ID

1888

Beskrivning

EBS Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=FF198F4E-0236-24CA-E034-0003BA3F9857

Länk

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=FF198F4E-0236-24CA-E034-0003BA3F9857

Nyckelord

Versioner (3)
  1. 2012-09-19 2012-09-19 -
  2. 2015-01-09 2015-01-09 - Martin Dugas
  3. 2015-06-16 2015-06-16 -
Uppladdad den

19 september 2012

DOI

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Licens

Creative Commons BY-NC 3.0 Legacy
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Leukemia, Myelocytic, Acute null Treatment - EBS - 2395543v3.0

Engelsk

No Instruction available.

1 Formulär  
Unnamed 1
Beskrivning

Unnamed 1

Visit number
Beskrivning

HospitalAdmissionOrdinalNumber

Datatyp

double

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C16696
UMLS 2011AA ObjectClass
C0019994
NCI Thesaurus Property
C25385
UMLS 2011AA Property
C0809949
If yes, record the date the peripheral blood sample for EBV testing was shipped
Beskrivning

SpecimenLabSubmittedDate

Datatyp

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus Property
C25294
UMLS 2011AA Property
C0022885
NCI Thesaurus ObjectClass
C19157
UMLS 2011AA ObjectClass
C0370003
NCI Thesaurus Property
C25695
UMLS 2011AA Property
C1515023
Date rituximab administered
Beskrivning

AgentAdministeredDate

Datatyp

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ValueDomain
C25367
NCI Thesaurus ObjectClass
C1708
UMLS 2011AA ObjectClass
C0450442
NCI Thesaurus Property
C25382
UMLS 2011AA Property
C1521801
Dose of rituximab administered
Beskrivning

AgentAdministeredDose

Datatyp

double

Alias
NCI Thesaurus ValueDomain
C25488
UMLS 2011AA ValueDomain
C0178602
NCI Thesaurus ObjectClass
C1708
UMLS 2011AA ObjectClass
C0450442
NCI Thesaurus ValueDomain
C1708
UMLS 2011AA ValueDomain
C0450442
NCI Thesaurus Property
C25382
UMLS 2011AA Property
C1521801
Has the patient developed a post-transplant lymphopropliferative disorder
Beskrivning

DiagnosisLymphoproliferativePresentTransplantInd-3

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C38008
UMLS 2011AA ObjectClass
C0687676
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Metathesaurus Property
CL051528
Was a peripheral blood sample drawn for EBV testing during this assessment period
Beskrivning

WasaperipheralbloodsampledrawnforEBVtestingduringthisassessmentperiod

Datatyp

text

Were the results greater than 1000 copies/mL
Beskrivning

Weretheresultsgreaterthan1000copies/mL

Datatyp

text

If yes was rituximab administered
Beskrivning

Ifyeswasrituximabadministered

Datatyp

text

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Similar models

No Instruction available.

1 Formulär
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Unnamed 1
HospitalAdmissionOrdinalNumber
Item
Visit number
double
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C16696 (NCI Thesaurus ObjectClass)
C0019994 (UMLS 2011AA ObjectClass)
C25385 (NCI Thesaurus Property)
C0809949 (UMLS 2011AA Property)
SpecimenLabSubmittedDate
Item
If yes, record the date the peripheral blood sample for EBV testing was shipped
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25294 (NCI Thesaurus Property)
C0022885 (UMLS 2011AA Property)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C25695 (NCI Thesaurus Property)
C1515023 (UMLS 2011AA Property)
AgentAdministeredDate
Item
Date rituximab administered
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain)
C1708 (NCI Thesaurus ObjectClass)
C0450442 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
AgentAdministeredDose
Item
Dose of rituximab administered
double
C25488 (NCI Thesaurus ValueDomain)
C0178602 (UMLS 2011AA ValueDomain)
C1708 (NCI Thesaurus ObjectClass)
C0450442 (UMLS 2011AA ObjectClass)
C1708 (NCI Thesaurus ValueDomain)
C0450442 (UMLS 2011AA ValueDomain)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
Item
Has the patient developed a post-transplant lymphopropliferative disorder
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C38008 (NCI Thesaurus ObjectClass)
C0687676 (UMLS 2011AA ObjectClass)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
CL051528 (NCI Metathesaurus Property)
CL.4
Code List
Has the patient developed a post-transplant lymphopropliferative disorder
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Comments (Comments)
Item
Was a peripheral blood sample drawn for EBV testing during this assessment period
text
CL.1
Code List
Was a peripheral blood sample drawn for EBV testing during this assessment period
CL Item
Yes (Yes)
CL Item
No (No)
Item
Were the results greater than 1000 copies/mL
text
CL.2
Code List
Were the results greater than 1000 copies/mL
CL Item
Yes (Yes)
CL Item
No (No)
CL Item
Results not available (Results not available)
Item
If yes was rituximab administered
text
CL.3
Code List
If yes was rituximab administered
CL Item
Yes (Yes)
CL Item
No (No)
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