ID

13356

Beschrijving

Test Study

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Versies (2)
  1. 09-02-16 09-02-16 -
  2. 11-02-16 11-02-16 -
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CC BY-NC 3.0

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9 februari 2016

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Creative Commons BY-NC 3.0
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SacBo: Case Report Form Hospitalization Patient Diary

Engels

SacBo: Case Report Form Hospitalization Patient Diary

1 Formulieren  
Starting date of documentation
Beschrijving

Starting date of documentation

When did documentation start?
Beschrijving

Starting date of documentation. 1) for first hospitalization documentation begins with the day of the first dose of the antibiotic initially used 2) for rehospitalization documentation begins with the first day of rehospitalization (for out-patient readmission there is no documentation necessary)

Datatype

date

Alias
UMLS CUI [1,1]
C0920316
UMLS CUI [1,2]
C0808070
Stool frequency and consistency
Beschrijving

Stool frequency and consistency

What day do the following items concern?
Beschrijving

Day

Datatype

text

What date is it?
Beschrijving

Date

Datatype

date

Alias
UMLS CUI [1]
C0011008
How many hard stools on this day?
Beschrijving

Hard Stool

Datatype

integer

Alias
UMLS CUI [1]
C0278016
Soft Stool
Beschrijving

Soft Stool

Datatype

integer

Alias
UMLS CUI [1]
C0577115
How many mushy or watery stools on this day?
Beschrijving

Mushy or watery stool

Datatype

integer

Alias
UMLS CUI [1]
C0860527
UMLS CUI [2]
C2129214
Was there no stool on this day or is the number of stools not known?
Beschrijving

No stool or not known

Datatype

integer

Alias
UMLS CUI [1]
C0015733
UMLS CUI [2]
C0439673
Until what date is there documentation in the diary?
Beschrijving

Diary duration

Datatype

date

Alias
UMLS CUI [1,1]
C0920316
UMLS CUI [1,2]
C0806020
New page
Beschrijving

New page

Do you want to start a new page in order to continue the patient diary?
Beschrijving

New page

Datatype

boolean

Terug naar het begin van de pagina

Similar models

SacBo: Case Report Form Hospitalization Patient Diary

1 Formulieren
Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
Starting date of documentation
Starting date of documentation
Item
When did documentation start?
date
C0920316 (UMLS CUI [1,1])
C0808070 (UMLS CUI [1,2])
Item Group
Stool frequency and consistency
Day
Item
What day do the following items concern?
text
Date
Item
What date is it?
date
C0011008 (UMLS CUI [1])
Hard Stool
Item
How many hard stools on this day?
integer
C0278016 (UMLS CUI [1])
Soft Stool
Item
Soft Stool
integer
C0577115 (UMLS CUI [1])
Mushy or watery stool
Item
How many mushy or watery stools on this day?
integer
C0860527 (UMLS CUI [1])
C2129214 (UMLS CUI [2])
Item
Was there no stool on this day or is the number of stools not known?
integer
C0015733 (UMLS CUI [1])
C0439673 (UMLS CUI [2])
No stool or not known
Code List
Was there no stool on this day or is the number of stools not known?
CL Item
no stool (1)
CL Item
unknown (2)
Diary duration
Item
Until what date is there documentation in the diary?
date
C0920316 (UMLS CUI [1,1])
C0806020 (UMLS CUI [1,2])
Item Group
New page
New page
Item
Do you want to start a new page in order to continue the patient diary?
boolean
Terug naar het begin van de pagina 

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