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1 forms
  1. StudyEvent: E1900 Hematology Form
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Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Header
ECOG Protocol Number
Item
ECOG Protocol No.
text
C3274381 (UMLS CUI-1)
C1512162 (UMLS CUI-2)
ECOG Patient ID
Item
ECOG Patient ID
text
C2348585 (UMLS CUI-1)
C1512162 (UMLS CUI-2)
Registration Step
Item
Registration Step
text
C1514821 (UMLS CUI-1)
Item
Reporting period
text
C3538994 (UMLS CUI-1)
CL.1
Code List
Reporting period
CL Item
Current Phase Of Leukemia Treatment For Patient Is Induction (induction)
CL Item
Current Phase Of Leukemia Treatment For Patient Is Consolidation (consolidation)
CL Item
post transplant (post transplant)
Patient Name
Item
Patient's Name
text
C1299487 (UMLS CUI-1)
Participating Group Protocol Number
Item
Participating Group Protocol No.
text
C3274381 (UMLS CUI-1)
C2347449 (UMLS CUI-2)
Participating Group Patient ID
Item
Participating Group Patient ID
text
C2348585 (UMLS CUI-1)
C2347449 (UMLS CUI-2)
Institution
Item
Institution/Affiliate
text
C1301943 (UMLS CUI-1)
Data amended
Item
Are data amended? (If yes, please circle amended items in red)
boolean
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
C0680532 (UMLS CUI-1)
Comments
Item
Comments
text
InvestigatorSignature
Item
Investigator Signature
text
C25678 (NCI Thesaurus Property)
C1519316 (UMLS 2011AA Property)
C17089 (NCI Thesaurus ObjectClass)
C0035173 (UMLS 2011AA ObjectClass)
InvestigatorSignatureDate
Item
Date
date
Item Group
Hematology lab
C0474523 (UMLS CUI-1)
Laboratory Name
Item
Laboratory Name
text
C25191 (NCI Thesaurus ValueDomain)
C25364 (NCI Thesaurus Property)
C37984 (NCI Thesaurus ObjectClass)
C19157 (NCI Thesaurus ObjectClass-2)
C1882331 (UMLS CUI-1)
Sample Collection Date
Item
Date obtained
date
C1317250 (UMLS CUI-1)
WBC LLN
Item
Peripheral WBC count (x1000), LLN
float
C0023508 (UMLS CUI-1)
C1518030 (UMLS CUI-2)
WBC count
Item
Peripheral WBC count (x1000), Value
float
C0023508 (UMLS CUI-1)
Granulocyte count
Item
Granulocyte count AGC/ANC
float
C0857490 (UMLS CUI-1)
Platelets LLN
Item
Peripheral Platelet count (x1000), LLN (Peripheral Platelet count x1000, Value)
float
C25712 (NCI Thesaurus ValueDomain)
C25555 (NCI Thesaurus ValueDomain-2)
C0005821 (UMLS CUI-1)
C1518030 (UMLS CUI-2)
Platelets
Item
Platelets
float
C0005821 (UMLS CUI-1)
Hemoglobin LLN
Item
Hemoglobin LLN
float
C0019046 (UMLS CUI-1)
C1518030 (UMLS CUI-2)
Hemoglobin
Item
Hemoglobin Value
float
C0019046 (UMLS CUI-1)
Blasts
Item
Blasts
float
C1982687 (UMLS CUI-1)
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