Engels

Administrative Data

1 Formulieren  
  1. StudyEvent: ODM
    1. Administrative Data
Administrative Data
Beschrijving

Administrative Data

Specify Name of study/ trial
Beschrijving

Study Name

Datatype

text

Alias
UMLS CUI [1]
C2348560
Patient ID code:
Beschrijving

Complete the specific Patient ID code

Datatype

text

Alias
UMLS CUI [1]
C1269815
Date of death
Beschrijving

The patient’s date of death should be recorded

Datatype

date

Alias
UMLS CUI [1]
C1148348
Section 1 Background demographics
Beschrijving

Section 1 Background demographics

A. Year of birth:
Beschrijving

Year of birth

Datatype

integer

Alias
UMLS CUI [1]
C2826771
B. Gender:
Beschrijving

Gender

Datatype

text

Alias
UMLS CUI [1]
C0079399
C. Height (cm):
Beschrijving

Height

Datatype

integer

Maateenheden
  • cm
Alias
UMLS CUI [1]
C0005890
cm
D. Weight:
Beschrijving

Body weight (most recent before death)

Datatype

float

Maateenheden
  • kg
Alias
UMLS CUI [1]
C0005910
kg
E. Date Weight Measured
Beschrijving

(dd-mmm-yy; weight measured)

Datatype

date

Alias
UMLS CUI [1,1]
C0005910
UMLS CUI [1,2]
C0011008
Section 2 Data Sources
Beschrijving

Section 2 Data Sources

A. Hospital files
Beschrijving

Hospital files

Datatype

text

Alias
UMLS CUI [1]
C0019980
B. Outpatient clinic chart
Beschrijving

Outpatient clinic chart

Datatype

text

Alias
UMLS CUI [1,1]
C0029916
UMLS CUI [1,2]
C0025102
C. Autopsy report
Beschrijving

Autopsy report

Datatype

text

Alias
UMLS CUI [1]
C1548372
D. Registry
Beschrijving

If other, specify:

Datatype

boolean

Alias
UMLS CUI [1]
C0034975
E. Obituary
Beschrijving

If other, specify:

Datatype

boolean

Alias
UMLS CUI [1]
C3828738
F. Patients relatives or partner
Beschrijving

Patients relatives or partner

Datatype

boolean

Alias
UMLS CUI [1]
C0015576
G. Patients medical provider
Beschrijving

Patients medical provider

Datatype

boolean

Alias
UMLS CUI [1,1]
C1138603
UMLS CUI [1,2]
C0205476
H. Nursing home
Beschrijving

Nursing home

Datatype

text

Alias
UMLS CUI [1]
C0028688
I. Other Source
Beschrijving

Other Source

Datatype

text

Alias
UMLS CUI [1]
C0011001
Completed by
Beschrijving

Completed by

Completed by: Name (in print)
Beschrijving

Name

Datatype

text

Alias
UMLS CUI [1]
C0027365
Position:
Beschrijving

Position

Datatype

text

Alias
UMLS CUI [1]
C0018722
Other, describe
Beschrijving

If "Position" was "Other"

Datatype

text

Alias
UMLS CUI [1,1]
C0018722
UMLS CUI [1,2]
C0205394
Directly involved in the medical care of the patient around the time of death?
Beschrijving

Involved in medical care

Datatype

boolean

Alias
UMLS CUI [1,1]
C0496675
UMLS CUI [1,2]
C1314939
Date:
Beschrijving

Date (dd/mmm/yy) :

Datatype

date

Alias
UMLS CUI [1]
C0011008
Signature:
Beschrijving

Signature

Datatype

text

Alias
UMLS CUI [1]
C1519316
Terug naar het begin van de pagina

Similar models

Administrative Data

1 Formulieren
  1. StudyEvent: ODM
    1. Administrative Data
Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
Administrative Data
Study Name
Item
Specify Name of study/ trial
text
C2348560 (UMLS CUI [1])
Patient ID
Item
Patient ID code:
text
C1269815 (UMLS CUI [1])
Date of death
Item
Date of death
date
C1148348 (UMLS CUI [1])
Item Group
Section 1 Background demographics
Year of birth
Item
A. Year of birth:
integer
C2826771 (UMLS CUI [1])
Item
B. Gender:
text
C0079399 (UMLS CUI [1])
Gender
Code List
B. Gender:
CL Item
male (male)
CL Item
female (female)
Height
Item
C. Height (cm):
integer
C0005890 (UMLS CUI [1])
Weight
Item
D. Weight:
float
C0005910 (UMLS CUI [1])
Date
Item
E. Date Weight Measured
date
C0005910 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Item Group
Section 2 Data Sources
Item
A. Hospital files
text
C0019980 (UMLS CUI [1])
Hospital files
Code List
A. Hospital files
CL Item
Yes, complete  (Yes, complete )
CL Item
Yes, incomplete (Yes, incomplete)
CL Item
No (No)
Item
B. Outpatient clinic chart
text
C0029916 (UMLS CUI [1,1])
C0025102 (UMLS CUI [1,2])
Outpatient clinic chart
Code List
B. Outpatient clinic chart
CL Item
Yes, complete  (Yes, complete )
CL Item
Yes, incomplete (Yes, incomplete)
CL Item
No (No)
Item
C. Autopsy report
text
C1548372 (UMLS CUI [1])
Autopsy report
Code List
C. Autopsy report
CL Item
Yes, complete  (Yes, complete )
CL Item
Yes, incomplete (Yes, incomplete)
CL Item
No (No)
Registry
Item
D. Registry
boolean
C0034975 (UMLS CUI [1])
Obituary
Item
E. Obituary
boolean
C3828738 (UMLS CUI [1])
Patients relatives or partner
Item
F. Patients relatives or partner
boolean
C0015576 (UMLS CUI [1])
Patients medical provider
Item
G. Patients medical provider
boolean
C1138603 (UMLS CUI [1,1])
C0205476 (UMLS CUI [1,2])
Nursing home
Item
H. Nursing home
text
C0028688 (UMLS CUI [1])
Other Source
Item
I. Other Source
text
C0011001 (UMLS CUI [1])
Item Group
Completed by
Name
Item
Completed by: Name (in print)
text
C0027365 (UMLS CUI [1])
Item
Position:
text
C0018722 (UMLS CUI [1])
Position
Code List
Position:
CL Item
Physician  (Physician )
CL Item
Nurse  (Nurse )
CL Item
Other, describe (Other, describe)
Other Position
Item
Other, describe
text
C0018722 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
Involved in medical care
Item
Directly involved in the medical care of the patient around the time of death?
boolean
C0496675 (UMLS CUI [1,1])
C1314939 (UMLS CUI [1,2])
Date
Item
Date:
date
C0011008 (UMLS CUI [1])
Signature
Item
Signature:
text
C1519316 (UMLS CUI [1])
Terug naar het begin van de pagina