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Record of Death BG00012 Monotherapy Safety and Efficacy Extension Study in Multiple Sclerosis (MS) (ENDORSE) NCT00835770

1 Formulär  
Subject Identification
Beskrivning

Subject Identification

Number of Facility
Beskrivning

Site number

Datatyp

integer

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

Subject number

Datatyp

integer

Alias
UMLS CUI [1]
C2348585
Subject Initials
Beskrivning

Subject Initials

Datatyp

text

Alias
UMLS CUI [1]
C2986440
Record of Death
Beskrivning

Record of Death

Date of death
Beskrivning

Date of death

Datatyp

date

Alias
UMLS CUI [1]
C1148348
Cause of death
Beskrivning

Cause of death

Datatyp

text

Alias
UMLS CUI [1]
C0007465
Is the cause of death related to an adverse event?
Beskrivning

If yes, please indicate the adverse event CRF page number.

Datatyp

boolean

Alias
UMLS CUI [1]
C1705232
Adverse Event CRF page number
Beskrivning

Adverse Event page number

Datatyp

integer

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C1704732
Relationship of death to study treatment
Beskrivning

death due to study treatment

Datatyp

integer

Alias
UMLS CUI [1,1]
C0007465
UMLS CUI [1,2]
C0949266
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Similar models

Record of Death BG00012 Monotherapy Safety and Efficacy Extension Study in Multiple Sclerosis (MS) (ENDORSE) NCT00835770

1 Formulär
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
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
Record of Death
Date of death
Item
Date of death
date
C1148348 (UMLS CUI [1])
Cause of death
Item
Cause of death
text
C0007465 (UMLS CUI [1])
Death Related to Adverse Event
Item
Is the cause of death related to an adverse event?
boolean
C1705232 (UMLS CUI [1])
Adverse Event page number
Item
Adverse Event CRF page number
integer
C0877248 (UMLS CUI [1,1])
C1704732 (UMLS CUI [1,2])
Item
Relationship of death to study treatment
integer
C0007465 (UMLS CUI [1,1])
C0949266 (UMLS CUI [1,2])
death due to study treatment
Code List
Relationship of death to study treatment
CL Item
not related  (0)
CL Item
unlikely  (1)
CL Item
possible  (2)
CL Item
related (3)
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