Site number
Item
Site Number
text
C0018704 (UMLS CUI [1,1])
C0600091 (UMLS CUI [1,2])
Patient Number
Item
Patient Number
text
C1830427 (UMLS CUI [1])
Patient Initials
Item
Patient Initials
text
C2986440 (UMLS CUI [1])
Date of death
Item
Date of death
date
C1148348 (UMLS CUI [1])
Item
Cause of death (check one)
text
C0007465 (UMLS CUI [1])
Code List
Cause of death (check one)
CL Item
Progression of lymphoma (Progression of lymphoma)
CL Item
Complications related to drug (complete adverse Experiences form) (Complications related to drug (complete adverse Experiences form))
CL Item
Other (specify) (Other (specify))
Complications of treatment
Item
If cause of death was related to complications of treatment, please describe or reference forms on which information was recorded.
text
C0087111 (UMLS CUI [1,1])
C0009566 (UMLS CUI [1,2])
Item
Relations of study drug to patients death
text
C0011065 (UMLS CUI [1,1])
C0304229 (UMLS CUI [1,2])
Code List
Relations of study drug to patients death
CL Item
Possible (Possible)
CL Item
Probable (Probable)
Item
Source of information concerning death of patient (check all that apply)
text
C0011065 (UMLS CUI [1,1])
C1955348 (UMLS CUI [1,2])
C0449416 (UMLS CUI [1,3])
Code List
Source of information concerning death of patient (check all that apply)
CL Item
Hospital physician (Hospital physician)
CL Item
Patient's physician (Patient's physician)
CL Item
Newspaper (obituary) (Newspaper (obituary))
CL Item
Tumor registry (Tumor registry)
CL Item
Other (specify) (Other (specify))