Clarification Form, Doses and Additional Hematology Laboratory Results

Clarification Form
Beschreibung

Clarification Form

Alias
UMLS CUI-1
C2986669
UMLS CUI-2
C1546922
Form Number
Beschreibung

Please detail below any previous or additional information that requires further description.

Datentyp

integer

Alias
UMLS CUI [1,1]
C1706499
UMLS CUI [1,2]
C1704732
UMLS CUI [1,3]
C0237753
Series Page Number
Beschreibung

Series Page Number

Datentyp

integer

Alias
UMLS CUI [1,1]
C1706499
UMLS CUI [1,2]
C1704732
UMLS CUI [1,3]
C0237753
Comments: clearly identify the item to which the comment applies (e.g., date, time, etc.)
Beschreibung

Comments

Datentyp

text

Alias
UMLS CUI [1]
C0947611
Administered Doses
Beschreibung

Administered Doses

Alias
UMLS CUI-1
C0678766
UMLS CUI-2
C1521801
Dose Specification
Beschreibung

Dose Specification

Datentyp

integer

Alias
UMLS CUI [1,1]
C3174092
UMLS CUI [1,2]
C2348235
Date administered
Beschreibung

Date administered

Datentyp

date

Alias
UMLS CUI [1,1]
C1533734
UMLS CUI [1,2]
C0011008
Actual lodine-131 Anti-B1 Antibody dose administered
Beschreibung

Actual Dose administered

Datentyp

integer

Maßeinheiten
  • mCi
Alias
UMLS CUI [1,1]
C3174092
UMLS CUI [1,2]
C1521801
mCi
Additional Hematology
Beschreibung

Additional Hematology

Alias
UMLS CUI-1
C0474523
UMLS CUI-2
C0022885
Visit:
Beschreibung

Visit

Datentyp

text

Alias
UMLS CUI [1]
C0545082
Date on or after:
Beschreibung

Date on or after

Datentyp

date

Alias
UMLS CUI [1]
C1320303
Date on or before:
Beschreibung

Date on or before

Datentyp

date

Alias
UMLS CUI [1]
C1320303
Laboratory Results - Date:
Beschreibung

Laboratory Results

Datentyp

date

Alias
UMLS CUI [1,1]
C1254595
UMLS CUI [1,2]
C0011008
ANC:
Beschreibung

ANC

Datentyp

integer

Maßeinheiten
  • 10³/mm³
Alias
UMLS CUI [1]
C0948762
10³/mm³
Hgb:
Beschreibung

Hgb

Datentyp

float

Maßeinheiten
  • g/dL
Alias
UMLS CUI [1]
C0019046
g/dL
Plt:
Beschreibung

Plt

Datentyp

integer

Maßeinheiten
  • 10³/mm³
Alias
UMLS CUI [1]
C0005821
10³/mm³
WBC:
Beschreibung

WBC

Datentyp

integer

Maßeinheiten
  • 10³/mm³
Alias
UMLS CUI [1]
C0023508
10³/mm³
Unable to Obtain - Specify:
Beschreibung

Unable to Obtain

Datentyp

text

Alias
UMLS CUI [1,1]
C0022885
UMLS CUI [1,2]
C1299582
Administration
Beschreibung

Administration

Alias
UMLS CUI-1
C1320722
Investigator Signature
Beschreibung

Investigator Signature

Datentyp

text

Alias
UMLS CUI [1]
C2346576
Date
Beschreibung

Date

Datentyp

date

Alias
UMLS CUI [1,1]
C2346576
UMLS CUI [1,2]
C0011008

Ähnliche Modelle

Clarification Form, Doses and Additional Hematology Laboratory Results

Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
Alias
Item Group
Clarification Form
C2986669 (UMLS CUI-1)
C1546922 (UMLS CUI-2)
Form Number
Item
Form Number
integer
C1706499 (UMLS CUI [1,1])
C1704732 (UMLS CUI [1,2])
C0237753 (UMLS CUI [1,3])
Series Page Number
Item
Series Page Number
integer
C1706499 (UMLS CUI [1,1])
C1704732 (UMLS CUI [1,2])
C0237753 (UMLS CUI [1,3])
Comments
Item
Comments: clearly identify the item to which the comment applies (e.g., date, time, etc.)
text
C0947611 (UMLS CUI [1])
Item Group
Administered Doses
C0678766 (UMLS CUI-1)
C1521801 (UMLS CUI-2)
Item
Dose Specification
integer
C3174092 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
Code List
Dose Specification
CL Item
Dosimetric Dose (1)
CL Item
Therapeutic Dose (2)
Date administered
Item
Date administered
date
C1533734 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Actual Dose administered
Item
Actual lodine-131 Anti-B1 Antibody dose administered
integer
C3174092 (UMLS CUI [1,1])
C1521801 (UMLS CUI [1,2])
Item Group
Additional Hematology
C0474523 (UMLS CUI-1)
C0022885 (UMLS CUI-2)
Visit
Item
Visit:
text
C0545082 (UMLS CUI [1])
Date on or after
Item
Date on or after:
date
C1320303 (UMLS CUI [1])
Date on or before
Item
Date on or before:
date
C1320303 (UMLS CUI [1])
Laboratory Results
Item
Laboratory Results - Date:
date
C1254595 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
ANC
Item
ANC:
integer
C0948762 (UMLS CUI [1])
Hgb
Item
Hgb:
float
C0019046 (UMLS CUI [1])
Plt
Item
Plt:
integer
C0005821 (UMLS CUI [1])
WBC
Item
WBC:
integer
C0023508 (UMLS CUI [1])
Unable to Obtain
Item
Unable to Obtain - Specify:
text
C0022885 (UMLS CUI [1,1])
C1299582 (UMLS CUI [1,2])
Item Group
Administration
C1320722 (UMLS CUI-1)
Investigator Signature
Item
Investigator Signature
text
C2346576 (UMLS CUI [1])
Date
Item
Date
date
C2346576 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])