CDE Detailed Report
Disease: Sickle Cell Disease
Sub-Domain: Disease Related Events
CRF: Acute GVHD Form

47 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
C58952 Etiology upper GI abnormality GVHD indicate code EtiolUpGIAbnormGVHDIndCode Code indicating whether the etiology of the upper GI (gastrointestinal tract) abnormality was determined to be GVHD (graft-versus-host disease). Code indicating whether the etiology of the upper GI (gastrointestinal tract) abnormality was determined to be GVHD (graft-versus-host disease). Upper intestinal tract etiologies: GVHD 1;2;1;2 Yes;No;Yes;No Numeric Values Adult;Pediatric Proposed 1.00 2019-01-04 13:57:59.0 Acute GVHD Form Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) UGIETGVH
C58963 Etiology lower GI abnormality total parenteral nutrition indicate code EtioLoGIAbnrmTPNIndCode Code indicating whether the etiology of the lower GI (gastrointestinal tract) abnormality was determined to be TPN (total parenteral nutrition). Code indicating whether the etiology of the lower GI (gastrointestinal tract) abnormality was determined to be TPN (total parenteral nutrition). Lower intestinal tract etiologies: TPN 1;2;1;2 Yes;No;Yes;No Numeric Values Adult;Pediatric Proposed 1.00 2019-01-04 14:24:15.0 Acute GVHD Form Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) LGIETTPN
C58942 GVHD immunosuppressant prophylaxis receive type code GVHDImmunsupProphRcvTypCode Code for the type of prophylactic immunosuppressant for GVHD (graft-versus-host disease) received by the patient during the assessment period. Code for the type of prophylactic immunosuppressant for GVHD (graft-versus-host disease) received by the patient during the assessment period. Immunosuppressant (prophylaxis) received 2;1;0;3 Tacrolimus;Cyclosporine;Prednisone;Not taken during assessment Numeric Values Adult;Pediatric Proposed 1.00 2019-01-04 13:43:11.0 Acute GVHD Form Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) IMMUNORC
C58974 Etiology liver abnormality other indicate code EtiolLivrAbnrmOthrIndCode Code indicating whether the etiology of the liver abnormality was determined to be Other. Code indicating whether the etiology of the liver abnormality was determined to be Other. Liver etiologies: Other 1;2;1;2 Yes;No;Yes;No Numeric Values Adult;Pediatric Proposed 1.00 2019-01-04 13:57:59.0 Acute GVHD Form Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) LIVETOTH
C58953 Etiology upper GI abnormality drug reaction indicate code EtiolUpGIAbnormDrRxnIndCode Code indicating whether the etiology of the upper GI (gastrointestinal tract) abnormality was determined to be a drug reaction. Code indicating whether the etiology of the upper GI (gastrointestinal tract) abnormality was determined to be a drug reaction. Upper intestinal tract etiologies: Drug reaction 1;2;1;2 Yes;No;Yes;No Numeric Values Adult;Pediatric Proposed 1.00 2019-01-04 13:57:59.0 Acute GVHD Form Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) UGIETDRG
C58964 Etiology lower GI abnormality infection indicate code EtiolLoGIAbnrmInfctnIndCode Code indicating whether the etiology of the lower GI (gastrointestinal tract) abnormality was determined to be an infection. Code indicating whether the etiology of the lower GI (gastrointestinal tract) abnormality was determined to be an infection. Lower intestinal tract etiologies: Infection 1;2;1;2 Yes;No;Yes;No Numeric Values Adult;Pediatric Proposed 1.00 2019-01-04 13:57:59.0 Acute GVHD Form Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) LGIETINF
C58943 GVHD immunosuppressant prophylaxis blood level measurement GVHDImmsupProphBldLvlMeasr Measurement in nanograms per milliliter of the blood level of prophylactic immunosuppressant received by the patient for GVHD (graft-versus-host disease). Measurement in nanograms per milliliter of the blood level of prophylactic immunosuppressant received by the patient for GVHD (graft-versus-host disease). Record most recent blood level of immunosuppressant (prophylaxis) Numeric Values Adult;Pediatric Proposed 1.00 2019-01-04 13:51:07.0 Acute GVHD Form Disease Related Events History of Disease Event

Free-Form Entry

0 9999.9 nanogram per milliliter BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) TROUGHLV
C58975 Etiology liver abnormality other indicate code other text EtiolLivrAbnrmOthrIndCodeOTH The free-text field related to 'Etiology liver abnormality other indicate code' specifying other text. The free-text field related to 'Etiology liver abnormality other indicate code' specifying other text. Specify other liver etiologies Alphanumeric Adult;Pediatric Proposed 1.00 2019-01-04 14:09:08.0 Acute GVHD Form Disease Related Events History of Disease Event 100

Free-Form Entry

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) GVHLIVRS
C58954 Etiology upper GI abnormality conditioning regimen toxicity indicate code EtioUpGIAbnConRegToxIndCode Code indicating whether the etiology of the upper GI (gastrointestinal tract) abnormality was determined to be conditioning regimen toxicity. Code indicating whether the etiology of the upper GI (gastrointestinal tract) abnormality was determined to be conditioning regimen toxicity. Upper intestinal tract etiologies: Conditioning regimen toxicity 1;2;1;2 Yes;No;Yes;No Numeric Values Adult;Pediatric Proposed 1.00 2019-01-04 13:57:59.0 Acute GVHD Form Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) UGIETCON
C58965 Etiology lower GI abnormality other indicate code EtiolLoGIAbnrmOthrIndCode Code indicating whether the etiology of the lower GI (gastrointestinal tract) abnormality was determined to be Other. Code indicating whether the etiology of the lower GI (gastrointestinal tract) abnormality was determined to be Other. Lower intestinal tract etiologies: Other 1;2;1;2 Yes;No;Yes;No Numeric Values Adult;Pediatric Proposed 1.00 2019-01-04 13:57:59.0 Acute GVHD Form Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) LGIETOTH
C58944 Blood sample date BloodSampleDate Date on which blood sample was obtained. Date on which blood sample was obtained. Record date blood sample obtained Date or Date & Time Adult;Pediatric Proposed 1.00 2019-01-04 13:56:08.0 Acute GVHD Form Disease Related Events History of Disease Event

Free-Form Entry

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) TROUGHDT
C58976 Liver biopsy GVHD result code LivrBiopsyGVHDResultCode Code for the result of the liver biopsy performed for graft-versus-host disease (GVHD) Code for the result of the liver biopsy performed for graft-versus-host disease (GVHD) Liver biopsy for GVHD 1;2;3;4 Positive;Negative;Equivocal;Not done Numeric Values Adult;Pediatric Proposed 1.00 2019-01-04 14:12:38.0 Acute GVHD Form Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) GVHLIVRB
C58955 Etiology upper GI abnormality total parenteral nutrition indicate code EtioUpGIAbnrmTPNIndCode Code indicating whether the etiology of the upper GI (gastrointestinal tract) abnormality was determined to be TPN (total parenteral nutrition). Code indicating whether the etiology of the upper GI (gastrointestinal tract) abnormality was determined to be TPN (total parenteral nutrition). Upper intestinal tract etiologies: TPN 1;2;1;2 Yes;No;Yes;No Numeric Values Adult;Pediatric Proposed 1.00 2019-01-04 14:24:15.0 Acute GVHD Form Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) UGIETTPN
C58966 Etiology lower GI abnormality other indicate code other text EtiolLoGIAbnrmOthrIndCodeOTH The free-text field related to 'Etiology lower GI abnormality other indicate code' specifying other text. The free-text field related to 'Etiology lower GI abnormality other indicate code' specifying other text. Specify other lower intestinal tract etiologies Alphanumeric Adult;Pediatric Proposed 1.00 2019-01-04 14:09:08.0 Acute GVHD Form Disease Related Events History of Disease Event 100

Free-Form Entry

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) LGIETSPC
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 Acute GVHD Form Disease Related Events History of Disease Event 4000

Free-Form Entry

DeBaun Forms
C58945 Etiology skin abnormality GVHD indicate code EtiolSkinAbnormGVHDIndCode Code indicating whether the etiology of the skin abnormality was determined to be GVHD (graft-versus-host disease). Code indicating whether the etiology of the skin abnormality was determined to be GVHD (graft-versus-host disease). Skin etiologies: GVHD 1;2;1;2 Yes;No;Yes;No Numeric Values Adult;Pediatric Proposed 1.00 2019-01-04 13:57:59.0 Acute GVHD Form Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) SETGVHD
C58977 GVHD treatment modify assess period indicate code GVHDTreatModAssesPerIndCode Code indicating whether treatment for GVHD (graft-versus-host disease) was modified during the assessment period. Code indicating whether treatment for GVHD (graft-versus-host disease) was modified during the assessment period. Was any treatment of GVHD modified during this assessment period? 1;2;1;2 Yes;No;Yes;No Numeric Values Adult;Pediatric Proposed 1.00 2019-01-04 15:00:44.0 Acute GVHD Form Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) GVHTHERP
C58956 Etiology upper GI abnormality infection indicate code EtiolUpGIAbnrmInfctnIndCode Code indicating whether the etiology of the upper GI (gastrointestinal tract) abnormality was determined to be an infection. Code indicating whether the etiology of the upper GI (gastrointestinal tract) abnormality was determined to be an infection. Upper intestinal tract etiologies: Infection 1;2;1;2 Yes;No;Yes;No Numeric Values Adult;Pediatric Proposed 1.00 2019-01-04 13:57:59.0 Acute GVHD Form Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) UGIETINF
C58967 Lower GI biopsy GVHD result code LoGIBiopsyGVHDResultCode Code for the result of the lower GI (gastrointestinal tract) biopsy performed for GVHD (graft-versus-host disease). Code for the result of the lower GI (gastrointestinal tract) biopsy performed for GVHD (graft-versus-host disease). Lower intestinal tract biopsy for GVHD 1;2;3;4 Positive;Negative;Equivocal;Not done Numeric Values Adult;Pediatric Proposed 1.00 2019-01-04 14:12:38.0 Acute GVHD Form Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) LGIBIORS
C58823 Assessment period start date AssessmentPeriodStartDate Date of the beginning of the assessment period Date of the beginning of the assessment period Start of GVHD assessment period Date or Date & Time Adult;Pediatric Proposed 1.00 2018-12-12 15:06:29.0 Acute GVHD Form Disease Related Events History of Disease Event

Free-Form Entry

BMTCTN 1507A Release 5.10 Follow Up/Chronic GVHD Form (FGV) DTPRVAST
C58946 Etiology skin abnormality drug reaction indicate code EtiolSkinAbnormDrRxnIndCode Code indicating whether the etiology of the skin abnormality was determined to be a drug reaction. Code indicating whether the etiology of the skin abnormality was determined to be a drug reaction. Skin etiologies: Drug reaction 1;2;1;2 Yes;No;Yes;No Numeric Values Adult;Pediatric Proposed 1.00 2019-01-04 13:57:59.0 Acute GVHD Form Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) SETDRGRX
C58978 GVHD treatment agent name code GVHDTreatmentAgentNameCode Code denoting the name of the GVHD treatment agent. Code denoting the name of the GVHD treatment agent. Specify agent name 1;2;3;4;5;6;7;8;9 CSA;FK506;Topical steroids;Prednisone;ATG;MMF;Daclizumab;Methylprednisolone;Other Numeric Values Adult Proposed 1.00 2019-01-04 15:04:13.0 Acute GVHD Form Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) GVHAGENT
C58957 Etiology upper GI abnormality other indicate code EtiolUpGIAbnrmOthrIndCode Code indicating whether the etiology of the upper GI (gastrointestinal tract) abnormality was determined to be Other. Code indicating whether the etiology of the upper GI (gastrointestinal tract) abnormality was determined to be Other. Upper intestinal tract etiologies: Other 1;2;1;2 Yes;No;Yes;No Numeric Values Adult;Pediatric Proposed 1.00 2019-01-04 13:57:59.0 Acute GVHD Form Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) UGIETOTH
C58968 Etiology liver abnormality GVHD indicate code EtiolLivrAbnormGVHDIndCode Code indicating whether the etiology of the liver abnormality was determined to be GVHD (graft-versus-host disease). Code indicating whether the etiology of the liver abnormality was determined to be GVHD (graft-versus-host disease). Liver etiologies: GVHD 1;2;1;2 Yes;No;Yes;No Numeric Values Adult;Pediatric Proposed 1.00 2019-01-04 13:57:59.0 Acute GVHD Form Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) LIVETGVH
C58824 Assessment period end date AssessmentPeriodEndDate Date of the end of the assessment period Date of the end of the assessment period End of GVHD assessment period Date or Date & Time Adult;Pediatric Proposed 1.00 2018-12-12 15:06:29.0 Acute GVHD Form Disease Related Events History of Disease Event

Free-Form Entry

BMTCTN 1507A Release 5.10 Follow Up/Chronic GVHD Form (FGV) DTASSESS
C58947 Etiology skin abnormality conditioning regimen toxicity indicate code EtioSknAbnConRegToxIndCode Code indicating whether the etiology of the skin abnormality was determined to be conditioning regimen toxicity. Code indicating whether the etiology of the skin abnormality was determined to be conditioning regimen toxicity. Skin etiologies: Conditioning regimen toxicity 1;2;1;2 Yes;No;Yes;No Numeric Values Adult;Pediatric Proposed 1.00 2019-01-04 13:57:59.0 Acute GVHD Form Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) SETCRTOX
C58979 GVHD treatment agent name code other text GVHDTreatmentAgentNameCodeOTH The free-text field related to 'GVHD treatment agent name code' specifying other text. The free-text field related to 'GVHD treatment agent name code' specifying other text. Specify other agent Alphanumeric Adult;Pediatric Proposed 1.00 2019-01-04 15:12:11.0 Acute GVHD Form Disease Related Events History of Disease Event 100

Free-Form Entry

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) GVHAGNSP
C58958 Etiology upper GI abnormality other indicate code other text EtiolUpGIAbnrmOthrIndCodeOTH The free-text field related to 'Etiology upper GI abnormality other indicate code' specifying other text. The free-text field related to 'Etiology upper GI abnormality other indicate code' specifying other text. Specify other upper intestinal tract etiologies Alphanumeric Adult;Pediatric Proposed 1.00 2019-01-04 14:09:08.0 Acute GVHD Form Disease Related Events History of Disease Event 100

Free-Form Entry

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) UGIETSPC
C58969 Etiology liver abnormality drug reaction indicate code EtiolLivrAbnormDrRxnIndCode Code indicating whether the etiology of the liver abnormality was determined to be a drug reaction. Code indicating whether the etiology of the liver abnormality was determined to be a drug reaction. Liver etiologies: Drug reaction 1;2;1;2 Yes;No;Yes;No Numeric Values Adult;Pediatric Proposed 1.00 2019-01-04 13:57:59.0 Acute GVHD Form Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) LIVETDRG
C58828 Skin abnormality severity at acute GVHD maximum overall grade code SknAbnSvrAtActGVHDMaxOvlGrdCod Code for the highest severity of skin abnormalities at the time of the maximum overall grade of GVHD (Graft Versus Host Disease) Code for the highest severity of skin abnormalities at the time of the maximum overall grade of GVHD (Graft Versus Host Disease) Skin abnormalities 0;1;2;3;4 No rash;Maculopapular rash, <25% of body surface;Maculopapular rash, 25–50% of body surface;Generalized erythrodema;Generalized erythrodema with bullus formation and desquamation Numeric Values

Record the highest level of organ abnormalities

Adult;Pediatric Proposed 1.00 2018-12-12 15:24:41.0 Acute GVHD Form Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Follow Up/Chronic GVHD Form (FGV) FGASKNAB
C58948 Etiology skin abnormality infection indicate code EtiolSknAbnrmInfctnIndCode Code indicating whether the etiology of the skin abnormality was determined to be an infection. Code indicating whether the etiology of the skin abnormality was determined to be an infection. Skin etiologies: Infection 1;2;1;2 Yes;No;Yes;No Numeric Values Adult;Pediatric Proposed 1.00 2019-01-04 13:57:59.0 Acute GVHD Form Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) SETINFCT
C58980 Treatment modify type code TreatmentModifyTypeCode Code denoting the type of treatment modification instituted. Code denoting the type of treatment modification instituted. Indicate treatment modification 1;2;4;5 Started;Stopped;Tapered;Increased Numeric Values Adult;Pediatric Proposed 1.00 2019-01-04 15:14:16.0 Acute GVHD Form Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) GVHTRMOD
C58959 Upper GI biopsy GVHD result code UpGIBiopsyGVHDResultCode Code for the result of the upper GI (gastrointestinal tract) biopsy performed for GVHD (graft-versus-host disease). Code for the result of the upper GI (gastrointestinal tract) biopsy performed for GVHD (graft-versus-host disease). Upper intestinal tract biopsy for GVHD 1;2;3;4 Positive;Negative;Equivocal;Not done Numeric Values Adult;Pediatric Proposed 1.00 2019-01-04 14:12:38.0 Acute GVHD Form Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) UGIBIORS
C58970 Etiology liver abnormality conditioning regimen toxicity indicate code EtioLivrAbnConRegToxIndCode Code indicating whether the etiology of the liver abnormality was determined to be conditioning regimen toxicity. Code indicating whether the etiology of the liver abnormality was determined to be conditioning regimen toxicity. Liver etiologies: Conditioning Regimen Toxicity 1;2;1;2 Yes;No;Yes;No Numeric Values Adult;Pediatric Proposed 1.00 2019-01-04 13:57:59.0 Acute GVHD Form Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) LIVETCND
C58829 Upper GI abnormality severity at acute GVHD maximum overall grade code UGIAbnSvrAtActGVHDMaxOvlGrdCod Code for the highest severity of upper GI (gastrointestinal tract) abnormalities at the time of the maximum overall grade of GVHD (Graft Versus Host Disease) Code for the highest severity of upper GI (gastrointestinal tract) abnormalities at the time of the maximum overall grade of GVHD (Graft Versus Host Disease) Upper GI abnormalities 1;0 Persistent nausea, vomiting or anorexia;No protracted nausea and vomiting Numeric Values

Record the highest level of organ abnormalities

Adult;Pediatric Proposed 1.00 2018-12-12 15:24:41.0 Acute GVHD Form Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Follow Up/Chronic GVHD Form (FGV) FGAUGIAB
C58949 Etiology skin abnormality other indicate code EtiolSknAbnrmOthrIndCode Code indicating whether the etiology of the skin abnormality was determined to be Other. Code indicating whether the etiology of the skin abnormality was determined to be Other. Skin etiologies: Other 1;2;1;2 Yes;No;Yes;No Numeric Values Adult;Pediatric Proposed 1.00 2019-01-04 13:57:59.0 Acute GVHD Form Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) SETOTHER
C58960 Etiology lower GI abnormality GVHD indicate code EtiolLoGIAbnormGVHDIndCode Code indicating whether the etiology of the lower GI (gastrointestinal tract) abnormality was determined to be GVHD (graft-versus-host disease). Code indicating whether the etiology of the lower GI (gastrointestinal tract) abnormality was determined to be GVHD (graft-versus-host disease). Lower intestinal tract etiologies: GVHD 1;2;1;2 Yes;No;Yes;No Numeric Values Adult;Pediatric Proposed 1.00 2019-01-04 13:57:59.0 Acute GVHD Form Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) LGIETGVH
C58971 Etiology liver abnormality total parenteral nutrition indicate code EtioLivrAbnrmTPNIndCode Code indicating whether the etiology of the liver abnormality was determined to be TPN (total parenteral nutrition). Code indicating whether the etiology of the liver abnormality was determined to be TPN (total parenteral nutrition). Liver etiologies: TPN 1;2;1;2 Yes;No;Yes;No Numeric Values Adult;Pediatric Proposed 1.00 2019-01-04 14:24:15.0 Acute GVHD Form Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) LIVETTPN
C58830 Lower GI abnormality severity at acute GVHD maximum overall grade code LGIAbnSvrAtActGVHDMaxOvlGrdCod Code for the highest severity of lower GI (gastrointestinal tract) abnormalities at the time of the maximum overall grade of GVHD (Graft Versus Host Disease) Code for the highest severity of lower GI (gastrointestinal tract) abnormalities at the time of the maximum overall grade of GVHD (Graft Versus Host Disease) Lower GI abnormalities 0;1;2;3;4;5 No diarrhea;Diarrhea less than or equal to 500 mL/day or <280 mL/m^2;Diarrhea >500 but less than or equal to 1000 mL/day or 280–555 mL/m^2;Diarrhea >1000 but less than or equal to 1500 mL/day or 556–833 mL/m^2;Diarrhea >1500 mL/day or >833 mL/m^2;Severe abdominal pain with or without ileus, or stool with frank blood or melena Numeric Values

Record the highest level of organ abnormalities. Use mL/day for adult patients and mL/m^2 for pediatric patients

Adult;Pediatric Proposed 1.00 2018-12-12 15:24:41.0 Acute GVHD Form Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Follow Up/Chronic GVHD Form (FGV) FGALGIAB
C58950 Etiology skin abnormality other indicate code other text EtiolSknAbnrmOthrIndCodeOTH The free-text field related to 'Etiology skin abnormality other indicate code' specifying other text. The free-text field related to 'Etiology skin abnormality other indicate code' specifying other text. Specify other skin etiologies Alphanumeric Adult;Pediatric Proposed 1.00 2019-01-04 14:09:08.0 Acute GVHD Form Disease Related Events History of Disease Event 100

Free-Form Entry

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) GVHSKNSP
C58961 Etiology lower GI abnormality drug reaction indicate code EtiolLoGIAbnormDrRxnIndCode Code indicating whether the etiology of the lower GI (gastrointestinal tract) abnormality was determined to be a drug reaction. Code indicating whether the etiology of the lower GI (gastrointestinal tract) abnormality was determined to be a drug reaction. Lower intestinal tract etiologies: Drug reaction 1;2;1;2 Yes;No;Yes;No Numeric Values Adult;Pediatric Proposed 1.00 2019-01-04 13:57:59.0 Acute GVHD Form Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) LGIETDRG
C58972 Etiology liver abnormality infection indicate code EtiolLivrAbnrmInfctnIndCode Code indicating whether the etiology of the liver abnormality was determined to be an infection. Code indicating whether the etiology of the liver abnormality was determined to be an infection. Liver etiologies: Infection 1;2;1;2 Yes;No;Yes;No Numeric Values Adult;Pediatric Proposed 1.00 2019-01-04 13:57:59.0 Acute GVHD Form Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) LIVETINF
C58834 Liver abnormality severity at acute GVHD maximum overall grade code LvrAbnSvrAtActGVHDMaxOvlGrdCod Code for the highest severity of liver abnormalities at the time of the maximum overall grade of GVHD (Graft Versus Host Disease) Code for the highest severity of liver abnormalities at the time of the maximum overall grade of GVHD (Graft Versus Host Disease) Liver abnormalities 0;1;2;3;4 Bilirubin <2.0 mg/dL;Bilirubin 2.0–3.0 mg/dL;Bilirubin 3.1–6.0 mg/dL;Bilirubin 6.1–15.0 mg/dL;Bilirubin >15.0 mg/dL Numeric Values

Record the highest level of organ abnormalities

Adult;Pediatric Proposed 1.00 2018-12-12 15:24:41.0 Acute GVHD Form Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Follow Up/Chronic GVHD Form (FGV) FGALVRAB
C58951 Skin biopsy GVHD result code SkinBiopsyGVHDResultCode Code for the result of the skin biopsy performed for GVHD (graft-versus-host disease). Code for the result of the skin biopsy performed for GVHD (graft-versus-host disease). Skin biopsy for GVHD 1;2;3;4 Positive;Negative;Equivocal;Not done Numeric Values Adult;Pediatric Proposed 1.00 2019-01-04 14:12:38.0 Acute GVHD Form Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) GVHSKINB
C58962 Etiology lower GI abnormality conditioning regimen toxicity indicate code EtioLoGIAbnConRegToxIndCode Code indicating whether the etiology of the lower GI (gastrointestinal tract) abnormality was determined to be conditioning regimen toxicity. Code indicating whether the etiology of the lower GI (gastrointestinal tract) abnormality was determined to be conditioning regimen toxicity. Lower intestinal tract etiologies: Conditioning regimen toxicity 1;2;1;2 Yes;No;Yes;No Numeric Values Adult;Pediatric Proposed 1.00 2019-01-04 13:57:59.0 Acute GVHD Form Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) LGIETCON
C58941 GVHD stage date GVHDStageDate Date on which GVHD (graft-versus-host disease) stage was determined. Date on which GVHD (graft-versus-host disease) stage was determined. Date of staging Date or Date & Time Adult;Pediatric Proposed 1.00 2019-01-04 13:36:16.0 Acute GVHD Form Disease Related Events History of Disease Event

Free-Form Entry

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) STAGEDT
C58973 Etiology liver abnormality veno-occlusive disease indicate code EtiolLivrAbnrmVODIndCode Code indicating whether the etiology of the liver abnormality was determined to be VOD (veno-occlusive disease). Code indicating whether the etiology of the liver abnormality was determined to be VOD (veno-occlusive disease). Liver etiologies: VOD 1;2;1;2 Yes;No;Yes;No Numeric Values Adult;Pediatric Proposed 1.00 2019-01-04 13:57:59.0 Acute GVHD Form Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Acute GVHD Form (GVH) LIVETVOD
47 results.
CSV