ID

13791

Descripción

ODM derived from HSCT forms on http://www.ebmt.org/

Link

http://www.ebmt.org/

Palabras clave

Versiones (1)
  1. 6/3/16 6/3/16 -
Subido en

6 de marzo de 2016

DOI

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Licencia

Creative Commons BY-NC-ND 3.0
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Genereral information EBMT CLL

Inglés

Genereral information EBMT CLL

1 formularios  
Team
Descripción

Team

EBMT Centre Identification Code (CIC)
Descripción

EBMT Centre Identification Code (CIC)

Tipo de datos

text

Alias
UMLS CUI [1]
C2348585
Name of the hospital
Descripción

Hospital

Tipo de datos

text

Alias
UMLS CUI [1]
C0019994
Unit
Descripción

Department

Tipo de datos

text

Alias
UMLS CUI [1]
C1704729
Name of contact person
Descripción

Contact person

Tipo de datos

text

Alias
UMLS CUI [1]
C0337611
Telephone number
Descripción

Telephone

Tipo de datos

text

Alias
UMLS CUI [1]
C1515258
Fax number
Descripción

Fax

Tipo de datos

text

Alias
UMLS CUI [1]
C1549619
E-Mail Address
Descripción

E-Mail

Tipo de datos

text

Alias
UMLS CUI [1]
C1705961
Date of this report
Descripción

Date of this report

Tipo de datos

date

Alias
UMLS CUI [1]
C1302584
Patient following national/ international study/ trial
Descripción

Study/ Trial

Tipo de datos

text

Alias
UMLS CUI [1]
C2348568
If yes, specify Name of study/ trial
Descripción

Study Name

Tipo de datos

text

Alias
UMLS CUI [1]
C2348560
Patient
Descripción

Patient

To be entered only if patient previously reported
Descripción

Unique Identification Code (UIC)

Tipo de datos

text

Alias
UMLS CUI [1]
C2348585
Hospital Unique Patient Number or Code
Descripción

Hospital Unique Patient Number or Code

Tipo de datos

text

Alias
UMLS CUI [1]
C1827636
First name(s)_surname(s) (Registrations will not be accepted if this item is left blank)
Descripción

Initials

Tipo de datos

text

Alias
UMLS CUI [1]
C2986440
Date of birth (Registrations will not be accepted if this item is left blank)
Descripción

Date of birth

Tipo de datos

date

Alias
UMLS CUI [1]
C0421451
Patient Gender
Descripción

Gender

Tipo de datos

text

Alias
UMLS CUI [1]
C0079399
AB0 Blood Group
Descripción

AB0 Blood Group

Tipo de datos

text

Alias
UMLS CUI [1]
C0005810
Specification of blood group (Rhesus factor)
Descripción

Rhesus Factor

Tipo de datos

text

Alias
UMLS CUI [1]
C0427641
Disease
Descripción

Disease

Date of Diagnosis
Descripción

Date of Diagnosis

Tipo de datos

date

Alias
UMLS CUI [1]
C2316983
Check the disease for which this transplant was performed
Descripción

Primary Disease Diagnosis

Tipo de datos

text

Alias
UMLS CUI [1]
C0277554
If other diagnosis, specify:
Descripción

Primary Disease Diagnosis

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0277554
UMLS CUI [1,2]
C2348235
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Similar models

Genereral information EBMT CLL

1 formularios
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
Team
EBMT Centre Identification Code (CIC)
Item
EBMT Centre Identification Code (CIC)
text
C2348585 (UMLS CUI [1])
Hospital
Item
Name of the hospital
text
C0019994 (UMLS CUI [1])
Department
Item
Unit
text
C1704729 (UMLS CUI [1])
Contact person
Item
Name of 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
Date of this report
date
C1302584 (UMLS CUI [1])
Item
Patient following national/ international study/ trial
text
C2348568 (UMLS CUI [1])
Study/ Trial
Code List
Patient following national/ international study/ trial
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Unknown (Unknown)
Study Name
Item
If yes, specify Name of study/ trial
text
C2348560 (UMLS CUI [1])
Item Group
Patient
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
C1827636 (UMLS CUI [1])
Initials
Item
First name(s)_surname(s) (Registrations will not be accepted if this item is left blank)
text
C2986440 (UMLS CUI [1])
Date of birth
Item
Date of birth (Registrations will not be accepted if this item is left blank)
date
C0421451 (UMLS CUI [1])
Item
Patient Gender
text
C0079399 (UMLS CUI [1])
Gender
Code List
Patient Gender
CL Item
Female (Female)
CL Item
Male (Male)
Item
AB0 Blood Group
text
C0005810 (UMLS CUI [1])
AB0 Blood Group
Code List
AB0 Blood Group
CL Item
A (A)
CL Item
B (B)
CL Item
0 (0)
CL Item
AB (AB)
Item
Specification of blood group (Rhesus factor)
text
C0427641 (UMLS CUI [1])
Rhesus Factor
Code List
Specification of blood group (Rhesus factor)
CL Item
absent (absent)
CL Item
present (present)
CL Item
not evaluated (not evaluated)
Item Group
Disease
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])
Primary Disease Diagnosis
Code List
Check the disease for which this transplant was performed
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 diagnosis, specify:
text
C0277554 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
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