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Falhas:
ID
1958
Descrição
CGV Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=FF18B4D3-D937-1066-E034-0003BA3F9857
Link
Palavras-chave
Versões (3)
- 19/09/2012 19/09/2012 -
- 09/01/2015 09/01/2015 - Martin Dugas
- 09/06/2015 09/06/2015 -
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19 de setembro de 2012
DOI
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Creative Commons BY-NC 3.0 Legacy
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Leukemia, Myelocytic, Acute null Treatment - CGV - 2394552v3.0
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- StudyEvent: CGV
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- StudyEvent: CGV
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de dados
Alias
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)
C0237753 (UMLS 2011AA ValueDomain)
C16696 (NCI Thesaurus ObjectClass)
C0019994 (UMLS 2011AA ObjectClass)
C25385 (NCI Thesaurus Property)
C0809949 (UMLS 2011AA Property)
Segment
Item
Segment
text
Startofassessmentperiod
Item
Start of assessment period
text
Endofassessmentperiod
Item
End of assessment period
text
Item
Maximum overall grade of acute GVHD during this assessment period
text
C4980 (NCI Thesaurus ObjectClass)
C0856825 (UMLS 2011AA ObjectClass)
C14140 (NCI Thesaurus ObjectClass)
C0205178 (UMLS 2011AA ObjectClass)
C25217 (NCI Thesaurus Property)
C1516048 (UMLS 2011AA Property)
C12981 (NCI Thesaurus Property)
C0332835 (UMLS 2011AA Property)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
C0856825 (UMLS 2011AA ObjectClass)
C14140 (NCI Thesaurus ObjectClass)
C0205178 (UMLS 2011AA ObjectClass)
C25217 (NCI Thesaurus Property)
C1516048 (UMLS 2011AA Property)
C12981 (NCI Thesaurus Property)
C0332835 (UMLS 2011AA Property)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
CL Item
0 (No symptoms of acute GVHD)
C0919414 (NCI Metathesaurus)
CL Item
1 (I)
CL Item
2 (II)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
C0205448 (UMLS 2011AA)
CL Item
3 (III)
CL Item
4 (IV)
Item
Did clinical signs and/or symptoms of acute GVHD develop during this assessment
text
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
TransplantAcuteGVHDBeginDate
Item
Date of diagnosis of acute GVHD
date
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C14140 (NCI Thesaurus Property)
C0205178 (UMLS 2011AA Property)
C0018133 (NCI Metathesaurus Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25431 (NCI Thesaurus ValueDomain)
C0439659 (UMLS 2011AA ValueDomain)
C0332835 (UMLS 2011AA ObjectClass)
C14140 (NCI Thesaurus Property)
C0205178 (UMLS 2011AA Property)
C0018133 (NCI Metathesaurus Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25431 (NCI Thesaurus ValueDomain)
C0439659 (UMLS 2011AA ValueDomain)
CL Item
Histologic Evidence (Histologic Evidence)
CL Item
Clinical Evidence (Clinical Evidence)
CL Item
Both (Both)
Item
Was prophylaxis for GVHD given during this assessment period
text
CL Item
Yes (Yes)
CL Item
No (No)
Item Group
If Yes, Specify All Immuno Suppressants Used For Gvhd Prophylaxis
Item
Cyclosporine
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C459 (NCI Thesaurus ObjectClass)
C0013227 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
C0018133 (NCI Metathesaurus ObjectClass)
C0332307 (UMLS 2011AA ValueDomain)
C459 (NCI Thesaurus ObjectClass)
C0013227 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
C0018133 (NCI Metathesaurus ObjectClass)
CL Item
Cyclosporine (Yes)
C406 (NCI Thesaurus)
C0010592 (UMLS 2011AA)
C0010592 (UMLS 2011AA)
CL Item
No (No)
PriorChemotherapyOtherName
Item
Specify other agent used
text
C15632 (NCI Thesaurus ObjectClass)
C0392920 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus ObjectClass)
C0332152 (UMLS 2011AA ObjectClass)
C17649 (NCI Thesaurus Property)
C0205394 (UMLS 2011AA Property)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C17649 (NCI Thesaurus ValueDomain)
C0205394 (UMLS 2011AA ValueDomain)
C0392920 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus ObjectClass)
C0332152 (UMLS 2011AA ObjectClass)
C17649 (NCI Thesaurus Property)
C0205394 (UMLS 2011AA Property)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C17649 (NCI Thesaurus ValueDomain)
C0205394 (UMLS 2011AA ValueDomain)
CL Item
Yes (Yes)
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
No (No)
Ifno,specifythedateGVHDprophylaxiswasdiscontinued
Item
If no, specify the date GVHD prophylaxis was discontinued
text
Item Group
Answer Questions 9-19 Relating To Chronic Gvhd
Item
Maximum overall severity of chronic GVHD during this assessment period
text
C25499 (NCI Thesaurus ObjectClass)
C0441471 (UMLS 2011AA ObjectClass)
C42614 (NCI Thesaurus ValueDomain)
C0027365 (UMLS 2011AA ValueDomain)
C25676 (NCI Thesaurus Property)
C0439793 (UMLS 2011AA Property)
C0441471 (UMLS 2011AA ObjectClass)
C42614 (NCI Thesaurus ValueDomain)
C0027365 (UMLS 2011AA ValueDomain)
C25676 (NCI Thesaurus Property)
C0439793 (UMLS 2011AA Property)
CL Item
No symptoms of chronic GVHD (No symptoms of chronic GVHD)
CL Item
Mild (Mild)
C70666 (NCI Thesaurus)
C2945599 (UMLS 2011AA)
C2945599 (UMLS 2011AA)
CL Item
Moderate (Moderate)
CL Item
Severe (Severe)
Item
Maximum overall grade of chronic GVHD during this assessment period
text
C14141 (NCI Thesaurus ObjectClass)
C0205191 (UMLS 2011AA ObjectClass)
C0018133 (NCI Metathesaurus ObjectClass)
C12981 (NCI Thesaurus Property)
C0332835 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C48309 (NCI Thesaurus ValueDomain)
C0441800 (UMLS 2011AA ValueDomain)
C0205191 (UMLS 2011AA ObjectClass)
C0018133 (NCI Metathesaurus ObjectClass)
C12981 (NCI Thesaurus Property)
C0332835 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C48309 (NCI Thesaurus ValueDomain)
C0441800 (UMLS 2011AA ValueDomain)
CL Item
Limited (Limited)
CL110648 (NCI Metathesaurus)
CL Item
Extensive (Extensive)
C47863 (NCI Thesaurus)
C0205231 (UMLS 2011AA)
C0205231 (UMLS 2011AA)
CL Item
Did clinical signs and/or symptoms of chronic GVHD develop during this assessment (Did clinical signs and/or symptoms of chronic GVHD develop during this assessment)
CL Item
Yes (Yes)
CL Item
No (No)
Item
Current Karnofsky/Lansky score
text
C25367 (NCI Thesaurus Property)
C20641 (NCI Thesaurus ObjectClass)
C1518965 (UMLS 2011AA ObjectClass)
C25338 (NCI Thesaurus ValueDomain)
C0449820 (UMLS 2011AA ValueDomain)
C20641 (NCI Thesaurus ObjectClass)
C1518965 (UMLS 2011AA ObjectClass)
C25338 (NCI Thesaurus ValueDomain)
C0449820 (UMLS 2011AA ValueDomain)
CL Item
Normal, No Complaints, No Evidence Of Disease (100 (Normal; No Complaints/Fully Active))
CL Item
Able To Carry On Normal Activity; Minor Signs Or Symptoms Of Disease (90 (Normal activity/minor restriction in strenuous play))
CL Item
Normal Activity With Effort; Some Signs Or Symptoms Of Disease (80 (Normal acitvity with efforts/restricted in strenuous play))
CL Item
Cares For Self, Unable To Carry On Normal Activity Or To Do Active Work (70 (Unable to carry on normal activity/less time spent in play))
CL Item
Requires Occasional Assistance, But Is Able To Care For Most Of His/her Needs (60 (Requires occasional assistance/minimal active play))
CL Item
Requires Considerable Assistance And Frequent Medical Care (50 (Requires considerable assistance/no active play))
CL Item
Disabled, Requires Special Care And Assistance (40 (Disabled/Able to initiate quiet activities))
CL Item
Severely Disabled, Hospitalization Indicated. Death Not Imminent (30 (Severely disabled/needs assistance for quiet play))
CL Item
Very Sick, Hospitalization Indicated. Death Not Imminent (20 (Very sick/limited to very passive activity))
CL Item
Moribund, Fatal Processes Progressing Rapidly (10 (Moribund; Completely disabled))
Item
Record method used to diagnose chronic GVHD
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C16847 (NCI Thesaurus Property)
C0449851 (UMLS 2011AA Property)
C15220 (NCI Thesaurus ObjectClass)
C0011900 (UMLS 2011AA ObjectClass)
C0332307 (UMLS 2011AA ValueDomain)
C16847 (NCI Thesaurus Property)
C0449851 (UMLS 2011AA Property)
C15220 (NCI Thesaurus ObjectClass)
C0011900 (UMLS 2011AA ObjectClass)
CL Item
Histology (Histologic Evidence)
C16681 (NCI Thesaurus)
C0019638 (UMLS 2011AA)
C16681 (NCI Thesaurus)
C0019638 (UMLS 2011AA)
C0019638 (UMLS 2011AA)
C16681 (NCI Thesaurus)
C0019638 (UMLS 2011AA)
CL Item
Clinical (Clinical Evidence)
C25398 (NCI Thesaurus)
C0205210 (UMLS 2011AA)
C0205210 (UMLS 2011AA)
CL Item
Both (Both)
LaboratoryProcedurePlateletResultSpecifiedValue
Item
Current platelet count
double
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C12520 (NCI Thesaurus Property)
C0005821 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C1274040 (UMLS 2011AA Property)
C12520 (NCI Thesaurus Property)
C0005821 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
RelevantDiagnosticTestResultDate
Item
Date of diagnosis of chronic GVHD
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C0011008 (UMLS 2011AA ValueDomain)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
PatientWeightMeasurement
Item
Current weight
double
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25208 (NCI Thesaurus Property)
C0043100 (UMLS 2011AA Property)
C0242485 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25208 (NCI Thesaurus Property)
C0043100 (UMLS 2011AA Property)
HepaticAlkalinePhosphataseLabValue
Item
Alkaline phosphatase at time of diagnosis
double
C13308 (NCI Thesaurus ObjectClass)
C0205054 (UMLS 2011AA ObjectClass)
C37984 (NCI Thesaurus Property)
C0022877 (UMLS 2011AA Property)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C16276 (NCI Thesaurus Property)
C0002059 (UMLS 2011AA Property)
C0205054 (UMLS 2011AA ObjectClass)
C37984 (NCI Thesaurus Property)
C0022877 (UMLS 2011AA Property)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C16276 (NCI Thesaurus Property)
C0002059 (UMLS 2011AA Property)
HepaticBilirubinLabValue
Item
Total bilirubin at time of diagnosis
double
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C305 (NCI Thesaurus Property)
C0005437 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C1274040 (UMLS 2011AA Property)
C305 (NCI Thesaurus Property)
C0005437 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
PatientBodySurfaceAreaMeasurement
Item
Body surface area involved with rash at time of diagnosis
double
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25157 (NCI Thesaurus Property)
C0005902 (UMLS 2011AA Property)
C0242485 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25157 (NCI Thesaurus Property)
C0005902 (UMLS 2011AA Property)
Item Group
Indicate The Maximum Severity Of Involvement For The Following Organ Systems During This Assessment Period
Item
Dyspnea
double
C2998 (NCI Thesaurus Property)
C0013404 (UMLS 2011AA Property)
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
C0013404 (UMLS 2011AA Property)
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
CL Item
Asymptomatic (Asymptomatic)
CL Item
Dyspnea with exertion (Dyspnea with exertion)
CL Item
Dyspnea with normal activities (Dyspnea with normal activities)
CL Item
Dyspnea at rest (Dyspnea at rest)
Item
Pulmonary fibrosis
double
C26869 (NCI Thesaurus Property)
C0034069 (UMLS 2011AA Property)
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
C0034069 (UMLS 2011AA Property)
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
CL Item
None (None)
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
C0549184 (UMLS 2011AA)
CL Item
Minimal Radiographic Findings (or Patchy Or Bi-basilar Changes) With Estimated Radiographic Proportion Of Total Lung Volume That Is Fibrotic Of <25% (Minimal radiographic findings)
CL Item
Patchy Or Bi-basilar Changes With Estimated Radiographic Proportion Of Total Lung Volume That Is Fibrotic Of 25 - <50% (Patchy or Bi-basilar radiographic findings)
CL Item
Extensive radiographic findings (Extensive radiographic findings)
CL Item
Not done (Not done)
Item
FEV1
double
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
C38084 (NCI Thesaurus Property)
C0849974 (UMLS 2011AA Property)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
C38084 (NCI Thesaurus Property)
C0849974 (UMLS 2011AA Property)
CL Item
>= 90% Of Pretreatment Or Normal Value (100-90%)
CL Item
90 - 75% Of Predicted Value (<90-75%)
CL Item
<75 - 50% Of Predicted Value (<75-50%)
CL Item
<50 - 25% Of Predicted Value (<50-25%)
CL Item
<25% Of Predicted Value (<25%)
Item
Oxygen saturation
double
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C0150411 (NCI Metathesaurus ObjectClass)
CL105480 (NCI Metathesaurus Property)
C0237753 (UMLS 2011AA ValueDomain)
C0150411 (NCI Metathesaurus ObjectClass)
CL105480 (NCI Metathesaurus Property)
CL Item
No symptoms (No symptoms)
CL Item
Desaturation with exercise (Desaturation with exercise)
CL Item
Requires supplemental oxygen (Requires supplemental oxygen)
Item
Nausea and vomiting
double
C3258 (NCI Thesaurus Property)
C0027497 (UMLS 2011AA Property)
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
C0027497 (UMLS 2011AA Property)
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
CL Item
None (No protracted nausea and vomiting)
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
C0549184 (UMLS 2011AA)
CL Item
Persistent nausea, vomiting, or anorexia (Persistent nausea, vomiting, or anorexia)
Item
Diarrhea
double
C2987 (NCI Thesaurus Property)
C0011991 (UMLS 2011AA Property)
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
C0011991 (UMLS 2011AA Property)
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
CL Item
None (None)
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
C0549184 (UMLS 2011AA)
CL Item
Persisting less than 2 weeks (Persisting less than 2 weeks)
CL Item
Persisting more than 2 weeks (Persisting more than 2 weeks)
Item
Malabsorption
double
C13359 (NCI Thesaurus Property)
C0521362 (UMLS 2011AA Property)
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
C0024523 (NCI Metathesaurus Property)
C0521362 (UMLS 2011AA Property)
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
C0024523 (NCI Metathesaurus Property)
CL Item
None (No symptoms)
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
C0549184 (UMLS 2011AA)
CL Item
Altered Diet; Oral Therapies Indicated (e.g., Enzymes, Medications, Dietary Supplements) (Altered diet, oral therapies indicated (e.g., enzymes, medications, dietary supplements))
CL Item
Inability To Aliment Adequately Via Gi Tract (i.e., Tpn Indicated) (Inability to aliment adequately via GI tract (e.g., TPN indicated))
CL Item
Life-threatening Consequences (Life-threatening consequences)
CL Item
Death (Death)
C28554 (NCI Thesaurus)
C0011065 (UMLS 2011AA)
C0011065 (UMLS 2011AA)
Item
Bilirubin level
double
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C305 (NCI Thesaurus Property)
C0005437 (UMLS 2011AA Property)
C25365 (NCI Thesaurus Property)
C0678257 (UMLS 2011AA Property)
C305 (NCI Thesaurus ValueDomain)
C0005437 (UMLS 2011AA ValueDomain)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
C1516728 (UMLS 2011AA ObjectClass)
C305 (NCI Thesaurus Property)
C0005437 (UMLS 2011AA Property)
C25365 (NCI Thesaurus Property)
C0678257 (UMLS 2011AA Property)
C305 (NCI Thesaurus ValueDomain)
C0005437 (UMLS 2011AA ValueDomain)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
CL Item
bilirubin <2.0 mg/dL (bilirubin <2.0 mg/dL)
CL Item
bilirubin 2.0-3.0 mg/dL (bilirubin 2.0-3.0 mg/dL)
CL Item
bilirubin 3.1-6.0 mg/dL (bilirubin 3.1-6.0 mg/dL)
CL Item
bilirubin 6.1-15.0 mg/dL (bilirubin 6.1-15.0 mg/dL)
CL Item
bilirubin >15.0 mg/dL (bilirubin >15.0 mg/dL)
Item
Vaginitis
double
C26911 (NCI Thesaurus Property)
C0042267 (UMLS 2011AA Property)
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
C0042267 (UMLS 2011AA Property)
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
CL Item
None (No symptoms or not applicable)
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
C0549184 (UMLS 2011AA)
CL Item
Mild, Intervention Not Indicated (Mild, intervention not indicated)
CL Item
Moderate, Intervention Indicated (Moderate, intervention indicated)
CL Item
Severe, Not Relieved With Treatment; Ulceration, But Operative Intervention Not Indicated (Severe, not relieved with treatment;ulceration)
Item
Myositis
double
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
C0027121 (NCI Metathesaurus Property)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
C0027121 (NCI Metathesaurus Property)
CL Item
Yes (Yes)
CL Item
None (No)
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
C0549184 (UMLS 2011AA)
DiseaseInvolvedSiteSpecify
Item
Specify other organ
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
C25547 (NCI Thesaurus Property)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C1521902 (UMLS 2011AA ValueDomain)
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
C25547 (NCI Thesaurus Property)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
CL Item
No Rash (No Rash)
CL Item
<25% of BSA involvement (<25% of BSA involvement)
CL Item
25-50% of BSA involvement (25-50% of BSA involvement)
CL Item
>50% of BSA involvement (>50% of BSA involvement)
CL Item
Generalized involvement (Generalized involvement)
Ifthereisskininvolvement,indicatethetypeofrash
Item
If there is skin involvement, indicate the type of rash
text
CL Item
Yes (Yes)
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
No (No)
CL Item
yes (yes)
CL Item
No (No)
CL Item
No symptoms (No symptoms)
CL Item
Minimal symptoms, normal diet (Minimal symptoms, normal diet)
CL Item
Symptomatic but can eat and swallow modified diet (Symptomatic but can eat and swallow modified diet)
CL Item
Symptomatic and unable to adequately aliment or hydrate orally (Symptomatic and unable to adequately aliment or hydrate orally)
CL Item
Yes, histologic diagnosis (Yes, histologic diagnosis)
CL Item
Yes, clinical diagnosis (Yes, clinical diagnosis)
CL Item
No (No)
CL Item
Unknown (Unknown)
CL Item
No changes (No changes)
CL Item
Symptomatic but can ear regular diet (Symptomatic but can ear regular diet)
CL Item
Dysphagia or odynophagia requiring dietary changes (Dysphagia or odynophagia requiring dietary changes)
CL Item
Need for parenteral nutrition (Need for parenteral nutrition)
Answeroneofthenexttwoquestions
Item
Answer one of the next two questions
text
CL Item
Increase of <4 stools/day over baseline; mild increase in ostomy output compared to baseline (Increase of <4 stools/day over baseline; mild increase in ostomy output compared to baseline)
CL Item
Increase of 4-6 stools;IV fluids indicated <24 hrs;moderate increase in ostomy output (Increase of 4-6 stools;IV fluids indicated <24 hrs;moderate increase in ostomy output)
CL Item
Increase of 7 or more stools/day, IV fluids indicated <24 hrs;moderate increase in ostomy output (Increase of 7 or more stools/day, IV fluids indicated <24 hrs;moderate increase in ostomy output)
CL Item
Life-threatening consequences (e.g., hemodynamic collapse) (Life-threatening consequences (e.g., hemodynamic collapse))
CL Item
Death (Death)
CL Item
Diarrhea less than or equal to 500 mL/day or <280 mL/m^s (Diarrhea less than or equal to 500 mL/day or <280 mL/m^s)
CL Item
Diarrhea >500 but less than or equal to 1000 mL/day or 280-555 mL/m^2 (Diarrhea >500 but less than or equal to 1000 mL/day or 280-555 mL/m^2)
CL Item
Diarrhea >1000 but less than or equal to 1500 mL/day or 556-833 mL/m^2 (Diarrhea >1000 but less than or equal to 1500 mL/day or 556-833 mL/m^2)
CL Item
Diarrhea >1500 mL/day or >833 mL/m^2 (Diarrhea >1500 mL/day or >833 mL/m^2)
CL Item
Severe abdominal pain with or without ileus, stool with frank blood or melena (Severe abdominal pain with or without ileus, stool with frank blood or melena)
CL Item
No symptoms (No symptoms)
CL Item
Mild joint contractures (does not affect ADL) (Mild joint contractures (does not affect ADL))
CL Item
Severe joint contractures (intereferes with ADL) (Severe joint contractures (intereferes with ADL))
CL Item
Yes (Yes)
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
No (No)
Wasthereotherorganinvolvement
Item
Was there other organ involvement
text
Item Group
Answer Questions 42-48 Related To Biopsies Performed During This Assessment Period
Item
Were any biopsies performed during this assessment period for suspected GVHD
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C15189 (NCI Thesaurus ObjectClass)
C0005558 (UMLS 2011AA ObjectClass)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C1512699 (UMLS 2011AA ValueDomain)
C15189 (NCI Thesaurus ObjectClass)
C0005558 (UMLS 2011AA ObjectClass)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
BiopsyDate
Item
Date of biopsy
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain)
C15189 (NCI Thesaurus ObjectClass)
C0005558 (UMLS 2011AA ObjectClass)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain)
C15189 (NCI Thesaurus ObjectClass)
C0005558 (UMLS 2011AA ObjectClass)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
Item
Result of biopsy
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C15189 (NCI Thesaurus ObjectClass)
C0005558 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C0332307 (UMLS 2011AA ValueDomain)
C15189 (NCI Thesaurus ObjectClass)
C0005558 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
CL Item
Positive (Positive)
C25246 (NCI Thesaurus)
C1446409 (UMLS 2011AA)
C1446409 (UMLS 2011AA)
CL Item
Negative (Negative)
C25247 (NCI Thesaurus)
C0205160 (UMLS 2011AA)
C0205160 (UMLS 2011AA)
CL Item
Equivocal (Equivocal)
C86071 (NCI Thesaurus)
C0332241 (UMLS 2011AA)
C0332241 (UMLS 2011AA)
CL Item
Skin biopsy (Skin biopsy)
CL Item
Oral biopsy (Oral biopsy)
CL Item
Upper GI biopsy (Upper GI biopsy)
CL Item
Lower GI biopsy (Lower GI biopsy)
CL Item
Liver biopsy (Liver biopsy)
CL Item
Lung biopse (Lung biopse)
Item
Was a specific therapy used to treat GVHD during this assessment period
text
CL Item
Yes, initiated this assessment period (Yes, initiated this assessment period)
CL Item
Yes, continuing from previous assessment period (Yes, continuing from previous assessment period)
CL Item
No (No)
Item Group
If Yes, Indicate Whether Or Not The Agents Listed Below Were Used To Treat Gvhd During This Assessment Period
Item
Other
text
C17649 (NCI Thesaurus ObjectClass)
C0205394 (UMLS 2011AA ObjectClass)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C459 (NCI Thesaurus ObjectClass)
C0013227 (UMLS 2011AA ObjectClass)
C25409 (NCI Thesaurus Property)
C1533734 (UMLS 2011AA Property)
C0205394 (UMLS 2011AA ObjectClass)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C459 (NCI Thesaurus ObjectClass)
C0013227 (UMLS 2011AA ObjectClass)
C25409 (NCI Thesaurus Property)
C1533734 (UMLS 2011AA Property)
CL Item
Yes (Yes, still taking drug)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No (No, drug not given)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
other,specify
Item
Specify other agent used
text
C25179 (NCI Thesaurus ObjectClass)
C0019993 (UMLS 2011AA ObjectClass)
C25365 (NCI Thesaurus Property)
C0678257 (UMLS 2011AA Property)
C0019993 (UMLS 2011AA ObjectClass)
C25365 (NCI Thesaurus Property)
C0678257 (UMLS 2011AA Property)
Item
Has treatment been discontinued
text
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25601 (NCI Thesaurus Property)
C1518544 (UMLS 2011AA Property)
C1522602 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25601 (NCI Thesaurus Property)
C1518544 (UMLS 2011AA Property)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
OffTreatmentDate
Item
If yes, enter date of discontinuation
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25601 (NCI Thesaurus ObjectClass)
C1518544 (UMLS 2011AA ObjectClass)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
C0011008 (UMLS 2011AA ValueDomain)
C25601 (NCI Thesaurus ObjectClass)
C1518544 (UMLS 2011AA ObjectClass)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
CL Item
Yes, still taking drug (Yes, still taking drug)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No, drug not given (No, drug not given)
CL Item
Yes, still taking drug (Yes, still taking drug)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No, drug not given (No, drug not given)
CL Item
Yes, still taking drug (Yes, still taking drug)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No, drug not given (No, drug not given)
CL Item
Yes, still taking drug (Yes, still taking drug)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No, drug not given (No, drug not given)
CL Item
Yes, still taking drug (Yes, still taking drug)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No, drug not given (No, drug not given)
CL Item
Yes, still taking drug (Yes, still taking drug)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No, drug not given (No, drug not given)
CL Item
Yes, still taking drug (Yes, still taking drug)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No, drug not given (No, drug not given)
CL Item
Yes, still taking drug (Yes, still taking drug)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No, drug not given (No, drug not given)
CL Item
Yes, still taking drug (Yes, still taking drug)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No, drug not given (No, drug not given)
CL Item
Yes, still taking drug (Yes, still taking drug)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No, drug not given (No, drug not given)
CL Item
Yes, still taking drug (Yes, still taking drug)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No, drug not given (No, drug not given)
CL Item
Yes, still taking drug (Yes, still taking drug)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No, drug not given (No, drug not given)
CL Item
Yes, still taking drug (Yes, still taking drug)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No, drug not given (No, drug not given)
CL Item
Yes, still taking drug (Yes, still taking drug)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No, drug not given (No, drug not given)
CL Item
Yes, still taking drug (Yes, still taking drug)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No, drug not given (No, drug not given)
CL Item
Yes, still taking drug (Yes, still taking drug)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No, drug not given (No, drug not given)
CL Item
Yes, still taking drug (Yes, still taking drug)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No, drug not given (No, drug not given)
Item
Specify in vivo anti T-lymphocyte monoclonal antibody used
text
CL Item
In vivo immunotoxin (In vivo immunotoxin)
CL Item
Yes, still taking drug (Yes, still taking drug)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No, drug not given (No, drug not given)
Specifyinvivoimmunotoxin
Item
Specify in vivo immunotoxin
text
IndicatethebestresponsetoGVHDtherapyduringthisassessmentperiod
Item
Indicate the best response to GVHD therapy during this assessment period
text
Item Group
Answer Questions 53-56 Relating To Current Patient Status
Item
Are symptoms of GVHD still present
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C4876 (NCI Thesaurus Property)
C1457887 (UMLS 2011AA Property)
C1512699 (UMLS 2011AA ValueDomain)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C4876 (NCI Thesaurus Property)
C1457887 (UMLS 2011AA Property)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
Item
Current Karnofsky/Lansky score
text
C25367 (NCI Thesaurus Property)
C20641 (NCI Thesaurus ObjectClass)
C1518965 (UMLS 2011AA ObjectClass)
C25338 (NCI Thesaurus ValueDomain)
C0449820 (UMLS 2011AA ValueDomain)
C20641 (NCI Thesaurus ObjectClass)
C1518965 (UMLS 2011AA ObjectClass)
C25338 (NCI Thesaurus ValueDomain)
C0449820 (UMLS 2011AA ValueDomain)
CL Item
Normal, No Complaints, No Evidence Of Disease (100 (Normal; No Complaints/Fully Active))
CL Item
Able To Carry On Normal Activity; Minor Signs Or Symptoms Of Disease (90 (Normal activity/minor restriction in strenuous play))
CL Item
Normal Activity With Effort; Some Signs Or Symptoms Of Disease (80 (Normal acitvity with efforts/restricted in strenuous play))
CL Item
Cares For Self, Unable To Carry On Normal Activity Or To Do Active Work (70 (Unable to carry on normal activity/less time spent in play))
CL Item
Requires Occasional Assistance, But Is Able To Care For Most Of His/her Needs (60 (Requires occasional assistance/minimal active play))
CL Item
Requires Considerable Assistance And Frequent Medical Care (50 (Requires considerable assistance/no active play))
CL Item
Disabled, Requires Special Care And Assistance (40 (Disabled/Able to initiate quiet activities))
CL Item
Severely Disabled, Hospitalization Indicated. Death Not Imminent (30 (Severely disabled/needs assistance for quiet play))
CL Item
Very Sick, Hospitalization Indicated. Death Not Imminent (20 (Very sick/limited to very passive activity))
CL Item
Moribund, Fatal Processes Progressing Rapidly (10 (Moribund; Completely disabled))
LaboratoryProcedurePlateletResultSpecifiedValue
Item
Current platelet count
double
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C12520 (NCI Thesaurus Property)
C0005821 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C1274040 (UMLS 2011AA Property)
C12520 (NCI Thesaurus Property)
C0005821 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
PatientWeightMeasurement
Item
Current weight
double
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25208 (NCI Thesaurus Property)
C0043100 (UMLS 2011AA Property)
C0242485 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25208 (NCI Thesaurus Property)
C0043100 (UMLS 2011AA Property)
ResearchCommentsText
Item
Comments
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C0282411 (UMLS 2011AA Property)
C1527021 (UMLS 2011AA ValueDomain)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C0282411 (UMLS 2011AA Property)