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Long NamePET Patient Prep NCI Standard Template
DefinitionThe collection of CDEs used in the PET patient prep modules.
ContextcaBIG
Protocol Long NameNCI Standard Template Forms
WorkflowDRAFT NEW
TypeCRF
Public ID3476327
Version1.0
Module Long NameModule InstructionsQuestionCDECDE Public IDCDE VersionQuestion InstructionsValue Domain Data TypeValue Domain Unit of MeasureDisplay FormatValid ValueForm Value Meaning TextForm Value Meaning Desc.
Mandatory PET Patient Prep Questions These items must be included when this data is collected for reporting.
WeightPerson Weight Value21796894.0NUMBER
Weight Unit of Measure UCUM CodePerson Weight Unit of Measure Unified Code for Units of Measure Code26302001.0CHARACTER
[lb_av]PoundA traditional unit of mass. By international agreement, one avoirdupois pound is equal to exactly 0.453 592 37 kilogram, 16 ounces, or 1.215 28 troy pounds.
[oz_av]OunceThe traditional unit of mass. The avoirdupois ounce is equal to 1/16 pound, or 28.3495 grams, or 0.911 457 troy ounce.
ggramgram
kgkilogramkilogram
HeightPerson Height Value21796434.0NUMBER
Height Unit of Measure UCUM CodePerson Height Unit of Measure Unified Code for Units of Measure Code25389201.0CHARACTER
[ft_i][ft_i]Foot (International customary units) UCUM Code
[in_i][in_i]inch (International Customary Units) UCUM Code
cmCENTIMETERA centimeter is a basic unit of length in the former CGS version of metric system, equal to one hundredth of a meter or approximately 0.393 700 787 inch.
mMeterThe unit of linear measure in the metric system, one of the seven base units of the International System of Units (Systeme International d'Unites, SI). Meter is defined as the length of the path traveled by light in a vacuum during a time interval of 1/299 792 458 of a second and is equal to 1.093 61 yards.
Conditional PET Patient Prep QuestionThere are business rules to indicate situations under which these elements should be used on a case report form.
Duration of patient fasting pre-PET imagingPrior To PET Fasting Hour Duration27148901.0This data element is captured based on the imaging agent used for the PET scan.NUMBER
Blood glucose before injection of imaging agentPET Blood Glucose Prior To Injection Value27148921.0This data element is captured based on the imaging agent used for the PET scan.NUMBER999.9
PET Blood GlucosePET Blood Glucose Measurement Military Time31623831.0This data element is captured based on the imaging agent used for the PET scan.TIMETIME (HR(24):MN)
Was Foley catheter in place for scan?PET Foley Catheter Placed Ind-327176502.0This data element is captured based on the imaging agent used for the PET scan.CHARACTER
NoNoThe non-affirmative response to a question.
UnknownUnknownNot known, not observed, not recorded, or refused.
YesYesThe affirmative response to a question or activity.
Patient voided immediately pre-imaging?PET Urination Prior Imaging Agent Ind-327165202.0This data element is captured based on the imaging agent used for the PET scan.CHARACTER
NoNoThe non-affirmative response to a question.
UnknownUnknownNot known, not observed, not recorded, or refused.
YesYesThe affirmative response to a question or activity.
Patient voided immediately post-imaging?PET Urination Post Imaging Agent Ind-327176522.0This data element is captured based on the imaging agent used for the PET scan.CHARACTER
NoNoThe non-affirmative response to a question.
UnknownUnknownNot known, not observed, not recorded, or refused.
YesYesThe affirmative response to a question or activity.