Diagnosis form

  1. StudyEvent: ODM
    1. Diagnosis form
Patient identification
Description

Patient identification

Name
Description

Patient name

Data type

text

Alias
UMLS CUI [1]
C1299487
Patient date of birth
Description

Patient date of birth

Data type

date

Alias
UMLS CUI [1]
C0421451
Patient address
Description

Patient address

Data type

text

Alias
UMLS CUI [1]
C0421449
General practitioner
Description

General practitioner

Data type

text

Alias
UMLS CUI [1]
C0017319
Psychiatrist
Description

Psychiatrist

Data type

text

Alias
UMLS CUI [1]
C0033872
Relatives
Description

Relatives

Data type

text

Alias
UMLS CUI [1]
C0080103
Diagnosis
Description

Diagnosis

Date of diagnosis
Description

Date of diagnosis

Data type

date

Alias
UMLS CUI [1]
C2316983
Diagnosis
Description

Diagnosis

Data type

text

Alias
UMLS CUI [1]
C0011900
Treating physician
Description

Treating physician

Data type

integer

Alias
UMLS CUI [1]
C1710470
Diagnosis code
Description

Diagnosis code

Data type

integer

Alias
UMLS CUI [1]
C1550350

Similar models

Diagnosis form

  1. StudyEvent: ODM
    1. Diagnosis form
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Patient identification
Patient name
Item
Name
text
C1299487 (UMLS CUI [1])
Patient date of birth
Item
Patient date of birth
date
C0421451 (UMLS CUI [1])
Patient address
Item
Patient address
text
C0421449 (UMLS CUI [1])
General practitioner
Item
General practitioner
text
C0017319 (UMLS CUI [1])
Psychiatrist
Item
Psychiatrist
text
C0033872 (UMLS CUI [1])
Relatives
Item
Relatives
text
C0080103 (UMLS CUI [1])
Item Group
Diagnosis
Date of diagnosis
Item
Date of diagnosis
date
C2316983 (UMLS CUI [1])
Diagnosis
Item
Diagnosis
text
C0011900 (UMLS CUI [1])
Treating physician
Item
Treating physician
integer
C1710470 (UMLS CUI [1])
Diagnosis code
Item
Diagnosis code
integer
C1550350 (UMLS CUI [1])