CRF Tracking/ Review Form (TRF)

CRF TRACKING/REVIEW FORM (TRF)
Beschrijving

CRF TRACKING/REVIEW FORM (TRF)

Alias
UMLS CUI-1
C3258859
Centre Number
Beschrijving

Centre Number

Datatype

integer

Alias
UMLS CUI [1,1]
C0600091
UMLS CUI [1,2]
C0019994
Patient Initials
Beschrijving

Patient Initials

Datatype

text

Alias
UMLS CUI [1]
C2986440
Investigator
Beschrijving

Investigator

Datatype

text

Alias
UMLS CUI [1]
C2826892
Screening Failure (archive only)
Beschrijving

Screening Failure

Datatype

boolean

Alias
UMLS CUI [1]
C1512714
MOD1
Beschrijving

Module Description: Enrolment

Datatype

text

Alias
UMLS CUI [1]
C1709061
Missing pages (if applicable)
Beschrijving

pages

Datatype

text

Alias
UMLS CUI [1]
C1548329
MOD3
Beschrijving

Module Description: Baseline, Day 2, Wk 1-8-Cont/Wthd

Datatype

text

Alias
UMLS CUI [1]
C1709061
Missing pages (if applicable)
Beschrijving

pages

Datatype

text

Alias
UMLS CUI [1]
C1548329
MOD4
Beschrijving

Module Description: Baseline Patient Rating Scales

Datatype

text

Alias
UMLS CUI [1]
C1709061
Missing pages (if applicable)
Beschrijving

pages

Datatype

text

Alias
UMLS CUI [1]
C1548329
MOD5
Beschrijving

Module Description: Baseline, Day 2, Wk1-8 RLS Scales

Datatype

text

Alias
UMLS CUI [1]
C1709061
Missing pages (if applicable)
Beschrijving

pages

Datatype

text

Alias
UMLS CUI [1]
C1548329
SAE1
Beschrijving

Module Description: Serious Adverse Experiences

Datatype

text

Alias
UMLS CUI [1]
C1709061
Missing pages (if applicable)
Beschrijving

pages

Datatype

text

Alias
UMLS CUI [1]
C1548329
SAE2
Beschrijving

Module Description: Serious Adverse Experiences

Datatype

text

Alias
UMLS CUI [1]
C1709061
Missing pages (if applicable)
Beschrijving

pages

Datatype

text

Alias
UMLS CUI [1]
C1548329
FORMD
Beschrijving

Module Description: Form D

Datatype

text

Alias
UMLS CUI [1]
C1709061
Missing pages (if applicable)
Beschrijving

pages

Datatype

text

Alias
UMLS CUI [1]
C1548329
Site Monitor’s comments (eg. protocol violations or deviations)
Beschrijving

comment

Datatype

text

Alias
UMLS CUI [1]
C0947611
Site Monitor’s Name
Beschrijving

Name

Datatype

text

Alias
UMLS CUI [1]
C0027365
Site Monitor’s Signature
Beschrijving

Signature

Datatype

text

Alias
UMLS CUI [1]
C1519316
Date Submitted
Beschrijving

Date Submitted

Datatype

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C1515022

Similar models

CRF Tracking/ Review Form (TRF)

Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
CRF TRACKING/REVIEW FORM (TRF)
C3258859 (UMLS CUI-1)
Centre Number
Item
Centre Number
integer
C0600091 (UMLS CUI [1,1])
C0019994 (UMLS CUI [1,2])
Patient Initials
Item
Patient Initials
text
C2986440 (UMLS CUI [1])
Investigator
Item
Investigator
text
C2826892 (UMLS CUI [1])
Screening Failure
Item
Screening Failure (archive only)
boolean
C1512714 (UMLS CUI [1])
Item
MOD1
text
C1709061 (UMLS CUI [1])
Code List
MOD1
CL Item
Sent to DM (Sent to DM)
CL Item
Unused (Unused)
pages
Item
Missing pages (if applicable)
text
C1548329 (UMLS CUI [1])
Item
MOD3
text
C1709061 (UMLS CUI [1])
Code List
MOD3
CL Item
Sent to DM (Sent to DM)
CL Item
Unused (Unused)
pages
Item
Missing pages (if applicable)
text
C1548329 (UMLS CUI [1])
Item
MOD4
text
C1709061 (UMLS CUI [1])
Code List
MOD4
CL Item
Sent to DM (Sent to DM)
CL Item
Unused (Unused)
pages
Item
Missing pages (if applicable)
text
C1548329 (UMLS CUI [1])
Item
MOD5
text
C1709061 (UMLS CUI [1])
Code List
MOD5
CL Item
Sent to DM (Sent to DM)
CL Item
Unused (Unused)
pages
Item
Missing pages (if applicable)
text
C1548329 (UMLS CUI [1])
Item
SAE1
text
C1709061 (UMLS CUI [1])
Code List
SAE1
CL Item
Sent to DM (Sent to DM)
CL Item
Unused (Unused)
pages
Item
Missing pages (if applicable)
text
C1548329 (UMLS CUI [1])
Item
SAE2
text
C1709061 (UMLS CUI [1])
Code List
SAE2
CL Item
Sent to DM (Sent to DM)
CL Item
Unused (Unused)
pages
Item
Missing pages (if applicable)
text
C1548329 (UMLS CUI [1])
Item
FORMD
text
C1709061 (UMLS CUI [1])
Code List
FORMD
CL Item
Sent to DM (Sent to DM)
CL Item
Unused (Unused)
pages
Item
Missing pages (if applicable)
text
C1548329 (UMLS CUI [1])
comment
Item
Site Monitor’s comments (eg. protocol violations or deviations)
text
C0947611 (UMLS CUI [1])
Name
Item
Site Monitor’s Name
text
C0027365 (UMLS CUI [1])
Signature
Item
Site Monitor’s Signature
text
C1519316 (UMLS CUI [1])
Date Submitted
Item
Date Submitted
date
C0011008 (UMLS CUI [1,1])
C1515022 (UMLS CUI [1,2])