ID

10339

Beskrivning

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

Länk

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

Nyckelord

Versioner (2)
  1. 2012-09-19 2012-09-19 -
  2. 2015-05-28 2015-05-28 -
Uppladdad den

28 maj 2015

DOI

För en begäran logga in.

Licens

Creative Commons BY-NC 3.0 Legacy
Modellkommentarer :

Här kan du kommentera modellen. Med hjälp av pratbubblor i Item-grupperna och Item kan du lägga in specifika kommentarer.

Tillbaka till modellkommentarer
Itemgroup-kommentar för :

Item-kommentar för :

  • Senaste
  • Äldsta
  • Önskad
  • Senaste
    • Senaste
    • Äldsta
    • Önskad

Inga kommentarer

Du måste vara inloggad för att kunna ladda ner formulär. Var vänlig logga in eller registrera dig utan kostnad.

CSL

Engelsk

No Instruction available.

1 Formulär  
Header Module
Beskrivning

Header Module

Visit Number
Beskrivning

HospitalAdmissionOrdinalNumber

Datatyp

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
Beskrivning

Segment

Datatyp

text

Record number of aphereses performed
Beskrivning

Recordnumberofapheresesperformed

Datatyp

text

Record Date Each Apheresis Was Performed
Beskrivning

Record Date Each Apheresis Was Performed

Apheresis #3
Beskrivning

BloodComponentTransfusionDate

Datatyp

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
Beskrivning

BloodComponentTransfusionDate

Datatyp

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
Beskrivning

BloodComponentTransfusionDate

Datatyp

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
Beskrivning

For Each Selection Procedure Performed, Record The Following Information

Starting Hpc-a Product #1
Beskrivning

Starting Hpc-a Product #1

Total nucleated cell count
Beskrivning

ImmunocytologyCellLabTotalValue

Datatyp

double

Viability as determined by 7-AAD flow cytometry
Beskrivning

Viabilityasdeterminedby7-AADflowcytometry

Datatyp

text

CD3+ T cell count
Beskrivning

CD3+Tcellcount

Datatyp

text

CD34+ cell count
Beskrivning

CD34+cellcount

Datatyp

text

Starting Hpc-a Product #2
Beskrivning

Starting Hpc-a Product #2

Total nucleated cell count
Beskrivning

SpecimenCellCountTotalValue

Datatyp

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
Beskrivning

Viabilityasdeterminedby7-AADflowcytometry

Datatyp

text

CD3+ T cell count
Beskrivning

CD3+Tcellcount

Datatyp

text

CD34+ cell count
Beskrivning

CD34+cellcount

Datatyp

text

Starting Hpc-a Product #3
Beskrivning

Starting Hpc-a Product #3

Total nucleated cell count
Beskrivning

SpecimenCellCountTotalValue

Datatyp

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
Beskrivning

Viabilityasdeterminedby7-AADflowcytometry

Datatyp

text

CD3+ T cell count
Beskrivning

CD3+Tcellcount

Datatyp

text

CD34+ cell count
Beskrivning

CD34+cellcount

Datatyp

text

Record number of columns used for the selection procedures
Beskrivning

Recordnumberofcolumnsusedfortheselectionprocedures

Datatyp

text

For Each Column Used, Record The Following Information
Beskrivning

For Each Column Used, Record The Following Information

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

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

Total nucleated cell count
Beskrivning

SpecimenCellCountTotalValue

Datatyp

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
Beskrivning

Viabilityasdeterminedby7-AADflowcytometry

Datatyp

text

CD34+ cell count
Beskrivning

CD34+cellcount

Datatyp

text

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

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

Total nucleated cell count
Beskrivning

SpecimenCellCountTotalValue

Datatyp

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
Beskrivning

Viabilityasdeterminedby7-AADflowcytometry

Datatyp

text

CD34+ cell count
Beskrivning

CD34+cellcount

Datatyp

text

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

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

Total nucleated cell count
Beskrivning

SpecimenCellCountTotalValue

Datatyp

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
Beskrivning

ResearchCommentsText

Datatyp

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
Beskrivning

Viabilityasdeterminedby7-AADflowcytometry

Datatyp

text

CD34+ cell count
Beskrivning

CD34+cellcount

Datatyp

text

Tillbaka till toppen

Similar models

No Instruction available.

1 Formulär
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
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
Tillbaka till toppen 

Kontakt

Använd detta formulär för feedback, frågor och förslag på förbättringar.

Fält markerade med * är obligatoriska.

Hjälp

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial