ID

13459

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.

Mots-clés

Versions (3)
  1. 17/11/2015 17/11/2015 -
  2. 27/11/2015 27/11/2015 -
  3. 11/02/2016 11/02/2016 -
Téléchargé le

11 février 2016

DOI

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Licence

Creative Commons BY-NC 3.0
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AML- Register_Therapy form_SAL_University hospital dresden

Anglais

AML- Register_Therapy form_SAL_University hospital dresden

1 Formulaires  
Patient information
Description

Patient information

Alias
UMLS CUI-1
C2707520
Patient name:
Description

Patient name

Type de données

text

Alias
UMLS CUI [1]
C1299487
Patient ID:
Description

Patient ID

Type de données

integer

Alias
UMLS CUI [1]
C2348585
Clinic code:
Description

Clinic code

Type de données

integer

Alias
UMLS CUI [1,1]
C2825164
UMLS CUI [1,2]
C0600091
Date of birth:
Description

Date of birth

Type de données

date

Alias
UMLS CUI [1]
C0421451
Gender:
Description

Gender

Type de données

integer

Alias
UMLS CUI [1]
C0079399
Cancer remission by therapy beginning (to be completed from 2nd therapy)
Description

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

Alias
UMLS CUI-1
C1704632
Date of cancer remission:
Description

date

Type de données

date

Alias
UMLS CUI [1]
C2985720
Through bone marrow puncture secured?
Description

bone marrow puncture

Type de données

boolean

Alias
UMLS CUI [1]
C0005953
Remission status:
Description

Remission status

Type de données

text

Alias
UMLS CUI [1,1]
C1704632
UMLS CUI [1,2]
C0449438
CR by acute promyelocytic leukemia:
Description

Complete remission

Type de données

integer

Alias
UMLS CUI [1]
C0677874
Recurrence by acute promyelocytic leukemia:
Description

recurrence

Type de données

integer

Alias
UMLS CUI [1]
C0035020
CRi/ CRp:
Description

CRi/ CRp

Type de données

boolean

Alias
UMLS CUI [1]
C3538993
UMLS CUI [2]
C3890735
Partial remission:
Description

Partial remission

Type de données

boolean

Alias
UMLS CUI [1]
C1521726
Progression / refractory:
Description

Progression; refractory

Type de données

boolean

Alias
UMLS CUI [1]
C1335499
Can not be assessed:
Description

assessment

Type de données

boolean

Alias
UMLS CUI [1]
C1883425
Chemotherapy
Description

Chemotherapy

Alias
UMLS CUI-1
C3665472
Date of chemotherapy:
Description

Date

Type de données

date

Alias
UMLS CUI [1,1]
C3665472
UMLS CUI [1,2]
C0011008
Chemotherapy:
Description

Chemotherapy

Type de données

integer

Alias
UMLS CUI [1]
C0392920
Therapy schema:
Description

Schema

Type de données

text

Alias
UMLS CUI [1]
C0392920
Medication (chemotherapy)
Description

Medication (chemotherapy)

Alias
UMLS CUI-1
C3665472
Medication:
Description

medication

Type de données

text

Alias
UMLS CUI [1]
C0003392
Chemotherapy start date:
Description

start date

Type de données

date

Alias
UMLS CUI [1]
C1627428
Days:
Description

days

Type de données

text

Alias
UMLS CUI [1,1]
C3665472
UMLS CUI [1,2]
C0439228
Total dose:
Description

dose

Type de données

integer

Unités de mesure
  • mg
Alias
UMLS CUI [1]
C2986497
mg
Transplantation
Description

Transplantation

Alias
UMLS CUI-1
C0472699
Date of transplantation:
Description

date

Type de données

date

Alias
UMLS CUI [1,1]
C0472699
UMLS CUI [1,2]
C0011008
Stem cell transplantation centre:
Description

stem Cell transplantation

Type de données

text

Alias
UMLS CUI [1]
C2825164
Stem cell transplantation type:
Description

Stem cell transplantation type

Type de données

integer

Alias
UMLS CUI [1]
C0472699
Donor:
Description

donor

Type de données

integer

Alias
UMLS CUI [1]
C0549171
Conditioning regimens:
Description

Conditioning regimens

Type de données

text

Alias
UMLS CUI [1]
C0392920
Toxicity grade III-IV
Description

Toxicity grade III-IV

Alias
UMLS CUI-1
C1516728
Creatinine:
Description

creatinine

Type de données

boolean

Alias
UMLS CUI [1]
C0201976
Hemorrhage:
Description

hemorrhage

Type de données

boolean

Alias
UMLS CUI [1]
C0019080
Bilirubin:
Description

Bilirubin

Type de données

boolean

Alias
UMLS CUI [1]
C0201913
Infection:
Description

Infection

Type de données

boolean

Alias
UMLS CUI [1]
C0009450
Heart:
Description

heart

Type de données

boolean

Alias
UMLS CUI [1]
C0018787
GvHD:
Description

GvHD

Type de données

boolean

Alias
UMLS CUI [1]
C0018133
ALAT/ASAT:
Description

ALAT/ASAT

Type de données

boolean

Alias
UMLS CUI [1]
C0201836
UMLS CUI [2]
C0004002
Other:
Description

Other

Type de données

text

Alias
UMLS CUI [1]
C0205394
Therapy outcome
Description

Therapy outcome

Alias
UMLS CUI-1
C1518681
Date of therapy response:
Description

date

Type de données

date

Alias
UMLS CUI [1,1]
C1704632
UMLS CUI [1,2]
C0011008
Through bone marrow puncture secured?
Description

bone marrow puncture

Type de données

boolean

Alias
UMLS CUI [1]
C0005953
Therapy outcome:
Description

therapy outcome

Type de données

integer

Alias
UMLS CUI [1]
C1274040
Retour au début de la page

Similar models

AML- Register_Therapy form_SAL_University hospital dresden

1 Formulaires
Name
Type
Description | Question | Decode (Coded Value)
Type de données
Alias
Item Group
Patient information
C2707520 (UMLS CUI-1)
Patient name
Item
Patient name:
text
C1299487 (UMLS CUI [1])
Patient ID
Item
Patient ID:
integer
C2348585 (UMLS CUI [1])
Clinic code
Item
Clinic code:
integer
C2825164 (UMLS CUI [1,1])
C0600091 (UMLS CUI [1,2])
Date of birth
Item
Date of birth:
date
C0421451 (UMLS CUI [1])
Item
Gender:
integer
C0079399 (UMLS CUI [1])
Gender
Code List
Gender:
CL Item
male  (1)
CL Item
female (2)
Item Group
Cancer remission by therapy beginning (to be completed from 2nd therapy)
C1704632 (UMLS CUI-1)
date
Item
Date of cancer remission:
date
C2985720 (UMLS CUI [1])
bone marrow puncture
Item
Through bone marrow puncture secured?
boolean
C0005953 (UMLS CUI [1])
Item
Remission status:
text
C1704632 (UMLS CUI [1,1])
C0449438 (UMLS CUI [1,2])
Remission status
Code List
Remission status:
CL Item
good response (blasts under 10%) (1)
C1704632 (UMLS CUI-1)
C0205170 (UMLS CUI-2)
CL Item
moderate response (min. halving the number of Blast auf >=10%) (2)
C1704632 (UMLS CUI-1)
C0205081 (UMLS CUI-2)
CL Item
no response (no decrease in the blasts, decrease of <50%) (3)
C3844738 (UMLS CUI-1)
Item
CR by acute promyelocytic leukemia:
integer
C0677874 (UMLS CUI [1])
Complete remission
Code List
CR by acute promyelocytic leukemia:
CL Item
hematological (1)
C0018943 (UMLS CUI-1)
CL Item
molecular (2)
C0026376 (UMLS CUI-1)
Item
Recurrence by acute promyelocytic leukemia:
integer
C0035020 (UMLS CUI [1])
Complete remission
Code List
Recurrence by acute promyelocytic leukemia:
CL Item
hematological (1)
C0018943 (UMLS CUI-1)
CL Item
molecular (2)
C0026376 (UMLS CUI-1)
CRi/ CRp
Item
CRi/ CRp:
boolean
C3538993 (UMLS CUI [1])
C3890735 (UMLS CUI [2])
Partial remission
Item
Partial remission:
boolean
C1521726 (UMLS CUI [1])
Progression; refractory
Item
Progression / refractory:
boolean
C1335499 (UMLS CUI [1])
assessment
Item
Can not be assessed:
boolean
C1883425 (UMLS CUI [1])
Item Group
Chemotherapy
C3665472 (UMLS CUI-1)
Date
Item
Date of chemotherapy:
date
C3665472 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Item
Chemotherapy:
integer
C0392920 (UMLS CUI [1])
Chemotherapy
Code List
Chemotherapy:
CL Item
during a study; curative  (1)
C0008976 (UMLS CUI-1)
C1273390 (UMLS CUI-2)
CL Item
during a study; palliative (2)
C0008976 (UMLS CUI-1)
C1285530 (UMLS CUI-2)
CL Item
outside of a study; curative  (3)
C0087111 (UMLS CUI-1)
C1273390 (UMLS CUI-2)
CL Item
outside of a study; palliative (4)
C0087111 (UMLS CUI-1)
C1285530 (UMLS CUI-2)
Schema
Item
Therapy schema:
text
C0392920 (UMLS CUI [1])
Item Group
Medication (chemotherapy)
C3665472 (UMLS CUI-1)
medication
Item
Medication:
text
C0003392 (UMLS CUI [1])
start date
Item
Chemotherapy start date:
date
C1627428 (UMLS CUI [1])
days
Item
Days:
text
C3665472 (UMLS CUI [1,1])
C0439228 (UMLS CUI [1,2])
dose
Item
Total dose:
integer
C2986497 (UMLS CUI [1])
Item Group
Transplantation
C0472699 (UMLS CUI-1)
date
Item
Date of transplantation:
date
C0472699 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
stem Cell transplantation
Item
Stem cell transplantation centre:
text
C2825164 (UMLS CUI [1])
Item
Stem cell transplantation type:
integer
C0472699 (UMLS CUI [1])
Stem cell transplantation type
Code List
Stem cell transplantation type:
CL Item
Autologous (1)
C0194037 (UMLS CUI-1)
CL Item
Allogeneic (related) (2)
C1705576 (UMLS CUI-1)
C3494891 (UMLS CUI-2)
CL Item
Allogeneic (unrelated) (3)
C1705576 (UMLS CUI-1)
C3179133 (UMLS CUI-2)
Item
Donor:
integer
C0549171 (UMLS CUI [1])
donor
Code List
Donor:
CL Item
identical (1)
C0205280 (UMLS CUI-1)
CL Item
haploidentical  (2)
C3829897 (UMLS CUI-1)
CL Item
Mismatch (3)
C1881865 (UMLS CUI-1)
Conditioning regimens
Item
Conditioning regimens:
text
C0392920 (UMLS CUI [1])
Item Group
Toxicity grade III-IV
C1516728 (UMLS CUI-1)
creatinine
Item
Creatinine:
boolean
C0201976 (UMLS CUI [1])
hemorrhage
Item
Hemorrhage:
boolean
C0019080 (UMLS CUI [1])
Bilirubin
Item
Bilirubin:
boolean
C0201913 (UMLS CUI [1])
Infection
Item
Infection:
boolean
C0009450 (UMLS CUI [1])
heart
Item
Heart:
boolean
C0018787 (UMLS CUI [1])
GvHD
Item
GvHD:
boolean
C0018133 (UMLS CUI [1])
ALAT/ASAT
Item
ALAT/ASAT:
boolean
C0201836 (UMLS CUI [1])
C0004002 (UMLS CUI [2])
Other
Item
Other:
text
C0205394 (UMLS CUI [1])
Item Group
Therapy outcome
C1518681 (UMLS CUI-1)
date
Item
Date of therapy response:
date
C1704632 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
bone marrow puncture
Item
Through bone marrow puncture secured?
boolean
C0005953 (UMLS CUI [1])
Item
Therapy outcome:
integer
C1274040 (UMLS CUI [1])
therapy outcome
Code List
Therapy outcome:
CL Item
good response (blasts under 10%) (1)
C1704632 (UMLS CUI-1)
C0205170 (UMLS CUI-2)
CL Item
moderate response (min. halving the number of Blast auf >=10%) (2)
C1704632 (UMLS CUI-1)
C0205081 (UMLS CUI-2)
CL Item
no response (no decrease in the blasts, decrease of <50%) (3)
C3844738 (UMLS CUI-1)
CL Item
CR by acute promyelocytic leukemia, hematological (4)
C0677874 (UMLS CUI-1)
C0023487 (UMLS CUI-2)
C0018943 (UMLS CUI-3)
CL Item
CR by acute promyelocytic leukemia, molecular (5)
C0677874 (UMLS CUI-1)
C0023487 (UMLS CUI-2)
C0026376 (UMLS CUI-3)
CL Item
Recurrence by acute promyelocytic leukemia, hematological (6)
C0035020 (UMLS CUI-1)
C0023487 (UMLS CUI-2)
C0018943 (UMLS CUI-3)
CL Item
Recurrence by acute promyelocytic leukemia, molecular (7)
C0035020 (UMLS CUI-1)
C0023487 (UMLS CUI-2)
C0026376 (UMLS CUI-3)
CL Item
CRi (8)
C3538993 (UMLS CUI-1)
CL Item
CRp (9)
C3890735 (UMLS CUI-1)
CL Item
Partial remission (10)
C1521726 (UMLS CUI-1)
CL Item
Patient dead (11)
C0011065 (UMLS CUI-1)
CL Item
Progression / refractory (12)
C1335499 (UMLS CUI-1)
CL Item
can not be assessed (13)
C1883425 (UMLS CUI-1)
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