ID

13598

Description

NINDS Common Data Elements [Participant/Subject History and Family History] [Amyotrophic Lateral Sclerosis] Used from the National Institute of Neurological Disorders and Stroke Common Data Elements (https://www.commondataelements.ninds.nih.gov/) References: Grinnon ST, Miller K, Marler JR, Lu Y, Stout A, Odenkirchen J, Kunitz S. National Institute of Neurological Disorders and Stroke Common Data Element Project - approach and methods. Clin Trials. 2012;9(3):322-9.

Lien

https://www.commondataelements.ninds.nih.gov/

Mots-clés

  1. 19/02/2016 19/02/2016 -
  2. 19/02/2016 19/02/2016 -
  3. 13/05/2016 13/05/2016 -
Téléchargé le

19 février 2016

DOI

Pour une demande vous connecter.

Licence

Creative Commons BY-NC 3.0

Modèle Commentaires :

Ici, vous pouvez faire des commentaires sur le modèle. À partir des bulles de texte, vous pouvez laisser des commentaires spécifiques sur les groupes Item et les Item.

Groupe Item commentaires pour :

Item commentaires pour :

Vous devez être connecté pour pouvoir télécharger des formulaires. Veuillez vous connecter ou s’inscrire gratuitement.

NINDS CDE [Medical History][Amyotrophic Lateral Sclerosis]

General Health History

  1. StudyEvent: ODM
    1. General Health History
Medical history
Description

Medical history

Study-ID
Description

study ID

Type de données

integer

Alias
UMLS CUI [1]
C2826693
Study site name
Description

Study site

Type de données

text

Alias
UMLS CUI [1]
C2825164
Subject ID
Description

Patient Study ID

Type de données

text

Alias
UMLS CUI [1]
C2348585
Date Medical History Taken
Description

Date

Type de données

date

Alias
UMLS CUI [1]
C0011008
Have you experienced problems with constitutional symptoms in the past?
Description

Constitutional symptoms (e.g., fever, weight loss)

Type de données

boolean

Alias
UMLS CUI [1]
C0009812
Please specify the constitutional symptom you experienced. If there´s more than one, please describe one be one.
Description

Constitutional symptoms (e.g., fever, weight loss...)Enter all significant medical history items, including surgeries, EXCEPT the problem/condition that is the focus of this study. Use only one line per description

Type de données

text

Alias
UMLS CUI [1]
C0009812
Start date of constitutional symptom
Description

Start date

Type de données

date

Alias
UMLS CUI [1]
C0011008
End date of constitutional symptom
Description

End date

Type de données

date

Alias
UMLS CUI [1]
C0011008
Is the symptom persistent?
Description

Ongoing

Type de données

boolean

Alias
UMLS CUI [1]
C0549178
Have you experienced problems with your eyes in the past?
Description

Eye problems

Type de données

boolean

Alias
UMLS CUI [1]
C0262477
Please specify the eye problems you experienced. If there´s more than one, please describe one be one.
Description

Enter all significant medical history items, including surgeries, EXCEPT the problem/condition that is the focus of this study. Use only one line per description

Type de données

text

Alias
UMLS CUI [1]
C0262477
Start date of eye problems
Description

Start date

Type de données

date

Alias
UMLS CUI [1]
C0011008
End date of eye problems
Description

End date

Type de données

date

Alias
UMLS CUI [1]
C0011008
Is the symptom persistent?
Description

Ongoing

Type de données

boolean

Alias
UMLS CUI [1]
C0549178
Have you experienced ENT or mouth problems in the past?
Description

Otorhinolaryngologic conditions

Type de données

boolean

Alias
UMLS CUI [1]
C0029896
Please specify the otorhinolaryngologic conditions or problems with your mouth you experienced. If there´s more than one, please describe one be one.
Description

Enter all significant medical history items, including surgeries, EXCEPT the problem/condition that is the focus of this study. Use only one line per description

Type de données

text

Alias
UMLS CUI [1]
C0029896
Start date of you ENT or mouth problems
Description

Start date

Type de données

date

Alias
UMLS CUI [1]
C0011008
End date of your ENT or mouth problems
Description

End date

Type de données

date

Alias
UMLS CUI [1]
C0011008
Is the system persistent?
Description

Ongoing

Type de données

boolean

Alias
UMLS CUI [1]
C0549178
Have you experienced problems with your cardiovascular system in the past?
Description

Cardiovascular diseases

Type de données

boolean

Alias
UMLS CUI [1]
C0007222
Please specify the problems you experienced with your cardiovascular system. If there´s more than one, describe it one by one.
Description

Enter all significant medical history items, including surgeries, EXCEPT the problem/condition that is the focus of this study. Use only one line per description.

Type de données

text

Alias
UMLS CUI [1]
C0007222
Start date of your cardiovascular problems
Description

Start date

Type de données

date

Alias
UMLS CUI [1]
C0011008
End date of your cardiovascular problems
Description

End date

Type de données

date

Alias
UMLS CUI [1]
C0011008
Is the symptom persistent?
Description

Ongoing

Type de données

boolean

Alias
UMLS CUI [1]
C0549178
Have you experienced respiratory problems in the past?
Description

Respiratory disorders

Type de données

boolean

Alias
UMLS CUI [1]
C0035204
Please specify the respiratory problems you experienced. If there´s more than one, describe it one by one.
Description

Enter all significant medical history items, including surgeries, EXCEPT the problem/condition that is the focus of this study. Use only one line per description.

Type de données

text

Alias
UMLS CUI [1]
C0035204
Start date of your respiratory problems
Description

Start date

Type de données

date

Alias
UMLS CUI [1]
C0011008
End date of your respiratory problems
Description

End date

Type de données

date

Alias
UMLS CUI [1]
C0011008
Is the symptom persistent?
Description

Ongoing

Type de données

boolean

Alias
UMLS CUI [1]
C0549178
Have you experienced gastrointestinal problems in the past?
Description

Gastrointestinal system

Type de données

boolean

Alias
UMLS CUI [1]
C0012240
Please specify the gastrointestinal problem you experienced. If there´s more than one, describe it one by one
Description

Enter all significant medical history items, including surgeries, EXCEPT the problem/condition that is the focus of this study. Use only one line per description.

Type de données

text

Alias
UMLS CUI [1]
C0012240
Start date of your gastrointestinal problems
Description

Start date

Type de données

date

Alias
UMLS CUI [1]
C0011008
End date of your gastrointestinal problems
Description

End date

Type de données

date

Alias
UMLS CUI [1]
C0011008
Is the symptom persistent?
Description

Ongoing

Type de données

boolean

Alias
UMLS CUI [1]
C0549178
Have you experienced problems with your genitourinary system in the past?
Description

Genitourinary system

Type de données

boolean

Alias
UMLS CUI [1]
C0042066
Please specify the problems with your genitourinary system. If there´s more than one, describe it one by one.
Description

Enter all significant medical history items, including surgeries, EXCEPT the problem/condition that is the focus of this study. Use only one line per description.

Type de données

text

Alias
UMLS CUI [1]
C0042066
Start date of your genitourinary problems
Description

Start date

Type de données

date

Alias
UMLS CUI [1]
C0011008
End date of your genitourinary problems
Description

End date

Type de données

date

Alias
UMLS CUI [1]
C0011008
Is the symptom persistent?
Description

Ongoing

Type de données

boolean

Alias
UMLS CUI [1]
C0549178
Have you experienced problems with musculoskeletal system in the past?
Description

Musculoskeletal system

Type de données

boolean

Alias
UMLS CUI [1]
C0026860
Please specify the problem with your musculoskeletal system. If there´s more than one, describe it one by one.
Description

Enter all significant medical history items, including surgeries, EXCEPT the problem/condition that is the focus of this study. Use only one line per description.

Type de données

text

Alias
UMLS CUI [1]
C0026860
Start date of your musculoskeletal problem
Description

Start date

Type de données

date

Alias
UMLS CUI [1]
C0011008
End date of your musculoskeletal problem
Description

End date

Type de données

date

Alias
UMLS CUI [1]
C0011008
Is the symptom persistent
Description

Ongoing

Type de données

boolean

Alias
UMLS CUI [1]
C0549178
Have you experienced problems with your skin or your breast in the past?
Description

Integumentary system

Type de données

boolean

Alias
UMLS CUI [1]
C0037267
Please specify the problems with your integumentary system you experienced. If there´s more than one, describe it one by one.
Description

Enter all significant medical history items, including surgeries, EXCEPT the problem/condition that is the focus of this study. Use only one line per description.

Type de données

text

Alias
UMLS CUI [1]
C0037267
Start date of your problems with the integumentary system
Description

Start date

Type de données

date

Alias
UMLS CUI [1]
C0011008
End date of your problems with the integumentary system
Description

End date

Type de données

date

Alias
UMLS CUI [1]
C0011008
Is the symptom persistent?
Description

Ongoing

Type de données

boolean

Alias
UMLS CUI [1]
C0549178
Have you experienced neurological problems with in the past?
Description

Neurological problems

Type de données

boolean

Alias
UMLS CUI [1]
C0221571
Please specify the neurological problems you experienced. If there´s more than one, please describe it one be one.
Description

Enter all significant medical history items, including surgeries, EXCEPT the problem/condition that is the focus of this study. Use only one line per description.

Type de données

text

Alias
UMLS CUI [1]
C0221571
Start date of the neurological problem
Description

Start date

Type de données

date

Alias
UMLS CUI [1]
C0011008
End date of the neurological problem
Description

End date

Type de données

date

Alias
UMLS CUI [1]
C0011008
Is the symptom persistent?
Description

Ongoing

Type de données

boolean

Alias
UMLS CUI [1]
C0549178
Have you experienced problems with your mental health in the past?
Description

Mental disorders

Type de données

boolean

Alias
UMLS CUI [1]
C0004936
Please specify the mental problem you experienced. If there´s more than one, please describe it one by one.
Description

Enter all significant medical history items, including surgeries, EXCEPT the problem/condition that is the focus of this study. Use only one line per description.

Type de données

text

Alias
UMLS CUI [1]
C0004936
Start date of your mental illness
Description

Start date

Type de données

date

Alias
UMLS CUI [1]
C0011008
End date of your mental illness
Description

End date

Type de données

date

Alias
UMLS CUI [1]
C0011008
Is the symptom persistent?
Description

Ongoing

Type de données

boolean

Alias
UMLS CUI [1]
C0549178
Have you experienced problems with your endocrine system in the past?
Description

Endocrine system diseases

Type de données

boolean

Alias
UMLS CUI [1]
C0014130
Please specify the endocrine system disease you experienced. If there´s more than one,please describe it one by one
Description

Endocrine system diseases

Type de données

text

Alias
UMLS CUI [1]
C0014130
Start date of the endocrine system disease
Description

Start date

Type de données

date

Alias
UMLS CUI [1]
C0011008
End date of the endocrine system disease
Description

End date

Type de données

date

Alias
UMLS CUI [1]
C0011008
Is the symptom persistent?
Description

Ongoing

Type de données

boolean

Alias
UMLS CUI [1]
C0549178
Have you experienced problems with diseases of blood and bloodforming organs in the past?
Description

Hematological disease

Type de données

boolean

Alias
UMLS CUI [1]
C0018939
Please specify the disease of blood and bloodforming organs you experienced. If there´s more than one,please describe it one by one.
Description

Hematological disease

Type de données

text

Alias
UMLS CUI [1]
C0018939
Start date of your problems with the blood or bloodforming system
Description

Start date

Type de données

date

Alias
UMLS CUI [1]
C0011008
End date of the problems with your blood or bloodforming system
Description

End date

Type de données

date

Alias
UMLS CUI [1]
C0011008
Is the symptom persistent?
Description

Ongoing

Type de données

boolean

Alias
UMLS CUI [1]
C0549178
Have you experienced problems with lymphatic diseases in the past?
Description

Lymphatic disease

Type de données

boolean

Alias
UMLS CUI [1]
C0024228
Please specify the problem with your lymphatic system you experienced. If there´s more than one, please describe it one by one
Description

Enter all significant medical history items, including surgeries, EXCEPT the problem/condition that is the focus of this study. Use only one line per description.

Type de données

text

Alias
UMLS CUI [1]
C0024228
Start date of your problems with the lymphatic system
Description

Start date

Type de données

date

Alias
UMLS CUI [1]
C0011008
End date of your problems with the lymphatic system
Description

End date

Type de données

date

Alias
UMLS CUI [1]
C0011008
Is the symptom persistent?
Description

Ongoing

Type de données

boolean

Alias
UMLS CUI [1]
C0549178
Have you experienced problems with allergies in the past?
Description

Allergies

Type de données

boolean

Alias
UMLS CUI [1]
C0020517
Please specify the allergy you experienced. If there´s more than one, please describe it one by one.
Description

Enter all significant medical history items, including surgeries, EXCEPT the problem/condition that is the focus of this study. Use only one line per description.

Type de données

text

Alias
UMLS CUI [1]
C0020517
Start date of the allergy
Description

Start date

Type de données

date

Alias
UMLS CUI [1]
C0011008
End date of the allergy
Description

End date

Type de données

date

Alias
UMLS CUI [1]
C0011008
Is the allergy persistent?
Description

Ongoing

Type de données

boolean

Alias
UMLS CUI [1]
C0549178
Have you experienced problems with your immune system in the past?
Description

Immunologic diseases

Type de données

boolean

Alias
UMLS CUI [1]
C0021053
Please specify the problem with your immune system you experienced. If there´s more than one, please desribe it one by one
Description

Enter all significant medical history items, including surgeries, EXCEPT the problem/condition that is the focus of this study. Use only one line per description.

Type de données

text

Alias
UMLS CUI [1]
C0021053
Start date of your problems with the immune system
Description

Start date

Type de données

date

Alias
UMLS CUI [1]
C0011008
End date of the problems with your immune system
Description

End date

Type de données

date

Alias
UMLS CUI [1]
C0011008
Is the symptom persistent?
Description

Ongoing

Type de données

boolean

Alias
UMLS CUI [1]
C0549178
Does the subject have allergies?
Description

Allergies

Type de données

boolean

Alias
UMLS CUI [1]
C0020517
If the subject does have allergies, please specify which type:
Description

Allergies

Type de données

text

Alias
UMLS CUI [1]
C0020517
Is the subject of childbearing potential
Description

Childbearing potential

Type de données

boolean

Alias
UMLS CUI [1]
C3831118
Females of childbearing potential, using safe contraceptive measures? Please check one below
Description

Contraceptive measures

Type de données

text

Alias
UMLS CUI [1]
C0700589
Please specify other contraceptive measures, if none of the above applied.
Description

Contraceptive measures

Type de données

text

Alias
UMLS CUI [1]
C0700589
If the subject was surgically sterilized, please specify:
Description

Surgical sterilization

Type de données

text

Alias
UMLS CUI [1]
C0015787
Please specify other method of surgical sterilization if none of the above applied.
Description

Surgical sterilization

Type de données

text

Alias
UMLS CUI [1]
C0015787

Similar models

General Health History

  1. StudyEvent: ODM
    1. General Health History
Name
Type
Description | Question | Decode (Coded Value)
Type de données
Alias
Item Group
Medical history
study ID
Item
Study-ID
integer
C2826693 (UMLS CUI [1])
Study site
Item
Study site name
text
C2825164 (UMLS CUI [1])
Patient Study ID
Item
Subject ID
text
C2348585 (UMLS CUI [1])
Date
Item
Date Medical History Taken
date
C0011008 (UMLS CUI [1])
Constitutional symptoms
Item
Have you experienced problems with constitutional symptoms in the past?
boolean
C0009812 (UMLS CUI [1])
Constitutional symptoms
Item
Please specify the constitutional symptom you experienced. If there´s more than one, please describe one be one.
text
C0009812 (UMLS CUI [1])
Start date
Item
Start date of constitutional symptom
date
C0011008 (UMLS CUI [1])
End date
Item
End date of constitutional symptom
date
C0011008 (UMLS CUI [1])
Ongoing
Item
Is the symptom persistent?
boolean
C0549178 (UMLS CUI [1])
Eye problems
Item
Have you experienced problems with your eyes in the past?
boolean
C0262477 (UMLS CUI [1])
Eye problems
Item
Please specify the eye problems you experienced. If there´s more than one, please describe one be one.
text
C0262477 (UMLS CUI [1])
Start date
Item
Start date of eye problems
date
C0011008 (UMLS CUI [1])
End date
Item
End date of eye problems
date
C0011008 (UMLS CUI [1])
Ongoing
Item
Is the symptom persistent?
boolean
C0549178 (UMLS CUI [1])
Otorhinolaryngologic conditions
Item
Have you experienced ENT or mouth problems in the past?
boolean
C0029896 (UMLS CUI [1])
Otorhinolaryngologic conditions
Item
Please specify the otorhinolaryngologic conditions or problems with your mouth you experienced. If there´s more than one, please describe one be one.
text
C0029896 (UMLS CUI [1])
Start date
Item
Start date of you ENT or mouth problems
date
C0011008 (UMLS CUI [1])
End date
Item
End date of your ENT or mouth problems
date
C0011008 (UMLS CUI [1])
Ongoing
Item
Is the system persistent?
boolean
C0549178 (UMLS CUI [1])
Cardiovascular diseases
Item
Have you experienced problems with your cardiovascular system in the past?
boolean
C0007222 (UMLS CUI [1])
Cardiovascular Diseases
Item
Please specify the problems you experienced with your cardiovascular system. If there´s more than one, describe it one by one.
text
C0007222 (UMLS CUI [1])
Start date
Item
Start date of your cardiovascular problems
date
C0011008 (UMLS CUI [1])
End date
Item
End date of your cardiovascular problems
date
C0011008 (UMLS CUI [1])
Ongoing
Item
Is the symptom persistent?
boolean
C0549178 (UMLS CUI [1])
Respiratory disorders
Item
Have you experienced respiratory problems in the past?
boolean
C0035204 (UMLS CUI [1])
Respiration disorders
Item
Please specify the respiratory problems you experienced. If there´s more than one, describe it one by one.
text
C0035204 (UMLS CUI [1])
Start date
Item
Start date of your respiratory problems
date
C0011008 (UMLS CUI [1])
End date
Item
End date of your respiratory problems
date
C0011008 (UMLS CUI [1])
Ongoing
Item
Is the symptom persistent?
boolean
C0549178 (UMLS CUI [1])
Gastrointestinal system
Item
Have you experienced gastrointestinal problems in the past?
boolean
C0012240 (UMLS CUI [1])
Gastrointestinal system
Item
Please specify the gastrointestinal problem you experienced. If there´s more than one, describe it one by one
text
C0012240 (UMLS CUI [1])
Start date
Item
Start date of your gastrointestinal problems
date
C0011008 (UMLS CUI [1])
End date
Item
End date of your gastrointestinal problems
date
C0011008 (UMLS CUI [1])
Ongoing
Item
Is the symptom persistent?
boolean
C0549178 (UMLS CUI [1])
Genitourinary system
Item
Have you experienced problems with your genitourinary system in the past?
boolean
C0042066 (UMLS CUI [1])
Genitourinary system
Item
Please specify the problems with your genitourinary system. If there´s more than one, describe it one by one.
text
C0042066 (UMLS CUI [1])
Start date
Item
Start date of your genitourinary problems
date
C0011008 (UMLS CUI [1])
End date
Item
End date of your genitourinary problems
date
C0011008 (UMLS CUI [1])
Ongoing
Item
Is the symptom persistent?
boolean
C0549178 (UMLS CUI [1])
Musculoskeletal system
Item
Have you experienced problems with musculoskeletal system in the past?
boolean
C0026860 (UMLS CUI [1])
Musculoskeletal System
Item
Please specify the problem with your musculoskeletal system. If there´s more than one, describe it one by one.
text
C0026860 (UMLS CUI [1])
Start date
Item
Start date of your musculoskeletal problem
date
C0011008 (UMLS CUI [1])
End date
Item
End date of your musculoskeletal problem
date
C0011008 (UMLS CUI [1])
Ongoing
Item
Is the symptom persistent
boolean
C0549178 (UMLS CUI [1])
Integumentary system
Item
Have you experienced problems with your skin or your breast in the past?
boolean
C0037267 (UMLS CUI [1])
Integumentary system
Item
Please specify the problems with your integumentary system you experienced. If there´s more than one, describe it one by one.
text
C0037267 (UMLS CUI [1])
Start date
Item
Start date of your problems with the integumentary system
date
C0011008 (UMLS CUI [1])
End date
Item
End date of your problems with the integumentary system
date
C0011008 (UMLS CUI [1])
Ongoing
Item
Is the symptom persistent?
boolean
C0549178 (UMLS CUI [1])
Neurological problems
Item
Have you experienced neurological problems with in the past?
boolean
C0221571 (UMLS CUI [1])
Neurological problems
Item
Please specify the neurological problems you experienced. If there´s more than one, please describe it one be one.
text
C0221571 (UMLS CUI [1])
Start date
Item
Start date of the neurological problem
date
C0011008 (UMLS CUI [1])
End date
Item
End date of the neurological problem
date
C0011008 (UMLS CUI [1])
Ongoing
Item
Is the symptom persistent?
boolean
C0549178 (UMLS CUI [1])
Mental disorders
Item
Have you experienced problems with your mental health in the past?
boolean
C0004936 (UMLS CUI [1])
Mental disorders
Item
Please specify the mental problem you experienced. If there´s more than one, please describe it one by one.
text
C0004936 (UMLS CUI [1])
Start date
Item
Start date of your mental illness
date
C0011008 (UMLS CUI [1])
End date
Item
End date of your mental illness
date
C0011008 (UMLS CUI [1])
Ongoing
Item
Is the symptom persistent?
boolean
C0549178 (UMLS CUI [1])
Endocrine system diseases
Item
Have you experienced problems with your endocrine system in the past?
boolean
C0014130 (UMLS CUI [1])
Endocrine system diseases
Item
Please specify the endocrine system disease you experienced. If there´s more than one,please describe it one by one
text
C0014130 (UMLS CUI [1])
Start date
Item
Start date of the endocrine system disease
date
C0011008 (UMLS CUI [1])
End date
Item
End date of the endocrine system disease
date
C0011008 (UMLS CUI [1])
Ongoing
Item
Is the symptom persistent?
boolean
C0549178 (UMLS CUI [1])
Hematological disease
Item
Have you experienced problems with diseases of blood and bloodforming organs in the past?
boolean
C0018939 (UMLS CUI [1])
Hematological disease
Item
Please specify the disease of blood and bloodforming organs you experienced. If there´s more than one,please describe it one by one.
text
C0018939 (UMLS CUI [1])
Start date
Item
Start date of your problems with the blood or bloodforming system
date
C0011008 (UMLS CUI [1])
End date
Item
End date of the problems with your blood or bloodforming system
date
C0011008 (UMLS CUI [1])
Ongoing
Item
Is the symptom persistent?
boolean
C0549178 (UMLS CUI [1])
Lymphatic disease
Item
Have you experienced problems with lymphatic diseases in the past?
boolean
C0024228 (UMLS CUI [1])
Lymphatic disease
Item
Please specify the problem with your lymphatic system you experienced. If there´s more than one, please describe it one by one
text
C0024228 (UMLS CUI [1])
Start date
Item
Start date of your problems with the lymphatic system
date
C0011008 (UMLS CUI [1])
End date
Item
End date of your problems with the lymphatic system
date
C0011008 (UMLS CUI [1])
Ongoing
Item
Is the symptom persistent?
boolean
C0549178 (UMLS CUI [1])
Allergies
Item
Have you experienced problems with allergies in the past?
boolean
C0020517 (UMLS CUI [1])
Allergies
Item
Please specify the allergy you experienced. If there´s more than one, please describe it one by one.
text
C0020517 (UMLS CUI [1])
Start date
Item
Start date of the allergy
date
C0011008 (UMLS CUI [1])
End date
Item
End date of the allergy
date
C0011008 (UMLS CUI [1])
Ongoing
Item
Is the allergy persistent?
boolean
C0549178 (UMLS CUI [1])
Immunologic diseases
Item
Have you experienced problems with your immune system in the past?
boolean
C0021053 (UMLS CUI [1])
Immunologic diseases
Item
Please specify the problem with your immune system you experienced. If there´s more than one, please desribe it one by one
text
C0021053 (UMLS CUI [1])
Start date
Item
Start date of your problems with the immune system
date
C0011008 (UMLS CUI [1])
End date
Item
End date of the problems with your immune system
date
C0011008 (UMLS CUI [1])
Ongoing
Item
Is the symptom persistent?
boolean
C0549178 (UMLS CUI [1])
Allergies
Item
Does the subject have allergies?
boolean
C0020517 (UMLS CUI [1])
Item
If the subject does have allergies, please specify which type:
text
C0020517 (UMLS CUI [1])
Code List
If the subject does have allergies, please specify which type:
CL Item
food (1)
CL Item
seasonal (2)
CL Item
medication (3)
Childbearing potential
Item
Is the subject of childbearing potential
boolean
C3831118 (UMLS CUI [1])
Item
Females of childbearing potential, using safe contraceptive measures? Please check one below
text
C0700589 (UMLS CUI [1])
Code List
Females of childbearing potential, using safe contraceptive measures? Please check one below
CL Item
Abstinence (1)
CL Item
Hormonal (oral,implanted,injected...) (2)
CL Item
Intrauterine device in place for ≥ 3 months (3)
CL Item
Adequate barrier method in conjunction with spermicide (4)
CL Item
Postmenopausal (5)
CL Item
Surgically sterile (6)
CL Item
Non-surgically sterile  (7)
CL Item
Other (8)
Contraceptive measures
Item
Please specify other contraceptive measures, if none of the above applied.
text
C0700589 (UMLS CUI [1])
Item
If the subject was surgically sterilized, please specify:
text
C0015787 (UMLS CUI [1])
Code List
If the subject was surgically sterilized, please specify:
CL Item
Hysterectomy (1)
CL Item
Tubal ligation (2)
CL Item
Other (3)
Surgical sterilization
Item
Please specify other method of surgical sterilization if none of the above applied.
text
C0015787 (UMLS CUI [1])

Utilisez ce formulaire pour les retours, les questions et les améliorations suggérées.

Les champs marqués d’un * sont obligatoires.

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial