Item
Negative/trace (Negative/trace)
CL Item
1+ (1+)
CL Item
2+ (2+)
CL Item
3+ (3+)
CL Item
4+ (4+)
Urobilingogen
Item
Urobilingogen
text
WBC
Item
WBC
text
RBC
Item
RBC
text
Cast
Item
Cast
text
Item
Crystals
text
CL.6
Code List
Crystals
CL Item
Negative/trace (Negative/trace)
CL Item
1+ (1+)
CL Item
2+ (2+)
CL Item
3+ (3+)
CL Item
4+ (4+)
Item
Bacteria
text
CL.7
Code List
Bacteria
CL Item
Negative/trace (Negative/trace)
CL Item
1+ (1+)
CL Item
2+ (2+)
CL Item
3+ (3+)
CL Item
4+ (4+)
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