CDE Detailed Report
Disease: Sickle Cell Disease
Sub-Domain: Treatment/Intervention Data
CRF: Transplant Form (TXP)

5 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
C59081 Initiation conditioning regimen date InitnConsRgmnDate Date indicating the initiation of conditioning regimen Date indicating the initiation of conditioning regimen Record date of initiation of conditioning regimen: Date or Date & Time

Data sharing instructions: When date/time data are prepared for aggregation or sharing, they should be converted to the format specified by ISO 8601; YYYY-MM-DD T:hh:mm:ss.

Adult;Pediatric Proposed 1.00 2019-01-14 10:23:24.0 Transplant Form (TXP) Treatment/Intervention Data Transplantation/Stem Cell Transplant

Free-Form Entry

BMTCTN 1507A Release 5.10 Transplant Form (TXP) CONDNGDT
C59082 Hematopoietic stem cell infusion date HemtpcStemCellInfsnDate Date indicating hematopoietic stem cell infusion Date indicating hematopoietic stem cell infusion Record date of hematopoietic stem cell infusion Date or Date & Time

Data sharing instructions: When date/time data are prepared for aggregation or sharing, they should be converted to the format specified by ISO 8601; YYYY-MM-DD T:hh:mm:ss.

Adult;Pediatric Proposed 1.00 2019-01-14 10:27:55.0 Transplant Form (TXP) Treatment/Intervention Data Transplantation/Stem Cell Transplant

Free-Form Entry

BMTCTN 1507A Release 5.10 Transplant Form (TXP) TXDTTXP
C59083 Pre-transplant CMV antibody status PreTrnsplntCMVAntbdyStatus Status indicating the patient's pre-transplant Cytomegalovirus (CMV) antibody immunoglobulin G (IgG) status Status indicating the patient's pre-transplant Cytomegalovirus (CMV) antibody immunoglobulin G (IgG) status Record the patient's pre-transplant CMV antibody (IgG) status: 1;2 Positive;Negative Alphanumeric Adult;Pediatric Proposed 1.00 2019-01-14 10:30:43.0 Transplant Form (TXP) Treatment/Intervention Data Transplantation/Stem Cell Transplant

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Transplant Form (TXP) CMVSTAT
C59084 IUBMID patient code IUBMIDPtntCode Code indicating IUBMID for patient Code indicating IUBMID for patient IUBMID for this patient (if available): Alphanumeric Adult;Pediatric Proposed 1.00 2019-01-14 11:02:21.0 Transplant Form (TXP) Treatment/Intervention Data Transplantation/Stem Cell Transplant 255

Free-Form Entry

BMTCTN 1507A Release 5.10 Transplant Form (TXP) T_IUBMID
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 Transplant Form (TXP) Treatment/Intervention Data Transplantation/Stem Cell Transplant 4000

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DeBaun Forms
5 results.
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