ID
16538
Beskrivning
ODM Form derived from: https://ictr.wisc.edu/CaseReptTempt. Template Name: Concomitant Medication Log. Case Report Form (CRF)/Source Document templates were created for University of Wisconsin-Madison researchers. These templates are consistent with the FDA's CDASH (Clinical Data Acquisition Standards Harmonization) standards. The CDASH standards identify those elements that should be captured on a Case Report Form (CRF). The forms serve only as templates, and must be edited to meet the study data collection needs as described in the protocol.
Länk
https://ictr.wisc.edu/CaseReptTempt
Nyckelord
Versioner (2)
- 2016-07-23 2016-07-23 -
- 2016-11-17 2016-11-17 -
Uppladdad den
23 juli 2016
DOI
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Licens
Creative Commons BY-NC 3.0
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Concomitant Medication Log: CRF Wisconsin Madison
Concomitant Medication Log: CRF Wisconsin Madison
- StudyEvent: ODM
Beskrivning
Concomitant Medication Log
Beskrivning
#
Datatyp
integer
Beskrivning
Medication/ Non-drug Therapy
Datatyp
text
Beskrivning
Indication
Datatyp
text
Beskrivning
Dose (per admin)
Datatyp
float
Beskrivning
1= g 2= mg 3= ug 4= L 5= mL 6= IU 7= Other
Datatyp
text
Beskrivning
1= QD (once a day) 2= BID (twice a day) 3= TID (three times a day) 4= QID (four times a day) 5= QOD (every other day) 6= QM (every month) 7= QOM (every other month) 8= QH (every hour) 9= AC (before meals) 10= PC (after meals) 11= PRN (as needed) 12= Other
Datatyp
text
Beskrivning
1= Tablet 2= Capsule 3= Ointment 4=Suppository 5=Aerosol 6=Spray 7=Suspension 8= Patch 9=Gas 10=Gel 11=Cream 12=Powder
Datatyp
text
Beskrivning
1= Oral 2= Topical 3= Subcutaneous 4= Intradermal 5= Transdermal 6= Intraocular 7= Intramuscular 8= Inhalation 9= Intravenous 10= Intraperitoneal 11= Nasal 12= Vaginal 13= Rectal 14= Other
Datatyp
text
Beskrivning
Start Date
Datatyp
date
Beskrivning
End Date
Datatyp
date
Beskrivning
Baseline Med
Datatyp
boolean
Beskrivning
Continuing at end of study
Datatyp
boolean
Similar models
Concomitant Medication Log: CRF Wisconsin Madison
- StudyEvent: ODM