Englisch

Baseline Visit (Day 1): Medical History BG00012 Monotherapy Safety and Efficacy Extension Study in Multiple Sclerosis (MS) (ENDORSE) NCT00835770

1 Formulare  
Subject Identification
Beschreibung

Subject Identification

Number of Facility
Beschreibung

Site number

Datentyp

integer

Alias
UMLS CUI [1,1]
C0018704
UMLS CUI [1,2]
C0600091
Subject number
Beschreibung

Subject number

Datentyp

integer

Alias
UMLS CUI [1]
C2348585
Subject Initials
Beschreibung

Subject Initials

Datentyp

text

Alias
UMLS CUI [1]
C2986440
Medical history Update
Beschreibung

Medical history Update

Has the subject had any new medical or surgical history since enrolling in 109-MS-301 or 109-MS-302
Beschreibung

If yes, record below

Datentyp

boolean

Alias
UMLS CUI [1]
C0262926
Medical history List
Beschreibung

Medical history List

Medical History, Category
Beschreibung

Category of Event

Datentyp

integer

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0683312
ongoing
Beschreibung

ongoing

Datentyp

boolean

Alias
UMLS CUI [1]
C0549178
Medical Condition
Beschreibung

Medical Condition

Datentyp

text

Alias
UMLS CUI [1]
C0012634
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Ähnliche Modelle

Baseline Visit (Day 1): Medical History BG00012 Monotherapy Safety and Efficacy Extension Study in Multiple Sclerosis (MS) (ENDORSE) NCT00835770

1 Formulare
Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
Alias
Item Group
Subject Identification
Site number
Item
Number of Facility
integer
C0018704 (UMLS CUI [1,1])
C0600091 (UMLS CUI [1,2])
Subject number
Item
Subject number
integer
C2348585 (UMLS CUI [1])
Subject Initials
Item
Subject Initials
text
C2986440 (UMLS CUI [1])
Item Group
Medical history Update
Medical history
Item
Has the subject had any new medical or surgical history since enrolling in 109-MS-301 or 109-MS-302
boolean
C0262926 (UMLS CUI [1])
Item Group
Medical history List
Item
Medical History, Category
integer
C0262926 (UMLS CUI [1,1])
C0683312 (UMLS CUI [1,2])
Category of Event
Code List
Medical History, Category
CL Item
Allergy  (1)
CL Item
Hepatic (2)
CL Item
Respiratory  (3)
CL Item
Cardiovascular (4)
CL Item
Gastrointestinal  (5)
CL Item
Hepatic (6)
CL Item
Genitourinary  (7)
CL Item
Hematopoetic/Lymphatic (8)
CL Item
Neurological (9)
CL Item
Endocrine/Metabolic (10)
CL Item
Musculoskeletal (11)
CL Item
Dermatilogical  (12)
CL Item
Psychosocial/ Psychiatric  (13)
CL Item
Infectious disease (14)
CL Item
Other (15)
ongoing
Item
ongoing
boolean
C0549178 (UMLS CUI [1])
Medical Condition
Item
Medical Condition
text
C0012634 (UMLS CUI [1])
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