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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

  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

    No Instruction available.

    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

    Similar models

    No Instruction available.

    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
    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
    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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