ID

12407

Beschrijving

Hyper-PEI-protocol:a programme with regional deep hyperthermia(RHT)in combination with PEI-chemotherapy.The Hyper-PEI protocol is offered in place of the intensive standard chemotherapy for high-risk patie nts with malignant, extracranial tumors. Patients have a measurable relapsed tumor,or a primary tumor that did not respond sufficiently to treatment according to standard protocols. Responsible MD: PD Dr. med. R Wessalowski, Clinic for pediatric oncology,haematology and immunology UKD, Moorenstr. 5, 40225 Düsseldorf

Trefwoorden

  1. 16-11-15 16-11-15 - Julian Varghese
  2. 19-11-15 19-11-15 - Julian Varghese
  3. 19-11-15 19-11-15 - Julian Varghese
Geüploaded op

16 november 2015

DOI

Voor een aanvraag inloggen.

Licentie

Creative Commons BY-NC 3.0

Model Commentaren :

Hier kunt u commentaar leveren op het model. U kunt de tekstballonnen bij de itemgroepen en items gebruiken om er specifiek commentaar op te geven.

Itemgroep Commentaren voor :

Item Commentaren voor :

U moet ingelogd zijn om formulieren te downloaden. AUB inloggen of schrijf u gratis in.

Registration Hyperthermia Treatment Study

Registration Form HYPER-PEI

General Information
Beschrijving

General Information

Alias
UMLS CUI-1
C1507644
Weight
Beschrijving

Body weight of patient

Datatype

float

Maateenheden
  • kg
Alias
UMLS CUI [1]
C0005910
kg
Height
Beschrijving

Body height of patient

Datatype

float

Maateenheden
  • cm
Alias
UMLS CUI [1]
C0489786
cm
Diagnosis
Beschrijving

Diagnose

Datatype

text

Alias
UMLS CUI [1]
C0011900
Date of diagnosis
Beschrijving

Date of Diagnosis

Datatype

date

Alias
UMLS CUI [1]
C2316983
Localisation
Beschrijving

Localisation of malignancy

Datatype

text

Alias
UMLS CUI [1,1]
C0475264
UMLS CUI [1,2]
C0027651
Primary Neoplasm
Beschrijving

Primary Neoplasm

Datatype

integer

Alias
UMLS CUI [1]
C0677930
1. Relapse
Beschrijving

first Relapse

Datatype

text

Alias
UMLS CUI [1]
C0277556
2./3./... Relapse
Beschrijving

second/third Relapse

Datatype

text

Alias
UMLS CUI [1]
C0277556
Metastasis
Beschrijving

Evidence of metastatic disease

Datatype

text

Alias
UMLS CUI [1]
C0027627
metastasis unifocal
Beschrijving

metastatis unifocal

Datatype

text

Alias
UMLS CUI [1,1]
C0027627
UMLS CUI [1,2]
C0443337
Metastasis multifocal
Beschrijving

metastasis multifocal

Datatype

text

Alias
UMLS CUI [1,1]
C0027627
UMLS CUI [1,2]
C0205292
Transferring Hospital
Beschrijving

Transferring Hospital

Alias
UMLS CUI-1
C0019994
Hospital Name
Beschrijving

Name of transferring,cooperating hospital

Datatype

text

Alias
UMLS CUI [1]
C2926025
Date
Beschrijving

Issuing Date

Datatype

date

Alias
UMLS CUI [1]
C0011008
Treating Physician
Beschrijving

Responsible Physician for Transfer

Datatype

text

Alias
UMLS CUI [1]
C1710470
Signature
Beschrijving

Responsible Person Signature

Datatype

text

Alias
UMLS CUI [1]
C1519316
Email
Beschrijving

Email

Datatype

text

Alias
UMLS CUI [1]
C0013849
Phone Number
Beschrijving

Phone number

Datatype

float

Alias
UMLS CUI [1]
C0039457

Similar models

Registration Form HYPER-PEI

Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
General Information
C1507644 (UMLS CUI-1)
Patient Weight
Item
Weight
float
C0005910 (UMLS CUI [1])
Patient Height
Item
Height
float
C0489786 (UMLS CUI [1])
Diagnose
Item
Diagnosis
text
C0011900 (UMLS CUI [1])
Date of Diagnosis
Item
Date of diagnosis
date
C2316983 (UMLS CUI [1])
Localisation
Item
Localisation
text
C0475264 (UMLS CUI [1,1])
C0027651 (UMLS CUI [1,2])
Item
Primary Neoplasm
integer
C0677930 (UMLS CUI [1])
Code List
Primary Neoplasm
CL Item
Yes (Yes)
CL Item
No (No)
CL Item
no information (no information)
Item
1. Relapse
text
C0277556 (UMLS CUI [1])
Code List
1. Relapse
CL Item
yes, No=No, not known=not known (Yes)
Item
2./3./... Relapse
text
C0277556 (UMLS CUI [1])
Code List
2./3./... Relapse
CL Item
Yes, No=No, not known=not known (Yes)
Item
Metastasis
text
C0027627 (UMLS CUI [1])
Code List
Metastasis
CL Item
Yes, No0No, not known=not known (Yes)
Item
metastasis unifocal
text
C0027627 (UMLS CUI [1,1])
C0443337 (UMLS CUI [1,2])
Code List
metastasis unifocal
CL Item
Yes, No=No, not known=not known (Yes)
Item
Metastasis multifocal
text
C0027627 (UMLS CUI [1,1])
C0205292 (UMLS CUI [1,2])
Code List
Metastasis multifocal
CL Item
Yes, No=No, not known=not known (Yes)
Item Group
Transferring Hospital
C0019994 (UMLS CUI-1)
Treating Hospital Name
Item
Hospital Name
text
C2926025 (UMLS CUI [1])
Date
Item
Date
date
C0011008 (UMLS CUI [1])
Physician
Item
Treating Physician
text
C1710470 (UMLS CUI [1])
Responsible Person Signature
Item
Signature
text
C1519316 (UMLS CUI [1])
Email
Item
Email
text
C0013849 (UMLS CUI [1])
Phone number
Item
Phone Number
float
C0039457 (UMLS CUI [1])

Gebruik dit formulier voor feedback, vragen en verbeteringsvoorstellen.

Velden gemarkeerd met een * zijn verplicht.

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