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Prior and Concomitant Medications

1 forms  
Prior and Concomitant Medications
Description

Prior and Concomitant Medications

Study-ID
Description

Study ID

Data type

integer

Alias
UMLS CUI [1]
C2826693
Study site name
Description

Study site

Data type

text

Alias
UMLS CUI [1]
C2825164
Subject ID
Description

Subject ID

Data type

text

Alias
UMLS CUI [1]
C2348585
Did the participant/subject take any medications before or during the study?
Description

If no, leave the rest of form blank

Data type

boolean

Alias
UMLS CUI [1]
C2347852
Medication name
Description

(Trade or generic name)

Data type

text

Alias
UMLS CUI [1]
C2360065
Indication
Description

(If given for AE, enter exact term from AE CRF)

Data type

text

Alias
UMLS CUI [1]
C2826696
Dose
Description

Medication Dose

Data type

float

Alias
UMLS CUI [1]
C3174092
Units
Description

(mg, microgr,...)

Data type

text

Alias
UMLS CUI [1]
C1519795
Medication frequency
Description

Medication frequency

Data type

text

Alias
UMLS CUI [1]
C3476109
Route of administration
Description

Route of administration

Data type

integer

Alias
UMLS CUI [1]
C0013153
If other route of administration, please specify
Description

Route of administration

Data type

text

Alias
UMLS CUI [1]
C0013153
Agent Start Date (yyyy-mm-dd)
Description

Medication Start Date

Data type

date

Alias
UMLS CUI [1,1]
C2347852
UMLS CUI [1,2]
C0808070
Agent End Date (yyyy-mm-dd)
Description

Medication End Date

Data type

date

Alias
UMLS CUI [1,1]
C2347852
UMLS CUI [1,2]
C0808070
Medication ongoing
Description

Medication ongoing

Data type

boolean

Alias
UMLS CUI [1]
C2826666
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Similar models

Prior and Concomitant Medications

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Prior and Concomitant Medications
Study ID
Item
Study-ID
integer
C2826693 (UMLS CUI [1])
Study site
Item
Study site name
text
C2825164 (UMLS CUI [1])
Subject ID
Item
Subject ID
text
C2348585 (UMLS CUI [1])
Concomitant medication
Item
Did the participant/subject take any medications before or during the study?
boolean
C2347852 (UMLS CUI [1])
Medication name
Item
Medication name
text
C2360065 (UMLS CUI [1])
Indication
Item
Indication
text
C2826696 (UMLS CUI [1])
Medication Dose
Item
Dose
float
C3174092 (UMLS CUI [1])
Units
Item
Units
text
C1519795 (UMLS CUI [1])
Medication frequency
Item
Medication frequency
text
C3476109 (UMLS CUI [1])
Item
Route of administration
integer
C0013153 (UMLS CUI [1])
Route of administration
Code List
Route of administration
CL Item
Buccal (1)
CL Item
Inhaled (2)
CL Item
Intramuscular (3)
CL Item
Intravenous (4)
CL Item
Nasal (5)
CL Item
Oral (6)
CL Item
Rectal (7)
CL Item
By ear (8)
CL Item
Topical (9)
CL Item
Subcutaneous (10)
CL Item
Sublingual (11)
CL Item
Transdermal (12)
CL Item
Unknown (13)
CL Item
Other specify (14)
Route of administration
Item
If other route of administration, please specify
text
C0013153 (UMLS CUI [1])
Medication Start Date
Item
Agent Start Date (yyyy-mm-dd)
date
C2347852 (UMLS CUI [1,1])
C0808070 (UMLS CUI [1,2])
Medication End Date
Item
Agent End Date (yyyy-mm-dd)
date
C2347852 (UMLS CUI [1,1])
C0808070 (UMLS CUI [1,2])
Medication ongoing
Item
Medication ongoing
boolean
C2826666 (UMLS CUI [1])
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