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AML- Register_Progress sheet_SAL_University hospital dresden

1 forms  
Patient information
Description

Patient information

Patient name:
Description

Patient name

Data type

text

Patient ID:
Description

Patient ID

Data type

integer

Clinic code:
Description

Clinic code

Data type

integer

Date of birth:
Description

Date of birth

Data type

date

Gender:
Description

gender

Data type

text

Date of last Progress sheet:
Description

date

Data type

date

Date of previous contact:
Description

date

Data type

date

Number of therapies since the last visit (Chemotherapy, immunotherapies, small molecules, transplants):
Description

Therapy number

Data type

integer

Patient alive
Description

Patient alive

CR by acute promyelocytic leukemia (leukocytes >=1,0 GPt/l ; platelets >=100 GPt/l):
Description

complete remission

Data type

text

CRi (Leukocytes <1,0 GPt/l):
Description

complete remission

Data type

boolean

CRp (Leukocytes >=1,0 GPt/l ; Platelets <100 GPt/l):
Description

complete remission

Data type

boolean

No CR by by acute promyelocytic leukemia :
Description

complete remission

Data type

text

Patient dead (Please fill only when the patient is dead)
Description

Patient dead (Please fill only when the patient is dead)

Date of death:
Description

death date

Data type

date

Cause of death:
Description

Cause of death

Data type

text

For other, please mention:
Description

Other

Data type

text

Recurrence
Description

Recurrence

Recurrence since last documentation?
Description

recurrence

Data type

boolean

Date of recurrence:
Description

date

Data type

date

Recurrence number:
Description

recurrence number

Data type

integer

Localization:
Description

localization

Data type

text

Tumor site:
Description

site

Data type

text

Therapy and delayed effect:
Description

therapy; delayed effect

Data type

text

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Similar models

AML- Register_Progress sheet_SAL_University hospital dresden

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Patient information
Patient name
Item
Patient name:
text
Patient ID
Item
Patient ID:
integer
Clinic code
Item
Clinic code:
integer
Date of birth
Item
Date of birth:
date
Item
Gender:
text
gender
Code List
Gender:
CL Item
male (1)
CL Item
female (2)
date
Item
Date of last Progress sheet:
date
date
Item
Date of previous contact:
date
Therapy number
Item
Number of therapies since the last visit (Chemotherapy, immunotherapies, small molecules, transplants):
integer
Item Group
Patient alive
Item
CR by acute promyelocytic leukemia (leukocytes >=1,0 GPt/l ; platelets >=100 GPt/l):
text
complete remission
Code List
CR by acute promyelocytic leukemia (leukocytes >=1,0 GPt/l ; platelets >=100 GPt/l):
CL Item
hematological (1)
CL Item
molecular (2)
complete remission
Item
CRi (Leukocytes <1,0 GPt/l):
boolean
complete remission
Item
CRp (Leukocytes >=1,0 GPt/l ; Platelets <100 GPt/l):
boolean
Item
No CR by by acute promyelocytic leukemia :
text
complete remission
Code List
No CR by by acute promyelocytic leukemia :
CL Item
primary refractory; hematological (1)
CL Item
primary refractory; molecular (2)
CL Item
recurrence; hematological (3)
CL Item
recurrence; molecular (4)
Item Group
Patient dead (Please fill only when the patient is dead)
death date
Item
Date of death:
date
Item
Cause of death:
text
Cause of death
Code List
Cause of death:
CL Item
due to tumor (1)
CL Item
unknown (2)
CL Item
other (3)
Other
Item
For other, please mention:
text
Item Group
Recurrence
recurrence
Item
Recurrence since last documentation?
boolean
date
Item
Date of recurrence:
date
recurrence number
Item
Recurrence number:
integer
Item
Localization:
text
localization
Code List
Localization:
CL Item
bone marrow/ blood (1)
CL Item
extramedullary (2)
site
Item
Tumor site:
text
Item
Therapy and delayed effect:
text
therapy; delayed effect
Code List
Therapy and delayed effect:
CL Item
secondary malignancy (1)
CL Item
chronic GvHD (2)
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