Item
Is the subject a screen failure (signed an informed consent but was not randomized)?
integer
C1710476 (UMLS CUI [1])
Code List
Is the subject a screen failure (signed an informed consent but was not randomized)?
Item
Reason for Not Meeting Admission Criteria
integer
C0030673 (UMLS CUI [1,1])
C0392360 (UMLS CUI [1,2])
Code List
Reason for Not Meeting Admission Criteria
CL Item
Not fulfill inclusion or exclusion criteria (1 )
CL Item
Untoward Medical Symptoms (3 )
CL Item
Subject lost to follow up (7 )
CL Item
Withdrawal of consent (6 )
Other
Item
If 'Other' specify
text
C0205394 (UMLS CUI [1])
Item
Sex
text
C0079399 (UMLS CUI [1])
Birth Date
Item
Birth Date
date
C0421451 (UMLS CUI [1])
Age
Item
Age
integer
C0001779 (UMLS CUI [1])
Item
Race
integer
C0034510 (UMLS CUI [1])
CL Item
Black or African American (3 )
CL Item
American Indian or Alaskan Native (5 )
CL Item
Native Hawaiian or Other Pacific Islander (6 )
Other race
Item
If 'Other', specify
text
C0205394 (UMLS CUI [1,1])
C0034510 (UMLS CUI [1,2])
Item
Is there any past or present Medical Condition? If 'Yes', please provide details below
integer
C0012634 (UMLS CUI [1])
Code List
Is there any past or present Medical Condition? If 'Yes', please provide details below
Medical Condition
Item
MedicalCondition, specify
text
C0012634 (UMLS CUI [1])
Onset Date
Item
Onset Date
date
C0574845 (UMLS CUI [1])
Item
Is Medical Condition ongoing? If 'No', please provide 'Recovered Date'.
integer
C0549178 (UMLS CUI [1,1])
C0012634 (UMLS CUI [1,2])
Code List
Is Medical Condition ongoing? If 'No', please provide 'Recovered Date'.
date of recovery
Item
Recovered Date
date
C0237820 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])