ID

12411

Beskrivning

Items used as routine documentation for the SAL (Studienallianz Leukämie) study centre of university hospital dresden. ODM derived from original form "AML-Register Therapiebogen-D", converted to ODM format.

Nyckelord

  1. 2015-11-17 2015-11-17 -
  2. 2015-11-27 2015-11-27 -
  3. 2016-02-11 2016-02-11 -
Uppladdad den

17 november 2015

DOI

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Licens

Creative Commons BY-NC 3.0

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AML- Register_Therapy form_SAL_University hospital dresden

AML- Register_Therapy form_SAL_University hospital dresden

Patient information
Beskrivning

Patient information

Patient name:
Beskrivning

Patient name

Datatyp

text

Patient ID:
Beskrivning

Patient ID

Datatyp

integer

Clinic code:
Beskrivning

Clinic code

Datatyp

integer

Date of birth:
Beskrivning

Date of birth

Datatyp

date

Gender:
Beskrivning

Gender

Datatyp

text

Cancer remission by therapy beginning (to be completed from 2nd therapy)
Beskrivning

Cancer remission by therapy beginning (to be completed from 2nd therapy)

Date of cancer remission:
Beskrivning

date

Datatyp

date

Through bone marrow puncture secured?
Beskrivning

bone marrow puncture

Datatyp

boolean

Remission status:
Beskrivning

Remission status

Datatyp

text

CR by acute promyelocytic leukemia:
Beskrivning

Complete remission

Datatyp

text

Recurrence by acute promyelocytic leukemia:
Beskrivning

recurrence

Datatyp

text

CRi/ CRp:
Beskrivning

CRi/ CRp

Datatyp

boolean

Partial remission:
Beskrivning

Partial remission

Datatyp

boolean

Progression / refractory:
Beskrivning

Progression; refractory

Datatyp

boolean

Can not be assessed:
Beskrivning

assessment

Datatyp

boolean

Chemotherapy
Beskrivning

Chemotherapy

Date of chemotherapy:
Beskrivning

Date

Datatyp

date

Chemotherapy:
Beskrivning

Chemotherapy

Datatyp

text

Therapy schema:
Beskrivning

Schema

Datatyp

text

Medication (chemotherapy)
Beskrivning

Medication (chemotherapy)

Medication:
Beskrivning

medication

Datatyp

text

Chemotherapy start date:
Beskrivning

start date

Datatyp

date

Days:
Beskrivning

days

Datatyp

text

Total dose:
Beskrivning

dose

Datatyp

integer

Måttenheter
  • mg
mg
Transplantation
Beskrivning

Transplantation

Date of transplantation:
Beskrivning

date

Datatyp

date

Stem cell transplantation centre:
Beskrivning

stem Cell transplantation

Datatyp

text

Stem cell transplantation type:
Beskrivning

Stem cell transplantation type

Datatyp

text

Donor:
Beskrivning

donor

Datatyp

text

Conditioning regimens:
Beskrivning

Conditioning regimens

Datatyp

text

Toxicity grade III-IV
Beskrivning

Toxicity grade III-IV

Creatinine:
Beskrivning

creatinine

Datatyp

boolean

Hemorrhage:
Beskrivning

hemorrhage

Datatyp

boolean

Bilirubin:
Beskrivning

Bilirubin

Datatyp

boolean

Infection:
Beskrivning

Infection

Datatyp

boolean

Heart:
Beskrivning

heart

Datatyp

boolean

GvHD:
Beskrivning

GvHD

Datatyp

boolean

ALAT/ASAT:
Beskrivning

ALAT/ASAT

Datatyp

boolean

Other:
Beskrivning

Other

Datatyp

text

Therapy outcome
Beskrivning

Therapy outcome

Date of therapy response:
Beskrivning

date

Datatyp

date

Through bone marrow puncture secured?
Beskrivning

bone marrow puncture

Datatyp

boolean

Therapy outcome:
Beskrivning

therapy outcome

Datatyp

text

Similar models

AML- Register_Therapy form_SAL_University hospital dresden

Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
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
Code List
Gender:
CL Item
male  (1)
CL Item
female (2)
Item Group
Cancer remission by therapy beginning (to be completed from 2nd therapy)
date
Item
Date of cancer remission:
date
bone marrow puncture
Item
Through bone marrow puncture secured?
boolean
Item
Remission status:
text
Code List
Remission status:
CL Item
good response (blasts under 10%) (1)
CL Item
moderate response (min. halving the number of Blast auf >=10%) (2)
CL Item
no response (no decrease in the blasts, decrease of <50%) (3)
Item
CR by acute promyelocytic leukemia:
text
Code List
CR by acute promyelocytic leukemia:
CL Item
hematological (1)
CL Item
molecular (2)
Item
Recurrence by acute promyelocytic leukemia:
text
Code List
Recurrence by acute promyelocytic leukemia:
CL Item
hematological (1)
CL Item
molecular (2)
CRi/ CRp
Item
CRi/ CRp:
boolean
Partial remission
Item
Partial remission:
boolean
Progression; refractory
Item
Progression / refractory:
boolean
assessment
Item
Can not be assessed:
boolean
Item Group
Chemotherapy
Date
Item
Date of chemotherapy:
date
Item
Chemotherapy:
text
Code List
Chemotherapy:
CL Item
during a study; curative  (1)
CL Item
during a study; palliative (2)
CL Item
outside of a study; curative  (3)
CL Item
outside of a study; palliative (4)
Schema
Item
Therapy schema:
text
Item Group
Medication (chemotherapy)
medication
Item
Medication:
text
start date
Item
Chemotherapy start date:
date
days
Item
Days:
text
dose
Item
Total dose:
integer
Item Group
Transplantation
date
Item
Date of transplantation:
date
stem Cell transplantation
Item
Stem cell transplantation centre:
text
Item
Stem cell transplantation type:
text
Code List
Stem cell transplantation type:
CL Item
Autologous (1)
CL Item
Allogeneic (related) (2)
CL Item
Allogeneic (unrelated) (3)
Item
Donor:
text
Code List
Donor:
CL Item
identical (1)
CL Item
haploidentical  (2)
CL Item
Mismatch (3)
Conditioning regimens
Item
Conditioning regimens:
text
Item Group
Toxicity grade III-IV
creatinine
Item
Creatinine:
boolean
hemorrhage
Item
Hemorrhage:
boolean
Bilirubin
Item
Bilirubin:
boolean
Infection
Item
Infection:
boolean
heart
Item
Heart:
boolean
GvHD
Item
GvHD:
boolean
ALAT/ASAT
Item
ALAT/ASAT:
boolean
Other
Item
Other:
text
Item Group
Therapy outcome
date
Item
Date of therapy response:
date
bone marrow puncture
Item
Through bone marrow puncture secured?
boolean
Item
Therapy outcome:
text
Code List
Therapy outcome:
CL Item
good response (blasts under 10%) (1)
CL Item
moderate response (min. halving the number of Blast auf >=10%) (2)
CL Item
no response (no decrease in the blasts, decrease of <50%) (3)
CL Item
CR by acute promyelocytic leukemia, hematological (4)
CL Item
CR by acute promyelocytic leukemia, molecular (5)
CL Item
Recurrence by acute promyelocytic leukemia, hematological (6)
CL Item
Recurrence by acute promyelocytic leukemia, molecular (7)
CL Item
CRi (8)
CL Item
CRp (9)
CL Item
Partial remission (10)
CL Item
Patient dead (11)
CL Item
Progression / refractory (12)
CL Item
can not be assessed (13)

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