Information: Detta är inte den senaste versionen av datamodellen. Du hittar en versionsöversikt till vänster under versioner. Den senaste versionen hittar du här.
Information:
Fel:
ID
13628
Beskrivning
ODM derived from HSCT forms on http://www.ebmt.org/
Länk
Nyckelord
Versioner (2)
- 2016-02-21 2016-02-21 -
- 2016-02-29 2016-02-29 -
Uppladdad den
21 februari 2016
DOI
För en begäran logga in.
Licens
Creative Commons BY-NC-ND 3.0
Modellkommentarer :
Här kan du kommentera modellen. Med hjälp av pratbubblor i Item-grupperna och Item kan du lägga in specifika kommentarer.
Itemgroup-kommentar för :
Item-kommentar för :
Du måste vara inloggad för att kunna ladda ner formulär. Var vänlig logga in eller registrera dig utan kostnad.
General Information EBMT CML
General Information EBMT CML
- StudyEvent: ODM
Similar models
General Information EBMT CML
- StudyEvent: ODM
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
EBMT Centre Identification Code (CIC)
Item
EBMT Centre Identification Code (CIC)
text
C2348585 (UMLS CUI [1])
Hospital
Item
Hospital
text
C0019994 (UMLS CUI [1])
Unit
Item
Department within the Hospital
text
C1704729 (UMLS CUI [1])
Contact Person
Item
Name of a Contact Person
text
C0337611 (UMLS CUI [1])
Telephone
Item
Telephone number
text
C1515258 (UMLS CUI [1])
Fax
Item
Fax number
text
C1549619 (UMLS CUI [1])
E-Mail
Item
E-Mail Address
text
C1705961 (UMLS CUI [1])
Date of this report
Item
C2348585
date
C1302584 (UMLS CUI [1])
Item
Patient follwing national/ international study/ trial
text
C2348568 (UMLS CUI [1])
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Unknown (Unknown)
Study/Trial
Item
Patient following national/ international study/ trial: If yes, specify:
text
C2348568 (UMLS CUI [1])
Unique Identification Code (UIC)
Item
To be entered only if patient previously reported
text
C2348585 (UMLS CUI [1])
Hospital Unique Patient Number or Code
Item
Hospital Unique Patient Number or Code
text
C2348585 (UMLS CUI [1])
Initials
Item
First name(s) - surname(s) (Registration will not be accepted if this item is left blank)
text
C2986440 (UMLS CUI [1])
Date of birth
Item
Date of birth (Registration will not be accepted if this item is left blank)
date
C0421451 (UMLS CUI [1])
Item
Patient's sex (Registration will not be accepted if this item is left blank)
text
C0079399 (UMLS CUI [1])
CL Item
Male (Male)
CL Item
Female (Female)
CL Item
A (A)
CL Item
B (B)
CL Item
0 (0)
CL Item
AB (AB)
CL Item
Absent (Absent)
CL Item
Present (Present)
CL Item
Not evaluated (Not evaluated)
Date of Diagnosis
Item
Date of Diagnosis
date
C2316983 (UMLS CUI [1])
Item
Check the disease for which this transplant was performed
text
C0277554 (UMLS CUI [1])
CL Item
Acute Leukaemia (Acute Leukaemia)
CL Item
Acute Myelogenous Leukaemia (AML) (Acute Myelogenous Leukaemia (AML))
CL Item
Acute Lymphoblastic Leukaemia (ALL) (Acute Lymphoblastic Leukaemia (ALL))
CL Item
Secondary Acute Leukaemia (do not use if transformed from MDS/MPN) (Secondary Acute Leukaemia (do not use if transformed from MDS/MPN))
CL Item
Chronic Leukaemia (Chronic Leukaemia)
CL Item
Chronic Myeloid Leukaemia (CML) (Chronic Myeloid Leukaemia (CML))
CL Item
Chronic Lymphocytic Leukaemia (Chronic Lymphocytic Leukaemia)
CL Item
Lymphoma (Lymphoma)
CL Item
Non Hodgkin (Non Hodgkin)
CL Item
Hodgkin's Disease (Hodgkin's Disease)
CL Item
Myeloma/ Plasma cell disorder (Myeloma/ Plasma cell disorder)
CL Item
Solid Tumour (Solid Tumour)
CL Item
Myelodysplastic syndromes (Myelodysplastic syndromes)
CL Item
MDS (MDS)
CL Item
MD/ MPN (MD/ MPN)
CL Item
Myeloproliferative neoplasm (Myeloproliferative neoplasm)
CL Item
Bone marrow failure including Aplastic anaemia (Bone marrow failure including Aplastic anaemia)
CL Item
Inherited disorders (Inherited disorders)
CL Item
Primary immune deficiencies (Primary immune deficiencies)
CL Item
Metabolic disorders (Metabolic disorders)
CL Item
Histiocytic disorders (Histiocytic disorders)
CL Item
Autoimmune disease (Autoimmune disease)
CL Item
Juvenile Idiopathic Arthritis (Juvenile Idiopathic Arthritis)
CL Item
Multiple Sclerosis (Multiple Sclerosis)
CL Item
Systemic Lupus (Systemic Lupus)
CL Item
Systemic Sclerosis (Systemic Sclerosis)
CL Item
Haemoglobinopathiy (Haemoglobinopathiy)
CL Item
Other diagnosis (Other diagnosis)
Primary Disease Diagnosis
Item
If other, specify:
text
C0277554 (UMLS CUI [1])