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Safety Assessment Multiple Sclerosis ALAIN01 NCT02419378

1 forms  
Safety Assessment
Description

Safety Assessment

Alias
UMLS CUI-1
C0549076
Patient ID (derived)
Description

Patient ID (derived)

Data type

text

Alias
UMLS CUI [1]
C2348585
Safety Lab. Assessments: Sheet No
Description

Safety Lab. Assessments: Sheet No

Data type

integer

Safety Lab. Assessments: New eForm
Description

Safety Lab. Assessments: New eForm

Data type

text

Safety Lab. Assessments: Date of Signature
Description

Safety Lab. Assessments: Date of Signature

Data type

date

Alias
UMLS CUI [1,1]
C1519316
UMLS CUI [1,2]
C0011008
Date of Signature Status
Description

Safety Lab. Assessments: Date of Signature Status

Data type

text

Alias
UMLS CUI [1,1]
C1519316
UMLS CUI [1,2]
C0011008
UMLS CUI [1,3]
C0449438
Safety Lab. Assessments: Signature yes/no
Description

Safety Lab. Assessments: Signature yes/no

Data type

text

Alias
UMLS CUI [1,1]
C1519316
UMLS CUI [1,2]
C1705848
Comment Safety Assessment
Description

Comment Safety Assessment

Data type

text

Alias
UMLS CUI [1,1]
C0549076
UMLS CUI [1,2]
C0947611
Safety Lab. Assessments RQG
Description

Safety Lab. Assessments RQG

Safety Lab. Assessments: Date
Description

Safety Lab. Assessments: Date

Data type

date

Safety Lab. Assessments: Date Status
Description

Safety Lab. Assessments: Date Status

Data type

text

Safety Lab. Assessments: Serum Creatinine
Description

Safety Lab. Assessments: Serum Creatinine

Data type

text

Alias
UMLS CUI [1]
C0201976
Safety Lab. Assessments: Platelets
Description

Safety Lab. Assessments: Platelets

Data type

text

Alias
UMLS CUI [1]
C0005821
Safety Lab. Assessments: TSH
Description

Safety Lab. Assessments: TSH

Data type

text

Alias
UMLS CUI [1]
C0202230
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Similar models

Safety Assessment Multiple Sclerosis ALAIN01 NCT02419378

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Safety Assessment
C0549076 (UMLS CUI-1)
Patient ID (derived)
Item
Patient ID (derived)
text
C2348585 (UMLS CUI [1])
Safety Lab. Assessments: Sheet No
Item
integer
Safety Lab. Assessments: New eForm
Code List
Safety Lab. Assessments: New eForm
CL Item
yes (1)
Safety Lab. Assessments: Date of Signature
Item
date
C1519316 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Item
Date of Signature Status
text
C1519316 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C0449438 (UMLS CUI [1,3])
Safety Lab. Assessments: Date of Signature Status
Code List
Date of Signature Status
CL Item
T (1)
CL Item
TM (2)
CL Item
M (3)
Item
Safety Lab. Assessments: Signature yes/no
text
C1519316 (UMLS CUI [1,1])
C1705848 (UMLS CUI [1,2])
Safety Lab. Assessments: Signature yes/no
Code List
Safety Lab. Assessments: Signature yes/no
CL Item
yes (1)
CL Item
no (0)
Comment Safety Assessment
Item
Comment Safety Assessment
text
C0549076 (UMLS CUI [1,1])
C0947611 (UMLS CUI [1,2])
Safety Lab. Assessments: Date
Item
date
Safety Lab. Assessments: Date Status
Code List
Safety Lab. Assessments: Date Status
CL Item
T (1)
CL Item
TM (2)
CL Item
M (3)
Item
Safety Lab. Assessments: Serum Creatinine
text
C0201976 (UMLS CUI [1])
Safety Lab. Assessments: Serum Creatinine
Code List
Safety Lab. Assessments: Serum Creatinine
CL Item
normal (1)
CL Item
abnormal, without clinical significance (2)
CL Item
abnormal, with clinical significance (3)
CL Item
ND (9)
Item
Safety Lab. Assessments: Platelets
text
C0005821 (UMLS CUI [1])
Safety Lab. Assessments: Platelets
Code List
Safety Lab. Assessments: Platelets
CL Item
normal (1)
CL Item
abnormal, without clinical significance (2)
CL Item
abnormal, with clinical significance (3)
CL Item
ND (9)
Item
Safety Lab. Assessments: TSH
text
C0202230 (UMLS CUI [1])
Safety Lab. Assessments: TSH
Code List
Safety Lab. Assessments: TSH
CL Item
normal (1)
CL Item
abnormal, without clinical significance (2)
CL Item
abnormal, with clinical significance (3)
CL Item
ND (9)
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