0 Ratings
ID

17006

Description

ODM derived from: http://www.qmcr.ualberta.ca/en/ToolsandTemplates/CaseReportFormCRFTemplates.aspx. Template Name: Vital Signs. University of Alberta, Quality Management in Clinical Research. Copyright: 2002-2016 University of Alberta.

Link

http://www.qmcr.ualberta.ca/en/ToolsandTemplates/CaseReportFormCRFTemplates.aspx

Keywords

Versions (1)
  1. 8/20/16 8/20/16 -
Uploaded on

August 20, 2016

DOI

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License

Creative Commons BY-NC 3.0
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    Vital Signs: CRF QMCR University of Alberta

    English

    Vital Signs: CRF QMCR University of Alberta

    1 forms  
    General Information
    Description

    General Information

    Study Name
    Description

    Study Name

    Data type

    text

    Site Number
    Description

    Site Number

    Data type

    integer

    Pt_ID
    Description

    Pt_ID

    Data type

    integer

    Visit Date
    Description

    Visit Date

    Data type

    date

    Visit Type
    Description

    Visit Type

    Data type

    text

    1. Time
    Description

    1. Time

    Data type

    time

    Time
    Description

    Time

    Data type

    text

    2. Heart Rate
    Description

    2. Heart Rate

    Data type

    integer

    Measurement units
    • bpm
    bpm
    Heart Rate - not done
    Description

    Heart Rate - not done

    Data type

    boolean

    3. Blood pressure (systolic)
    Description

    3. Blood pressure

    Data type

    integer

    Blood pressure (diastolic)
    Description

    Blood pressure

    Data type

    integer

    Blood pressure - not done
    Description

    Blood pressure - not done

    Data type

    boolean

    3.a BP position
    Description

    3.a BP position

    Data type

    text

    4. Temperature
    Description

    4. Temperature

    Data type

    integer

    Temperature
    Description

    Temperature

    Data type

    text

    Temperature - not done
    Description

    Temperature

    Data type

    boolean

    5. Respiratory Rate
    Description

    5. Respiratory Rate

    Data type

    integer

    Measurement units
    • _/min
    _/min
    Respiratory Rate - not done
    Description

    Respiratory Rate

    Data type

    boolean

    6. Weight
    Description

    6. Weight

    Data type

    integer

    Weight
    Description

    Weight

    Data type

    text

    Weight - Estimated?
    Description

    Weight

    Data type

    boolean

    Weight - not done
    Description

    Weight

    Data type

    boolean

    7. Height
    Description

    7. Height

    Data type

    integer

    Height
    Description

    Height

    Data type

    text

    Height - Estimated?
    Description

    Height

    Data type

    boolean

    Height - not done
    Description

    Height

    Data type

    boolean

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    Similar models

    Vital Signs: CRF QMCR University of Alberta

    1 forms
    Name
    Type
    Description | Question | Decode (Coded Value)
    Data type
    Alias
    Item Group
    General Information
    Study Name
    Item
    Study Name
    text
    Site Number
    Item
    Site Number
    integer
    Pt_ID
    Item
    Pt_ID
    integer
    Visit Date
    Item
    Visit Date
    date
    Item
    Visit Type
    text
    Visit Type
    Code List
    Visit Type
    CL Item
    Screening (1)
    CL Item
    Baseline (2)
    CL Item
    Visit 1 (3)
    CL Item
    Visit 2 (4)
    CL Item
    Visit 3 (5)
    CL Item
    Visit 4 (6)
    CL Item
    Visit 5 (7)
    CL Item
    Completion Visit (8)
    1. Time
    Item
    1. Time
    time
    Item
    Time
    text
    Time
    Code List
    Time
    CL Item
    AM (1)
    CL Item
    PM (2)
    2. Heart Rate
    Item
    2. Heart Rate
    integer
    Heart Rate - not done
    Item
    Heart Rate - not done
    boolean
    3. Blood pressure
    Item
    3. Blood pressure (systolic)
    integer
    Blood pressure
    Item
    Blood pressure (diastolic)
    integer
    Blood pressure - not done
    Item
    Blood pressure - not done
    boolean
    Item
    3.a BP position
    text
    3.a BP position
    Code List
    3.a BP position
    CL Item
    Sitting (1)
    CL Item
    Supine (2)
    CL Item
    Standing (3)
    4. Temperature
    Item
    4. Temperature
    integer
    Item
    Temperature
    text
    Temperature
    Code List
    Temperature
    CL Item
    °F (1)
    CL Item
    °C (2)
    Temperature
    Item
    Temperature - not done
    boolean
    5. Respiratory Rate
    Item
    5. Respiratory Rate
    integer
    Respiratory Rate
    Item
    Respiratory Rate - not done
    boolean
    6. Weight
    Item
    6. Weight
    integer
    Item
    Weight
    text
    Weight
    Code List
    Weight
    CL Item
    pounds (1)
    CL Item
    kilograms (2)
    Weight
    Item
    Weight - Estimated?
    boolean
    Weight
    Item
    Weight - not done
    boolean
    7. Height
    Item
    7. Height
    integer
    Item
    Height
    text
    Height
    Code List
    Height
    CL Item
    inches (1)
    CL Item
    centimeters (2)
    Height
    Item
    Height - Estimated?
    boolean
    Height
    Item
    Height - not done
    boolean
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