ID

43596

Beskrivning

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

Nyckelord

Versioner (4)
  1. 2015-11-17 2015-11-17 -
  2. 2015-11-27 2015-11-27 -
  3. 2016-02-11 2016-02-11 -
  4. 2021-09-20 2021-09-20 -
Uppladdad den

20 september 2021

DOI

För en begäran logga in.

Licens

Creative Commons BY-NC 3.0
Modellkommentarer :

Här kan du kommentera modellen. Med hjälp av pratbubblor i Item-grupperna och Item kan du lägga in specifika kommentarer.

Tillbaka till modellkommentarer
Itemgroup-kommentar för :

Item-kommentar för :

Du måste vara inloggad för att kunna ladda ner formulär. Var vänlig logga in eller registrera dig utan kostnad.

AML- Register_Accompanying Material Form_SAL_University hospital dresden

Engelsk

AML- Register_Accompanying Material Form_SAL_University hospital dresden

1 Formulär  
Patient information
Beskrivning

Patient information

Alias
UMLS CUI-1
C2707520
Patient name:
Beskrivning

Patient name

Datatyp

text

Alias
UMLS CUI [1]
C1299487
Patient ID:
Beskrivning

Patient ID

Datatyp

integer

Alias
UMLS CUI [1]
C2348585
Clinic code:
Beskrivning

Clinic code

Datatyp

integer

Alias
UMLS CUI [1,1]
C2825164
UMLS CUI [1,2]
C0600091
Date of birth:
Beskrivning

Date of birth

Datatyp

date

Alias
UMLS CUI [1]
C0421451
Gender:
Beskrivning

gender

Datatyp

integer

Alias
UMLS CUI [1]
C0079399
Collected material
Beskrivning

Collected material

Alias
UMLS CUI-1
C0021430
Date of collection:
Beskrivning

date

Datatyp

date

Alias
UMLS CUI [1]
C1302413
Specimen collected during:
Beskrivning

SpecimenCollectedTime

Datatyp

integer

Alias
UMLS CUI [1]
C1302181
Please state the month, if you chose "x month":
Beskrivning

month

Datatyp

integer

Alias
UMLS CUI [1,1]
C1522577
UMLS CUI [1,2]
C0439231
UMLS CUI [1,3]
C0750480
Specimen sent to study centre:
Beskrivning

Specimen

Datatyp

integer

Alias
UMLS CUI [1]
C0456204
Patient agrees with the transfer of ownership (transfer of ownership) of the tissue samples to the SAL biomaterial storage and use for scientific purposes?
Beskrivning

transfer of ownership

Datatyp

boolean

Alias
UMLS CUI [1]
C0021430
The following diagnostic desired:
Beskrivning

diagnostik

Datatyp

integer

Alias
UMLS CUI [1]
C0430022
Sender information
Beskrivning

Sender information

Physician:
Beskrivning

physician

Datatyp

text

Alias
UMLS CUI [1]
C2826892
Clinic:
Beskrivning

Clinic

Datatyp

text

Alias
UMLS CUI [1]
C2825164
Telephone:
Beskrivning

telephone

Datatyp

integer

Alias
UMLS CUI [1]
C1515258
Tillbaka till toppen

Similar models

AML- Register_Accompanying Material Form_SAL_University hospital dresden

1 Formulär
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Patient information
C2707520 (UMLS CUI-1)
Patient name
Item
Patient name:
text
C1299487 (UMLS CUI [1])
Patient ID
Item
Patient ID:
integer
C2348585 (UMLS CUI [1])
Clinic code
Item
Clinic code:
integer
C2825164 (UMLS CUI [1,1])
C0600091 (UMLS CUI [1,2])
Date of birth
Item
Date of birth:
date
C0421451 (UMLS CUI [1])
Item
Gender:
integer
C0079399 (UMLS CUI [1])
gender
Code List
Gender:
CL Item
female (1)
C0086287 (UMLS CUI-1)
CL Item
male (2)
C0086582 (UMLS CUI-1)
Item Group
Collected material
C0021430 (UMLS CUI-1)
date
Item
Date of collection:
date
C1302413 (UMLS CUI [1])
Item
Specimen collected during:
integer
C1302181 (UMLS CUI [1])
SpecimenCollectedTime
Code List
Specimen collected during:
CL Item
first diagnosis (1)
C0006826 (UMLS CUI-1)
CL Item
progress (2)
C1335499 (UMLS CUI-1)
CL Item
recurrence (3)
C0035020 (UMLS CUI-1)
CL Item
after end of treatment (4)
C0087111 (UMLS CUI-1)
C0444930 (UMLS CUI-2)
CL Item
3rd month (5)
C1522577 (UMLS CUI-1)
C0439231 (UMLS CUI-2)
C0205449 (UMLS CUI-3)
CL Item
6th month (6)
C1522577 (UMLS CUI-1)
C0439231 (UMLS CUI-2)
C0205452 (UMLS CUI-3)
CL Item
9th month (7)
C1522577 (UMLS CUI-1)
C0439231 (UMLS CUI-2)
C0205455 (UMLS CUI-3)
CL Item
12th month (8)
C1522577 (UMLS CUI-1)
C0439231 (UMLS CUI-2)
C0205458 (UMLS CUI-3)
CL Item
x month (9)
C1522577 (UMLS CUI-1)
C0439231 (UMLS CUI-2)
C0205394 (UMLS CUI-3)
month
Item
Please state the month, if you chose "x month":
integer
C1522577 (UMLS CUI [1,1])
C0439231 (UMLS CUI [1,2])
C0750480 (UMLS CUI [1,3])
Item
Specimen sent to study centre:
integer
C0456204 (UMLS CUI [1])
Specimen
Code List
Specimen sent to study centre:
CL Item
10 ml of heparinized bone marrow (1)
CL Item
50 ml of heparinized peripheral blood (2)
CL Item
min. 4 unstained bone marrow smears (if cytomorphology desired) (3)
CL Item
min. 3 unstained peripheral blood smear (if cytomorphology desired) (4)
transfer of ownership
Item
Patient agrees with the transfer of ownership (transfer of ownership) of the tissue samples to the SAL biomaterial storage and use for scientific purposes?
boolean
C0021430 (UMLS CUI [1])
Item
The following diagnostic desired:
integer
C0430022 (UMLS CUI [1])
diagnostik
Code List
The following diagnostic desired:
CL Item
cytomorphology (1)
C2238079 (UMLS CUI-1)
CL Item
Molecular Biology (2)
C0026376 (UMLS CUI-1)
CL Item
immunophenotyping (3)
C0079611 (UMLS CUI-1)
CL Item
cytogenetics (4)
C0010802 (UMLS CUI-1)
Item Group
Sender information
physician
Item
Physician:
text
C2826892 (UMLS CUI [1])
Clinic
Item
Clinic:
text
C2825164 (UMLS CUI [1])
telephone
Item
Telephone:
integer
C1515258 (UMLS CUI [1])
Tillbaka till toppen 

Kontakt

Använd detta formulär för feedback, frågor och förslag på förbättringar.

Fält markerade med * är obligatoriska.

Hjälp

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial