English

Subject contact worksheet GSK study Prostatic neoplasms NCT00883909

1 forms  
Administrative data
Description

Administrative data

Alias
UMLS CUI-1
C1320722
Center
Description

Center

Data type

text

Alias
UMLS CUI [1,1]
C1301943
UMLS CUI [1,2]
C0600091
Subject number
Description

Subject number

Data type

text

Alias
UMLS CUI [1]
C2348585
Year 1 - 1st Attempt
Description

Year 1 - 1st Attempt

Alias
UMLS CUI-1
C1516084
UMLS CUI-2
C1705415
Date of Contact Attempt
Description

Date of Contact Attempt

Data type

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C1516084
UMLS CUI [1,3]
C1705415
Contact Made?
Description

succesful contact attempt

Data type

boolean

Alias
UMLS CUI [1,1]
C0597535
UMLS CUI [1,2]
C1516084
UMLS CUI [1,3]
C1705415
Year 1 - 2nd Attempt
Description

Year 1 - 2nd Attempt

Alias
UMLS CUI-1
C1516084
UMLS CUI-2
C1705415
Date of Contact Attempt
Description

Date of Contact Attempt

Data type

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C1516084
UMLS CUI [1,3]
C1705415
Contact Made?
Description

succesful contact attempt

Data type

boolean

Alias
UMLS CUI [1,1]
C0597535
UMLS CUI [1,2]
C1516084
UMLS CUI [1,3]
C1705415
Year 1 - 3rd Attempt
Description

Year 1 - 3rd Attempt

Alias
UMLS CUI-1
C1516084
UMLS CUI-2
C1705415
Date of Contact Attempt
Description

Date of Contact Attempt

Data type

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C1516084
UMLS CUI [1,3]
C1705415
Contact Made?
Description

succesful contact attempt

Data type

boolean

Alias
UMLS CUI [1,1]
C0597535
UMLS CUI [1,2]
C1516084
UMLS CUI [1,3]
C1705415
Date Faxed To Monitor (if 3rd contact attempt is unsuccessful)
Description

Date Fax

Data type

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C1549619
Year 2 - 1st Attempt
Description

Year 2 - 1st Attempt

Alias
UMLS CUI-1
C1516084
UMLS CUI-2
C1705415
Date of Contact Attempt
Description

Date of Contact Attempt

Data type

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C1516084
UMLS CUI [1,3]
C1705415
Contact Made?
Description

succesful contact attempt

Data type

boolean

Alias
UMLS CUI [1,1]
C0597535
UMLS CUI [1,2]
C1516084
UMLS CUI [1,3]
C1705415
Year 2 - 2nd Attempt
Description

Year 2 - 2nd Attempt

Alias
UMLS CUI-1
C1516084
UMLS CUI-2
C1705415
Date of Contact Attempt
Description

Date of Contact Attempt

Data type

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C1516084
UMLS CUI [1,3]
C1705415
Contact Made?
Description

succesful contact attempt

Data type

boolean

Alias
UMLS CUI [1,1]
C0597535
UMLS CUI [1,2]
C1516084
UMLS CUI [1,3]
C1705415
Year 2 - 3rd Attempt
Description

Year 2 - 3rd Attempt

Alias
UMLS CUI-1
C1516084
UMLS CUI-2
C1705415
Date of Contact Attempt
Description

Date of Contact Attempt

Data type

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C1516084
UMLS CUI [1,3]
C1705415
Contact Made?
Description

succesful contact attempt

Data type

boolean

Alias
UMLS CUI [1,1]
C0597535
UMLS CUI [1,2]
C1516084
UMLS CUI [1,3]
C1705415
Date Faxed To Monitor (if 3rd contact attempt is unsuccessful)
Description

Date Fax

Data type

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C1549619
Back to the top of the page

Similar models

Subject contact worksheet GSK study Prostatic neoplasms NCT00883909

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Administrative data
C1320722 (UMLS CUI-1)
Center
Item
Center
text
C1301943 (UMLS CUI [1,1])
C0600091 (UMLS CUI [1,2])
Subject number
Item
Subject number
text
C2348585 (UMLS CUI [1])
Item Group
Year 1 - 1st Attempt
C1516084 (UMLS CUI-1)
C1705415 (UMLS CUI-2)
Date of Contact Attempt
Item
Date of Contact Attempt
date
C0011008 (UMLS CUI [1,1])
C1516084 (UMLS CUI [1,2])
C1705415 (UMLS CUI [1,3])
succesful contact attempt
Item
Contact Made?
boolean
C0597535 (UMLS CUI [1,1])
C1516084 (UMLS CUI [1,2])
C1705415 (UMLS CUI [1,3])
Item Group
Year 1 - 2nd Attempt
C1516084 (UMLS CUI-1)
C1705415 (UMLS CUI-2)
Date of Contact Attempt
Item
Date of Contact Attempt
date
C0011008 (UMLS CUI [1,1])
C1516084 (UMLS CUI [1,2])
C1705415 (UMLS CUI [1,3])
succesful contact attempt
Item
Contact Made?
boolean
C0597535 (UMLS CUI [1,1])
C1516084 (UMLS CUI [1,2])
C1705415 (UMLS CUI [1,3])
Item Group
Year 1 - 3rd Attempt
C1516084 (UMLS CUI-1)
C1705415 (UMLS CUI-2)
Date of Contact Attempt
Item
Date of Contact Attempt
date
C0011008 (UMLS CUI [1,1])
C1516084 (UMLS CUI [1,2])
C1705415 (UMLS CUI [1,3])
succesful contact attempt
Item
Contact Made?
boolean
C0597535 (UMLS CUI [1,1])
C1516084 (UMLS CUI [1,2])
C1705415 (UMLS CUI [1,3])
Date Fax
Item
Date Faxed To Monitor (if 3rd contact attempt is unsuccessful)
date
C0011008 (UMLS CUI [1,1])
C1549619 (UMLS CUI [1,2])
Item Group
Year 2 - 1st Attempt
C1516084 (UMLS CUI-1)
C1705415 (UMLS CUI-2)
Date of Contact Attempt
Item
Date of Contact Attempt
date
C0011008 (UMLS CUI [1,1])
C1516084 (UMLS CUI [1,2])
C1705415 (UMLS CUI [1,3])
succesful contact attempt
Item
Contact Made?
boolean
C0597535 (UMLS CUI [1,1])
C1516084 (UMLS CUI [1,2])
C1705415 (UMLS CUI [1,3])
Item Group
Year 2 - 2nd Attempt
C1516084 (UMLS CUI-1)
C1705415 (UMLS CUI-2)
Date of Contact Attempt
Item
Date of Contact Attempt
date
C0011008 (UMLS CUI [1,1])
C1516084 (UMLS CUI [1,2])
C1705415 (UMLS CUI [1,3])
succesful contact attempt
Item
Contact Made?
boolean
C0597535 (UMLS CUI [1,1])
C1516084 (UMLS CUI [1,2])
C1705415 (UMLS CUI [1,3])
Item Group
Year 2 - 3rd Attempt
C1516084 (UMLS CUI-1)
C1705415 (UMLS CUI-2)
Date of Contact Attempt
Item
Date of Contact Attempt
date
C0011008 (UMLS CUI [1,1])
C1516084 (UMLS CUI [1,2])
C1705415 (UMLS CUI [1,3])
succesful contact attempt
Item
Contact Made?
boolean
C0597535 (UMLS CUI [1,1])
C1516084 (UMLS CUI [1,2])
C1705415 (UMLS CUI [1,3])
Date Fax
Item
Date Faxed To Monitor (if 3rd contact attempt is unsuccessful)
date
C0011008 (UMLS CUI [1,1])
C1549619 (UMLS CUI [1,2])
Back to the top of the page