Inglés

WTZ-GIST-09-01 (Imatinib + LBH589) Patient registration

1 formularios  
Registration
Descripción

Registration

Alias
UMLS CUI-1
C1514821
Patient identification
Descripción

Patient identification

Tipo de datos

text

Alias
UMLS CUI [1]
C1269815
Date of birth
Descripción

Patient date of birth

Tipo de datos

date

Unidades de medida
  • YYYY-MM-DD
Alias
UMLS CUI [1]
C0421451
YYYY-MM-DD
Sex
Descripción

Gender

Tipo de datos

integer

Alias
UMLS CUI [1]
C0079399
Initials (1st letter first name, 1st letter last name)
Descripción

Initials

Tipo de datos

text

Alias
UMLS CUI [1]
C2986440
Date
Descripción

Date of report

Tipo de datos

date

Unidades de medida
  • YYYY-MM-DD
Alias
UMLS CUI [1]
C1302584
YYYY-MM-DD
Investigator signature
Descripción

Investigator signature

Tipo de datos

boolean

Alias
UMLS CUI [1]
C2346576
Study Centrer Information - ATTENTION! This part will be completed by the center in Essen
Descripción

Study Centrer Information - ATTENTION! This part will be completed by the center in Essen

Alias
UMLS CUI-1
C2825181
UMLS CUI-2
C1533716
Patient No.
Descripción

Clinical Trial Subject Unique Identifier

Tipo de datos

integer

Alias
UMLS CUI [1]
C2348585
Cohort
Descripción

Cohort

Tipo de datos

integer

Alias
UMLS CUI [1]
C0599755
Date
Descripción

Date of report - study center

Tipo de datos

date

Unidades de medida
  • YYYY-MM-DD
Alias
UMLS CUI [1]
C1302584
UMLS CUI [2]
C2825181
YYYY-MM-DD
Signature patient registration center
Descripción

Signature patient registration center

Tipo de datos

boolean

Alias
UMLS CUI [1]
C2346576
UMLS CUI [2]
C2825181
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Similar models

WTZ-GIST-09-01 (Imatinib + LBH589) Patient registration

1 formularios
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
Registration
C1514821 (UMLS CUI-1)
Patient identification
Item
Patient identification
text
C1269815 (UMLS CUI [1])
Patient date of birth
Item
Date of birth
date
C0421451 (UMLS CUI [1])
Item
Sex
integer
C0079399 (UMLS CUI [1])
Gender
Code List
Sex
CL Item
male (1)
CL Item
female (2)
Initials
Item
Initials (1st letter first name, 1st letter last name)
text
C2986440 (UMLS CUI [1])
Date of report
Item
Date
date
C1302584 (UMLS CUI [1])
Investigator signature
Item
Investigator signature
boolean
C2346576 (UMLS CUI [1])
Item Group
Study Centrer Information - ATTENTION! This part will be completed by the center in Essen
C2825181 (UMLS CUI-1)
C1533716 (UMLS CUI-2)
Clinical Trial Subject Unique Identifier
Item
Patient No.
integer
C2348585 (UMLS CUI [1])
Item
Cohort
integer
C0599755 (UMLS CUI [1])
Cohort
Code List
Cohort
CL Item
10 mg LBH589 (-1)
CL Item
20 mg LBH589 (0)
CL Item
30 mg LBH589 (1)
CL Item
40 mg LBH589 (2)
Date of report - study center
Item
Date
date
C1302584 (UMLS CUI [1])
C2825181 (UMLS CUI [2])
Signature patient registration center
Item
Signature patient registration center
boolean
C2346576 (UMLS CUI [1])
C2825181 (UMLS CUI [2])
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