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Seizure Diary

1 Formulär  
  1. StudyEvent: ODM
    1. Seizure Diary
Seizure Diary
Beskrivning

Seizure Diary

Study ID
Beskrivning

Study ID

Datatyp

text

Alias
UMLS CUI [1]
C2826693
Study site name
Beskrivning

Study site

Datatyp

text

Alias
UMLS CUI [1]
C2825164
Subject ID
Beskrivning

Subject ID

Datatyp

text

Alias
UMLS CUI [1]
C2348585
Date
Beskrivning

Date

Datatyp

date

Alias
UMLS CUI [1]
C0011008
Day of week
Beskrivning

Day of week

Datatyp

integer

Alias
UMLS CUI [1]
C0585023
Did you have seizures today?
Beskrivning

Seizures

Datatyp

boolean

Alias
UMLS CUI [1]
C0036572
Please specify the Type of seizure. Select all that apply
Beskrivning

If you had any seizures that day, write down the number of seizures you had next to the seizure type.

Datatyp

integer

Alias
UMLS CUI [1]
C0036572
Please specify the number of seizures you had today, matching it to the type selected before: i.e.: A2; C1...
Beskrivning

Seizures

Datatyp

text

Alias
UMLS CUI [1]
C0036572
Who is completing the diary?
Beskrivning

Select all that apply

Datatyp

integer

Alias
UMLS CUI [1,1]
C0018700
UMLS CUI [1,2]
C0850287
Further comments
Beskrivning

Further comments

Datatyp

text

Alias
UMLS CUI [1]
C1830770
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Similar models

Seizure Diary

1 Formulär
  1. StudyEvent: ODM
    1. Seizure Diary
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Seizure Diary
Study ID
Item
Study ID
text
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])
Date
Item
Date
date
C0011008 (UMLS CUI [1])
Item
Day of week
integer
C0585023 (UMLS CUI [1])
Day of week
Code List
Day of week
CL Item
Monday (1)
CL Item
Tuesday (2)
CL Item
Wednesday (3)
CL Item
Thursday (4)
CL Item
Friday (5)
CL Item
Saturday (6)
CL Item
Sunday (7)
Seizures
Item
Did you have seizures today?
boolean
C0036572 (UMLS CUI [1])
Item
Please specify the Type of seizure. Select all that apply
integer
C0036572 (UMLS CUI [1])
Seizure
Code List
Please specify the Type of seizure. Select all that apply
CL Item
Dizzy, double vision (Involving subjective sensory or psychic phenomena only)Feeling of déjà vu (Involving subjective sensory or psychic phenomena only)**This patient has more than one seizure of this type (both will be assigned the same letter) (A)
CL Item
Dizzy, double vision; shaking of the right hand (Focal Seizure with observable motor or autonomic components) (B)
CL Item
Dizziness followed by confusion/staring (Focal Seizure with observable motor or autonomic components →Focal Seizure with impairment of consciousness or responsiveness) (C)
CL Item
Confusion/staring with no warning (Focal Seizure with impairment of consciousness or responsiveness) (D)
CL Item
Dizziness followed by staring and convulsion (Focal Seizure with observable motor or autonomic components → Evolving to a bilateral, convulsive seizure (involving tonic, clonic, or tonic and clonic components)) (E)
CL Item
Convulsion with no warning (Evolving to a bilateral, convulsive seizure involving tonic, clonic, or tonic and clonic components) (F)
Seizures
Item
Please specify the number of seizures you had today, matching it to the type selected before: i.e.: A2; C1...
text
C0036572 (UMLS CUI [1])
Item
Who is completing the diary?
integer
C0018700 (UMLS CUI [1,1])
C0850287 (UMLS CUI [1,2])
Completion of the diary
Code List
Who is completing the diary?
CL Item
Participant/Subject (1)
CL Item
Caregiver (2)
Further comments
Item
Further comments
text
C1830770 (UMLS CUI [1])
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