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Genetic Screening For HLA-B*5701 Follow-Up Contact NCT00340080

1 forms  
Follow-Up Contact
Description

Follow-Up Contact

Alias
UMLS CUI-1
C1522577
UMLS CUI-2
C1705415
Subject Identifier
Description

Subject Identifier

Data type

text

Alias
UMLS CUI [1]
C2348585
Is a follow-up contact required due to unresolved AE or SAE?
Description

follow-up contact required

Data type

text

Alias
UMLS CUI [1,1]
C1522577
UMLS CUI [1,2]
C0392360
UMLS CUI [1,3]
C0877248
If Yes, Date of contact
Description

Date of contact

Data type

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C1705415
UMLS CUI [1,3]
C1522577
Form of Contact
Description

Form of Contact

Data type

integer

Alias
UMLS CUI [1,1]
C1705415
UMLS CUI [1,2]
C0332307
UMLS CUI [1,3]
C1522577
Form of Contact
Description

If other, specify

Data type

text

Alias
UMLS CUI [1,1]
C1705415
UMLS CUI [1,2]
C0332307
UMLS CUI [1,3]
C1522577
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Similar models

Genetic Screening For HLA-B*5701 Follow-Up Contact NCT00340080

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Follow-Up Contact
C1522577 (UMLS CUI-1)
C1705415 (UMLS CUI-2)
Subject Identifier
Item
Subject Identifier
text
C2348585 (UMLS CUI [1])
Item
Is a follow-up contact required due to unresolved AE or SAE?
text
C1522577 (UMLS CUI [1,1])
C0392360 (UMLS CUI [1,2])
C0877248 (UMLS CUI [1,3])
follow-up contact
Code List
Is a follow-up contact required due to unresolved AE or SAE?
CL Item
Yes (Y)
CL Item
No (N)
Date of contact
Item
If Yes, Date of contact
date
C0011008 (UMLS CUI [1,1])
C1705415 (UMLS CUI [1,2])
C1522577 (UMLS CUI [1,3])
Item
Form of Contact
integer
C1705415 (UMLS CUI [1,1])
C0332307 (UMLS CUI [1,2])
C1522577 (UMLS CUI [1,3])
Form of Contact
Code List
Form of Contact
CL Item
Visit (1)
CL Item
Phone (2)
CL Item
Other, specify (3)
Form of Contact
Item
Form of Contact
text
C1705415 (UMLS CUI [1,1])
C0332307 (UMLS CUI [1,2])
C1522577 (UMLS CUI [1,3])
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