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Pre- Treatment events

8 forms  
PRE-TREATMENT EVENTS
Description

PRE-TREATMENT EVENTS

CTC CODE:
Description

CTC CODE:

Data type

text

Alias
UMLS CUI-1
C0805701
UMLS CUI-2
C1516728
UMLS CUI-3
C1705313
Onset date:
Description

ONSET DATE

Data type

date

Alias
UMLS CUI-1
C0011008
CTC grade:
Description

CTC grade

Data type

text

Alias
UMLS CUI-1
C2985911
Treatment required:
Description

Treatment required

Data type

boolean

Alias
UMLS CUI-1
C0332307
UMLS CUI-2
C0877248
UMLS CUI-3
C0087111
UMLS CUI-4
C1521801
BONE MARROW BIOPSY I ASPIRATE
Description

BONE MARROW BIOPSY I ASPIRATE

Alias
UMLS CUI-1
C0005954
Date of procedure:
Description

DATE OF PROCEDURE

Data type

date

Alias
UMLS CUI-1
C0011008
Indicate procedure:
Description

INDICATE PROCEDURE

Data type

text

Was cytogenetic analysis performed?
Description

WAS CYTOGENETIC ANALYSIS PERFORMED ?

Data type

boolean

Alias
UMLS CUI-1
C0752095
UMLS CUI-2
C0162789
UMLS CUI-3
C0022526
UMLS CUI-4
C0884358
UMLS CUI-5
C0011008
Number of metaphases examined:
Description

NUMBER OF METAPHASES EXAMINED

Data type

integer

Alias
UMLS CUI-1
C1621812
Number of metaphases positive for philadelphia chromosome:
Description

NUMBER OF ME T APHASES POSITIVE FOR PHILADELPHIA CHROMOSOME

Data type

integer

Alias
UMLS CUI-1
C0856536
Was the specimen adequate for light microscopic analysis?
Description

WAS THE SPECIMEN ADEQUATE FOR LIGHT MICROSCOPIC ANALYSIS ?

Data type

boolean

Number of blasts:
Description

Number of blasts

Data type

integer

Alias
UMLS CUI-1
C1982687
Number of promyelocytes:
Description

Number of promyelocytes

Data type

integer

Alias
UMLS CUI-1
C0455279
Number of basophils:
Description

Number of basophils

Data type

integer

Alias
UMLS CUI-1
C0200641
Cellularity form:
Description

Cellularity form

Data type

text

Cellularity results:
Description

Cellularity results

Data type

text

Is the subject eligible based on clonal evolution?
Description

IS THE SUBJECT ELIGIBLE BASED ON CLONAL EVOLUTION?

Data type

boolean

If yes, specify additional clones
Description

Additional clones

Data type

text

EQ-5D
Description

EQ-5D

Alias
UMLS CUI-1
C2733251
Mobility:
Description

Mobility

Data type

text

Alias
UMLS CUI-1
C0518214
UMLS CUI-2
C0031809
UMLS CUI-3
C0449438
Self-Care:
Description

Self-Care

Data type

text

Alias
UMLS CUI-1
C3639376
Usual Activitiese.g. work, study, housework, family or leisure activities):
Description

Usual Activitiese.g. work, study, housework, family or leisure activities)

Data type

text

Alias
UMLS CUI-1
C3639377
Pain/Discomfort:
Description

Pain/Discomfort

Data type

text

Alias
UMLS CUI-1
C3639378
Anxiety/Depression:
Description

Anxiety/Depression

Data type

text

Alias
UMLS CUI-1
C0518214
UMLS CUI-2
C0031809
UMLS CUI-3
C0003467
UMLS CUI-4
C0449438
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Similar models

Pre- Treatment events

8 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
PRE-TREATMENT EVENTS
CTC CODE
Item
CTC CODE:
text
C0805701 (UMLS CUI-1)
C1516728 (UMLS CUI-2)
C1705313 (UMLS CUI-3)
DATE
Item
Onset date:
date
C0011008 (UMLS CUI-1)
CTC grade
Item
CTC grade:
text
C2985911 (UMLS CUI-1)
Treatment required
Item
Treatment required:
boolean
C0332307 (UMLS CUI-1)
C0877248 (UMLS CUI-2)
C0087111 (UMLS CUI-3)
C1521801 (UMLS CUI-4)
Item Group
BONE MARROW BIOPSY I ASPIRATE
C0005954 (UMLS CUI-1)
DATE
Item
Date of procedure:
date
C0011008 (UMLS CUI-1)
Item
Indicate procedure:
text
INDICATE PROCEDURE
Code List
Indicate procedure:
CL Item
Aspirate (1)
CL Item
Biopsy (2)
CL Item
Both (Aspirate and biopsy) (3)
CYTOGENETIC ANALYSIS
Item
Was cytogenetic analysis performed?
boolean
C0752095 (UMLS CUI-1)
C0162789 (UMLS CUI-2)
C0022526 (UMLS CUI-3)
C0884358 (UMLS CUI-4)
C0011008 (UMLS CUI-5)
NUMBER OF METAPHASES
Item
Number of metaphases examined:
integer
C1621812 (UMLS CUI-1)
PHILADELPHIA CHROMOSOME POSITIVE
Item
Number of metaphases positive for philadelphia chromosome:
integer
C0856536 (UMLS CUI-1)
MICROSCOPIC ANALYSIS
Item
Was the specimen adequate for light microscopic analysis?
boolean
BLASTS
Item
Number of blasts:
integer
C1982687 (UMLS CUI-1)
PROMYELOCYTES
Item
Number of promyelocytes:
integer
C0455279 (UMLS CUI-1)
BASOPHILS
Item
Number of basophils:
integer
C0200641 (UMLS CUI-1)
Item
Cellularity form:
text
CELLULARITY FORM
Code List
Cellularity form:
CL Item
Clot (1)
CL Item
Biopsy (2)
Item
Cellularity results:
text
CELLULARITY RESULTS
Code List
Cellularity results:
CL Item
Absent (1)
CL Item
Hypocellular (Less than 20%) (2)
CL Item
Normal (20-40%) (3)
CL Item
Hypercellular (41-100%) (4)
CL Item
Not done (5)
CLONAL EVOLUTION
Item
Is the subject eligible based on clonal evolution?
boolean
Additional clones
Item
If yes, specify additional clones
text
Item Group
EQ-5D
C2733251 (UMLS CUI-1)
Item
Mobility:
text
C0518214 (UMLS CUI-1)
C0031809 (UMLS CUI-2)
C0449438 (UMLS CUI-3)
Mobility
Code List
Mobility:
CL Item
1 I have no problems in walking about (1)
CL Item
2 I have some problems in walking about (2)
CL Item
3 I am confined to bed (3)
Item
Self-Care:
text
C3639376 (UMLS CUI-1)
Self-Care
Code List
Self-Care:
CL Item
1 I have no problems with self-care (1)
CL Item
2 I have some problems washing or dressing myself (2)
CL Item
3 I am unable to wash or dress myself (3)
Item
Usual Activitiese.g. work, study, housework, family or leisure activities):
text
C3639377 (UMLS CUI-1)
Usual Activities
Code List
Usual Activitiese.g. work, study, housework, family or leisure activities):
CL Item
1 I have no problems with performing my usual activities (1)
CL Item
2 I have some problems with performing my usual activities (2)
CL Item
3 I am unable to perform my usual activities (3)
Item
Pain/Discomfort:
text
C3639378 (UMLS CUI-1)
Pain/Discomfort
Code List
Pain/Discomfort:
CL Item
1 I have no pain or discomfort (1)
CL Item
2 I have moderate pain or discomfort (2)
CL Item
3 I have extreme pain or discomfort (3)
Item
Anxiety/Depression:
text
C0518214 (UMLS CUI-1)
C0031809 (UMLS CUI-2)
C0003467 (UMLS CUI-3)
C0449438 (UMLS CUI-4)
Anxiety/Depression
Code List
Anxiety/Depression:
CL Item
1 I am not anxious or depressed (1)
CL Item
2 I am moderately anxious or depressed (2)
CL Item
3 I am extremely anxious or depressed (3)
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