Inglese

STUDY DRUG TREATMENT COMPLETION / EARLY DISCONTINUATION (UNSCHEDULED)CRFs Roche FVF4168G Macular Edema NCT00473330

1 moduli  
Patient administration
Descrizione

Patient administration

Subject Number
Descrizione

PT

Tipo di dati

integer

Alias
UMLS CUI [1]
C2348585
Subject Initials:
Descrizione

PTINIT

Tipo di dati

text

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

VDT

Tipo di dati

date

Alias
UMLS CUI [1,1]
C1302584
STUDY DRUG TREATMENT COMPLETION / EARLY DISCONTINUATION (UNSCHEDULED)
Descrizione

STUDY DRUG TREATMENT COMPLETION / EARLY DISCONTINUATION (UNSCHEDULED)

Indicate if the subject completed the study drug treatment or discontinued early (check one only):
Descrizione

TX_DRUG_DISC [TXDISC]

Tipo di dati

integer

Alias
UMLS CUI [1]
C2826674
Date Subject Discontinued Study Drug Treatment Early:
Descrizione

TX_DISCONTINUED_DT [TXDCDT]

Tipo di dati

date

Unità di misura
  • DD/MMM/YY
Alias
UMLS CUI [1,1]
C0558681
UMLS CUI [1,2]
C0011008
DD/MMM/YY
Check the PRIMARY reason the subject discontinued study drug treatment early
Descrizione

TX_DRUG_DISC_REASON [TXREAS]

Tipo di dati

integer

Alias
UMLS CUI [1,1]
C0558681
UMLS CUI [1,2]
C0566251
Please specify intervention:
Descrizione

TX_DISC_REASON_SP [TXDCRS]

Tipo di dati

text

Alias
UMLS CUI [1,1]
C0558681
UMLS CUI [1,2]
C0566251
UMLS CUI [1,3]
C0184661
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Similar models

STUDY DRUG TREATMENT COMPLETION / EARLY DISCONTINUATION (UNSCHEDULED)CRFs Roche FVF4168G Macular Edema NCT00473330

1 moduli
Name
genere
Description | Question | Decode (Coded Value)
Tipo di dati
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
STUDY DRUG TREATMENT COMPLETION / EARLY DISCONTINUATION (UNSCHEDULED)
Item
Indicate if the subject completed the study drug treatment or discontinued early (check one only):
integer
C2826674 (UMLS CUI [1])
TX_DRUG_DISC [TXDISC]
Code List
Indicate if the subject completed the study drug treatment or discontinued early (check one only):
CL Item
Subject Completed Study Drug Treatment (1)
CL Item
Subject Discontinued Study Drug Treatment Early (2)
TX_DISCONTINUED_DT [TXDCDT]
Item
Date Subject Discontinued Study Drug Treatment Early:
date
C0558681 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Item
Check the PRIMARY reason the subject discontinued study drug treatment early
integer
C0558681 (UMLS CUI [1,1])
C0566251 (UMLS CUI [1,2])
TX_DRUG_DISC_REASON [TXREAS]
Code List
Check the PRIMARY reason the subject discontinued study drug treatment early
CL Item
Adverse Event (complete appropriate Adverse Event CRF) (1)
CL Item
Death (complete Study Completion / Early Discontinuation CRF) (2)
CL Item
Lost to follow-up (3)
CL Item
Physician’s decision to discontinue treatment (for reasons other than AE) (4)
CL Item
Subject’s decision to discontinue treatment (for reasons other than AE) (5)
CL Item
Sponsor’s decision to terminate study (6)
CL Item
Pregnancy (complete Pregnancy CRF) (7)
CL Item
Subject non-compliance (8)
CL Item
Subject’s condition mandated other therapeutic intervention (9)
Item
Please specify intervention:
text
C0558681 (UMLS CUI [1,1])
C0566251 (UMLS CUI [1,2])
C0184661 (UMLS CUI [1,3])
TX_DRUG_DISC_REASON [TXREAS]
Code List
Please specify intervention:
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