Engelsk

Baseline Signs and Symptoms Week 1 Pre-dose (Visit 1)

1 Formulär  
BASELINE SIGNS AND SYMPTOMS
Beskrivning

BASELINE SIGNS AND SYMPTOMS

Alias
UMLS CUI-1
C0037088
Patient Number
Beskrivning

Patient Number

Datatyp

text

Alias
UMLS CUI [1]
C1830427
Centre Number
Beskrivning

Centre Number

Datatyp

integer

Alias
UMLS CUI [1,1]
C0600091
UMLS CUI [1,2]
C0019994
Onset Date and Time
Beskrivning

Onset Date and Time

Datatyp

datetime

Alias
UMLS CUI [1]
C2826806
End Date and Time
Beskrivning

End Date and Time

Datatyp

datetime

Alias
UMLS CUI [1]
C2826793
Outcome
Beskrivning

Outcome

Datatyp

text

Alias
UMLS CUI [1]
C1705586
Event Course
Beskrivning

Event Course

Datatyp

text

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C0750729
No. of Episodes
Beskrivning

number of episodes

Datatyp

integer

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C4086638
Intensity (maximum)
Beskrivning

Intensity

Datatyp

text

Alias
UMLS CUI [1]
C1710066
Relationship to study procedures performed prior to randomisation
Beskrivning

Relationship to study drug

Datatyp

text

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C0439849
UMLS CUI [1,3]
C0013227
Corrective Therapy
Beskrivning

Corrective Therapy

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C0087111
Was subject withdrawn due to this event?
Beskrivning

subject withdrawn

Datatyp

boolean

Alias
UMLS CUI [1]
C0422727
Investigator’s Signature
Beskrivning

Investigator Signature

Datatyp

text

Alias
UMLS CUI [1]
C2346576
Date:
Beskrivning

Date

Datatyp

date

Alias
UMLS CUI [1]
C0011008
Tillbaka till toppen

Similar models

Baseline Signs and Symptoms Week 1 Pre-dose (Visit 1)

1 Formulär
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
BASELINE SIGNS AND SYMPTOMS
C0037088 (UMLS CUI-1)
Patient Number
Item
Patient Number
text
C1830427 (UMLS CUI [1])
Centre Number
Item
Centre Number
integer
C0600091 (UMLS CUI [1,1])
C0019994 (UMLS CUI [1,2])
Onset Date and Time
Item
Onset Date and Time
datetime
C2826806 (UMLS CUI [1])
End Date and Time
Item
End Date and Time
datetime
C2826793 (UMLS CUI [1])
Item
Outcome
text
C1705586 (UMLS CUI [1])
Outcome
Code List
Outcome
CL Item
Resolved (Resolved)
CL Item
Ongoing (Ongoing)
CL Item
Died (Died)
Item
Event Course
text
C0877248 (UMLS CUI [1,1])
C0750729 (UMLS CUI [1,2])
Event Course
Code List
Event Course
CL Item
Intermittent (Intermittent)
CL Item
Constant (Constant)
number of episodes
Item
No. of Episodes
integer
C0877248 (UMLS CUI [1,1])
C4086638 (UMLS CUI [1,2])
Item
Intensity (maximum)
text
C1710066 (UMLS CUI [1])
Intensity
Code List
Intensity (maximum)
CL Item
Mild (Mild)
CL Item
Moderate (Moderate)
CL Item
Severe (Severe)
Item
Relationship to study procedures performed prior to randomisation
text
C0877248 (UMLS CUI [1,1])
C0439849 (UMLS CUI [1,2])
C0013227 (UMLS CUI [1,3])
Relationship to study drug
Code List
Relationship to study procedures performed prior to randomisation
CL Item
Not related (Not related)
CL Item
Unlikely (Unlikely)
CL Item
Suspected (Suspected)
CL Item
Probable (Probable)
Corrective Therapy
Item
Corrective Therapy
boolean
C0877248 (UMLS CUI [1,1])
C0087111 (UMLS CUI [1,2])
subject withdrawn
Item
Was subject withdrawn due to this event?
boolean
C0422727 (UMLS CUI [1])
Investigator Signature
Item
Investigator’s Signature
text
C2346576 (UMLS CUI [1])
Date
Item
Date:
date
C0011008 (UMLS CUI [1])
Tillbaka till toppen