ID

10339

Description

CSL Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=FF1A00BE-B650-1746-E034-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=FF1A00BE-B650-1746-E034-0003BA3F9857

Keywords

Versions (2)
  1. 9/19/12 9/19/12 -
  2. 5/28/15 5/28/15 -
Uploaded on

May 28, 2015

DOI

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License

Creative Commons BY-NC 3.0 Legacy
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CSL

English

No Instruction available.

1 forms  
Header Module
Description

Header Module

Visit Number
Description

HospitalAdmissionOrdinalNumber

Data type

double

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C16696
UMLS 2011AA ObjectClass
C0019994
NCI Thesaurus Property
C25385
UMLS 2011AA Property
C0809949
Segment
Description

Segment

Data type

text

Record number of aphereses performed
Description

Recordnumberofapheresesperformed

Data type

text

Record Date Each Apheresis Was Performed
Description

Record Date Each Apheresis Was Performed

Apheresis #3
Description

BloodComponentTransfusionDate

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus Property
C25409
UMLS 2011AA Property
C1533734
NCI Thesaurus ObjectClass
C15192
UMLS 2011AA ObjectClass
C0005841
NCI Thesaurus ObjectClass
C81304
UMLS 2011AA ObjectClass
C0456388
Apheresis #3
Description

BloodComponentTransfusionDate

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus Property
C25409
UMLS 2011AA Property
C1533734
NCI Thesaurus ObjectClass
C15192
UMLS 2011AA ObjectClass
C0005841
NCI Thesaurus ObjectClass
C81304
UMLS 2011AA ObjectClass
C0456388
Apheresis #3
Description

BloodComponentTransfusionDate

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus Property
C25409
UMLS 2011AA Property
C1533734
NCI Thesaurus ObjectClass
C15192
UMLS 2011AA ObjectClass
C0005841
NCI Thesaurus ObjectClass
C81304
UMLS 2011AA ObjectClass
C0456388
For Each Selection Procedure Performed, Record The Following Information
Description

For Each Selection Procedure Performed, Record The Following Information

Starting Hpc-a Product #1
Description

Starting Hpc-a Product #1

Total nucleated cell count
Description

ImmunocytologyCellLabTotalValue

Data type

double

Viability as determined by 7-AAD flow cytometry
Description

Viabilityasdeterminedby7-AADflowcytometry

Data type

text

CD3+ T cell count
Description

CD3+Tcellcount

Data type

text

CD34+ cell count
Description

CD34+cellcount

Data type

text

Starting Hpc-a Product #2
Description

Starting Hpc-a Product #2

Total nucleated cell count
Description

SpecimenCellCountTotalValue

Data type

double

Alias
NCI Thesaurus ObjectClass
C19157
UMLS 2011AA ObjectClass
C0370003
NCI Thesaurus Property
C12508
UMLS 2011AA Property
C0007634
NCI Thesaurus Property
C25256
UMLS 2011AA Property
C1265611
NCI Thesaurus ValueDomain
C25304
UMLS 2011AA ValueDomain
C0439810
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
Viability as determined by 7-AAD flow cytometry
Description

Viabilityasdeterminedby7-AADflowcytometry

Data type

text

CD3+ T cell count
Description

CD3+Tcellcount

Data type

text

CD34+ cell count
Description

CD34+cellcount

Data type

text

Starting Hpc-a Product #3
Description

Starting Hpc-a Product #3

Total nucleated cell count
Description

SpecimenCellCountTotalValue

Data type

double

Alias
NCI Thesaurus ObjectClass
C19157
UMLS 2011AA ObjectClass
C0370003
NCI Thesaurus Property
C12508
UMLS 2011AA Property
C0007634
NCI Thesaurus Property
C25256
UMLS 2011AA Property
C1265611
NCI Thesaurus ValueDomain
C25304
UMLS 2011AA ValueDomain
C0439810
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
Viability as determined by 7-AAD flow cytometry
Description

Viabilityasdeterminedby7-AADflowcytometry

Data type

text

CD3+ T cell count
Description

CD3+Tcellcount

Data type

text

CD34+ cell count
Description

CD34+cellcount

Data type

text

Record number of columns used for the selection procedures
Description

Recordnumberofcolumnsusedfortheselectionprocedures

Data type

text

For Each Column Used, Record The Following Information
Description

For Each Column Used, Record The Following Information

Pre-selection/post Platelet & Antibody Wash Product #1
Description

Pre-selection/post Platelet & Antibody Wash Product #1

Total nucleated cell count
Description

SpecimenCellCountTotalValue

Data type

double

Alias
NCI Thesaurus ObjectClass
C19157
UMLS 2011AA ObjectClass
C0370003
NCI Thesaurus Property
C12508
UMLS 2011AA Property
C0007634
NCI Thesaurus Property
C25256
UMLS 2011AA Property
C1265611
NCI Thesaurus ValueDomain
C25304
UMLS 2011AA ValueDomain
C0439810
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
Viability as determined by 7-AAD flow cytometry
Description

Viabilityasdeterminedby7-AADflowcytometry

Data type

text

CD34+ cell count
Description

CD34+cellcount

Data type

text

Pre-selection/post Platelet & Antibody Wash Product #2
Description

Pre-selection/post Platelet & Antibody Wash Product #2

Total nucleated cell count
Description

SpecimenCellCountTotalValue

Data type

double

Alias
NCI Thesaurus ObjectClass
C19157
UMLS 2011AA ObjectClass
C0370003
NCI Thesaurus Property
C12508
UMLS 2011AA Property
C0007634
NCI Thesaurus Property
C25256
UMLS 2011AA Property
C1265611
NCI Thesaurus ValueDomain
C25304
UMLS 2011AA ValueDomain
C0439810
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
Viability as determined by 7-AAD flow cytometry
Description

Viabilityasdeterminedby7-AADflowcytometry

Data type

text

CD34+ cell count
Description

CD34+cellcount

Data type

text

Pre-selection/post Platelet & Antibody Wash Product #3
Description

Pre-selection/post Platelet & Antibody Wash Product #3

Total nucleated cell count
Description

SpecimenCellCountTotalValue

Data type

double

Alias
NCI Thesaurus ObjectClass
C19157
UMLS 2011AA ObjectClass
C0370003
NCI Thesaurus Property
C12508
UMLS 2011AA Property
C0007634
NCI Thesaurus Property
C25256
UMLS 2011AA Property
C1265611
NCI Thesaurus ValueDomain
C25304
UMLS 2011AA ValueDomain
C0439810
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
Comments
Description

ResearchCommentsText

Data type

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus ObjectClass
C15319
NCI Thesaurus Property
C25393
UMLS 2011AA Property
C0282411
Viability as determined by 7-AAD flow cytometry
Description

Viabilityasdeterminedby7-AADflowcytometry

Data type

text

CD34+ cell count
Description

CD34+cellcount

Data type

text

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Similar models

No Instruction available.

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Header Module
HospitalAdmissionOrdinalNumber
Item
Visit Number
double
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C16696 (NCI Thesaurus ObjectClass)
C0019994 (UMLS 2011AA ObjectClass)
C25385 (NCI Thesaurus Property)
C0809949 (UMLS 2011AA Property)
Segment
Item
Segment
text
Item
Record number of aphereses performed
text
CL.1
Code List
Record number of aphereses performed
CL Item
One apheresis (One apheresis)
CL Item
Two apheresis (Two apheresis)
CL Item
Three apheresis (Three apheresis)
Item Group
Record Date Each Apheresis Was Performed
BloodComponentTransfusionDate
Item
Apheresis #3
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25409 (NCI Thesaurus Property)
C1533734 (UMLS 2011AA Property)
C15192 (NCI Thesaurus ObjectClass)
C0005841 (UMLS 2011AA ObjectClass)
C81304 (NCI Thesaurus ObjectClass)
C0456388 (UMLS 2011AA ObjectClass)
BloodComponentTransfusionDate
Item
Apheresis #3
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25409 (NCI Thesaurus Property)
C1533734 (UMLS 2011AA Property)
C15192 (NCI Thesaurus ObjectClass)
C0005841 (UMLS 2011AA ObjectClass)
C81304 (NCI Thesaurus ObjectClass)
C0456388 (UMLS 2011AA ObjectClass)
BloodComponentTransfusionDate
Item
Apheresis #3
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25409 (NCI Thesaurus Property)
C1533734 (UMLS 2011AA Property)
C15192 (NCI Thesaurus ObjectClass)
C0005841 (UMLS 2011AA ObjectClass)
C81304 (NCI Thesaurus ObjectClass)
C0456388 (UMLS 2011AA ObjectClass)
Item Group
For Each Selection Procedure Performed, Record The Following Information
Item Group
Starting Hpc-a Product #1
ImmunocytologyCellLabTotalValue
Item
Total nucleated cell count
double
Viabilityasdeterminedby7-AADflowcytometry
Item
Viability as determined by 7-AAD flow cytometry
text
CD3+Tcellcount
Item
CD3+ T cell count
text
CD34+cellcount
Item
CD34+ cell count
text
Item Group
Starting Hpc-a Product #2
SpecimenCellCountTotalValue
Item
Total nucleated cell count
double
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C12508 (NCI Thesaurus Property)
C0007634 (UMLS 2011AA Property)
C25256 (NCI Thesaurus Property)
C1265611 (UMLS 2011AA Property)
C25304 (NCI Thesaurus ValueDomain)
C0439810 (UMLS 2011AA ValueDomain)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
Viabilityasdeterminedby7-AADflowcytometry
Item
Viability as determined by 7-AAD flow cytometry
text
CD3+Tcellcount
Item
CD3+ T cell count
text
CD34+cellcount
Item
CD34+ cell count
text
Item Group
Starting Hpc-a Product #3
SpecimenCellCountTotalValue
Item
Total nucleated cell count
double
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C12508 (NCI Thesaurus Property)
C0007634 (UMLS 2011AA Property)
C25256 (NCI Thesaurus Property)
C1265611 (UMLS 2011AA Property)
C25304 (NCI Thesaurus ValueDomain)
C0439810 (UMLS 2011AA ValueDomain)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
Viabilityasdeterminedby7-AADflowcytometry
Item
Viability as determined by 7-AAD flow cytometry
text
CD3+Tcellcount
Item
CD3+ T cell count
text
CD34+cellcount
Item
CD34+ cell count
text
Item
Record number of columns used for the selection procedures
text
CL.2
Code List
Record number of columns used for the selection procedures
CL Item
One column (One column)
CL Item
Two columns (Two columns)
CL Item
Three columns (Three columns)
Item Group
For Each Column Used, Record The Following Information
Item Group
Pre-selection/post Platelet & Antibody Wash Product #1
SpecimenCellCountTotalValue
Item
Total nucleated cell count
double
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C12508 (NCI Thesaurus Property)
C0007634 (UMLS 2011AA Property)
C25256 (NCI Thesaurus Property)
C1265611 (UMLS 2011AA Property)
C25304 (NCI Thesaurus ValueDomain)
C0439810 (UMLS 2011AA ValueDomain)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
Viabilityasdeterminedby7-AADflowcytometry
Item
Viability as determined by 7-AAD flow cytometry
text
CD34+cellcount
Item
CD34+ cell count
text
Item Group
Pre-selection/post Platelet & Antibody Wash Product #2
SpecimenCellCountTotalValue
Item
Total nucleated cell count
double
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C12508 (NCI Thesaurus Property)
C0007634 (UMLS 2011AA Property)
C25256 (NCI Thesaurus Property)
C1265611 (UMLS 2011AA Property)
C25304 (NCI Thesaurus ValueDomain)
C0439810 (UMLS 2011AA ValueDomain)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
Viabilityasdeterminedby7-AADflowcytometry
Item
Viability as determined by 7-AAD flow cytometry
text
CD34+cellcount
Item
CD34+ cell count
text
Item Group
Pre-selection/post Platelet & Antibody Wash Product #3
SpecimenCellCountTotalValue
Item
Total nucleated cell count
double
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C12508 (NCI Thesaurus Property)
C0007634 (UMLS 2011AA Property)
C25256 (NCI Thesaurus Property)
C1265611 (UMLS 2011AA Property)
C25304 (NCI Thesaurus ValueDomain)
C0439810 (UMLS 2011AA ValueDomain)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
ResearchCommentsText
Item
Comments
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C0282411 (UMLS 2011AA Property)
Viabilityasdeterminedby7-AADflowcytometry
Item
Viability as determined by 7-AAD flow cytometry
text
CD34+cellcount
Item
CD34+ cell count
text
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