ID

11429

Beskrivning

AE4 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=FF18A11D-FD35-0EE3-E034-0003BA3F9857

Länk

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=FF18A11D-FD35-0EE3-E034-0003BA3F9857

Nyckelord

Versioner (3)
  1. 2012-09-19 2012-09-19 -
  2. 2015-01-09 2015-01-09 - Martin Dugas
  3. 2015-07-03 2015-07-03 -
Uppladdad den

3 juli 2015

DOI

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Licens

Creative Commons BY-NC 3.0 Legacy
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AE4

Engelsk

No Instruction available.

1 Formulär  
Header module
Beskrivning

Header module

Date of Onset
Beskrivning

Adverse Event Onset Date

Datatyp

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS CUI-1
C2985916
NCI Thesaurus ValueDomain-2
C25367
NCI Thesaurus ObjectClass
C49704
NCI Thesaurus Property
C25279
Event description
Beskrivning

AdverseEventDescriptiveText

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus ObjectClass
C41331
UMLS 2011AA ObjectClass
C0877248
NCI Metathesaurus Property
C0678257
Segment
Beskrivning

Segment

Datatyp

text

Laboratory Test Results
Beskrivning

Laboratory Test Results

No relevant laboratory test results
Beskrivning

RelevantLaboratoryTestIndicator

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
NCI Thesaurus ObjectClass
C38470
NCI Metathesaurus Property
C0022885
Test
Beskrivning

RelevantLaboratoryTestNames

Datatyp

text

Alias
NCI Metathesaurus ObjectClass
C0022885
NCI Thesaurus Property
C42614
UMLS 2011AA Property
C0027365
NCI Thesaurus ValueDomain
C42614
UMLS 2011AA ValueDomain
C0027365
Collection Data
Beskrivning

RelevantLaboratoryTestDate

Datatyp

date

Alias
NCI Thesaurus Property
C25164
UMLS 2011AA Property
C0011008
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Metathesaurus ObjectClass
C0022885
Result (including units)
Beskrivning

RelevantLaboratoryTestResultValueMeasure

Datatyp

text

Alias
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
Result Pending
Beskrivning

ResultPending

Datatyp

text

Site Name??? (Include??)
Beskrivning

SiteName???(Include??)

Datatyp

text

Diagnostic Tests (ex: Mr, Ct Scan, Ultrasound)
Beskrivning

Diagnostic Tests (ex: Mr, Ct Scan, Ultrasound)

No relevant diagnostic tests
Beskrivning

RelevantDiagnosticTestPerformedIndicator

Datatyp

text

Alias
NCI Thesaurus Property
C25180
UMLS 2011AA Property
C1522602
NCI Metathesaurus ObjectClass
C0525034
Test
Beskrivning

DiagnosticTestName

Datatyp

text

Alias
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property
C25482
UMLS 2011AA Property
C0348026
NCI Thesaurus ValueDomain
C42614
UMLS 2011AA ValueDomain
C0027365
Date Performed
Beskrivning

TestPerfomedDate

Datatyp

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property
C25482
UMLS 2011AA Property
C0348026
Comments
Beskrivning

Research Comments

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS CUI-1
C0947611
NCI Thesaurus ObjectClass
C15319
NCI Thesaurus Property
C25393
Comments
Beskrivning

Research Comments

Datatyp

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS CUI-1
C0947611
NCI Thesaurus ObjectClass
C15319
NCI Thesaurus Property
C25393
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Similar models

No Instruction available.

1 Formulär
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Header module
Adverse Event Onset Date
Item
Date of Onset
date
C25164 (NCI Thesaurus ValueDomain)
C2985916 (UMLS CUI-1)
C25367 (NCI Thesaurus ValueDomain-2)
C49704 (NCI Thesaurus ObjectClass)
C25279 (NCI Thesaurus Property)
AdverseEventDescriptiveText
Item
Event description
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
C0678257 (NCI Metathesaurus Property)
Segment
Item
Segment
text
Item Group
Laboratory Test Results
RelevantLaboratoryTestIndicator
Item
No relevant laboratory test results
text
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C38470 (NCI Thesaurus ObjectClass)
C0022885 (NCI Metathesaurus Property)
RelevantLaboratoryTestNames
Item
Test
text
C0022885 (NCI Metathesaurus ObjectClass)
C42614 (NCI Thesaurus Property)
C0027365 (UMLS 2011AA Property)
C42614 (NCI Thesaurus ValueDomain)
C0027365 (UMLS 2011AA ValueDomain)
RelevantLaboratoryTestDate
Item
Collection Data
date
C25164 (NCI Thesaurus Property)
C0011008 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C0022885 (NCI Metathesaurus ObjectClass)
RelevantLaboratoryTestResultValueMeasure
Item
Result (including units)
text
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
ResultPending
Item
Result Pending
text
SiteName???(Include??)
Item
Site Name??? (Include??)
text
Item Group
Diagnostic Tests (ex: Mr, Ct Scan, Ultrasound)
RelevantDiagnosticTestPerformedIndicator
Item
No relevant diagnostic tests
text
C25180 (NCI Thesaurus Property)
C1522602 (UMLS 2011AA Property)
C0525034 (NCI Metathesaurus ObjectClass)
DiagnosticTestName
Item
Test
text
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25482 (NCI Thesaurus Property)
C0348026 (UMLS 2011AA Property)
C42614 (NCI Thesaurus ValueDomain)
C0027365 (UMLS 2011AA ValueDomain)
TestPerfomedDate
Item
Date Performed
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25482 (NCI Thesaurus Property)
C0348026 (UMLS 2011AA Property)
Research Comments
Item
Comments
text
C25704 (NCI Thesaurus ValueDomain)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
Research Comments
Item
Comments
text
C25704 (NCI Thesaurus ValueDomain)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
Tillbaka till toppen 

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