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Visit 1 Run-In Medical History NCT01117584

1 Formulär  
Elements of Medical History
Beskrivning

Elements of Medical History

Respiratory
Beskrivning

Respiratory

Datatyp

text

Cardiovascular
Beskrivning

Cardiovascular

Datatyp

text

Gastrointestinal
Beskrivning

Gastrointestinal

Datatyp

text

Musculoskeletal
Beskrivning

Musculoskeletal

Datatyp

text

Neurological
Beskrivning

Neurological

Datatyp

text

Endocrine/metabolic
Beskrivning

Endocrine/metabolic

Datatyp

text

Lymphatic/Hematologic
Beskrivning

Lymphatic/Hematologic

Datatyp

text

Dermatological
Beskrivning

Dermatological

Datatyp

text

Psychological
Beskrivning

Psychological

Datatyp

text

Genitourinary
Beskrivning

Genitourinary

Datatyp

text

Allergies
Beskrivning

Allergies

Datatyp

text

General Information
Beskrivning

General Information

Is there any past or present Medical Condition?
Beskrivning

Medical Condition

Datatyp

boolean

If yes, please provide details.
Beskrivning

Specification of Medical Condition

Datatyp

text

Reported Term for Medical Condition
Beskrivning

Reported Term for Medical Condition

Datatyp

text

Onset Date
Beskrivning

Onset Date

Datatyp

date

Is Medical Condition ongoing?
Beskrivning

Ongoing Medical Condition

Datatyp

text

Recovered Date
Beskrivning

If no, please provide "Recovered Date"

Datatyp

date

Current Treatment with medication?
Beskrivning

Current Treatment

Datatyp

text

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Visit 1 Run-In Medical History NCT01117584

1 Formulär
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Elements of Medical History
Respiratory
Item
Respiratory
text
Cardiovascular
Item
Cardiovascular
text
Gastrointestinal
Item
Gastrointestinal
text
Musculoskeletal
Item
Musculoskeletal
text
Neurological
Item
Neurological
text
Endocrine/metabolic
Item
Endocrine/metabolic
text
Lymphatic/Hematologic
Item
Lymphatic/Hematologic
text
Dermatological
Item
Dermatological
text
Psychological
Item
Psychological
text
Genitourinary
Item
Genitourinary
text
Allergies
Item
Allergies
text
Item Group
General Information
Medical Condition
Item
Is there any past or present Medical Condition?
boolean
Specification of Medical Condition
Item
If yes, please provide details.
text
Reported Term for Medical Condition
Item
Reported Term for Medical Condition
text
Onset Date
Item
Onset Date
date
Item
Is Medical Condition ongoing?
text
Ongoing Medical Condition
Code List
Is Medical Condition ongoing?
CL Item
No (1)
CL Item
Yes (2)
Recovered Date
Item
Recovered Date
date
Item
Current Treatment with medication?
text
Current Treatment
Code List
Current Treatment with medication?
CL Item
No (1)
CL Item
Yes (2)
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