ID

25269

Beschreibung

Concomitant Medications Excluding Antiretroviral Therapy - RF09 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=CCE1D9E3-15E5-4307-E034-0003BA12F5E7

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=CCE1D9E3-15E5-4307-E034-0003BA12F5E7

Stichworte

  1. 19.09.12 19.09.12 -
  2. 29.08.17 29.08.17 -
Hochgeladen am

29. August 2017

DOI

Für eine Beantragung loggen Sie sich ein.

Lizenz

Creative Commons BY-NC 3.0 Legacy

Modell Kommentare :

Hier können Sie das Modell kommentieren. Über die Sprechblasen an den Itemgruppen und Items können Sie diese spezifisch kommentieren.

Itemgroup Kommentare für :

Item Kommentare für :

Um Formulare herunterzuladen müssen Sie angemeldet sein. Bitte loggen Sie sich ein oder registrieren Sie sich kostenlos.

Concomitant Medications Excluding Antiretroviral Therapy - RF09

No Instruction available.

  1. StudyEvent: Concomitant Medications Excluding Antiretroviral Therapy - RF09
    1. No Instruction available.
Ccrr Module For Concomitant Medications Excluding Antiretroviral Therapy - Rf09
Beschreibung

Ccrr Module For Concomitant Medications Excluding Antiretroviral Therapy - Rf09

Alias
UMLS CUI-1
C2347852
UMLS CUI-2
C0013227
Patient Initials
Beschreibung

PatientInitials

Datentyp

text

Alias
UMLS CUI [1]
C2986440
Study Number
Beschreibung

Study Identifier

Datentyp

text

Alias
UMLS CUI [1]
C2826693
Site Number
Beschreibung

Site Identifier

Datentyp

text

Alias
UMLS CUI [1,1]
C0018704
UMLS CUI [1,2]
C0600091
ID
Beschreibung

ID

Datentyp

text

Alias
UMLS CUI [1]
C2348585
Cycle Number
Beschreibung

Cycle Number

Datentyp

text

Alias
UMLS CUI [1]
C2045829
First day of cycle
Beschreibung

First day of cycle

Datentyp

date

Alias
UMLS CUI [1,1]
C1302181
UMLS CUI [1,2]
C0808070
During this cycle, has the subject started or stopped any medications?
Beschreibung

medications

Datentyp

boolean

Alias
UMLS CUI [1]
C0013227
Medication
Beschreibung

Medication Name

Datentyp

text

Alias
UMLS CUI [1]
C2360065
ACTG Drug Code
Beschreibung

ACTG Drug Code

Datentyp

text

Alias
UMLS CUI [1,1]
C1318970
UMLS CUI [1,2]
C0013227
UMLS CUI [1,3]
C0805701
Amount
Beschreibung

Amount

Datentyp

text

Alias
UMLS CUI [1,1]
C0178602
UMLS CUI [1,2]
C0013227
Units
Beschreibung

Units

Datentyp

text

Alias
UMLS CUI [1,1]
C1519795
UMLS CUI [1,2]
C0013227
Frequency
Beschreibung

Frequency(perday)

Datentyp

text

Alias
UMLS CUI [1]
C3476109
Started prior to study?
Beschreibung

Started prior to study

Datentyp

boolean

Alias
UMLS CUI [1]
C0013227
Date Started
Beschreibung

Date Started

Datentyp

date

Alias
UMLS CUI [1,1]
C0013227
UMLS CUI [1,2]
C0808070
Stopped?
Beschreibung

Stopped medication

Datentyp

boolean

Alias
UMLS CUI [1,1]
C0013227
UMLS CUI [1,2]
C2746065
Date Stopped
Beschreibung

Date Stopped

Datentyp

date

Alias
UMLS CUI [1,1]
C0013227
UMLS CUI [1,2]
C0806020

Ähnliche Modelle

No Instruction available.

  1. StudyEvent: Concomitant Medications Excluding Antiretroviral Therapy - RF09
    1. No Instruction available.
Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
Alias
Item Group
Ccrr Module For Concomitant Medications Excluding Antiretroviral Therapy - Rf09
C2347852 (UMLS CUI-1)
C0013227 (UMLS CUI-2)
PatientInitials
Item
Patient Initials
text
C2986440 (UMLS CUI [1])
Study Identifier
Item
Study Number
text
C2826693 (UMLS CUI [1])
Site Identifier
Item
Site Number
text
C0018704 (UMLS CUI [1,1])
C0600091 (UMLS CUI [1,2])
ID
Item
ID
text
C2348585 (UMLS CUI [1])
Cycle Number
Item
Cycle Number
text
C2045829 (UMLS CUI [1])
First day of cycle
Item
First day of cycle
date
C1302181 (UMLS CUI [1,1])
C0808070 (UMLS CUI [1,2])
medications
Item
During this cycle, has the subject started or stopped any medications?
boolean
C0013227 (UMLS CUI [1])
Medication Name
Item
Medication
text
C2360065 (UMLS CUI [1])
ACTG Drug Code
Item
ACTG Drug Code
text
C1318970 (UMLS CUI [1,1])
C0013227 (UMLS CUI [1,2])
C0805701 (UMLS CUI [1,3])
Amount
Item
Amount
text
C0178602 (UMLS CUI [1,1])
C0013227 (UMLS CUI [1,2])
Units
Item
Units
text
C1519795 (UMLS CUI [1,1])
C0013227 (UMLS CUI [1,2])
Frequency(perday)
Item
Frequency
text
C3476109 (UMLS CUI [1])
Started prior to study
Item
Started prior to study?
boolean
C0013227 (UMLS CUI [1])
Date Started
Item
Date Started
date
C0013227 (UMLS CUI [1,1])
C0808070 (UMLS CUI [1,2])
Stopped medication
Item
Stopped?
boolean
C0013227 (UMLS CUI [1,1])
C2746065 (UMLS CUI [1,2])
Date Stopped
Item
Date Stopped
date
C0013227 (UMLS CUI [1,1])
C0806020 (UMLS CUI [1,2])

Benutzen Sie dieses Formular für Rückmeldungen, Fragen und Verbesserungsvorschläge.

Mit * gekennzeichnete Felder sind notwendig.

Benötigen Sie Hilfe bei der Suche? Um mehr Details zu erfahren und die Suche effektiver nutzen zu können schauen Sie sich doch das entsprechende Video auf unserer Tutorial Seite an.

Zum Video