ID

1505

Description

The patient's ECG. Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=ACFB66E7-BCB1-6D16-E040-BB89AD4363C3

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=ACFB66E7-BCB1-6D16-E040-BB89AD4363C3

Keywords

Versions (2)
  1. 8/27/12 8/27/12 -
  2. 1/16/15 1/16/15 - Martin Dugas
Uploaded on

August 27, 2012

DOI

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License

Creative Commons BY-NC 3.0 Legacy
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Diagnostic ECG - 3276558v1.0

English

No Instruction available.

1 forms  
  1. StudyEvent: Diagnostic ECG
    1. No Instruction available.
Ecg
Description

Ecg

Visit Date
Description

FormCompletionDate

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C40988
UMLS 2011AA ObjectClass
C1516308
NCI Thesaurus Property
C25250
UMLS 2011AA Property
C0205197
Course #
Description

CourseNumber

Data type

double

Alias
NCI Thesaurus Property
C25337
UMLS 2011AA Property
C0237753
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C25379
UMLS 2011AA ObjectClass
C0750729
Day in Course (Cycle)
Description

CourseDayNumber

Data type

double

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus Property
C25301
UMLS 2011AA Property
C0439228
NCI Thesaurus ObjectClass
C25379
UMLS 2011AA ObjectClass
C0750729
Date of Examination (Enter the date the ECG was performed.)
Description

EvaluationDate

Data type

date

Alias
NCI Thesaurus Property
C25164
UMLS 2011AA Property
C0011008
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C25214
UMLS 2011AA ObjectClass
C0220825
Time (Enter the time the ECG was performed.)
Description

ProcedureTime

Data type

time

Alias
NCI Thesaurus ObjectClass
C25218
UMLS 2011AA ObjectClass
C1948041
NCI Thesaurus ValueDomain
C25207
UMLS 2011AA ValueDomain
C0040223
NCI Thesaurus ObjectClass
C71104
UMLS 2011AA ObjectClass
C0008976
NCI Thesaurus Property
C42614
UMLS 2011AA Property
C0027365
QRSD Interval (Enter the QRS duration QRSD interval in milliseconds.)
Description

QRSDIntervalTimeinMilliseconds

Data type

double

Alias
NCI Thesaurus ObjectClass
C38053
UMLS 2011AA ObjectClass
C1623258
NCI Thesaurus Property
C25543
UMLS 2011AA Property
C1272706
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ValueDomain
C25207
UMLS 2011AA ValueDomain
C0040223
NCI Thesaurus ValueDomain
C41140
UMLS 2011AA ValueDomain
C0439223
QT Interval (Enter the QT interval in milliseconds.)
Description

QTIntervalTimeinMilliseconds

Data type

double

Alias
NCI Thesaurus ObjectClass
C38053
UMLS 2011AA ObjectClass
C1623258
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ValueDomain
C25207
UMLS 2011AA ValueDomain
C0040223
NCI Thesaurus ValueDomain
C41140
UMLS 2011AA ValueDomain
C0439223
QTC (corrected) Interval (Enter the QTC interval in milliseconds.)
Description

QTC(Corrected)IntervalResult

Data type

double

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus ObjectClass
C38053
UMLS 2011AA ObjectClass
C1623258
PR Interval (Enter the PR interval in milliseconds.)
Description

PRIntervalTimeinMilliseconds

Data type

double

Alias
NCI Metathesaurus ObjectClass
C0013798
NCI Thesaurus Property
C25543
UMLS 2011AA Property
C1272706
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ValueDomain
C25207
UMLS 2011AA ValueDomain
C0040223
NCI Thesaurus ValueDomain
C41140
UMLS 2011AA ValueDomain
C0439223
ECG Impression (Select one of the following summary finding:)
Description

ElectrocardiogramNormalAbnormalCode

Data type

text

Alias
NCI Thesaurus ObjectClass
C38053
UMLS 2011AA ObjectClass
C1623258
NCI Thesaurus Property
C3367
UMLS 2011AA Property
C0037088
NCI Thesaurus ValueDomain
C25162
UMLS 2011AA ValueDomain
C0805701
NCI Thesaurus ValueDomain
C25401
UMLS 2011AA ValueDomain
C0205161
NCI Thesaurus ValueDomain
C48554
UMLS 2011AA ValueDomain
C1704701
Rate (Enter the patients pulse rate.)
Description

PulseRateMeasurementValue

Data type

double

Alias
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus ObjectClass
C25749
UMLS 2011AA ObjectClass
C0391850
NCI Thesaurus Property
C25636
UMLS 2011AA Property
C1521828
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
NCI Thesaurus ValueDomain
C25749
UMLS 2011AA ValueDomain
C0391850
Rhythm (Select one of the following rhythm finding:)
Description

ElectrocardiographyResultNormalAbnormalCode

Data type

text

Alias
NCI Thesaurus ObjectClass
C38053
UMLS 2011AA ObjectClass
C1623258
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus ValueDomain
C25162
UMLS 2011AA ValueDomain
C0805701
NCI Thesaurus ValueDomain
C25401
UMLS 2011AA ValueDomain
C0205161
NCI Thesaurus ValueDomain
C48554
UMLS 2011AA ValueDomain
C1704701
Arrhythmia type (Select the patients arrhythmia type.)
Description

ElectrocardiographicFindingArrhythmiaType

Data type

text

Alias
NCI Thesaurus ObjectClass
C38053
UMLS 2011AA ObjectClass
C1623258
NCI Thesaurus Property
C3367
UMLS 2011AA Property
C0037088
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ValueDomain
C2881
UMLS 2011AA ValueDomain
C0003811
NCI Thesaurus ValueDomain
C41328
UMLS 2011AA ValueDomain
C0438154
P Wave (Select one of the following P Wave finding:)
Description

PWaveFindingNormalAbnormalCode

Data type

text

Alias
NCI Metathesaurus ObjectClass
C0429084
NCI Thesaurus Property
C3367
UMLS 2011AA Property
C0037088
NCI Thesaurus ValueDomain
C25162
UMLS 2011AA ValueDomain
C0805701
NCI Thesaurus ValueDomain
C25401
UMLS 2011AA ValueDomain
C0205161
NCI Thesaurus ValueDomain
C48554
UMLS 2011AA ValueDomain
C1704701
QRS Complex (Select one of the following QRS Complex finding:)
Description

QRSComplexFindingNormalAbnormalCode

Data type

text

Alias
NCI Metathesaurus ObjectClass
C0429097
NCI Thesaurus Property
C3367
UMLS 2011AA Property
C0037088
NCI Thesaurus ValueDomain
C25162
UMLS 2011AA ValueDomain
C0805701
NCI Thesaurus ValueDomain
C25401
UMLS 2011AA ValueDomain
C0205161
NCI Thesaurus ValueDomain
C48554
UMLS 2011AA ValueDomain
C1704701
ST Segment (Select one of the following ST Segment finding:)
Description

STSegmentFindingNormalAbnormalCode

Data type

text

Alias
NCI Metathesaurus ObjectClass
C0520887
NCI Thesaurus Property
C3367
UMLS 2011AA Property
C0037088
NCI Thesaurus ValueDomain
C25162
UMLS 2011AA ValueDomain
C0805701
NCI Thesaurus ValueDomain
C25401
UMLS 2011AA ValueDomain
C0205161
NCI Thesaurus ValueDomain
C48554
UMLS 2011AA ValueDomain
C1704701
Comments (Enter comments applicable to the ECG.)
Description

CommentChangeFromBaselineText

Data type

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus ObjectClass
C25213
UMLS 2011AA ObjectClass
C1442488
NCI Thesaurus ObjectClass
C25446
UMLS 2011AA ObjectClass
C0392747
NCI Metathesaurus Property
C0947611
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Similar models

No Instruction available.

1 forms
  1. StudyEvent: Diagnostic ECG
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Ecg
FormCompletionDate
Item
Visit Date
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C40988 (NCI Thesaurus ObjectClass)
C1516308 (UMLS 2011AA ObjectClass)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
CourseNumber
Item
Course #
double
C25337 (NCI Thesaurus Property)
C0237753 (UMLS 2011AA Property)
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C25379 (NCI Thesaurus ObjectClass)
C0750729 (UMLS 2011AA ObjectClass)
CourseDayNumber
Item
Day in Course (Cycle)
double
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C25301 (NCI Thesaurus Property)
C0439228 (UMLS 2011AA Property)
C25379 (NCI Thesaurus ObjectClass)
C0750729 (UMLS 2011AA ObjectClass)
EvaluationDate
Item
Date of Examination (Enter the date the ECG was performed.)
date
C25164 (NCI Thesaurus Property)
C0011008 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25214 (NCI Thesaurus ObjectClass)
C0220825 (UMLS 2011AA ObjectClass)
ProcedureTime
Item
Time (Enter the time the ECG was performed.)
time
C25218 (NCI Thesaurus ObjectClass)
C1948041 (UMLS 2011AA ObjectClass)
C25207 (NCI Thesaurus ValueDomain)
C0040223 (UMLS 2011AA ValueDomain)
C71104 (NCI Thesaurus ObjectClass)
C0008976 (UMLS 2011AA ObjectClass)
C42614 (NCI Thesaurus Property)
C0027365 (UMLS 2011AA Property)
QRSDIntervalTimeinMilliseconds
Item
QRSD Interval (Enter the QRS duration QRSD interval in milliseconds.)
double
C38053 (NCI Thesaurus ObjectClass)
C1623258 (UMLS 2011AA ObjectClass)
C25543 (NCI Thesaurus Property)
C1272706 (UMLS 2011AA Property)
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C25207 (NCI Thesaurus ValueDomain)
C0040223 (UMLS 2011AA ValueDomain)
C41140 (NCI Thesaurus ValueDomain)
C0439223 (UMLS 2011AA ValueDomain)
QTIntervalTimeinMilliseconds
Item
QT Interval (Enter the QT interval in milliseconds.)
double
C38053 (NCI Thesaurus ObjectClass)
C1623258 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C25207 (NCI Thesaurus ValueDomain)
C0040223 (UMLS 2011AA ValueDomain)
C41140 (NCI Thesaurus ValueDomain)
C0439223 (UMLS 2011AA ValueDomain)
QTC(Corrected)IntervalResult
Item
QTC (corrected) Interval (Enter the QTC interval in milliseconds.)
double
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C38053 (NCI Thesaurus ObjectClass)
C1623258 (UMLS 2011AA ObjectClass)
PRIntervalTimeinMilliseconds
Item
PR Interval (Enter the PR interval in milliseconds.)
double
C0013798 (NCI Metathesaurus ObjectClass)
C25543 (NCI Thesaurus Property)
C1272706 (UMLS 2011AA Property)
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C25207 (NCI Thesaurus ValueDomain)
C0040223 (UMLS 2011AA ValueDomain)
C41140 (NCI Thesaurus ValueDomain)
C0439223 (UMLS 2011AA ValueDomain)
Item
ECG Impression (Select one of the following summary finding:)
text
C38053 (NCI Thesaurus ObjectClass)
C1623258 (UMLS 2011AA ObjectClass)
C3367 (NCI Thesaurus Property)
C0037088 (UMLS 2011AA Property)
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
C25401 (NCI Thesaurus ValueDomain)
C0205161 (UMLS 2011AA ValueDomain)
C48554 (NCI Thesaurus ValueDomain)
C1704701 (UMLS 2011AA ValueDomain)
CL.1
Code List
ECG Impression (Select one of the following summary finding:)
CL Item
Abnormal (A)
C25401 (NCI Thesaurus)
C0205161 (UMLS 2011AA)
CL Item
Borderline (B)
C14157 (NCI Thesaurus)
C0205189 (UMLS 2011AA)
CL Item
Normal (N)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
PulseRateMeasurementValue
Item
Rate (Enter the patients pulse rate.)
double
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25749 (NCI Thesaurus ObjectClass)
C0391850 (UMLS 2011AA ObjectClass)
C25636 (NCI Thesaurus Property)
C1521828 (UMLS 2011AA Property)
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
C25749 (NCI Thesaurus ValueDomain)
C0391850 (UMLS 2011AA ValueDomain)
Item
Rhythm (Select one of the following rhythm finding:)
text
C38053 (NCI Thesaurus ObjectClass)
C1623258 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
C25401 (NCI Thesaurus ValueDomain)
C0205161 (UMLS 2011AA ValueDomain)
C48554 (NCI Thesaurus ValueDomain)
C1704701 (UMLS 2011AA ValueDomain)
CL.2
Code List
Rhythm (Select one of the following rhythm finding:)
CL Item
Abnormal (A)
C25401 (NCI Thesaurus)
C0205161 (UMLS 2011AA)
CL Item
Normal (N)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
Item
Arrhythmia type (Select the patients arrhythmia type.)
text
C38053 (NCI Thesaurus ObjectClass)
C1623258 (UMLS 2011AA ObjectClass)
C3367 (NCI Thesaurus Property)
C0037088 (UMLS 2011AA Property)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C2881 (NCI Thesaurus ValueDomain)
C0003811 (UMLS 2011AA ValueDomain)
C41328 (NCI Thesaurus ValueDomain)
C0438154 (UMLS 2011AA ValueDomain)
CL.3
Code List
Arrhythmia type (Select the patients arrhythmia type.)
CL Item
Asystole (Asystole)
CL Item
Atrial Fibrillation: C50466 (Atrial fibrillation)
C50466 (NCI Thesaurus)
C0004238 (UMLS 2011AA)
CL Item
Atrial Flutter (Atrial flutter)
C51224 (NCI Thesaurus)
C0004239 (UMLS 2011AA)
CL Item
Atrial Tachycardia/paroxysmal Atrial Tachycardia (pat) (Atrial tachycardia/Paroxysmal Atrial Tachycardia (PAT))
CL Item
Atrioventricular Block: First Degree Block (AV block: First degree block)
CL Item
Atrioventricular Block: Second Degree Motitz Type I (wenckebach) (AV block: Second degree Motitz Type I (Wenckebach))
CL Item
Atrioventricular Block: Second Degree Motitz Type Ii (AV block: Second degree Motitz Type II)
CL Item
Atrioventricular Block: Third Degree (complete Av Bloc (AV block: Third degree (Complete AV block))
CL Item
Bigeminy (Bigeminy)
CL Item
Bundle Branch Block (Bundle branch block)
CL Item
Conduction Abnormality, Not Otherwise Specified (Conduction abnormality NOS)
CL Item
Idioventricular Rhythm (Idioventricular rhythm)
CL Item
Nodal/junctional Arrhythmia (Nodal/Junctional arrhythmia)
CL Item
Sinus Rhythm (Normal Sinus rhythm)
CL Item
Paced Rhythm (Paced Rhythm)
CL Item
Premature Ventricular Contractions (pvcs) (Premature ventricular contractions (PVCs))
CL Item
Prolonged Qtc Interval (Prolonged QTc interval)
CL Item
Sick Sinus Syndrome (Sick Sinus Syndrome)
C62244 (NCI Thesaurus)
C0037052 (UMLS 2011AA)
CL Item
Sinus Bradycardia (Sinus bradycardia)
C26923 (NCI Thesaurus)
C0085610 (UMLS 2011AA)
CL Item
Sinus Tachycardia (Sinus tachycardia)
C26889 (NCI Thesaurus)
C0039239 (UMLS 2011AA)
CL Item
Stokes-adams Syndrome (Stokes-Adams Syndrome)
CL Item
Supraventricular Arrhythmia, Not Otherwise Specified (Supraventricular arrhythmia NOS)
CL Item
Supraventricular Extrasystoles (Supraventricular extrasystoles)
CL Item
Supraventricular Tachycardia (svt) (Supraventricular tachycardia (SVT))
CL Item
Torsade De Pointes (Torsade de pointes)
CL Item
Trigeminy (Trigeminy)
CL Item
Ventricular Arrhythmia, Not Otherwise Specified (Ventricular arrhythmia NOS)
CL Item
Ventricular Fibrillation (Ventricular fibrillation)
C0042510 (NCI Metathesaurus)
CL Item
Ventricular Flutter (Ventricular flutter)
CL Item
Ventricular Tachycardia (Ventricular tachycardia)
CL Item
Wolff-parkinson-white Syndrome (Wolff-Parkinson-White Syndrome)
C35132 (NCI Thesaurus)
C0043202 (UMLS 2011AA)
Item
P Wave (Select one of the following P Wave finding:)
text
C0429084 (NCI Metathesaurus ObjectClass)
C3367 (NCI Thesaurus Property)
C0037088 (UMLS 2011AA Property)
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
C25401 (NCI Thesaurus ValueDomain)
C0205161 (UMLS 2011AA ValueDomain)
C48554 (NCI Thesaurus ValueDomain)
C1704701 (UMLS 2011AA ValueDomain)
CL.4
Code List
P Wave (Select one of the following P Wave finding:)
CL Item
Abnormal (A)
C25401 (NCI Thesaurus)
C0205161 (UMLS 2011AA)
CL Item
Normal (N)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
Item
QRS Complex (Select one of the following QRS Complex finding:)
text
C0429097 (NCI Metathesaurus ObjectClass)
C3367 (NCI Thesaurus Property)
C0037088 (UMLS 2011AA Property)
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
C25401 (NCI Thesaurus ValueDomain)
C0205161 (UMLS 2011AA ValueDomain)
C48554 (NCI Thesaurus ValueDomain)
C1704701 (UMLS 2011AA ValueDomain)
CL.5
Code List
QRS Complex (Select one of the following QRS Complex finding:)
CL Item
Abnormal (A)
C25401 (NCI Thesaurus)
C0205161 (UMLS 2011AA)
CL Item
Normal (N)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
Item
ST Segment (Select one of the following ST Segment finding:)
text
C0520887 (NCI Metathesaurus ObjectClass)
C3367 (NCI Thesaurus Property)
C0037088 (UMLS 2011AA Property)
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
C25401 (NCI Thesaurus ValueDomain)
C0205161 (UMLS 2011AA ValueDomain)
C48554 (NCI Thesaurus ValueDomain)
C1704701 (UMLS 2011AA ValueDomain)
CL.6
Code List
ST Segment (Select one of the following ST Segment finding:)
CL Item
Abnormal (A)
C25401 (NCI Thesaurus)
C0205161 (UMLS 2011AA)
CL Item
Normal (N)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
CommentChangeFromBaselineText
Item
Comments (Enter comments applicable to the ECG.)
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C25213 (NCI Thesaurus ObjectClass)
C1442488 (UMLS 2011AA ObjectClass)
C25446 (NCI Thesaurus ObjectClass)
C0392747 (UMLS 2011AA ObjectClass)
C0947611 (NCI Metathesaurus Property)
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