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Other Medical Conditions GSK study Chronic Coronary Heart Disease NCT00799903

1 forms  
Other medical conditions
Description

Other medical conditions

1. Is there a family history of premature CHD? (Male family member <55 years or female family member <65 years)
Description

family history cardiovascular risk factors

Data type

integer

2. Has subject had any history of cancer?
Description

history of cancer

Data type

integer

History of cancer
Description

History of cancer

1.a Specific condition
Description

Specific condition

Data type

integer

1.b Date of diagnosis
Description

Date of diagnosis

Data type

date

Sequence Number
Description

Sequence Number

Data type

text

Specific condition
Description

Specific condition

Data type

text

Modified Term
Description

Modified Term

Data type

text

MedDRA Synonym
Description

MedDRA Synonym

Data type

text

MedDRA lower level term code
Description

MedDRA lower level term code

Data type

text

Failed coding
Description

Failed coding

Data type

text

Date of diagnosis
Description

Date of diagnosis

Data type

text

Other history of cancer
Description

Other history of cancer

2.a Sequence Number
Description

Sequence Number other

Data type

text

2.b Specific Condition
Description

Specific Condition other

Data type

text

2.c Modified Term
Description

Modified Term other

Data type

text

MedDRA Synonym
Description

MedDRA Synonym other

Data type

text

MedDRA lower level term code
Description

MedDRA lower level term code other

Data type

text

Failed coding
Description

Failed coding other

Data type

text

2.d Date of diagnosis
Description

Date of diagnosis

Data type

date

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Similar models

Other Medical Conditions GSK study Chronic Coronary Heart Disease NCT00799903

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Other medical conditions
Item
1. Is there a family history of premature CHD? (Male family member <55 years or female family member <65 years)
integer
family history of premature CHD
Code List
1. Is there a family history of premature CHD? (Male family member <55 years or female family member <65 years)
CL Item
Yes (1)
CL Item
No (0)
Item
2. Has subject had any history of cancer?
integer
family history of premature CHD
Code List
2. Has subject had any history of cancer?
CL Item
Yes (1)
CL Item
No (0)
Item Group
History of cancer
Item
1.a Specific condition
integer
Specific condition
Code List
1.a Specific condition
CL Item
Benign neoplasm (1)
CL Item
Bile duct cancer (2)
CL Item
Bladder cancer (3)
CL Item
Bowel cancer (4)
CL Item
Breast cancer (5)
CL Item
Cervical cancer (6)
CL Item
Endometrial cancer (7)
CL Item
Esophageal cancer (8)
CL Item
Fallopian tube cancer (9)
CL Item
Gallbladder cancer (10)
CL Item
Gastric cancer (11)
CL Item
Hodgkin's disease (12)
CL Item
Leukemia (13)
CL Item
Lip cancer (14)
CL Item
Liver cancer (15)
CL Item
Lung cancer (16)
CL Item
Lymphoma (17)
CL Item
Multiple myeloma (18)
CL Item
Myelodysplastic syndrome (19)
CL Item
Non-melanoma skin cancer (20)
CL Item
Oral cancer (21)
CL Item
Ovarian cancer (22)
CL Item
Pancreatic cancer (23)
CL Item
Penile cancer (24)
CL Item
Pharyngeal cancer (25)
CL Item
Prostate cancer (26)
CL Item
Renal cancer (27)
CL Item
Scrotum cancer (28)
CL Item
Skin melanoma (29)
CL Item
Testicular cancer (30)
CL Item
Vaginal cancer (31)
CL Item
Vulval cancer (32)
Date of diagnosis
Item
1.b Date of diagnosis
date
Sequence Number
Item
Sequence Number
text
Specific condition
Item
Specific condition
text
Modified Term
Item
Modified Term
text
MedDRA Synonym
Item
MedDRA Synonym
text
MedDRA lower level term code
Item
MedDRA lower level term code
text
Failed coding
Item
Failed coding
text
Date of diagnosis
Item
Date of diagnosis
text
Item Group
Other history of cancer
Sequence Number other
Item
2.a Sequence Number
text
Specific Condition other
Item
2.b Specific Condition
text
Modified Term other
Item
2.c Modified Term
text
MedDRA Synonym other
Item
MedDRA Synonym
text
MedDRA lower level term code other
Item
MedDRA lower level term code
text
Failed coding other
Item
Failed coding
text
Date of diagnosis
Item
2.d Date of diagnosis
date
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