ID

13325

Descripción

Test Study

Palabras clave

Versiones (3)
  1. 4/2/16 4/2/16 -
  2. 11/2/16 11/2/16 -
  3. 11/2/16 11/2/16 -
Titular de derechos de autor

CC BY-NC 3.0

Subido en

4 de febrero de 2016

DOI

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Licencia

Creative Commons BY-NC 3.0
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SacBo TI: Case Report Form Phone Interview Diary TI

Inglés

SacBo TI: Case Report Form Phone Interview Diary TI

1 formularios  
Current contact
Descripción

Current contact

Was the current contact a phone call?
Descripción

phone call

Tipo de datos

boolean

Was the current contact performed at an alternative date?
Descripción

Alternative date (14 days after prior phone call)

Tipo de datos

date

Alias
UMLS CUI [1]
C0011008
Until what date was the documentation on the current eForm performed?
Descripción

documentation on current eform until

Tipo de datos

date

Alias
UMLS CUI [1,1]
C0920316
UMLS CUI [1,2]
C0011008
When is the maximum end of documentation
Descripción

maximum end of documentation

Tipo de datos

date

Alias
UMLS CUI [1,1]
C0920316
UMLS CUI [1,2]
C0806020
What date did the current contact take place?
Descripción

Date of current contact

Tipo de datos

date

Alias
UMLS CUI [1]
C0011008
Stool frequency and consistency
Descripción

Stool frequency and consistency

What date do the following items concern?
Descripción

Date the next items concern including those items from the following itemgroup

Tipo de datos

date

Alias
UMLS CUI [1]
C0011008
Was the patient rehospitalized in the study hospital?
Descripción

Rehospitalization in study hospital

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0019993
How many hard stools?
Descripción

Amount of hard stools

Tipo de datos

integer

Alias
UMLS CUI [1]
C0278016
How many soft stools?
Descripción

Amount of soft stools

Tipo de datos

integer

Alias
UMLS CUI [1]
C0577115
How many mushy or watery stools?
Descripción

Amount of mushy or watery stools

Tipo de datos

integer

Alias
UMLS CUI [1]
C0860527
UMLS CUI [2]
C2129214
Was there no stool on this date or is the amount not known?
Descripción

No stool or not known

Tipo de datos

integer

Alias
UMLS CUI [1]
C0426642
Intake of investigational agent
Descripción

Intake of investigational agent

Did the patient take the investigational agent in the morning?
Descripción

Intake of investigational agent in the morning

Tipo de datos

integer

Alias
UMLS CUI [1]
C0332170
Did the patient take the investigational agent in the evening?
Descripción

Intake of the investigational agent in the evening

Tipo de datos

integer

Alias
UMLS CUI [1]
C0587117
Did the patient use any laxatives?
Descripción

Use of laxatives

Tipo de datos

integer

Alias
UMLS CUI [1]
C0282090
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Similar models

SacBo TI: Case Report Form Phone Interview Diary TI

1 formularios
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
Current contact
phone call
Item
Was the current contact a phone call?
boolean
Alternative date
Item
Was the current contact performed at an alternative date?
date
C0011008 (UMLS CUI [1])
documentation until
Item
Until what date was the documentation on the current eForm performed?
date
C0920316 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
end of documentation
Item
When is the maximum end of documentation
date
C0920316 (UMLS CUI [1,1])
C0806020 (UMLS CUI [1,2])
Date of current contact
Item
What date did the current contact take place?
date
C0011008 (UMLS CUI [1])
Item Group
Stool frequency and consistency
Date
Item
What date do the following items concern?
date
C0011008 (UMLS CUI [1])
Rehospitalization in study hospital
Item
Was the patient rehospitalized in the study hospital?
boolean
C0019993 (UMLS CUI [1])
hard stool
Item
How many hard stools?
integer
C0278016 (UMLS CUI [1])
soft stool
Item
How many soft stools?
integer
C0577115 (UMLS CUI [1])
mushy or watery stool
Item
How many mushy or watery stools?
integer
C0860527 (UMLS CUI [1])
C2129214 (UMLS CUI [2])
Item
Was there no stool on this date or is the amount not known?
integer
C0426642 (UMLS CUI [1])
no stool or not known
Code List
Was there no stool on this date or is the amount not known?
CL Item
no stool (1)
CL Item
not known (2)
Item Group
Intake of investigational agent
Item
Did the patient take the investigational agent in the morning?
integer
C0332170 (UMLS CUI [1])
in the morning
Code List
Did the patient take the investigational agent in the morning?
CL Item
yes (1)
CL Item
no (2)
CL Item
not known (3)
Item
Did the patient take the investigational agent in the evening?
integer
C0587117 (UMLS CUI [1])
in the evening
Code List
Did the patient take the investigational agent in the evening?
CL Item
yes (1)
CL Item
no (2)
CL Item
not known (3)
Item
Did the patient use any laxatives?
integer
C0282090 (UMLS CUI [1])
Use of laxatives
Code List
Did the patient use any laxatives?
CL Item
yes (1)
CL Item
no (2)
CL Item
not known (3)
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