Englisch

SacBo: Case Report Form Hospitalization Patient Diary NCT01143272

1 Formulare  
Starting date of documentation
Beschreibung

Starting date of documentation

When did documentation start?
Beschreibung

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)

Datentyp

date

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

Stool frequency and consistency

What day do the following items concern?
Beschreibung

Day

Datentyp

text

What date is it?
Beschreibung

Date

Datentyp

date

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

Hard Stool

Datentyp

integer

Alias
UMLS CUI [1]
C0278016
Soft Stool
Beschreibung

Soft Stool

Datentyp

integer

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

Mushy or watery stool

Datentyp

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?
Beschreibung

No stool or not known

Datentyp

integer

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

Diary duration

Datentyp

date

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

New page

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

New page

Datentyp

boolean

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Ähnliche Modelle

SacBo: Case Report Form Hospitalization Patient Diary NCT01143272

1 Formulare
Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
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
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