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Basic Subject Data & Eligibility Topical SB-275833 Ointment 1% For The Treatment Of Impetigo NCT00133874

1 forms  
Inform Screening (SCREEN)
Description

Inform Screening (SCREEN)

Subject Initials
Description

This item is hidden to all users and will be autopopulated by the system as "---"

Data type

text

Alias
UMLS CUI [1]
C2986440
Date of birth
Description

Will be automatically mapped to demography form

Data type

date

Measurement units
  • DDMONYYYY
Alias
UMLS CUI [1]
C0421451
DDMONYYYY
Inform enrolment (ENROL)
Description

Inform enrolment (ENROL)

Subject number
Description

Subject number

Data type

text

Alias
UMLS CUI [1]
C1709561
Date of visit
Description

Date of visit

Date of visit
Description

DOV

Data type

date

Measurement units
  • DDMONYYYY
Alias
UMLS CUI [1]
C0011008
DDMONYYYY
SDV Performed at this visit
Description

Item is not required

Data type

text

Alias
UMLS CUI [1]
C1710088
Subject Identification
Description

Subject Identification

This item will be mapped from the InForm enrollment form so that the number can be changed if needed
Description

Design Note

Data type

text

Subject number
Description

If Subject number was entered incorrectly, please correct and submit; otherwise disregard

Data type

text

Alias
UMLS CUI [1]
C2348585
Eligibility Question
Description

Eligibility Question

Did the subject meet all the entry criteria?
Description

Did the subject meet all the entry criteria?

Data type

boolean

Alias
UMLS CUI [1]
C1516637
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Similar models

Basic Subject Data & Eligibility Topical SB-275833 Ointment 1% For The Treatment Of Impetigo NCT00133874

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Inform Screening (SCREEN)
Subject Initials
Item
Subject Initials
text
C2986440 (UMLS CUI [1])
Date of birth
Item
Date of birth
date
C0421451 (UMLS CUI [1])
Item Group
Inform enrolment (ENROL)
Subject number
Item
Subject number
text
C1709561 (UMLS CUI [1])
Item Group
Date of visit
DOV
Item
Date of visit
date
C0011008 (UMLS CUI [1])
Item
SDV Performed at this visit
text
C1710088 (UMLS CUI [1])
SDV Performed at this visit
Code List
SDV Performed at this visit
CL Item
Yes (Y)
Item Group
Subject Identification
Design Note
Item
This item will be mapped from the InForm enrollment form so that the number can be changed if needed
text
Subject number
Item
Subject number
text
C2348585 (UMLS CUI [1])
Item Group
Eligibility Question
Did the subject meet all the entry criteria?
Item
Did the subject meet all the entry criteria?
boolean
C1516637 (UMLS CUI [1])
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