Medical History
Item
Is the subject suffering from or has he/she ever suffered from any significant medical or surgical condition? List below one diagnosis per line. (Please print clearly) Only in the absence of a diagnosis, record the signs and symptoms on separate lines.
boolean
C0262926 (UMLS CUI [1,1])
C0750502 (UMLS CUI [1,2])
Diagnosis
Item
Diagnosis
text
C0011900 (UMLS CUI [1])
GSK Use
Item
GSK Use
text
Year of first diagnosis
Item
Year of first diagnosis
partialDate
C0439234 (UMLS CUI [1,1])
C0011900 (UMLS CUI [1,2])
Past disease
Item
Past
boolean
C1444637 (UMLS CUI [1,1])
C0012634 (UMLS CUI [1,2])
Ongoing Disease
Item
Ongoing
boolean
C0549178 (UMLS CUI [1,1])
C0012634 (UMLS CUI [1,2])
GSK Use
Item
For GSK
text
Item
Study Time
text
C2348563 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
CL Item
Screening (Screening)
CL Item
Unscheduled (Unscheduled)
CL Item
Unscheduled (Unscheduled)
Date
Item
Date
date
C0011008 (UMLS CUI [1])
Time
Item
Actual Time
time
C0040223 (UMLS CUI [1])
Systolic Blood Pressure
Item
Standing BP (mmHg) Systolic
text
C0871470 (UMLS CUI [1])
Diastolic Blood Pressure
Item
Standing BP (mmHg) Diastolic
text
C0428883 (UMLS CUI [1])
Item
Study Time
text
C2348563 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
CL Item
Screening (Screening)
CL Item
Unsched (Unsched)
CL Item
Unsched (Unsched)
Date
Item
Date
date
C0011008 (UMLS CUI [1])
Time
Item
Actual Time
time
C0040223 (UMLS CUI [1])
Heart Rate
Item
Heart Rate (bpm)
text
C0018810 (UMLS CUI [1])
PR
Item
PR
text
C0429087 (UMLS CUI [1])
QRS
Item
QRS
text
C1880451 (UMLS CUI [1])
QT
Item
QT
text
C1287082 (UMLS CUI [1])
QTc
Item
QTc
text
C0489625 (UMLS CUI [1])
ECG normal
Item
ECG normal
boolean
C0522054 (UMLS CUI [1])
Comments
Item
Comments
text
C0947611 (UMLS CUI [1])
Start Date
Item
Monitoring Start date
date
C0808070 (UMLS CUI [1,1])
C4055630 (UMLS CUI [1,2])
Start time
Item
Monitoring Start Time
time
C1301880 (UMLS CUI [1,1])
C4055630 (UMLS CUI [1,2])
Stop Date
Item
Monitoring Stop Date
date
C0806020 (UMLS CUI [1,1])
C4055630 (UMLS CUI [1,2])
Stop Time
Item
Monitoring Stop Time
time
C1522314 (UMLS CUI [1,1])
C4055630 (UMLS CUI [1,2])
Rhythms of Concern
Item
Rhythms of Concern
boolean
C0420200 (UMLS CUI [1,1])
C0871269 (UMLS CUI [1,2])
C2699424 (UMLS CUI [1,3])
Rhythm of Concern Description
Item
Describe Rhythm
text
C0420200 (UMLS CUI [1,1])
C0871269 (UMLS CUI [1,2])
C2699424 (UMLS CUI [1,3])
C0678257 (UMLS CUI [1,4])