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DEMOGRAPHICS (SCREENING) CRFs Roche FVF4168G Macular Edema NCT00473330

1 forms  
Patient administration
Description

Patient administration

Subject Number
Description

PT

Data type

integer

Alias
UMLS CUI [1]
C2348585
Subject Initials:
Description

PTINIT

Data type

text

Alias
UMLS CUI [1,1]
C1997894
UMLS CUI [1,2]
C2986440
Report Date:
Description

VDT

Data type

date

Alias
UMLS CUI [1,1]
C1302584
DEMOGRAPHICS (SCREENING)
Description

DEMOGRAPHICS (SCREENING)

Date of Birth:
Description

DD-MMM-YYYY

Data type

date

Alias
UMLS CUI [1]
C0421451
Sex:
Description

SEX

Data type

text

Alias
UMLS CUI [1]
C0079399
Ethnicity (check one only):
Description

ETHNICITY

Data type

integer

Alias
UMLS CUI [1]
C0015031
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Similar models

DEMOGRAPHICS (SCREENING) CRFs Roche FVF4168G Macular Edema NCT00473330

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Patient administration
PT
Item
Subject Number
integer
C2348585 (UMLS CUI [1])
PTINIT
Item
Subject Initials:
text
C1997894 (UMLS CUI [1,1])
C2986440 (UMLS CUI [1,2])
VDT
Item
Report Date:
date
C1302584 (UMLS CUI [1,1])
Item Group
DEMOGRAPHICS (SCREENING)
BIRTH_DT
Item
Date of Birth:
date
C0421451 (UMLS CUI [1])
Item
Sex:
text
C0079399 (UMLS CUI [1])
LIGHT_PERCEPTION [LIPEC]
Code List
Sex:
CL Item
With Projection (1)
CL Item
Without Projection (2)
Item
Ethnicity (check one only):
integer
C0015031 (UMLS CUI [1])
MAXIMUM_DISTANCE [MAXDST]
Code List
Ethnicity (check one only):
CL Item
4 ft (1)
CL Item
2 ft (2)
CL Item
1 ft (3)
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