Informazione:
Errore:
ID
42711
Descrizione
ODM form derived from 14pp EBMT Solid Tumors 11SoTu.pdf refer to: http://www.ebmt.org/Contents/Data-Management/Registrystructure/MED-ABdatacollectionforms/Pages/MED-AB-data-collection-forms.aspx
collegamento
Keywords
versioni (3)
- 05/04/16 05/04/16 -
- 27/07/16 27/07/16 -
- 17/09/21 17/09/21 -
Caricato su
17 settembre 2021
DOI
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Licenza
Creative Commons BY-NC 3.0
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EBMT Solid Tumors
Similar models
EBMT Solid Tumors
- StudyEvent: ODM
Name
genere
Description | Question | Decode (Coded Value)
Tipo di dati
Alias
EBMT FORM GENERAL INFORMATION
Item
EBMT FORM GENERAL INFORMATION
integer
C3826859 (UMLS CUI [1,1])
C1508263 (UMLS CUI [1,2])
C1508263 (UMLS CUI [1,2])
Klinik
Item
Hospital
text
C0019994 (UMLS CUI [1])
Unit
Item
Unit
integer
C1519795 (UMLS CUI [1])
Contact person
Item
Name of contact person
text
C0337611 (UMLS CUI [1])
Patient phone number
Item
Telephone
text
C1515258 (UMLS CUI [1])
Fax
Item
Fax
integer
C1549619 (UMLS CUI [1])
E-mail
Item
E-mail address of contact number
text
C1705961 (UMLS CUI [1])
Date of this report
Item
Date of this report
date
C1302584 (UMLS CUI [1])
Item
Patient following national / international study / trial
integer
C1997894 (UMLS CUI [1])
CL Item
No (1)
C1298908 (UMLS CUI-1)
CL Item
Yes (2)
C1705108 (UMLS CUI-1)
CL Item
Not evaluated (3)
C3846720 (UMLS CUI-1)
CL Item
Unknown (4)
C0439673 (UMLS CUI-1)
Name of study / trial
Item
Name of study / trial
integer
C0008976 (UMLS CUI [1])
Unique Identification Code (UIC)
Item
To be entered only if patient previously reported
text
C2348585 (UMLS CUI [1])
Hospital Unique Patient Number or Code
Item
Hospital Unique Patient Number or Code
text
C1827636 (UMLS CUI [1])
Initials
Item
First name(s)_surname(s)
text
C2986440 (UMLS CUI [1])
Date of Birth
Item
Date of Birth
date
C0421451 (UMLS CUI [1])
CL Item
Male (1)
C1706180 (UMLS CUI-1)
CL Item
Female (2)
C0086287 (UMLS CUI-1)
ABO Group
Item
ABO Group
text
C0000778 (UMLS CUI [1])
CL Item
Absent (1)
C2699077 (UMLS CUI-1)
CL Item
Present (2)
C2699078 (UMLS CUI-1)
CL Item
Not evaluated (3)
C3846720 (UMLS CUI-1)
Date of diagnosis
Item
Date of diagnosis
date
C2316983 (UMLS CUI [1])
Item
Check the disease for which this transplant was performed
integer
C0277554 (UMLS CUI [1])
CL Item
Acute Leukaemia (Acute Leukaemia)
C0085669 (UMLS CUI-1)
CL Item
Acute Myelogenous Leukaemia (AML) (Acute Myelogenous Leukaemia (AML))
C0023467 (UMLS CUI-1)
CL Item
Acute Lymphoblastic Leukaemia (ALL) (Acute Lymphoblastic Leukaemia (ALL))
C0023449 (UMLS CUI-1)
CL Item
Secondary Acute Leukaemia (do not use if transformed from MDS/MPN) (Secondary Acute Leukaemia (do not use if transformed from MDS/MPN))
C0856053 (UMLS CUI-1)
CL Item
Chronic Leukaemia (Chronic Leukaemia)
C0856053 (UMLS CUI-1)
CL Item
Chronic Myeloid Leukaemia (CML) (Chronic Myeloid Leukaemia (CML))
C0023473 (UMLS CUI-1)
CL Item
Chronic Lymphocytic Leukaemia (Chronic Lymphocytic Leukaemia)
C0023434 (UMLS CUI-1)
CL Item
Lymphoma (Lymphoma)
C0024299 (UMLS CUI-1)
CL Item
Non Hodgkin (Non Hodgkin)
C0024305 (UMLS CUI-1)
CL Item
Hodgkin´s Disease (Hodgkin´s Disease)
C0019829 (UMLS CUI-1)
CL Item
Myeloma/ Plasma cell disorder (Myeloma/ Plasma cell disorder)
C0026764 (UMLS CUI-1)
CL Item
Solid Tumour (Solid Tumour)
C0006826 (UMLS CUI-1)
CL Item
Myelodysplastic syndromes (Myelodysplastic syndromes)
C0280450 (UMLS CUI-1)
CL Item
MDS (MDS)
C3463824 (UMLS CUI-1)
CL Item
MD/ MPN (MD/ MPN)
C1292778 (UMLS CUI-1)
CL Item
Myeloproliferative neoplasm (Myeloproliferative neoplasm)
C1333046 (UMLS CUI-1)
CL Item
Bone marrow failure including Aplastic anaemia (Bone marrow failure including Aplastic anaemia)
C0002874 (UMLS CUI-1)
CL Item
Inherited disorders (Inherited disorders)
C0019247 (UMLS CUI-1)
CL Item
Primary immune deficiencies (Primary immune deficiencies)
C0398686 (UMLS CUI-1)
CL Item
Metabolic disorders (Metabolic disorders)
C0025517 (UMLS CUI-1)
CL Item
Histiocytic disorders (Histiocytic disorders)
C0398597 (UMLS CUI-1)
CL Item
Autoimmune disease (Autoimmune disease)
C0004364 (UMLS CUI-1)
CL Item
Juvenile Idiopathic Arthritis (Juvenile Idiopathic Arthritis)
C1444841 (UMLS CUI-1)
CL Item
Multiple Sclerosis (Multiple Sclerosis)
C0026769 (UMLS CUI-1)
CL Item
Systemic Lupus (Systemic Lupus)
C0024141 (UMLS CUI-1)
CL Item
Systemic Sclerosis (Systemic Sclerosis)
C0036421 (UMLS CUI-1)
CL Item
Haemoglobinopathies (Haemoglobinopathiy)
C0019045 (UMLS CUI-1)
CL Item
Other diagnosis (Other diagnosis)
C0205394 (UMLS CUI-1)
CL Item
Bone sarcoma (excluding Ewing sarcoma/PNET) (1)
C0029463 (UMLS CUI-1)
CL Item
Central nervous system tumors (include CNS PNET) (2)
C0085136 (UMLS CUI-1)
CL Item
Colorectal (3)
C0555952 (UMLS CUI-1)
CL Item
Ewing sarcoma/PNET, extra-skeletal (4)
C0553580 (UMLS CUI-1)
CL Item
Ewing sarcoma/PNET, skeletal (5)
C0585474 (UMLS CUI-1)
CL Item
Germ cell tumour, extragonadal only (6)
C0205851 (UMLS CUI-1)
CL Item
Hepatobiliary (7)
C0267792 (UMLS CUI-1)
CL Item
Lung cancer, non-small cell (8)
C0007131 (UMLS CUI-1)
CL Item
Lung cancer, small cell (9)
C0149925 (UMLS CUI-1)
CL Item
Medulloblastoma (10)
C0025149 (UMLS CUI-1)
CL Item
Melanoma (11)
C0025202 (UMLS CUI-1)
CL Item
Other, specify (12)
C1299220 (UMLS CUI-1)
CL Item
Breast cancer (13)
C0678222 (UMLS CUI-1)
CL Item
Neuroblastoma (14)
C0027819 (UMLS CUI-1)
CL Item
Ovarian cancer (15)
C0029925 (UMLS CUI-1)
CL Item
Pancreas (16)
C0030274 (UMLS CUI-1)
CL Item
Prostate (17)
C0033572 (UMLS CUI-1)
CL Item
Renal cell (18)
C0007134 (UMLS CUI-1)
CL Item
Retinoblastoma (19)
C0035335 (UMLS CUI-1)
CL Item
Rhabdomyosarcoma (20)
C0035412 (UMLS CUI-1)
CL Item
Soft tissue sarcoma (21)
C0334449 (UMLS CUI-1)
CL Item
Testicular cancer (22)
C0153594 (UMLS CUI-1)
CL Item
Thymoma (23)
C0040100 (UMLS CUI-1)
CL Item
Wilms tumour (24)
C0027708 (UMLS CUI-1)
INITIAL DIAGNOSIS
Item
INITIAL DIAGNOSIS: if other specify
integer
C0011900 (UMLS CUI [1,1])
C3845569 (UMLS CUI [1,2])
C3845569 (UMLS CUI [1,2])
Item
Clinical TNM classification Tumor
integer
C0809869 (UMLS CUI [1])
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
CL Item
X (6)
CL Item
not evaluated (7)
Item
Clinical TNM classification Tumor Nodes
integer
C0809869 (UMLS CUI [1,1])
C0024204 (UMLS CUI [1,2])
C0024204 (UMLS CUI [1,2])
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
X (5)
CL Item
not evaluated (6)
CL Item
unknown (7)
Item
Clinical TNM classification Metastases
integer
C0027627 (UMLS CUI [1,1])
C0809869 (UMLS CUI [1,2])
C0809869 (UMLS CUI [1,2])
CL Item
0 (1)
CL Item
1 (2)
CL Item
X (3)
CL Item
not evaluated (4)
CL Item
unknown (5)
CL Item
1 (1)
CL Item
2 (2)
CL Item
3 (3)
CL Item
4 (4)
HISTOLOGICAL SUBCLASSIFICATION Describe
Item
HISTOLOGICAL SUBCLASSIFICATION Describe
text
CL Item
Inflammatory (1)
C0333348 (UMLS CUI-1)
CL Item
Non-inflammatory (2)
C0006142 (UMLS CUI-1)
C0442743 (UMLS CUI-2)
C0442743 (UMLS CUI-2)
CL Item
Negative (1)
CL Item
Not evaluated (2)
CL Item
Positive (3)
CL Item
Unknown (4)
CL Item
Not evaluated (5)
CL Item
Unknown (6)
RECEPTOR STATUS Estrogen (ER)
Item
RECEPTOR STATUS positive: Values
float
C1719706 (UMLS CUI [1])
Item
RECEPTOR STATUS Progesterone (PgR)
integer
C1514471 (UMLS CUI [1])
CL Item
Negative (1)
C0205160 (UMLS CUI-1)
CL Item
Not evaluated (2)
C3846720 (UMLS CUI-1)
CL Item
Positive (3)
C1446409 (UMLS CUI-1)
CL Item
Unknown (4)
C0439673 (UMLS CUI-1)
CL Item
Not evaluated (5)
C3846720 (UMLS CUI-1)
CL Item
( )
RECEPTOR STATUS Progesterone (PgR)
Item
Progesterone Receptor Status positive: Values
float
C1514471 (UMLS CUI [1,1])
C0279759 (UMLS CUI [1,2])
C0279759 (UMLS CUI [1,2])
Item
RECEPTOR STATUS HER2/neu (c-erb-B2)
integer
C1512413 (UMLS CUI [1])
CL Item
Negative (1)
C0205160 (UMLS CUI-1)
CL Item
Positive (2)
C1446409 (UMLS CUI-1)
CL Item
Not evaluated (3)
C3846720 (UMLS CUI-1)
CL Item
Unknown (4)
C0439673 (UMLS CUI-1)
Item
If RECEPTOR STATUS HER2/neu (c-erb-B2) positiv :
integer
C2348909 (UMLS CUI [1])
CL Item
IHC 3+ (1)
CL Item
IHC 2+ and FISH + (2)
CL Item
Unknown (3)
Item Group
HISTOLOGICAL SUBCLASSIFICATION FOR BREAST CARCINOMA
Axillary lymph nodes
Item
Number of positive Axillary lymph nodes
float
C0729594 (UMLS CUI [1,1])
C0746319 (UMLS CUI [1,2])
C0746319 (UMLS CUI [1,2])
Axillary lymph nodes
Item
Number of examined Axillary lymph nodes
float
C0807728 (UMLS CUI [1])
Axillary lymph nodes
Item
Axillary lymph nodes Not evaluated
integer
C0220825 (UMLS CUI [1,1])
C0398420 (UMLS CUI [1,2])
C0398420 (UMLS CUI [1,2])
Item
S.B.R. (Scarff-Bloom-Richardson)
integer
C3828224 (UMLS CUI [1])
CL Item
1 (1)
CL Item
2 (2)
CL Item
3 (3)
CL Item
not evaluated (4)
CL Item
unknown (5)
CL Item
yes (1)
C1705108 (UMLS CUI-1)
CL Item
no (2)
C1298908 (UMLS CUI-1)
CL Item
not evaluated (3)
C3846720 (UMLS CUI-1)
CL Item
unknown (4)
C0439673 (UMLS CUI-1)
CL Item
yes (1)
CL Item
no (2)
CL Item
not evaluated (3)
CL Item
unknown (4)
CL Item
Normal (1)
CL Item
Abnormal (2)
CL Item
Not done (3)
CL Item
Unknown (4)
CL Item
If aberrations, notify chromosomal aberrations (e.g. tri/monosomy) and/or other results, in clear (1)
CL Item
Evaluated: Absent (1)
CL Item
Evaluated: Present (2)
CL Item
Not evaluated (3)
CL Item
unknown (4)
CL Item
no (1)
CL Item
yes (2)
treatment start date
Item
1st line treatment started
date
C3173309 (UMLS CUI [1])
CL Item
yes (1)
CL Item
no (2)
Item
if the first-line treatment include HSCT
integer
C0472699 (UMLS CUI [1])
CL Item
Upfront (1)
CL Item
Adjuvant (2)
C1298675 (UMLS CUI-1)
CL Item
Chemotherapy (1)
CL Item
Adjuvant Chemotherapy (2)
CL Item
Neoadjuvant Chemotherapy (3)
CL Item
Surgery (4)
CL Item
Radiotherapy (5)
CL Item
Other (6)
CL Item
Anthracyclines (1)
C0282564 (UMLS CUI-1)
CL Item
Taxanes (2)
C3541958 (UMLS CUI-1)
CL Item
Platinum compounds (3)
C3536920 (UMLS CUI-1)
CL Item
Antimetabolites (4)
C0003376 (UMLS CUI-1)
CL Item
Cyclophosphamide or other alkylating agents (5)
C0010583 (UMLS CUI-1)
CL Item
Vinca Alkaloids (6)
C0042672 (UMLS CUI-1)
CL Item
Etoposide (7)
C0015133 (UMLS CUI-1)
CL Item
Other (8)
C0205394 (UMLS CUI-1)
Drugs
Item
if other drugs
text
CL Item
Mastectomy (1)
CL Item
Conservative (2)
Modality
Item
if other Modality
text
Item
Status of disease after first line treatment (best response)
text
Code List
Status of disease after first line treatment (best response)
CL Item
Complete Remission (1)
CL Item
Partial Remission (2)
CL Item
Not Evaluable (3)
CL Item
Stable Disease (4)
CL Item
Refractory Disease (5)
CL Item
WHO criteria (1)
CL Item
RECIST criteria (2)
Item
ADDITIONAL LINES OF TREATMENT BEFORE THIS HSCT FOR RELAPSED/REFRACTORY DISEASE
text
Code List
ADDITIONAL LINES OF TREATMENT BEFORE THIS HSCT FOR RELAPSED/REFRACTORY DISEASE
CL Item
no (1)
CL Item
yes (2)
Date of HSCT
Item
Date of HSCT
date
C2584899 (UMLS CUI [1])
CL Item
1 (1)
CL Item
2 (2)
CL Item
3 (3)
CL Item
4 (4)
CL Item
>4 (5)
CL Item
unknown (6)
CL Item
no (1)
C1298908 (UMLS CUI-1)
CL Item
yes (2)
C1705108 (UMLS CUI-1)
CL Item
unknown (3)
C0439673 (UMLS CUI-1)
CL Item
no (1)
CL Item
yes (2)
CL Item
unknown (3)
CL Item
no (1)
CL Item
yes (2)
CL Item
unknown (3)
CL Item
no (1)
CL Item
yes (2)
CL Item
unknown (3)
Item
STATUS OF DISEASE AT HSCT
integer
C1704632 (UMLS CUI [1,1])
C0472699 (UMLS CUI [1,2])
C0472699 (UMLS CUI [1,2])
CL Item
Adjuvant (1)
CL Item
Never treated (upfront) (2)
CL Item
Primary refractory (3)
CL Item
Complete remission (CR) (4)
CL Item
1st Partial remission (PR1) (5)
CL Item
Relapse (6)
CL Item
Progressive disease (PD) (7)
CL Item
Confirmed (1)
CL Item
Unconfirmed (CRU*) (2)
CL Item
Unknown (3)
CL Item
Local (1)
C0205276 (UMLS CUI-1)
CL Item
Metastatic (2)
C0036525 (UMLS CUI-1)
Item
Complete remission (CR) Number
integer
C0237753 (UMLS CUI [1,1])
C0677874 (UMLS CUI [1,2])
C0677874 (UMLS CUI [1,2])
CL Item
1st (1)
CL Item
2nd (2)
CL Item
3rd or higher (3)
Item
Complete relapse Number
integer
C2347944 (UMLS CUI [1,1])
C0237753 (UMLS CUI [1,2])
C0237753 (UMLS CUI [1,2])
CL Item
1st (1)
CL Item
2nd (2)
CL Item
3rd or higher (3)
CL Item
Sensitive (SR:>50% response) (1)
C1522640 (UMLS CUI-1)
CL Item
Resistant (RR:<50% response) (2)
C0332325 (UMLS CUI-1)
CL Item
Untreated (3)
C0332155 (UMLS CUI-1)
CL Item
Nodes Below Diaphragm (1)
C0230210 (UMLS CUI-1)
C0024204 (UMLS CUI-2)
C0024204 (UMLS CUI-2)
CL Item
Bone marrow (2)
C0005953 (UMLS CUI-1)
CL Item
CNS (3)
C3714787 (UMLS CUI-1)
CL Item
Mediastinum (4)
C0025066 (UMLS CUI-1)
CL Item
Soft Tissue (5)
C0225317 (UMLS CUI-1)
CL Item
Gastrointestinal tract (6)
C0017189 (UMLS CUI-1)
CL Item
Liver (7)
C0023884 (UMLS CUI-1)
CL Item
Nodes Above Diaphragm (8)
C0024204 (UMLS CUI-1)
CL Item
Bone (9)
C0265917 (UMLS CUI-1)
CL Item
Lungs (10)
C0024109 (UMLS CUI-1)
CL Item
Heart (11)
C0018787 (UMLS CUI-1)
CL Item
Skin (12)
C1123023 (UMLS CUI-1)
CL Item
Urogenital tract (13)
C0042066 (UMLS CUI-1)
CL Item
Ovaries/Testes (14)
C0545968 (UMLS CUI-1)
CL Item
yes (1)
CL Item
no (2)
Additional Disease Treatment
Item
Additional Disease Treatment
boolean
C1706712 (UMLS CUI [1])
CL Item
Planned (planned before HSCT took place) (1)
CL Item
Not planned (for relapse/progression or persistent disease) (2)
Item
BEST RESPONSE AT 100 DAYS AFTER HSCT
text
C2986560 (UMLS CUI [1])
CL Item
Complete Remission (1)
C0677874 (UMLS CUI-1)
CL Item
Very Good Partial Remission (2)
C4053871 (UMLS CUI-1)
CL Item
Partial Remission (>50%) (3)
C1521726 (UMLS CUI-1)
CL Item
Not Evaluable (4)
C1883425 (UMLS CUI-1)
CL Item
Stable Disease (5)
C0677946 (UMLS CUI-1)
CL Item
Progressive Disease (6)
C1335499 (UMLS CUI-1)
CL Item
Minor Response (>25% and <50%) (7)
C4050513 (UMLS CUI-1)
LesionAssessmentDate
Item
Date of Evaluation
date
C0011008 (UMLS CUI [1,1])
C0221198 (UMLS CUI [1,2])
C0031809 (UMLS CUI [1,3])
C0221198 (UMLS CUI [1,2])
C0031809 (UMLS CUI [1,3])
CL Item
AUTOgraft, proceed to Autograft form (1)
CL Item
ALLOgraft or Syngeneic graft, proceed to Allograft form (2)
CL Item
Other (3)
TYPE OF TRANSPLANT
Item
it other type of transplant contact the EBMT Central Registry Office for instructions
text
C0559189 (UMLS CUI [1,1])
C0040739 (UMLS CUI [1,2])
C0040739 (UMLS CUI [1,2])