Nerventra Study Visit 8

Informed Consent and Demography Data
Description

Informed Consent and Demography Data

Protocol Number
Description

Protocol Number

Data type

text

Alias
UMLS CUI [1,1]
C0008971
UMLS CUI [1,2]
C0600091
Visit Type
Description

i.e "Screening"

Data type

text

Alias
UMLS CUI [1]
C0545082
Date of visit
Description

Visit date

Data type

date

Alias
UMLS CUI [1]
C1320303
Study site number
Description

Study site

Data type

integer

Alias
UMLS CUI [1]
C2825164
Subject number:
Description

Subject number

Data type

integer

Alias
UMLS CUI [1]
C1709561
Section blank?
Description

Blank

Data type

boolean

Alias
UMLS CUI [1]
C0750479
Pasat Summary Score Sheet
Description

Pasat Summary Score Sheet

PASAT Form used
Description

PASAT Form used

Data type

text

Alias
UMLS CUI [1,1]
C0589060
UMLS CUI [1,2]
C0180975
PASAT3: Total correct (range 0-60)
Description

PASAT3 total correct

Data type

integer

Alias
UMLS CUI [1,1]
C3898055
UMLS CUI [1,2]
C0205449
For a complete PASAT3, record any circumstances that affected the subjects performance
Description

PASAT

Data type

text

Alias
UMLS CUI [1]
C0589060
PASAT3: if test was not completed
Description

PASAT3: not completed

Data type

integer

Alias
UMLS CUI [1,1]
C0589060
UMLS CUI [1,2]
C0205449
UMLS CUI [1,3]
C2732579
PASAT3: please specify physical limitations and/or other reason
Description

PASAT3: not completed

Data type

text

Alias
UMLS CUI [1,1]
C0589060
UMLS CUI [1,2]
C0205449
UMLS CUI [1,3]
C2732579

Similar models

Nerventra Study Visit 8

Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Informed Consent and Demography Data
Protocol Number
Item
Protocol Number
text
C0008971 (UMLS CUI [1,1])
C0600091 (UMLS CUI [1,2])
Visit
Item
Visit Type
text
C0545082 (UMLS CUI [1])
Visit date
Item
Date of visit
date
C1320303 (UMLS CUI [1])
Study site
Item
Study site number
integer
C2825164 (UMLS CUI [1])
Subject number
Item
Subject number:
integer
C1709561 (UMLS CUI [1])
Blank
Item
Section blank?
boolean
C0750479 (UMLS CUI [1])
Item Group
Pasat Summary Score Sheet
Item
PASAT Form used
text
C0589060 (UMLS CUI [1,1])
C0180975 (UMLS CUI [1,2])
Code List
PASAT Form used
CL Item
Form A (1)
CL Item
Form B (2)
PASAT3 total correct
Item
PASAT3: Total correct (range 0-60)
integer
C3898055 (UMLS CUI [1,1])
C0205449 (UMLS CUI [1,2])
PASAT
Item
For a complete PASAT3, record any circumstances that affected the subjects performance
text
C0589060 (UMLS CUI [1])
Item
PASAT3: if test was not completed
integer
C0589060 (UMLS CUI [1,1])
C0205449 (UMLS CUI [1,2])
C2732579 (UMLS CUI [1,3])
Code List
PASAT3: if test was not completed
CL Item
Unable due to physical limitations (1)
CL Item
Other (2)
PASAT3: not completed
Item
PASAT3: please specify physical limitations and/or other reason
text
C0589060 (UMLS CUI [1,1])
C0205449 (UMLS CUI [1,2])
C2732579 (UMLS CUI [1,3])