CDE Detailed Report
Disease: Sickle Cell Disease
Sub-Domain: Additional Proposed Instruments
CRF: Hematopoiesis Form - BMTCTN 1507A
Sub-Domain: Additional Proposed Instruments
CRF: Hematopoiesis Form - BMTCTN 1507A
24 results.
| CDE ID | CDE Name | Variable Name | Definition | Short Description | Additional Notes (Question Text) | Permissible Values | Description | Data Type | Disease Specific Instructions | Disease Specific Reference | Population | Classification (e.g., Core) | Version Number | Version Date | CRF Name (CRF Module / Guideline) | Sub Domain Name | Domain Name | Size | Input Restrictions | Min Value | Max Value | Measurement Type | Source | Form Set | Form | Field | Domain | CDASH Variable | CDASH Definition | CDASH Label | Controlled Terminology | Prompt | Essentiality | Question Text | CDASH imp guidance | SDTM IG target | csDSR | PhenX | Data Type | CRF Completion Inst | SDTMIG Target Var | SDTMIG Target Map | Codelist Name | PVs | Pre Pop Value | Query Display | List Style |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C58988 | Absolute neutrophil count most recent measurement | ANCMostRecentMeasr | Measurement of the most recent ANC (absolute neutrophil count) per microliter. | Measurement of the most recent ANC (absolute neutrophil count) per microliter. | Record the most recent absolute neutrophil count | Numeric Values | Adult;Pediatric | Proposed | 1.00 | 2019-01-07 12:20:14.0 | Hematopoiesis Form - BMTCTN 1507A | Additional Proposed Instruments | Other |
Free-Form Entry |
0 | 99999 | Count per microliter | BMTCTN | 1507A Release 5.10 | Hematopoiesis Form (HF6) | RECNTANC | ||||||||||||||||||||||||||
| C58999 | Chimerism assay T cell sample type code | ChmrsmAssyTCellSamplTypCode | Code denoting the type of T cell sample on which a chimerism assay was performed. | Code denoting the type of T cell sample on which a chimerism assay was performed. | Record the type of T cell sample | 1;2 | Blood;Marrow | Numeric Values | Adult;Pediatric | Proposed | 1.00 | 2019-01-07 13:59:59.0 | Hematopoiesis Form - BMTCTN 1507A | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
BMTCTN | 1507A Release 5.10 | Hematopoiesis Form (HF6) | TCLTYPE | |||||||||||||||||||||||||||
| C58989 | Absolute neutrophil count most recent measurement date | ANCMstRctMeasrDate | Date of the most recent measurement of the patient's ANC (absolute neutrophil count). | Date of the most recent measurement of the patient's ANC (absolute neutrophil count). | Date most recent absolute neutrophil count obtained | Date or Date & Time | Adult;Pediatric | Proposed | 1.00 | 2019-01-07 12:22:22.0 | Hematopoiesis Form - BMTCTN 1507A | Additional Proposed Instruments | Other |
Free-Form Entry |
BMTCTN | 1507A Release 5.10 | Hematopoiesis Form (HF6) | RCTANCDT | |||||||||||||||||||||||||||||
| C59000 | Chimerism assay myeloid cell sample indicate code | ChmrsmAssyMyldClSmplIndCode | Code indicating whether a chimerism assay was performed on a myeloid cell sample. | Code indicating whether a chimerism assay was performed on a myeloid cell sample. | Was a chimerism assay performed on a myeloid cell sample during this assessment period? | 1;2;1;2 | Yes;No;Yes;No | Numeric Values | Adult;Pediatric | Proposed | 1.00 | 2019-01-07 12:27:22.0 | Hematopoiesis Form - BMTCTN 1507A | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
BMTCTN | 1507A Release 5.10 | Hematopoiesis Form (HF6) | MRWCHIM | |||||||||||||||||||||||||||
| C01701 | Lab specimen collection date and time | LabSpecmnCollDateTime | Date (and time if applicable and known) when the specimen was collected | Date (and time if applicable and known) when the specimen was collected | Record date specimen collected | Date or Date & Time | Adult;Pediatric | Proposed | 3.00 | 2013-07-25 08:54:08.2 | Hematopoiesis Form - BMTCTN 1507A | Additional Proposed Instruments | Other |
Free-Form Entry |
2004004 | DeBaun Forms | LB | LBDTC |
Specimen Collection Date |
Collection Date |
What was the date of the lab specimen collection? |
LBDTC | Char | Record the date when specimen collection was done using this format (DD-MON-YYYY). | Prompt | ||||||||||||||||||||||
| C58990 | Chimerism assay marrow sample indicate code | ChmrsmAssyMrrwSmplIndCode | Code indicating whether a chimerism assay was performed on a marrow sample. | Code indicating whether a chimerism assay was performed on a marrow sample. | Was a chimerism assay performed on a marrow sample during this assessment period? | 1;2;1;2 | Yes;No;Yes;No | Numeric Values | Adult;Pediatric | Proposed | 1.00 | 2019-01-07 12:27:22.0 | Hematopoiesis Form - BMTCTN 1507A | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
BMTCTN | 1507A Release 5.10 | Hematopoiesis Form (HF6) | MRWCHIM | |||||||||||||||||||||||||||
| C59001 | Chimerism sort myeloid cell type code | ChmrsmSrtMyldClTypCode | Code denoting the type of myeloid cell by which the chimerism was sorted. | Code denoting the type of myeloid cell by which the chimerism was sorted. | Record the cell type by which the chimerism was sorted | 1;2 | CD15+;CD33+ | Numeric Values | Adult;Pediatric | Proposed | 1.00 | 2019-01-07 14:04:22.0 | Hematopoiesis Form - BMTCTN 1507A | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
BMTCTN | 1507A Release 5.10 | Hematopoiesis Form (HF6) | MYELCELL | |||||||||||||||||||||||||||
| C18027 | Comment text | CmmntTxt | Provide any additional information that pertains to the question. | Provide any additional information that pertains to the question. | Comments | Alphanumeric | Adult;Pediatric | Proposed | 3.00 | 2013-07-16 14:01:43.01 | Hematopoiesis Form - BMTCTN 1507A | Additional Proposed Instruments | Other | 4000 |
Free-Form Entry |
DeBaun Forms | |||||||||||||||||||||||||||||||
| C58991 | Chimerism assay evaluation method code | ChmrsmAssyEvalMethodCode | Code denoting the method of evaluation used in the chimerism assay being recorded. | Code denoting the method of evaluation used in the chimerism assay being recorded. | Record method of evaluation | 1;2;3;4;5;9 | Standard cytogenetics;Fluorescent in situ hybridization (FISH);Restriction fragment length polymorphisms (RFLP);Polymerase chain reaction (PCR) [VNTR, STR, micro or mini satellite];HLA serotyping;Other, specify | Numeric Values | Adult;Pediatric | Proposed | 1.00 | 2019-01-07 12:32:08.0 | Hematopoiesis Form - BMTCTN 1507A | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
BMTCTN | 1507A Release 5.10 | Hematopoiesis Form (HF6) | MRWMTHD | |||||||||||||||||||||||||||
| C59002 | Chimerism assay myeloid cell sample type code | ChmrsmAssyMyldCellSamplTypCode | Code denoting the type of myeloid cell sample on which a chimerism assay was performed. | Code denoting the type of myeloid cell sample on which a chimerism assay was performed. | Record the type of myeloid cell sample | 1;2 | Blood;Marrow | Numeric Values | Adult;Pediatric | Proposed | 1.00 | 2019-01-07 13:59:59.0 | Hematopoiesis Form - BMTCTN 1507A | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
BMTCTN | 1507A Release 5.10 | Hematopoiesis Form (HF6) | TCLTYPE | |||||||||||||||||||||||||||
| C58981 | Granulocyte colony stimulating factor receive indicate code | GCSFReceiveIndicateCode | Code indicating whether the patient received G-CSF (granulocyte colony stimulating factor). | Code indicating whether the patient received G-CSF (granulocyte colony stimulating factor). | Did the patient receive G-CSF during this assessment period? | 1;2;1;2 | Yes;No;Yes;No | Numeric Values | Adult;Pediatric | Proposed | 1.00 | 2019-01-07 11:47:16.0 | Hematopoiesis Form - BMTCTN 1507A | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
BMTCTN | 1507A Release 5.10 | Hematopoiesis Form (HF6) | GCSFREC | |||||||||||||||||||||||||||
| C58992 | Chimerism assay evaluation method code other text | ChmrsmAssyEvalMethodCodeOTH | The free-text field related to 'Chimerism assay evaluation method code' specifying other text. | The free-text field related to 'Chimerism assay evaluation method code' specifying other text. | Specify other method of evaluation | Alphanumeric | Adult;Pediatric | Proposed | 1.00 | 2019-01-07 12:39:06.0 | Hematopoiesis Form - BMTCTN 1507A | Additional Proposed Instruments | Other | 100 |
Free-Form Entry |
BMTCTN | 1507A Release 5.10 | Hematopoiesis Form (HF6) | MRWMTHSP | ||||||||||||||||||||||||||||
| C58982 | Granulocyte colony stimulating factor initiate assess period indicate code | GCSFInitAsesPerIndCode | Code indicating whether G-CSF (granulocyte colony stimulating factor) was initiated during the assessment period. | Code indicating whether G-CSF (granulocyte colony stimulating factor) was initiated during the assessment period. | Was G-CSF initated during this assessment period? | 1;2;1;2 | Yes;No;Yes;No | Numeric Values | Adult;Pediatric | Proposed | 1.00 | 2019-01-07 11:50:13.0 | Hematopoiesis Form - BMTCTN 1507A | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
BMTCTN | 1507A Release 5.10 | Hematopoiesis Form (HF6) | GCSFIN | |||||||||||||||||||||||||||
| C58993 | Chimerism cell type code | ChimerismCellTypeCode | Code denoting the chimerism cell type | Code denoting the chimerism cell type | Record chimerism cell type | 1;2 | Unmanipulated;Manipulated/sorted | Numeric Values | Adult;Pediatric | Proposed | 1.00 | 2019-01-07 12:42:44.0 | Hematopoiesis Form - BMTCTN 1507A | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
BMTCTN | 1507A Release 5.10 | Hematopoiesis Form (HF6) | MRWTYPE | |||||||||||||||||||||||||||
| C58983 | Granulocyte colony stimulating factor initiate date | GCSFInitiateDate | Date on which G-CSF (granulocyte colony stimulating factor) was initiated. | Date on which G-CSF (granulocyte colony stimulating factor) was initiated. | Date G-CSF was initiated | Date or Date & Time | Adult;Pediatric | Proposed | 1.00 | 2019-01-07 11:52:40.0 | Hematopoiesis Form - BMTCTN 1507A | Additional Proposed Instruments | Other |
Free-Form Entry |
BMTCTN | 1507A Release 5.10 | Hematopoiesis Form (HF6) | GCFSDT | |||||||||||||||||||||||||||||
| C58994 | Chimerism assay sample sort text | ChimerismAssaySampleSortTxt | Text describing how the chimerism assay sample was sorted. | Text describing how the chimerism assay sample was sorted. | Record how the sample was sorted | Alphanumeric | Adult;Pediatric | Proposed | 1.00 | 2019-01-07 12:45:10.0 | Hematopoiesis Form - BMTCTN 1507A | Additional Proposed Instruments | Other | 100 |
Free-Form Entry |
BMTCTN | 1507A Release 5.10 | Hematopoiesis Form (HF6) | MRWSORT | ||||||||||||||||||||||||||||
| C58984 | Absolute neutrophil count drop below 500 per microliter after condition regimen initiate indicate code | ANCDpBl500PrULAfCnRgInIndCode | Code indicating whether the patient's ANC (absolute neutrophil count) dropped below 500 per microliter after initiation of conditioning regimen. | Code indicating whether the patient's ANC (absolute neutrophil count) dropped below 500 per microliter after initiation of conditioning regimen. | Did the patient's ANC drop below 500/?L after the initiation of the conditioning regimen? | 1;2;1;2 | Yes;No;Yes;No | Numeric Values | Adult;Pediatric | Proposed | 1.00 | 2019-01-07 12:03:22.0 | Hematopoiesis Form - BMTCTN 1507A | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
BMTCTN | 1507A Release 5.10 | Hematopoiesis Form (HF6) | ANCDRP | |||||||||||||||||||||||||||
| C58995 | Chimerism assay result code | ChimerismAssayResultCode | Code denoting the results of the chimerism assay being documented. | Code denoting the results of the chimerism assay being documented. | Record assay results | 1;2;3;88 | All host cells;All donor cells;Host and donor;Not evaluable/not enough cells | Numeric Values | Adult;Pediatric | Proposed | 1.00 | 2019-01-07 13:46:49.0 | Hematopoiesis Form - BMTCTN 1507A | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
BMTCTN | 1507A Release 5.10 | Hematopoiesis Form (HF6) | MRWRSLT | |||||||||||||||||||||||||||
| C58985 | Absolute neutrophil count greater equal 500 per microliter 3 consecutive measurement different day indicate code | ANCGrEq500PrUL3CsMrDfDyIndCode | Code indicating whether the patient achieved ANC (absolute neutrophil count) greater than or equal to 500 per microliter for three consecutive measurements on different days. | Code indicating whether the patient achieved ANC (absolute neutrophil count) greater than or equal to 500 per microliter for three consecutive measurements on different days. | Did the patient achieve ANC >= 500/?L for three consecutive measurements obtained on different days? | 1;2;3 | Yes;No;Previously reported | Numeric Values | Adult;Pediatric | Proposed | 1.00 | 2019-01-07 12:07:09.0 | Hematopoiesis Form - BMTCTN 1507A | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
BMTCTN | 1507A Release 5.10 | Hematopoiesis Form (HF6) | ANCREC | |||||||||||||||||||||||||||
| C58996 | Chimerism assay result donor percent value | ChmrsmAssyRsltDonrPctVal | Value in percent of the proportion of donor cells in the chimerism assay being recorded. | Value in percent of the proportion of donor cells in the chimerism assay being recorded. | % donor | Numeric Values | Adult;Pediatric | Proposed | 1.00 | 2019-01-07 13:51:22.0 | Hematopoiesis Form - BMTCTN 1507A | Additional Proposed Instruments | Other |
Free-Form Entry |
0 | 99 | percent | BMTCTN | 1507A Release 5.10 | Hematopoiesis Form (HF6) | MRWPCTD | ||||||||||||||||||||||||||
| C58986 | Absolute neutrophil count measurement | ANCMeasr | Measurement of ANC (absolute neutrophil count) per microliter. | Measurement of ANC (absolute neutrophil count) per microliter. | Record absolute neutrophil count | Numeric Values | Adult;Pediatric | Proposed | 1.00 | 2019-01-07 12:13:05.0 | Hematopoiesis Form - BMTCTN 1507A | Additional Proposed Instruments | Other |
Free-Form Entry |
0 | 99999 | Count per microliter | BMTCTN | 1507A Release 5.10 | Hematopoiesis Form (HF6) | D1ANC | ||||||||||||||||||||||||||
| C58997 | Chimerism assay blood sample indicate code | ChmrsmAssyBloodSmplIndCode | Code indicating whether a chimerism assay was performed on a blood sample. | Code indicating whether a chimerism assay was performed on a blood sample. | Was a chimerism assay performed on a blood sample during this assessment period? | 1;2;1;2 | Yes;No;Yes;No | Numeric Values | Adult;Pediatric | Proposed | 1.00 | 2019-01-07 12:27:22.0 | Hematopoiesis Form - BMTCTN 1507A | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
BMTCTN | 1507A Release 5.10 | Hematopoiesis Form (HF6) | MRWCHIM | |||||||||||||||||||||||||||
| C58987 | Absolute neutrophil count measurement date | ANCMeasrDate | Date on which ANC (absolute neutrophil count) was measured. | Date on which ANC (absolute neutrophil count) was measured. | Record date absolute neutrophil count obtained | Date or Date & Time | Adult;Pediatric | Proposed | 1.00 | 2019-01-07 12:15:34.0 | Hematopoiesis Form - BMTCTN 1507A | Additional Proposed Instruments | Other |
Free-Form Entry |
BMTCTN | 1507A Release 5.10 | Hematopoiesis Form (HF6) | D1ANCDT | |||||||||||||||||||||||||||||
| C58998 | Chimerism assay T cell sample indicate code | ChmrsmAssyTCellSmplIndCode | Code indicating whether a chimerism assay was performed on a T cell sample. | Code indicating whether a chimerism assay was performed on a T cell sample. | Was a chimerism assay performed on a T cell sample during this assessment period? | 1;2;1;2 | Yes;No;Yes;No | Numeric Values | Adult;Pediatric | Proposed | 1.00 | 2019-01-07 12:27:22.0 | Hematopoiesis Form - BMTCTN 1507A | Additional Proposed Instruments | Other |
Single Pre-Defined Value Selected |
BMTCTN | 1507A Release 5.10 | Hematopoiesis Form (HF6) | MRWCHIM |
24 results.