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CRF MRI Contraindications

1 forms  
Questionaire - MRI contraindications
Description

Questionaire - MRI contraindications

Study-ID:
Description

study id

Data type

text

Alias
UMLS CUI [1]
C2826693
Body weight
Description

weight

Data type

float

Measurement units
  • kg
Alias
UMLS CUI [1]
C0005910
kg
Height
Description

height

Data type

float

Measurement units
  • cm
Alias
UMLS CUI [1]
C0005890
cm
1. Were heart or head surgeries performed?
Description

heart or head surgery

Data type

text

Alias
UMLS CUI [1]
C0018821
UMLS CUI [2]
C0195772
2. Do you have implants?
Description

e.g. cardiac pacemaker, inner ear implant, nerve stimulator, defibrillator, infusion pump

Data type

text

Alias
UMLS CUI [1]
C0021102
3. Are there any metal pieces or foreign bodies in or on your body?
Description

e.g acupuncture needles, artificial joints, stents, dental prosthesis/braces, metal splinters, metal clips, implanted electrodes, mechanical contraceptive device (contraceptive coil)

Data type

text

4. Did you work in a metalworking industry?
Description

metalworking industry

Data type

text

Alias
UMLS CUI [1,1]
C2904334
UMLS CUI [1,2]
C0521127
5. Do you suffer from tinnitus?
Description

tinnitus

Data type

text

Alias
UMLS CUI [1]
C0040264
6. Do you have an anxiety of confined space (e.g. riding in an elevator)?
Description

claustrophobia

Data type

text

Alias
UMLS CUI [1]
C0008909
7. Do you wear body jewellery that you cannot get off?
Description

body jewellery

Data type

text

Alias
UMLS CUI [1]
C0336902
8. Do you have a family history of epilepsy?
Description

e.g. unconsciousness, seizures

Data type

text

Alias
UMLS CUI [1]
C0478623
9. Are you under the influence of drinks or drugs (e.g. alcohol)?
Description

influence of drinks or drug

Data type

text

Alias
UMLS CUI [1]
C0013146
UMLS CUI [2]
C0001948
10. Does a pregnancy exist?
Description

pregnancy

Data type

text

Alias
UMLS CUI [1]
C0032961
11. Do you suffer from pain, circulatory problems or respiratory problems, if you lie down on your back for a while?
Description

problems lying down

Data type

text

Alias
UMLS CUI [1]
C0555089
12. Do you have fever?
Description

fever

Data type

text

Alias
UMLS CUI [1]
C0015967
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Similar models

CRF MRI Contraindications

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Questionaire - MRI contraindications
study id
Item
Study-ID:
text
C2826693 (UMLS CUI [1])
weight
Item
Body weight
float
C0005910 (UMLS CUI [1])
height
Item
Height
float
C0005890 (UMLS CUI [1])
Item
1. Were heart or head surgeries performed?
text
C0018821 (UMLS CUI [1])
C0195772 (UMLS CUI [2])
heart or head surgery
Code List
1. Were heart or head surgeries performed?
CL Item
Yes (Yes)
CL Item
No  (No )
CL Item
? (?)
Item
2. Do you have implants?
text
C0021102 (UMLS CUI [1])
heart or head surgery
Code List
2. Do you have implants?
CL Item
Yes (Yes)
CL Item
No  (No )
CL Item
? (?)
Item
3. Are there any metal pieces or foreign bodies in or on your body?
text
heart or head surgery
Code List
3. Are there any metal pieces or foreign bodies in or on your body?
CL Item
Yes (Yes)
CL Item
No  (No )
CL Item
? (?)
Item
4. Did you work in a metalworking industry?
text
C2904334 (UMLS CUI [1,1])
C0521127 (UMLS CUI [1,2])
heart or head surgery
Code List
4. Did you work in a metalworking industry?
CL Item
Yes (Yes)
CL Item
No  (No )
CL Item
? (?)
Item
5. Do you suffer from tinnitus?
text
C0040264 (UMLS CUI [1])
heart or head surgery
Code List
5. Do you suffer from tinnitus?
CL Item
Yes (Yes)
CL Item
No  (No )
CL Item
? (?)
Item
6. Do you have an anxiety of confined space (e.g. riding in an elevator)?
text
C0008909 (UMLS CUI [1])
heart or head surgery
Code List
6. Do you have an anxiety of confined space (e.g. riding in an elevator)?
CL Item
Yes (Yes)
CL Item
No  (No )
CL Item
? (?)
Item
7. Do you wear body jewellery that you cannot get off?
text
C0336902 (UMLS CUI [1])
heart or head surgery
Code List
7. Do you wear body jewellery that you cannot get off?
CL Item
Yes (Yes)
CL Item
No  (No )
CL Item
? (?)
Item
8. Do you have a family history of epilepsy?
text
C0478623 (UMLS CUI [1])
heart or head surgery
Code List
8. Do you have a family history of epilepsy?
CL Item
Yes (Yes)
CL Item
No  (No )
CL Item
? (?)
Item
9. Are you under the influence of drinks or drugs (e.g. alcohol)?
text
C0013146 (UMLS CUI [1])
C0001948 (UMLS CUI [2])
heart or head surgery
Code List
9. Are you under the influence of drinks or drugs (e.g. alcohol)?
CL Item
Yes (Yes)
CL Item
No  (No )
CL Item
? (?)
Item
10. Does a pregnancy exist?
text
C0032961 (UMLS CUI [1])
heart or head surgery
Code List
10. Does a pregnancy exist?
CL Item
Yes (Yes)
CL Item
No  (No )
CL Item
? (?)
Item
11. Do you suffer from pain, circulatory problems or respiratory problems, if you lie down on your back for a while?
text
C0555089 (UMLS CUI [1])
heart or head surgery
Code List
11. Do you suffer from pain, circulatory problems or respiratory problems, if you lie down on your back for a while?
CL Item
Yes (Yes)
CL Item
No  (No )
CL Item
? (?)
Item
12. Do you have fever?
text
C0015967 (UMLS CUI [1])
heart or head surgery
Code List
12. Do you have fever?
CL Item
Yes (Yes)
CL Item
No  (No )
CL Item
? (?)
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