ID
42041
Beschreibung
ODM form derived from 19pp General Info EBMT Aplastic Anemia 06AA please refer to: http://www.ebmt.org/Contents/Data-Management/Registrystructure/MED-ABdatacollectionforms/Pages/MED-AB-data-collection-forms.aspx
Link
Stichworte
Versionen (5)
- 25.07.16 25.07.16 -
- 04.08.16 04.08.16 -
- 28.11.17 28.11.17 - Julian Varghese
- 15.03.21 15.03.21 - Dr. rer. medic Philipp Neuhaus
- 20.09.21 20.09.21 -
Rechteinhaber
EBMT
Hochgeladen am
15. März 2021
DOI
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16760_General Info EBMT Aplastic Anemia
General Info EBMT Aplastic Anemia
- StudyEvent: ODM
Beschreibung
GENERAL INFORMATION
Beschreibung
Unique Identification Code (UIC)
Datentyp
text
Alias
- UMLS CUI [1]
- C2348585
Beschreibung
Hospital Unique Patient Number or Code
Datentyp
text
Alias
- UMLS CUI [1]
- C1827636
Beschreibung
Initials
Datentyp
text
Alias
- UMLS CUI [1]
- C2986440
Beschreibung
Date of birth
Datentyp
date
Alias
- UMLS CUI [1]
- C0421451
Beschreibung
Sex
Datentyp
text
Alias
- UMLS CUI [1]
- C0079399
Beschreibung
ABO Group
Datentyp
integer
Alias
- UMLS CUI [1]
- C0000778
Beschreibung
Rh factor
Datentyp
integer
Alias
- UMLS CUI [1]
- C0035403
Beschreibung
GENERAL INFORMATION
Beschreibung
Date of diagnosis
Datentyp
date
Alias
- UMLS CUI [1,1]
- C2316983
- UMLS CUI [1,2]
- C1274082
Beschreibung
Primary Disease Diagnosis
Datentyp
text
Alias
- UMLS CUI [1]
- C0277554
Beschreibung
BONE MARROW FAILURE SYNDROME (INCLUDING APLASTIC ANAEMIA)
Beschreibung
SUBCLASSIFICATION
Beschreibung
Acquired
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0439661
Beschreibung
Aplastic anaemia
Datentyp
integer
Alias
- UMLS CUI [1]
- C0002874
Beschreibung
Pure red cell aplasia (non constitutional PRCA)
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0034902
Beschreibung
Paroxysmal nocturnal haemoglobinuria (PNH)
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0024790
Beschreibung
Haemolytic
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0002878
Beschreibung
Aplastic
Datentyp
boolean
Alias
- UMLS CUI [1]
- C1368107
Beschreibung
Thrombotic
Datentyp
boolean
Alias
- UMLS CUI [1]
- C2674163
Beschreibung
Pure white cell aplasia
Datentyp
boolean
Alias
- UMLS CUI [1]
- C2242624
Beschreibung
Amegakaryocytic thrombocytopenia (non constitutional)
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0398639
Beschreibung
Genetic
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0813145
Beschreibung
Fanconi
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0015625
Beschreibung
FANC complementation group
Datentyp
integer
Alias
- UMLS CUI [1]
- C1563385
Beschreibung
Diamond-Blackfan (congenital / constitutional PRCA)
Datentyp
boolean
Alias
- UMLS CUI [1]
- C1260899
Beschreibung
Shwachman-Diamond Syndrome
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0272170
Beschreibung
Dyserythropoietic Anaemia
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0002876
Beschreibung
Dyskeratosis congenita
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0265965
Beschreibung
Amegakaryocytic thrombocytopenia
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0398639
Beschreibung
ETIOLOGY
Datentyp
integer
Alias
- UMLS CUI [1]
- C1314792
Beschreibung
CYTOGENETICS
Beschreibung
Chromosome analysis
Datentyp
text
Alias
- UMLS CUI [1]
- C0200867
Beschreibung
CYTOGENETICS If done: Technique used
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C0010802
- UMLS CUI [1,2]
- C0449851
Beschreibung
Number of metaphases with anomalies
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C1621812
- UMLS CUI [1,2]
- C0449788
Beschreibung
number of metaphases examined
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C0582103
- UMLS CUI [1,2]
- C1621812
Beschreibung
trisomy 8
Datentyp
integer
Alias
- UMLS CUI [1]
- C0432412
Beschreibung
trisomy 3
Datentyp
integer
Alias
- UMLS CUI [1]
- C1519652
Beschreibung
Other or associated abnormalities (specify)
Datentyp
integer
Alias
- UMLS CUI [1]
- C0008625
Beschreibung
Chromosomal breakage test
Datentyp
integer
Alias
- UMLS CUI [1]
- C0398791
Beschreibung
HAEMATOLOGICAL VALUES
Beschreibung
Haemoglobin
Datentyp
float
Maßeinheiten
- g/dL
Alias
- UMLS CUI [1]
- C0518015
Beschreibung
Platelets
Datentyp
float
Alias
- UMLS CUI [1]
- C0005821
Beschreibung
Neutrophils
Datentyp
integer
Alias
- UMLS CUI [1]
- C0948762
Beschreibung
Reticulocytes
Datentyp
float
Alias
- UMLS CUI [1]
- C0035286
Beschreibung
Ferritin
Datentyp
float
Alias
- UMLS CUI [1]
- C0015879
Beschreibung
Haemoglobin
Datentyp
integer
Alias
- UMLS CUI [1]
- C0518015
Beschreibung
Platelets
Datentyp
integer
Alias
- UMLS CUI [1]
- C0005821
Beschreibung
COMPLICATIONS
Beschreibung
PNH TESTS
Beschreibung
Date of PNH test
Datentyp
date
Alias
- UMLS CUI [1,1]
- C0024790
- UMLS CUI [1,2]
- C2826247
Beschreibung
PNH diagnostics by flow cytometry
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C0024790
- UMLS CUI [1,2]
- C0016263
Beschreibung
Size of the PNH
Datentyp
integer
Maßeinheiten
- %
Alias
- UMLS CUI [1,1]
- C0024790
- UMLS CUI [1,2]
- C0456389
Beschreibung
Flow cytometry assessment done on
Datentyp
integer
Alias
- UMLS CUI [1]
- C0016263
Beschreibung
(if type of test unknown, write “unknown” here)
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C0022885
- UMLS CUI [1,2]
- C0024790
- UMLS CUI [1,3]
- C3845569
Beschreibung
PNH diagnostics by other test
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C0022885
- UMLS CUI [1,2]
- C0024790
Beschreibung
Clinical manifestations of PNH
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0024790
Beschreibung
FIRST IMMUNOSUPPRESSIVE TREATMENT EPISODE
Beschreibung
WAS THE PATIENT TREATED BEFORE THE HSCT PROCEDURE?
Datentyp
integer
Alias
- UMLS CUI [1]
- C1514463
Beschreibung
FIRST TREATMENT EPISODE FOR THIS REGISTRATION
Datentyp
date
Alias
- UMLS CUI [1,1]
- C3173309
- UMLS CUI [1,2]
- C0392920
Beschreibung
SEQUENTIAL NUMBER
Datentyp
integer
Alias
- UMLS CUI [1]
- C1115395
Beschreibung
IF 1ST TREATMENT EPISODE FOR THE PATIENT EVER
Beschreibung
NUMBER OF TRANSFUSIONS BEFORE HSCT
Datentyp
text
Alias
- UMLS CUI [1]
- C0014772
Beschreibung
RBC irradiated
Datentyp
integer
Alias
- UMLS CUI [1]
- C1548980
Beschreibung
Platelets
Datentyp
integer
Alias
- UMLS CUI [1]
- C0005821
Beschreibung
Platelets irradiated
Datentyp
integer
Alias
- UMLS CUI [1]
- C0443117
Beschreibung
IF PATIENT HAS BEEN TREATED BEFORE
Beschreibung
Haemoglobin
Datentyp
integer
Alias
- UMLS CUI [1]
- C0518015
Beschreibung
Platelets
Datentyp
float
Maßeinheiten
- 1000/uL
Alias
- UMLS CUI [1]
- C0005821
Beschreibung
Platelets
Datentyp
integer
Alias
- UMLS CUI [1]
- C0005821
Beschreibung
Neutrophils
Datentyp
integer
Alias
- UMLS CUI [1]
- C0948762
Beschreibung
Reticulocytes
Datentyp
float
Alias
- UMLS CUI [1]
- C0035286
Beschreibung
Ferritin
Datentyp
float
Alias
- UMLS CUI [1]
- C0373607
Beschreibung
REASON FOR THIS TREATMENT
Datentyp
integer
Alias
- UMLS CUI [1]
- C1443309
Beschreibung
Medication
Datentyp
integer
Alias
- UMLS CUI [1]
- C0013227
Beschreibung
RESPONSE TO THIS IMMUNOSUPPRESSIVE TREATMENT EPISODE
Datentyp
integer
Alias
- UMLS CUI [1]
- C0521982
Beschreibung
Date response evaluated
Datentyp
date
Alias
- UMLS CUI [1,1]
- C1269701
- UMLS CUI [1,2]
- C1269701
Beschreibung
SECONDARY CLONAL COMPLICATIONS
Datentyp
boolean
Alias
- UMLS CUI [1]
- C2939419
Beschreibung
Date of diagnosis of MDS
Datentyp
date
Alias
- UMLS CUI [1,1]
- C3463824
- UMLS CUI [1,2]
- C2316983
Beschreibung
MDS WHO classification
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C1301142
- UMLS CUI [1,2]
- C3463824
Beschreibung
Date of diagnosis of PNH
Datentyp
date
Alias
- UMLS CUI [1,1]
- C0024790
- UMLS CUI [1,2]
- C2826247
Beschreibung
Size of the PNH clone
Datentyp
float
Maßeinheiten
- %
Alias
- UMLS CUI [1,1]
- C0024790
- UMLS CUI [1,2]
- C0456389
Beschreibung
Flow cytometry assessment done on
Datentyp
integer
Alias
- UMLS CUI [1]
- C0016263
Beschreibung
Clinical manifestations of PNH
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0024790
Beschreibung
If HSCT registration also, please proceed to “Status before HSCT” on page 6 If only Immunosuppressive treatment continue to follow-up form
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0279085
Beschreibung
ADDITIONAL IMMUNOSUPPRESSIVE TREATMENT EPISODE
Beschreibung
Date treatment started
Datentyp
date
Beschreibung
SEQUENTIAL NUMBER OF THIS TREATMENT EPISODE
Datentyp
text
Beschreibung
REASON FOR THIS TREATMENT
Datentyp
text
Beschreibung
REASON FOR THIS TREATMENT
Datentyp
text
Beschreibung
Haemoglobin
Datentyp
integer
Alias
- UMLS CUI [1]
- C0518015
Beschreibung
Platelets
Datentyp
float
Maßeinheiten
- 1000/uL
Alias
- UMLS CUI [1]
- C0005821
Beschreibung
Platelets
Datentyp
integer
Alias
- UMLS CUI [1]
- C0005821
Beschreibung
Neutrophils
Datentyp
integer
Alias
- UMLS CUI [1]
- C0948762
Beschreibung
Reticulocytes
Datentyp
float
Alias
- UMLS CUI [1]
- C0035286
Beschreibung
Ferritin
Datentyp
float
Alias
- UMLS CUI [1]
- C0373607
Beschreibung
REASON FOR THIS TREATMENT
Datentyp
integer
Alias
- UMLS CUI [1]
- C1443309
Beschreibung
Medication
Datentyp
integer
Alias
- UMLS CUI [1]
- C0013227
Beschreibung
RESPONSE TO THIS IMMUNOSUPPRESSIVE TREATMENT EPISODE
Datentyp
integer
Alias
- UMLS CUI [1]
- C0521982
Beschreibung
Date response evaluated
Datentyp
date
Alias
- UMLS CUI [1,1]
- C1269701
- UMLS CUI [1,2]
- C1269701
Beschreibung
SECONDARY CLONAL COMPLICATIONS
Datentyp
boolean
Alias
- UMLS CUI [1]
- C2939419
Beschreibung
Date of diagnosis of MDS
Datentyp
date
Alias
- UMLS CUI [1,1]
- C3463824
- UMLS CUI [1,2]
- C2316983
Beschreibung
MDS WHO classification
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C1301142
- UMLS CUI [1,2]
- C3463824
Beschreibung
Date of diagnosis of PNH
Datentyp
date
Alias
- UMLS CUI [1,1]
- C0024790
- UMLS CUI [1,2]
- C2826247
Beschreibung
Size of the PNH clone
Datentyp
float
Maßeinheiten
- %
Alias
- UMLS CUI [1,1]
- C0024790
- UMLS CUI [1,2]
- C0456389
Beschreibung
Flow cytometry assessment done on
Datentyp
integer
Alias
- UMLS CUI [1]
- C0016263
Beschreibung
Clinical manifestations of PNH
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0024790
Beschreibung
If HSCT registration also, please proceed to “Status before HSCT” on page 6 If only Immunosuppressive treatment continue to follow-up form
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0279085
Beschreibung
STATUS AT HSCT
Beschreibung
Date of HSCT
Datentyp
date
Alias
- UMLS CUI [1]
- C2584899
Beschreibung
Chromosome analysis
Datentyp
integer
Alias
- UMLS CUI [1]
- C0200867
Beschreibung
Chromosome analysis
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C0200867
- UMLS CUI [1,2]
- C0200888
Beschreibung
Number of metaphases with anomalies
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C1621812
- UMLS CUI [1,2]
- C0449788
Beschreibung
number of metaphases examined
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C1621812
- UMLS CUI [1,2]
- C0449788
Beschreibung
Chromosome analysis
Datentyp
text
Beschreibung
Other or associated abnormalities (specify)
Datentyp
text
Beschreibung
Haemoglobin
Datentyp
float
Maßeinheiten
- g/dL
Alias
- UMLS CUI [1]
- C0518015
Beschreibung
Platelets
Datentyp
float
Alias
- UMLS CUI [1]
- C0005821
Beschreibung
Neutrophils
Datentyp
integer
Alias
- UMLS CUI [1]
- C0948762
Beschreibung
Reticulocytes
Datentyp
float
Alias
- UMLS CUI [1]
- C0035286
Beschreibung
Ferritin
Datentyp
float
Alias
- UMLS CUI [1]
- C0015879
Beschreibung
Haemoglobin
Datentyp
integer
Alias
- UMLS CUI [1]
- C0518015
Beschreibung
Platelets
Datentyp
integer
Alias
- UMLS CUI [1]
- C0005821
Beschreibung
Haemorrhages
Datentyp
integer
Alias
- UMLS CUI [1]
- C0019080
Beschreibung
Resistance to random platelets
Datentyp
integer
Alias
- UMLS CUI [1]
- C1277097
Beschreibung
Systemic infection
Datentyp
integer
Alias
- UMLS CUI [1]
- C0243026
Beschreibung
Date of PNH test
Datentyp
date
Alias
- UMLS CUI [1,1]
- C0024790
- UMLS CUI [1,2]
- C2826247
Beschreibung
PNH diagnostics by flow cytometry
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C0024790
- UMLS CUI [1,2]
- C0016263
Beschreibung
Size of the PNH
Datentyp
integer
Maßeinheiten
- %
Alias
- UMLS CUI [1,1]
- C0024790
- UMLS CUI [1,2]
- C0456389
Beschreibung
Flow cytometry assessment done on
Datentyp
integer
Alias
- UMLS CUI [1]
- C0016263
Beschreibung
(if type of test unknown, write “unknown” here)
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C0022885
- UMLS CUI [1,2]
- C0024790
- UMLS CUI [1,3]
- C3845569
Beschreibung
PNH diagnostics by other test
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C0022885
- UMLS CUI [1,2]
- C0024790
Beschreibung
Clinical manifestations of PNH
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0024790
Beschreibung
NUMBER OF TRANSFUSIONS BEFORE HSCT
Datentyp
text
Alias
- UMLS CUI [1]
- C0014772
Beschreibung
RBC irradiated
Datentyp
integer
Alias
- UMLS CUI [1]
- C1548980
Beschreibung
Platelets
Datentyp
integer
Alias
- UMLS CUI [1]
- C0005821
Beschreibung
Platelets irradiated
Datentyp
integer
Alias
- UMLS CUI [1]
- C0443117
Beschreibung
ADDITIONAL TREATMENT POST-HSCT
Beschreibung
BEST DISEASE RESPONSE AT 100 DAYS POST-HSCT
Beschreibung
BEST RESPONSE AT 100 DAYS AFTER HSCT
Datentyp
integer
Alias
- UMLS CUI [1]
- C1704632
Beschreibung
BEST RESPONSE AT 100 DAYS AFTER HSCT
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C1704632
- UMLS CUI [1,2]
- C3845569
Beschreibung
Date response evaluated
Datentyp
date
Alias
- UMLS CUI [1,1]
- C0011008
- UMLS CUI [1,2]
- C1269701
Beschreibung
FORMS TO BE FILLED IN
Ähnliche Modelle
General Info EBMT Aplastic Anemia
- StudyEvent: ODM
C3826859 (UMLS CUI [1,2])
C1274082 (UMLS CUI [1,2])
C0019158 (UMLS CUI-2)
C0449851 (UMLS CUI [1,2])
C0449788 (UMLS CUI [1,2])
C1621812 (UMLS CUI [1,2])
C2826247 (UMLS CUI [1,2])
C0016263 (UMLS CUI [1,2])
C0456389 (UMLS CUI [1,2])
C0024790 (UMLS CUI [1,2])
C3845569 (UMLS CUI [1,3])
C0024790 (UMLS CUI [1,2])
C0392920 (UMLS CUI [1,2])
C1269701 (UMLS CUI [1,2])
C2316983 (UMLS CUI [1,2])
C3463824 (UMLS CUI [1,2])
C2826247 (UMLS CUI [1,2])
C0456389 (UMLS CUI [1,2])
C1269701 (UMLS CUI [1,2])
C2316983 (UMLS CUI [1,2])
C3463824 (UMLS CUI [1,2])
C2826247 (UMLS CUI [1,2])
C0456389 (UMLS CUI [1,2])
C0200888 (UMLS CUI [1,2])
C0449788 (UMLS CUI [1,2])
C0449788 (UMLS CUI [1,2])
C2826247 (UMLS CUI [1,2])
C0016263 (UMLS CUI [1,2])
C0456389 (UMLS CUI [1,2])
C0024790 (UMLS CUI [1,2])
C3845569 (UMLS CUI [1,3])
C0024790 (UMLS CUI [1,2])
C3845569 (UMLS CUI [1,2])
C1269701 (UMLS CUI [1,2])