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ID
12411
Description
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.
Keywords
Versions (3)
- 11/17/15 11/17/15 -
- 11/27/15 11/27/15 -
- 2/11/16 2/11/16 -
Uploaded on
November 17, 2015
DOI
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License
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
- StudyEvent: ODM
Similar models
AML- Register_Therapy form_SAL_University hospital dresden
- StudyEvent: ODM
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
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
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
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
hematological (1)
CL Item
molecular (2)
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
Date
Item
Date of chemotherapy:
date
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
medication
Item
Medication:
text
start date
Item
Chemotherapy start date:
date
days
Item
Days:
text
dose
Item
Total dose:
integer
date
Item
Date of transplantation:
date
stem Cell transplantation
Item
Stem cell transplantation centre:
text
CL Item
Autologous (1)
CL Item
Allogeneic (related) (2)
CL Item
Allogeneic (unrelated) (3)
CL Item
identical (1)
CL Item
haploidentical (2)
CL Item
Mismatch (3)
Conditioning regimens
Item
Conditioning regimens:
text
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
date
Item
Date of therapy response:
date
bone marrow puncture
Item
Through bone marrow puncture secured?
boolean
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)