ID

43584

Beskrivning

Items used as routine documentation for the SAL (Studienallianz Leukämie) study centre of university hospital dresden. ODM derived from original form "AML-Register Meldebogen - A", converted to ODM format.

Nyckelord

Versioner (3)
  1. 2015-11-23 2015-11-23 -
  2. 2016-02-11 2016-02-11 -
  3. 2021-09-20 2021-09-20 -
Uppladdad den

20 september 2021

DOI

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Licens

Creative Commons BY-NC 3.0
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AML- Register_Registration form_SAL_University hospital dresden

Engelsk

AML- Register_Registration form_SAL_University hospital dresden

1 Formulär  
Clinic information
Beskrivning

Clinic information

Name of the hospital:
Beskrivning

hospital name

Datatyp

text

Alias
UMLS CUI [1]
C2825164
Clinic code:
Beskrivning

Clinic code

Datatyp

integer

Alias
UMLS CUI [1,1]
C2825164
UMLS CUI [1,2]
C0600091
Hospital address:
Beskrivning

hospital address

Datatyp

text

Alias
UMLS CUI [1]
C1442065
Telephone number:
Beskrivning

Telephone number

Datatyp

integer

Alias
UMLS CUI [1]
C1515258
Fax number:
Beskrivning

Fax number

Datatyp

integer

Alias
UMLS CUI [1]
C0085205
Patient information
Beskrivning

Patient information

Alias
UMLS CUI-1
C2707520
Patient's surname:
Beskrivning

Surname

Datatyp

text

Alias
UMLS CUI [1,1]
C1299487
UMLS CUI [1,2]
C1301584
Patient's first name:
Beskrivning

first name

Datatyp

text

Alias
UMLS CUI [1]
C1443235
Patient ID:
Beskrivning

Patient ID

Datatyp

integer

Alias
UMLS CUI [1]
C2348585
Date of birth:
Beskrivning

date of birth

Datatyp

date

Alias
UMLS CUI [1]
C0421451
Gender:
Beskrivning

Gender

Datatyp

text

Alias
UMLS CUI [1]
C0079399
Patient's address:
Beskrivning

Patient address

Datatyp

text

Alias
UMLS CUI [1]
C0421449
Address of the family doctor:
Beskrivning

family doctor address

Datatyp

text

Alias
UMLS CUI [1]
C0017319
Is the signed informed consent available?
Beskrivning

informed consent

Datatyp

boolean

Alias
UMLS CUI [1]
C0021430
Does the patient agree to the transfer of ownership of the collected tissue sample?
Beskrivning

transfer of ownership; tissue sample

Datatyp

boolean

Alias
UMLS CUI [1,1]
C1292533
UMLS CUI [1,2]
C0021430
Tillbaka till toppen

Similar models

AML- Register_Registration form_SAL_University hospital dresden

1 Formulär
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Clinic information
hospital name
Item
Name of the hospital:
text
C2825164 (UMLS CUI [1])
Clinic code
Item
Clinic code:
integer
C2825164 (UMLS CUI [1,1])
C0600091 (UMLS CUI [1,2])
hospital address
Item
Hospital address:
text
C1442065 (UMLS CUI [1])
Telephone number
Item
Telephone number:
integer
C1515258 (UMLS CUI [1])
Fax number
Item
Fax number:
integer
C0085205 (UMLS CUI [1])
Item Group
Patient information
C2707520 (UMLS CUI-1)
Surname
Item
Patient's surname:
text
C1299487 (UMLS CUI [1,1])
C1301584 (UMLS CUI [1,2])
first name
Item
Patient's first name:
text
C1443235 (UMLS CUI [1])
Patient ID
Item
Patient ID:
integer
C2348585 (UMLS CUI [1])
date of birth
Item
Date of birth:
date
C0421451 (UMLS CUI [1])
Item
Gender:
text
C0079399 (UMLS CUI [1])
Gender
Code List
Gender:
CL Item
Male (1)
C0086582 (UMLS CUI-1)
CL Item
Female (2)
C0086287 (UMLS CUI-1)
Patient address
Item
Patient's address:
text
C0421449 (UMLS CUI [1])
family doctor address
Item
Address of the family doctor:
text
C0017319 (UMLS CUI [1])
informed consent
Item
Is the signed informed consent available?
boolean
C0021430 (UMLS CUI [1])
transfer of ownership; tissue sample
Item
Does the patient agree to the transfer of ownership of the collected tissue sample?
boolean
C1292533 (UMLS CUI [1,1])
C0021430 (UMLS CUI [1,2])
Tillbaka till toppen 

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