Record of Death CRFs Multiple Sclerosis Tysabri NCT00027300

Record of Death
Beschrijving

Record of Death

Alias
UMLS CUI-1
C0011065
Date of Death
Beschrijving

Date of death

Datatype

date

Alias
UMLS CUI [1]
C1148348
Time of Death
Beschrijving

Time of death

Datatype

time

Alias
UMLS CUI [1]
C1301931
Cause of Death
Beschrijving

Cause of death

Datatype

text

Alias
UMLS CUI [1]
C0007465
Is the cause of death related to an adverse event which began during the dosing period?
Beschrijving

Death related to adverse event

Datatype

boolean

Alias
UMLS CUI [1]
C1705232
If Yes, describe and fill in Adverse Event CRF Page No.:
Beschrijving

Description

Datatype

text

Relationship of death to study drug(s):
Beschrijving

death related to study drug

Datatype

boolean

Alias
UMLS CUI [1,1]
C0011065
UMLS CUI [1,2]
C0439849
UMLS CUI [1,3]
C0013227
Autopsy
Beschrijving

Autopsy

Datatype

text

Alias
UMLS CUI [1]
C0004398
Date of autopsy
Beschrijving

Please provide two copies of the autopsy report if available.

Datatype

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C0004398

Similar models

Record of Death CRFs Multiple Sclerosis Tysabri NCT00027300

Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
Record of Death
C0011065 (UMLS CUI-1)
Date of death
Item
Date of Death
date
C1148348 (UMLS CUI [1])
Time of death
Item
Time of Death
time
C1301931 (UMLS CUI [1])
Cause of death
Item
Cause of Death
text
C0007465 (UMLS CUI [1])
Death related to adverse event
Item
Is the cause of death related to an adverse event which began during the dosing period?
boolean
C1705232 (UMLS CUI [1])
Description
Item
If Yes, describe and fill in Adverse Event CRF Page No.:
text
death related to study drug
Item
Relationship of death to study drug(s):
boolean
C0011065 (UMLS CUI [1,1])
C0439849 (UMLS CUI [1,2])
C0013227 (UMLS CUI [1,3])
Item
Autopsy
text
C0004398 (UMLS CUI [1])
Code List
Autopsy
CL Item
Not Done (1)
CL Item
Done (2)
Date of autopsy
Item
Date of autopsy
date
C0011008 (UMLS CUI [1,1])
C0004398 (UMLS CUI [1,2])