ID

18735

Beskrivning

ODM Form derived from: https://ictr.wisc.edu/CaseReptTempt. Template Name: Vital Sign Measurements (Standard). 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

  1. 2016-07-23 2016-07-23 -
  2. 2016-11-17 2016-11-17 -
Uppladdad den

17 november 2016

DOI

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Licens

Creative Commons BY-NC 3.0

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Vital Sign Measurements (Standard): CRF Wisconsin Madison

Vital Sign Measurements (Standard): CRF Wisconsin Madison

Header
Beskrivning

Header

PI Name
Beskrivning

PI Name

Datatyp

text

Alias
UMLS CUI [1,1]
C0027365
UMLS CUI [1,2]
C1521895
Protocol or IRB Number
Beskrivning

Protocol or IRB Number

Datatyp

integer

Alias
UMLS CUI [1]
C2348563
Protocol Short Title
Beskrivning

Protocol Short Title

Datatyp

text

Alias
UMLS CUI [1,1]
C2348563
UMLS CUI [1,2]
C1705824
Subject Initials
Beskrivning

Subject Initials

Datatyp

text

Alias
UMLS CUI [1]
C2986440
Subject ID
Beskrivning

Subject ID

Datatyp

integer

Alias
UMLS CUI [1]
C2348585
Exam Date
Beskrivning

Exam Date

Datatyp

date

Alias
UMLS CUI [1]
C2826643
Vital Sign Measurements (Standard)
Beskrivning

Vital Sign Measurements (Standard)

Vital Sign Measurement not performed
Beskrivning

Vital Sign Measurement not performed

Datatyp

boolean

Alias
UMLS CUI [1,1]
C2963216
UMLS CUI [1,2]
C0445106
Visit Number
Beskrivning

Visit Number

Datatyp

text

Alias
UMLS CUI [1]
C1549755
Height
Beskrivning

Height

Datatyp

float

Måttenheter
  • inches
Alias
UMLS CUI [1]
C0005890
inches
Height not measured
Beskrivning

Height

Datatyp

boolean

Alias
UMLS CUI [1]
C0005890
Weight
Beskrivning

Weight

Datatyp

float

Måttenheter
  • lbs
Alias
UMLS CUI [1]
C0005910
lbs
Weight not measured
Beskrivning

Weight

Datatyp

boolean

Alias
UMLS CUI [1]
C0005910
Time
Beskrivning

Time

Datatyp

time

Alias
UMLS CUI [1]
C0040223
Temperature
Beskrivning

Temperature

Datatyp

float

Måttenheter
  • Farenheit
Alias
UMLS CUI [1]
C0005903
Farenheit
Temperature not measured
Beskrivning

Temperature

Datatyp

boolean

Alias
UMLS CUI [1]
C0005903
Method
Beskrivning

Method

Datatyp

text

Alias
UMLS CUI [1]
C0871511
Respiratory Rate
Beskrivning

Respiratory Rate

Datatyp

integer

Måttenheter
  • breaths/min
Alias
UMLS CUI [1]
C0231832
breaths/min
Respiratory Rate not measured
Beskrivning

Respiratory Rate

Datatyp

boolean

Alias
UMLS CUI [1]
C0231832
Heart Rate
Beskrivning

Heart Rate

Datatyp

integer

Måttenheter
  • beats/min
Alias
UMLS CUI [1]
C0018810
beats/min
Heart Rate not measured
Beskrivning

Heart Rate

Datatyp

boolean

Alias
UMLS CUI [1]
C0018810
Systolic Blood Pressure
Beskrivning

Systolic Blood Pressure

Datatyp

integer

Måttenheter
  • mmHg
Alias
UMLS CUI [1]
C0871470
mmHg
Blood Pressure not measured
Beskrivning

Systolic Blood Pressure

Datatyp

boolean

Alias
UMLS CUI [1]
C0871470
Diastolic Blood Pressure
Beskrivning

Diastolic Blood Pressure

Datatyp

integer

Måttenheter
  • mmHg
Alias
UMLS CUI [1]
C0428883
mmHg
Method
Beskrivning

Method

Datatyp

text

Alias
UMLS CUI [1]
C0871511
Location
Beskrivning

Location

Datatyp

text

Alias
UMLS CUI [1]
C0450429
Position
Beskrivning

Position

Datatyp

text

Alias
UMLS CUI [1]
C0733755
Additional Notes
Beskrivning

Additional Notes

Datatyp

text

Alias
UMLS CUI [1]
C0947611
Vital Sign Measurements obtained by
Beskrivning

Vital Sign Measurements obtained by

Datatyp

text

Alias
UMLS CUI [1,1]
C2963216
UMLS CUI [1,2]
C1301820

Similar models

Vital Sign Measurements (Standard): CRF Wisconsin Madison

Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Header
PI Name
Item
PI Name
text
C0027365 (UMLS CUI [1,1])
C1521895 (UMLS CUI [1,2])
Protocol or IRB Number
Item
Protocol or IRB Number
integer
C2348563 (UMLS CUI [1])
Protocol Short Title
Item
Protocol Short Title
text
C2348563 (UMLS CUI [1,1])
C1705824 (UMLS CUI [1,2])
Subject Initials
Item
Subject Initials
text
C2986440 (UMLS CUI [1])
Subject ID
Item
Subject ID
integer
C2348585 (UMLS CUI [1])
Exam Date
Item
Exam Date
date
C2826643 (UMLS CUI [1])
Item Group
Vital Sign Measurements (Standard)
Vital Sign Measurement not performed
Item
Vital Sign Measurement not performed
boolean
C2963216 (UMLS CUI [1,1])
C0445106 (UMLS CUI [1,2])
Item
Visit Number
text
C1549755 (UMLS CUI [1])
Code List
Visit Number
CL Item
Visit # (1)
CL Item
Visit # (2)
CL Item
Visit # (3)
CL Item
Visit # (4)
CL Item
Visit # (5)
CL Item
Visit # (6)
Height
Item
Height
float
C0005890 (UMLS CUI [1])
Height
Item
Height not measured
boolean
C0005890 (UMLS CUI [1])
Weight
Item
Weight
float
C0005910 (UMLS CUI [1])
Weight
Item
Weight not measured
boolean
C0005910 (UMLS CUI [1])
Time
Item
Time
time
C0040223 (UMLS CUI [1])
Temperature
Item
Temperature
float
C0005903 (UMLS CUI [1])
Temperature
Item
Temperature not measured
boolean
C0005903 (UMLS CUI [1])
Item
Method
text
C0871511 (UMLS CUI [1])
Code List
Method
CL Item
Oral (1)
CL Item
Axillary (2)
CL Item
Tympanic (3)
Respiratory Rate
Item
Respiratory Rate
integer
C0231832 (UMLS CUI [1])
Respiratory Rate
Item
Respiratory Rate not measured
boolean
C0231832 (UMLS CUI [1])
Heart Rate
Item
Heart Rate
integer
C0018810 (UMLS CUI [1])
Heart Rate
Item
Heart Rate not measured
boolean
C0018810 (UMLS CUI [1])
Systolic Blood Pressure
Item
Systolic Blood Pressure
integer
C0871470 (UMLS CUI [1])
Systolic Blood Pressure
Item
Blood Pressure not measured
boolean
C0871470 (UMLS CUI [1])
Diastolic Blood Pressure
Item
Diastolic Blood Pressure
integer
C0428883 (UMLS CUI [1])
Item
Method
text
C0871511 (UMLS CUI [1])
Code List
Method
CL Item
Manual (1)
CL Item
Automated (2)
Item
Location
text
C0450429 (UMLS CUI [1])
Code List
Location
CL Item
Left Arm (1)
CL Item
Right Arm (2)
Item
Position
text
C0733755 (UMLS CUI [1])
Code List
Position
CL Item
Sitting (1)
CL Item
Supine (2)
CL Item
Standing (3)
Additional Notes
Item
Additional Notes
text
C0947611 (UMLS CUI [1])
Vital Sign Measurements obtained by
Item
Vital Sign Measurements obtained by
text
C2963216 (UMLS CUI [1,1])
C1301820 (UMLS CUI [1,2])

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