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Medical History CRFs Multiple Sclerosis Tysabri NCT00027300

1 Formulär  
Does the subject have a medical or surgical history, current or resolved, of any of the following categories?
Beskrivning

Does the subject have a medical or surgical history, current or resolved, of any of the following categories?

Alias
UMLS CUI-1
C0262926
1. Immunological (including allergies)
Beskrivning

Immune system disease

Datatyp

boolean

Alias
UMLS CUI [1]
C0021053
2. HEENT
Beskrivning

HEENT

Datatyp

boolean

Alias
UMLS CUI [1]
C1512338
3. Respiratory
Beskrivning

respiratory

Datatyp

boolean

Alias
UMLS CUI [1]
C0035237
4. Cardiovascular
Beskrivning

Cardiovascular

Datatyp

boolean

Alias
UMLS CUI [1]
C0007226
5. Gastrointestinal
Beskrivning

Gastrointestinal

Datatyp

boolean

Alias
UMLS CUI [1]
C0012240
6. Genitourinary
Beskrivning

Genitourinary System

Datatyp

boolean

Alias
UMLS CUI [1]
C0042066
7. Hematological
Beskrivning

Hematological

Datatyp

boolean

Alias
UMLS CUI [1]
C0279810
8. Neurological
Beskrivning

Neurological

Datatyp

boolean

Alias
UMLS CUI [1]
C0027763
9. Endocrine
Beskrivning

Endocrine

Datatyp

boolean

Alias
UMLS CUI [1]
C0014136
10. Musculoskeletal
Beskrivning

Musculoskeletal

Datatyp

boolean

Alias
UMLS CUI [1]
C0026860
11. Dermatological
Beskrivning

Dermatological

Datatyp

boolean

Alias
UMLS CUI [1]
C0037274
12. Psychosocial/ psychiatric
Beskrivning

Mental

Datatyp

boolean

Alias
UMLS CUI [1]
C0004936
If 'Yes' record each detail below. If a category has multiple details, record each on a separate line. Mark if resolved or current.
Beskrivning

If 'Yes' record each detail below. If a category has multiple details, record each on a separate line. Mark if resolved or current.

Line number
Beskrivning

Line

Datatyp

integer

Alias
UMLS CUI [1]
C0750480
Category Number
Beskrivning

Category Number

Datatyp

text

Alias
UMLS CUI [1]
C0683312
resolved or current
Beskrivning

resolved or current

Datatyp

integer

Pertinent Details
Beskrivning

details

Datatyp

text

Alias
UMLS CUI [1]
C1522508
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Similar models

Medical History CRFs Multiple Sclerosis Tysabri NCT00027300

1 Formulär
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Does the subject have a medical or surgical history, current or resolved, of any of the following categories?
C0262926 (UMLS CUI-1)
Immune system disease
Item
1. Immunological (including allergies)
boolean
C0021053 (UMLS CUI [1])
HEENT
Item
2. HEENT
boolean
C1512338 (UMLS CUI [1])
respiratory
Item
3. Respiratory
boolean
C0035237 (UMLS CUI [1])
Cardiovascular
Item
4. Cardiovascular
boolean
C0007226 (UMLS CUI [1])
Gastrointestinal
Item
5. Gastrointestinal
boolean
C0012240 (UMLS CUI [1])
Genitourinary System
Item
6. Genitourinary
boolean
C0042066 (UMLS CUI [1])
Hematological
Item
7. Hematological
boolean
C0279810 (UMLS CUI [1])
Neurological
Item
8. Neurological
boolean
C0027763 (UMLS CUI [1])
Endocrine
Item
9. Endocrine
boolean
C0014136 (UMLS CUI [1])
Musculoskeletal
Item
10. Musculoskeletal
boolean
C0026860 (UMLS CUI [1])
Dermatological
Item
11. Dermatological
boolean
C0037274 (UMLS CUI [1])
Mental
Item
12. Psychosocial/ psychiatric
boolean
C0004936 (UMLS CUI [1])
Item Group
If 'Yes' record each detail below. If a category has multiple details, record each on a separate line. Mark if resolved or current.
Item
Line number
integer
C0750480 (UMLS CUI [1])
Line
Code List
Line number
Category Number
Item
Category Number
text
C0683312 (UMLS CUI [1])
Item
resolved or current
integer
resolved or current
Code List
resolved or current
CL Item
resolved (1)
CL Item
current (2)
Item
Pertinent Details
text
C1522508 (UMLS CUI [1])
Line
Code List
Pertinent Details
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