Englisch

Medical History (General): CRF Wisconsin Madison

1 Formulare  
Header
Beschreibung

Header

PI Name
Beschreibung

PI Name

Datentyp

text

Protocol or IRB Number
Beschreibung

Protocol or IRB Number

Datentyp

integer

Protocol Short Title
Beschreibung

Protocol Short Title

Datentyp

text

Subject Initials
Beschreibung

Subject Initials

Datentyp

text

Subject ID
Beschreibung

Subject ID

Datentyp

integer

Date
Beschreibung

Date

Datentyp

date

Medical History (General)
Beschreibung

Medical History (General)

Insert body system being inquired about
Beschreibung

Body System

Datentyp

text

Diagnosed condition
Beschreibung

Diagnosed condition

Datentyp

boolean

Diagnosis/Condition/Surgery
Beschreibung

Diagnosis/Condition/Surgery

Datentyp

text

Onset Date or Year
Beschreibung

Onset Date or Year

Datentyp

integer

Current Problem
Beschreibung

Current Problem

Datentyp

boolean

Other (specify)
Beschreibung

Other (specify)

Diagnosed condition
Beschreibung

Diagnosed condition

Datentyp

boolean

Diagnosis/Condition/Surgery
Beschreibung

Diagnosis/Condition/Surgery

Datentyp

text

Onset Date Or Year
Beschreibung

Onset Date Or Year

Datentyp

integer

Current Problem
Beschreibung

Current Problem

Datentyp

boolean

Additional Notes
Beschreibung

Additional Notes

Datentyp

text

Medical History Not Obtained
Beschreibung

Medical History Not Obtained

Datentyp

boolean

Medical History Obtained By
Beschreibung

Medical History Obtained By

Datentyp

text

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Ähnliche Modelle

Medical History (General): CRF Wisconsin Madison

1 Formulare
Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
Alias
Item Group
Header
PI Name
Item
PI Name
text
Protocol or IRB Number
Item
Protocol or IRB Number
integer
Protocol Short Title
Item
Protocol Short Title
text
Subject Initials
Item
Subject Initials
text
Subject ID
Item
Subject ID
integer
Date
Item
Date
date
Item Group
Medical History (General)
Body System
Item
Insert body system being inquired about
text
Diagnosed condition
Item
Diagnosed condition
boolean
Diagnosis/Condition/Surgery
Item
Diagnosis/Condition/Surgery
text
Onset Date or Year
Item
Onset Date or Year
integer
Current Problem
Item
Current Problem
boolean
Item Group
Other (specify)
Diagnosed condition
Item
Diagnosed condition
boolean
Diagnosis/Condition/Surgery
Item
Diagnosis/Condition/Surgery
text
Onset Date Or Year
Item
integer
Current Problem
Item
Current Problem
boolean
Additional Notes
Item
Additional Notes
text
Medical History Not Obtained
Item
Medical History Not Obtained
boolean
Medical History Obtained By
Item
Medical History Obtained By
text
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