ID

1964

Beskrivning

DEM Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=FF1A18C7-58B3-19A7-E034-0003BA3F9857

Länk

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=FF1A18C7-58B3-19A7-E034-0003BA3F9857

Nyckelord

Versioner (4)
  1. 2012-09-19 2012-09-19 -
  2. 2015-01-09 2015-01-09 - Martin Dugas
  3. 2015-06-27 2015-06-27 -
  4. 2021-09-20 2021-09-20 -
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 - DEM - 2394908v3.0

    Engelsk

    No Instruction available.

    1 Formulär  
    Unnamed 1
    Beskrivning

    Unnamed 1

    Gender
    Beskrivning

    PatientGenderCategory

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25372
    UMLS 2011AA ValueDomain
    C0683312
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C17357
    UMLS 2011AA Property
    C0079399
    Date of Birth
    Beskrivning

    PersonBirthDate

    Datatyp

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ObjectClass
    C25190
    UMLS 2011AA ObjectClass
    C0027361
    NCI Thesaurus Property
    C25155
    UMLS 2011AA Property
    C0005615
    Ethnicity
    Beskrivning

    PatientEthnicGroupCategory

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25372
    UMLS 2011AA ValueDomain
    C0683312
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C16564
    UMLS 2011AA Property
    C0015031
    Race
    Beskrivning

    PatientRaceCategory

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25372
    UMLS 2011AA ValueDomain
    C0683312
    NCI Thesaurus ObjectClass
    C16960
    UMLS 2011AA ObjectClass
    C0030705
    NCI Thesaurus Property
    C17049
    UMLS 2011AA Property
    C0034510
    Specify race
    Beskrivning

    OtherRaceCategoryText

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25685
    UMLS 2011AA ValueDomain
    C1521902
    NCI Thesaurus Property
    C25372
    UMLS 2011AA Property
    C0683312
    NCI Thesaurus ObjectClass
    C17049
    UMLS 2011AA ObjectClass
    C0034510
    Specify race
    Beskrivning

    OtherRaceCategoryText

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25685
    UMLS 2011AA ValueDomain
    C1521902
    NCI Thesaurus Property
    C25372
    UMLS 2011AA Property
    C0683312
    NCI Thesaurus ObjectClass
    C17049
    UMLS 2011AA ObjectClass
    C0034510
    Comments
    Beskrivning

    ResearchCommentsText

    Datatyp

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704
    UMLS 2011AA ValueDomain
    C1527021
    NCI Thesaurus ObjectClass
    C15319
    NCI Thesaurus Property
    C25393
    UMLS 2011AA Property
    C0282411
    Name code
    Beskrivning

    Namecode

    Datatyp

    text

    IBMTR IUBMID # (if already known or assigned)
    Beskrivning

    IBMTRIUBMID#(ifalreadyknownorassigned)

    Datatyp

    text

    Secondary race
    Beskrivning

    Secondaryrace

    Datatyp

    text

    Tillbaka till toppen

    Similar models

    No Instruction available.

    1 Formulär
    Name
    Typ
    Description | Question | Decode (Coded Value)
    Datatyp
    Alias
    Item Group
    Unnamed 1
    Item
    Gender
    text
    C25372 (NCI Thesaurus ValueDomain)
    C0683312 (UMLS 2011AA ValueDomain)
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C17357 (NCI Thesaurus Property)
    C0079399 (UMLS 2011AA Property)
    CL.1
    Code List
    Gender
    CL Item
    Male (Male)
    C46109 (NCI Thesaurus)
    C1706180 (UMLS 2011AA)
    CL Item
    Female (Female)
    C46110 (NCI Thesaurus)
    C0015780 (UMLS 2011AA)
    PersonBirthDate
    Item
    Date of Birth
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C25190 (NCI Thesaurus ObjectClass)
    C0027361 (UMLS 2011AA ObjectClass)
    C25155 (NCI Thesaurus Property)
    C0005615 (UMLS 2011AA Property)
    Item
    Ethnicity
    text
    C25372 (NCI Thesaurus ValueDomain)
    C0683312 (UMLS 2011AA ValueDomain)
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C16564 (NCI Thesaurus Property)
    C0015031 (UMLS 2011AA Property)
    CL.2
    Code List
    Ethnicity
    CL Item
    A Person Of Mexican, Puerto Rican, Cuban, Central Or South American Or Other Spanish Culture Or Origin, Regardless Of Race. (Hispanic or Latino)
    C17459 (NCI Thesaurus)
    C0086409 (UMLS 2011AA)
    CL Item
    A Person Not Meeting The Definition For Hispanic Or Latino. (Not Hispanic or Latino)
    C41222 (NCI Thesaurus)
    C1518424 (UMLS 2011AA)
    CL Item
    Could Not Be Determined Or Unsure (Unknown)
    C17998 (NCI Thesaurus)
    C0439673 (UMLS 2011AA)
    CL Item
    Not Provided Or Available (Not answered)
    C43234 (NCI Thesaurus)
    C1706613 (UMLS 2011AA)
    Item
    Race
    text
    C25372 (NCI Thesaurus ValueDomain)
    C0683312 (UMLS 2011AA ValueDomain)
    C16960 (NCI Thesaurus ObjectClass)
    C0030705 (UMLS 2011AA ObjectClass)
    C17049 (NCI Thesaurus Property)
    C0034510 (UMLS 2011AA Property)
    CL.3
    Code List
    Race
    CL Item
    White (not otherwise specified) (White (not otherwise specified))
    CL Item
    European (not otherwise specified) (European (not otherwise specified))
    CL Item
    Mediterranean (Mediterranean)
    CL Item
    White North American (White North American)
    CL Item
    South or Central American White (South or Central American White)
    CL Item
    Eastern European (Eastern European)
    CL Item
    Northern European (Northern European)
    CL Item
    Western European (Western European)
    CL Item
    White Caribbean (White Caribbean)
    CL Item
    North Coast of Africa (North Coast of Africa)
    CL Item
    Black (not otherwise specified) (Black (not otherwise specified))
    CL Item
    African American (African American)
    CL Item
    African Black (both parents born in Africa) (African Black (both parents born in Africa))
    CL Item
    Caribbean Black (Caribbean Black)
    CL Item
    South or Central American Black (South or Central American Black)
    CL Item
    Black, other specify (Black, other specify)
    CL Item
    Asian (not otherwise specified) (Asian (not otherwise specified))
    CL Item
    Indian/South Asian (Indian/South Asian)
    CL Item
    Filipino (pilipino) (Filipino (pilipino))
    CL Item
    Japanese (Japanese)
    CL Item
    Korean (Korean)
    CL Item
    Chinese (Chinese)
    CL Item
    Other Southeast Asian (Other Southeast Asian)
    CL Item
    Vietnamese (Vietnamese)
    CL Item
    Native American (not otherwise specified) (Native American (not otherwise specified))
    CL Item
    Native Alaskan/Eskimo/Aleut (Native Alaskan/Eskimo/Aleut)
    CL Item
    American Indian (not otherwise specified) (American Indian (not otherwise specified))
    CL Item
    North American Indian (North American Indian)
    CL Item
    South or Central American Indian (South or Central American Indian)
    CL Item
    Caribbean Indian (Caribbean Indian)
    CL Item
    Native Pacific Islander (not otherwise specified) (Native Pacific Islander (not otherwise specified))
    CL Item
    Guamanian (Guamanian)
    CL Item
    Hawaiian (Hawaiian)
    CL Item
    Samoan (Samoan)
    CL Item
    Could Not Be Determined Or Unsure (Unknown)
    C17998 (NCI Thesaurus)
    C0439673 (UMLS 2011AA)
    CL Item
    Other, specify (Other, specify)
    CL Item
    Not Provided Or Available (Not answered)
    C43234 (NCI Thesaurus)
    C1706613 (UMLS 2011AA)
    OtherRaceCategoryText
    Item
    Specify race
    text
    C25685 (NCI Thesaurus ValueDomain)
    C1521902 (UMLS 2011AA ValueDomain)
    C25372 (NCI Thesaurus Property)
    C0683312 (UMLS 2011AA Property)
    C17049 (NCI Thesaurus ObjectClass)
    C0034510 (UMLS 2011AA ObjectClass)
    OtherRaceCategoryText
    Item
    Specify race
    text
    C25685 (NCI Thesaurus ValueDomain)
    C1521902 (UMLS 2011AA ValueDomain)
    C25372 (NCI Thesaurus Property)
    C0683312 (UMLS 2011AA Property)
    C17049 (NCI Thesaurus ObjectClass)
    C0034510 (UMLS 2011AA ObjectClass)
    ResearchCommentsText
    Item
    Comments
    text
    C25704 (NCI Thesaurus ValueDomain)
    C1527021 (UMLS 2011AA ValueDomain)
    C15319 (NCI Thesaurus ObjectClass)
    C25393 (NCI Thesaurus Property)
    C0282411 (UMLS 2011AA Property)
    Namecode
    Item
    Name code
    text
    IBMTRIUBMID#(ifalreadyknownorassigned)
    Item
    IBMTR IUBMID # (if already known or assigned)
    text
    Item
    Secondary race
    text
    CL.4
    Code List
    Secondary race
    CL Item
    White (not otherwise specified) (White (not otherwise specified))
    CL Item
    European (not otherwise specified) (European (not otherwise specified))
    CL Item
    Mediterranean (Mediterranean)
    CL Item
    White North American (White North American)
    CL Item
    South or Central American White (South or Central American White)
    CL Item
    Eastern European (Eastern European)
    CL Item
    Northern European (Northern European)
    CL Item
    Western European (Western European)
    CL Item
    White Caribbean (White Caribbean)
    CL Item
    North Coast of Africa (North Coast of Africa)
    CL Item
    Black (not otherwise specified) (Black (not otherwise specified))
    CL Item
    African American (African American)
    CL Item
    African Black (both parents born in Africa) (African Black (both parents born in Africa))
    CL Item
    Caribbean Black (Caribbean Black)
    CL Item
    South or Central American Black (South or Central American Black)
    CL Item
    Black, other specify (Black, other specify)
    CL Item
    Asian (not otherwise specified) (Asian (not otherwise specified))
    CL Item
    Indian/South Asian (Indian/South Asian)
    CL Item
    Filipino (pilipino) (Filipino (pilipino))
    CL Item
    Japanese (Japanese)
    CL Item
    Korean (Korean)
    CL Item
    Chinese (Chinese)
    CL Item
    Other Southeast Asian (Other Southeast Asian)
    CL Item
    Vietnamese (Vietnamese)
    CL Item
    Native American (not otherwise specified) (Native American (not otherwise specified))
    CL Item
    Native Alaskan/Eskimo/Aleut (Native Alaskan/Eskimo/Aleut)
    CL Item
    American Indian (not otherwise specified) (American Indian (not otherwise specified))
    CL Item
    North American Indian (North American Indian)
    CL Item
    South or Central American Indian (South or Central American Indian)
    CL Item
    Caribbean Indian (Caribbean Indian)
    CL Item
    Native Pacific Islander (not otherwise specified) (Native Pacific Islander (not otherwise specified))
    CL Item
    Guamanian (Guamanian)
    CL Item
    Hawaiian (Hawaiian)
    CL Item
    Samoan (Samoan)
    CL Item
    Unknown (Unknown)
    CL Item
    Other, specify (Other, specify)
    CL Item
    Not answered (Not answered)
    Tillbaka till toppen 

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