Information:
Fel:
ID
16981
Beskrivning
ODM derived from: http://www.qmcr.ualberta.ca/en/ToolsandTemplates/CaseReportFormCRFTemplates.aspx. Template Name: Medical History II. University of Alberta, Quality Management in Clinical Research. Copyright: 2002-2016 University of Alberta.
Länk
http://www.qmcr.ualberta.ca/en/ToolsandTemplates/CaseReportFormCRFTemplates.aspx
Nyckelord
Versioner (1)
- 2016-08-17 2016-08-17 -
Uppladdad den
17 augusti 2016
DOI
För en begäran logga in.
Licens
Creative Commons BY-NC 3.0
Modellkommentarer :
Här kan du kommentera modellen. Med hjälp av pratbubblor i Item-grupperna och Item kan du lägga in specifika kommentarer.
Itemgroup-kommentar för :
Item-kommentar för :
Du måste vara inloggad för att kunna ladda ner formulär. Var vänlig logga in eller registrera dig utan kostnad.
Medical History II: CRF QMCR University of Alberta
Medical History II: CRF QMCR University of Alberta
- StudyEvent: ODM
Similar models
Medical History II: CRF QMCR University of Alberta
- StudyEvent: ODM
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Study Name
Item
Study Name
text
Site Number
Item
Site Number
integer
Pt_ID
Item
Pt_ID
integer
Visit Date
Item
Visit Date
date
CL Item
Screening (1)
CL Item
Baseline (2)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
If Yes, Explain
Item
If Yes, Explain
text
CL Item
Current (1)
CL Item
Resolved (2)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
If Yes, Explain
Item
If Yes, Explain
text
CL Item
Current (1)
CL Item
Resolved (2)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
If Yes, Explain
Item
If Yes, Explain
text
CL Item
Current (1)
CL Item
Resolved (2)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
If Yes, Explain
Item
If Yes, Explain
text
CL Item
Current (1)
CL Item
Resolved (2)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
If Yes, Explain
Item
If Yes, Explain
text
CL Item
Current (1)
CL Item
Resolved (2)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
If Yes, Explain
Item
If Yes, Explain
text
CL Item
Current (1)
CL Item
Resolved (2)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
If Yes, Explain
Item
If Yes, Explain
text
CL Item
Current (1)
CL Item
Resolved (2)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
If Yes, Explain
Item
If Yes, Explain
text
CL Item
Current (1)
CL Item
Resolved (2)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
If Yes, Explain
Item
If Yes, Explain
text
CL Item
Current (1)
CL Item
Resolved (2)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
If Yes, Explain
Item
If Yes, Explain
text
CL Item
Current (1)
CL Item
Resolved (2)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
If Yes, Explain
Item
If Yes, Explain
text
CL Item
Current (1)
CL Item
Resolved (2)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
If Yes, Explain
Item
If Yes, Explain
text
CL Item
Current (1)
CL Item
Resolved (2)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Specification
Item
If Other, please specify
text
If Yes, Explain
Item
If Yes, Explain
text
CL Item
Current (1)
CL Item
Resolved (2)