Engelsk

Throughout: Mortality Report [MO_1] NCT01117584

1 Formulär  
General Information
Beskrivning

General Information

Date of Death
Beskrivning

Date of Death

Datatyp

date

Cause of Death
Beskrivning

Cause of Death

Datatyp

text

Relationship of Study Drug to Subject´s Death?
Beskrivning

Relationship to Study Drug

Datatyp

integer

Was Autopsy performed?
Beskrivning

If Yes, submit copy of autopsy report.

Datatyp

text

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Similar models

Throughout: Mortality Report [MO_1] NCT01117584

1 Formulär
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
General Information
Date of Death
Item
Date of Death
date
Cause of Death
Item
Cause of Death
text
Item
Relationship of Study Drug to Subject´s Death?
integer
Relationship to Study Drug
Code List
Relationship of Study Drug to Subject´s Death?
CL Item
Not related (1)
CL Item
Possible (2)
CL Item
Probable (3)
Item
Was Autopsy performed?
text
Autopsy
Code List
Was Autopsy performed?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
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