Engelsk

CRF Lumbar Puncture Follow Up

1 Formulär  
Date of visit
Beskrivning

Date of visit

Alias
UMLS CUI-1
C1320303
Date of visit
Beskrivning

date of visit

Datatyp

date

Alias
UMLS CUI [1]
C1320303
Study-ID:
Beskrivning

study id

Datatyp

text

Alias
UMLS CUI [1]
C2826693
Follow-Up:
Beskrivning

visit name

Datatyp

text

Alias
UMLS CUI [1]
C1522577
Lumbar puncture
Beskrivning

Lumbar puncture

Alias
UMLS CUI-1
C0037943
Date of information about lumbar puncture
Beskrivning

Information about lumbar puncture(Thieme information sheet)

Datatyp

date

Alias
UMLS CUI [1,1]
C0588446
UMLS CUI [1,2]
C0037943
UMLS CUI [1,3]
C0011008
Was a control of coagulation performed?
Beskrivning

Coagulation control

Datatyp

boolean

Alias
UMLS CUI [1]
C0491299
Coagulation control performed:
Beskrivning

coagulation control date

Datatyp

date

Alias
UMLS CUI [1,1]
C0491299
UMLS CUI [1,2]
C0011008
PPT (Partial Thromboplastin Time)
Beskrivning

PPT

Datatyp

integer

Måttenheter
  • sec
Alias
UMLS CUI [1]
C1531697
sec
International Normalization Ratio (INR)
Beskrivning

INR

Datatyp

float

Alias
UMLS CUI [1]
C0525032
Count platelets:
Beskrivning

platelets count

Datatyp

integer

Måttenheter
  • µl
Alias
UMLS CUI [1]
C0005821
µl
Was lumbar puncture performed?
Beskrivning

Lumbar puncture

Datatyp

boolean

Alias
UMLS CUI [1]
C0037943
Date of lumbar puncture
Beskrivning

Date lumbar puncure

Datatyp

date

Alias
UMLS CUI [1,1]
C0037943
UMLS CUI [1,2]
C0011008
Was the lumbar puncture successfully completed?
Beskrivning

lumbar puncture successful

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0037943
UMLS CUI [1,2]
C3258067
If 'successfully completed' any complications?
Beskrivning

complications

Datatyp

boolean

Alias
UMLS CUI [1]
C0009566
If complications, which one?
Beskrivning

complication specification

Datatyp

text

Alias
UMLS CUI [1]
C0009566
If 'not successfully completed' please give reasons:
Beskrivning

reasons procedure not successful

Datatyp

text

Alias
UMLS CUI [1,1]
C1443309
UMLS CUI [1,2]
C0424237
Other comments
Beskrivning

other comments

Datatyp

text

Alias
UMLS CUI [1]
C1830770
Date of lumbar puncture
Beskrivning

Date of lumbar puncture

Datatyp

datetime

Alias
UMLS CUI [1,1]
C0037943
UMLS CUI [1,2]
C0011008
Sampling
Beskrivning

Sampling

Empty-stomached (during last 12 hrs)?
Beskrivning

-> Was the participant empty-stomached in the last 12 hrs? If "no" please provide the following date and time informations about the last meal and last beverage.

Datatyp

boolean

Alias
UMLS CUI [1]
C3686898
Last meal:
Beskrivning

last meal

Datatyp

datetime

Alias
UMLS CUI [1,1]
C0578574
UMLS CUI [1,2]
C0011008
Last beverage:
Beskrivning

except water

Datatyp

datetime

Alias
UMLS CUI [1,1]
C0005329
UMLS CUI [1,2]
C0011008
Last beverage with coffeine:
Beskrivning

last beverage with coffeine

Datatyp

datetime

Alias
UMLS CUI [1,1]
C0678438
UMLS CUI [1,2]
C0011008
Tabacco smoke (during the last 12 hrs)
Beskrivning

-> Did the participant consume tabacco in the last 12 hrs? If "yes", please give the following date and time information about the last tabacco consumption

Datatyp

boolean

Alias
UMLS CUI [1]
C0439994
Last tabacco smoke:
Beskrivning

last tabacco smoke

Datatyp

datetime

Alias
UMLS CUI [1,1]
C0439994
UMLS CUI [1,2]
C0011008
1. Sampling performed according to SOP-BM-01?
Beskrivning

SOP for sampling

Datatyp

boolean

Alias
UMLS CUI [1,1]
C1710183
UMLS CUI [1,2]
C0870078
1.1. SOP version (No.)
Beskrivning

SOP version

Datatyp

text

Alias
UMLS CUI [1]
C1710183
2. Any deviations from SOP-BM-01
Beskrivning

deviations from SOP

Datatyp

boolean

Alias
UMLS CUI [1]
C1710183
2.1. Other container used for CSF sampling and not those at disposal.
Beskrivning

other container used

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0492861
UMLS CUI [1,2]
C0205394
2.1.1. other container, please specify:
Beskrivning

other container name

Datatyp

text

Alias
UMLS CUI [1,1]
C0492861
UMLS CUI [1,2]
C0205394
2.2. Any deviation from SOP-KA-02, Version X?
Beskrivning

deviation from SOP version

Datatyp

boolean

Alias
UMLS CUI [1]
C1710183
CSF tube volume
Beskrivning

CSF tube volume

Datatyp

integer

Måttenheter
  • ml
Alias
UMLS CUI [1,1]
C0181696
UMLS CUI [1,2]
C0449468
ml
CSF tube barcode
Beskrivning

CSF barcode

Datatyp

text

Alias
UMLS CUI [1,1]
C0004738
UMLS CUI [1,2]
C0181696
CSF sampling NOT DONE
Beskrivning

CSF-sampling not done

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0037943
UMLS CUI [1,2]
C1272696
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Similar models

CRF Lumbar Puncture Follow Up

1 Formulär
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Date of visit
C1320303 (UMLS CUI-1)
date of visit
Item
Date of visit
date
C1320303 (UMLS CUI [1])
study id
Item
Study-ID:
text
C2826693 (UMLS CUI [1])
visit name
Item
Follow-Up:
text
C1522577 (UMLS CUI [1])
Item Group
Lumbar puncture
C0037943 (UMLS CUI-1)
Date information lumbar puncture
Item
Date of information about lumbar puncture
date
C0588446 (UMLS CUI [1,1])
C0037943 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
coagulation control
Item
Was a control of coagulation performed?
boolean
C0491299 (UMLS CUI [1])
coagulation control date
Item
Coagulation control performed:
date
C0491299 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
PPT
Item
PPT (Partial Thromboplastin Time)
integer
C1531697 (UMLS CUI [1])
INR
Item
International Normalization Ratio (INR)
float
C0525032 (UMLS CUI [1])
platelets count
Item
Count platelets:
integer
C0005821 (UMLS CUI [1])
lumbar puncture
Item
Was lumbar puncture performed?
boolean
C0037943 (UMLS CUI [1])
Date lumbar puncure
Item
Date of lumbar puncture
date
C0037943 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
lumbar puncture successful
Item
Was the lumbar puncture successfully completed?
boolean
C0037943 (UMLS CUI [1,1])
C3258067 (UMLS CUI [1,2])
complications
Item
If 'successfully completed' any complications?
boolean
C0009566 (UMLS CUI [1])
complication specification
Item
If complications, which one?
text
C0009566 (UMLS CUI [1])
reasons procedure not successful
Item
If 'not successfully completed' please give reasons:
text
C1443309 (UMLS CUI [1,1])
C0424237 (UMLS CUI [1,2])
other comments
Item
Other comments
text
C1830770 (UMLS CUI [1])
Date of lumbar puncture
Item
Date of lumbar puncture
datetime
C0037943 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Item Group
Sampling
patient empty-stomached
Item
Empty-stomached (during last 12 hrs)?
boolean
C3686898 (UMLS CUI [1])
last meal
Item
Last meal:
datetime
C0578574 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
last beverage
Item
Last beverage:
datetime
C0005329 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
last beverage with coffeine
Item
Last beverage with coffeine:
datetime
C0678438 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
tabacco consumption
Item
Tabacco smoke (during the last 12 hrs)
boolean
C0439994 (UMLS CUI [1])
last tabacco smoke
Item
Last tabacco smoke:
datetime
C0439994 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
SOP for sampling
Item
1. Sampling performed according to SOP-BM-01?
boolean
C1710183 (UMLS CUI [1,1])
C0870078 (UMLS CUI [1,2])
SOP version
Item
1.1. SOP version (No.)
text
C1710183 (UMLS CUI [1])
deviations from SOP
Item
2. Any deviations from SOP-BM-01
boolean
C1710183 (UMLS CUI [1])
other container used
Item
2.1. Other container used for CSF sampling and not those at disposal.
boolean
C0492861 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
other container name
Item
2.1.1. other container, please specify:
text
C0492861 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
deviation from SOP version
Item
2.2. Any deviation from SOP-KA-02, Version X?
boolean
C1710183 (UMLS CUI [1])
CSF tube volume
Item
CSF tube volume
integer
C0181696 (UMLS CUI [1,1])
C0449468 (UMLS CUI [1,2])
CSF barcode
Item
CSF tube barcode
text
C0004738 (UMLS CUI [1,1])
C0181696 (UMLS CUI [1,2])
CSF-sampling not done
Item
CSF sampling NOT DONE
boolean
C0037943 (UMLS CUI [1,1])
C1272696 (UMLS CUI [1,2])
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