ID

28600

Beschreibung

A Phase IIa prospective, open-label, multicenter study to determine the pharmacokinetics (PK) and safety and tolerability of aztreonam-avibactam (ATM-AVI) for the treatment of complicated Intra-Abdominal Infections (cIAIs) in hospitalized adults. NCT02655419 Sponsors and Collaborators: Pfizer Innovative Medicines Initiative (IMI) COMBACTE-CARE Investigators: Study Director:Pfizer CT.gov Call Center;Pfizer Principal Investigator:Oliver Cornely;Clinical Trials Centre Cologne

Stichworte

  1. 24.01.18 24.01.18 -
Rechteinhaber

Pfizer

Hochgeladen am

24. Januar 2018

DOI

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Lizenz

Creative Commons BY-NC 3.0

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REJUVENATE NCT02655419

Screening Visit

  1. StudyEvent: ODM
    1. Screening Visit
Administrative Information
Beschreibung

Administrative Information

Alias
UMLS CUI-1
C1320722
Trial
Beschreibung

Trial name

Datentyp

text

Alias
UMLS CUI [1]
C1629065
Version
Beschreibung

Trial version

Datentyp

text

Alias
UMLS CUI [1]
C2985700
Site
Beschreibung

Study site

Datentyp

text

Alias
UMLS CUI [1]
C2825164
Patient type
Beschreibung

Patient type

Datentyp

text

Alias
UMLS CUI [1]
C1550335
Patient
Beschreibung

Patient ID

Datentyp

text

Alias
UMLS CUI [1]
C1269815
Version date
Beschreibung

CRF Version date

Datentyp

date

Alias
UMLS CUI [1,1]
C2985700
UMLS CUI [1,2]
C0011008
Date Generated
Beschreibung

Form generation date

Datentyp

date

Alias
UMLS CUI [1,1]
C3146294
UMLS CUI [1,2]
C0011008
Patient Information
Beschreibung

Patient Information

Alias
UMLS CUI-1
C1955348
Patient Number
Beschreibung

Patient Number

Datentyp

text

Alias
UMLS CUI [1]
C1830427
Patient Caption
Beschreibung

Patient Caption

Datentyp

text

Alias
UMLS CUI [1,1]
C2825231
UMLS CUI [1,2]
C0030705
Site No
Beschreibung

Site Number

Datentyp

integer

Alias
UMLS CUI [1]
C2826692
Enrolled
Beschreibung

Enrollment

Datentyp

boolean

Alias
UMLS CUI [1]
C2348568
Dropped
Beschreibung

Dropped

Datentyp

boolean

Alias
UMLS CUI [1]
C0422727
Visit Name
Beschreibung

Visit Name

Datentyp

text

Alias
UMLS CUI [1]
C2826704
Visit Number
Beschreibung

Visit Number

Datentyp

integer

Alias
UMLS CUI [1]
C1549755
Visit Date
Beschreibung

Visit Date

Datentyp

date

Alias
UMLS CUI [1]
C1320303
Demography
Beschreibung

Demography

Alias
UMLS CUI-1
C0011298
Date of informed consent
Beschreibung

Informed consent date

Datentyp

date

Alias
UMLS CUI [1,1]
C0021430
UMLS CUI [1,2]
C0011008
Time of Informed Consent
Beschreibung

Informed Consent time

Datentyp

time

Alias
UMLS CUI [1,1]
C0021430
UMLS CUI [1,2]
C0040223
Age
Beschreibung

Age

Datentyp

integer

Alias
UMLS CUI [1]
C0001779
Age unit
Beschreibung

Age unit

Datentyp

text

Alias
UMLS CUI [1,1]
C0001779
UMLS CUI [1,2]
C1519795
Gender
Beschreibung

Gender

Datentyp

integer

Alias
UMLS CUI [1]
C0079399
Ethnicity
Beschreibung

Ethnicity

Datentyp

integer

Alias
UMLS CUI [1]
C0015031
Race
Beschreibung

Race

Datentyp

integer

Alias
UMLS CUI [1]
C0034510
Specify other Race
Beschreibung

Specify other Race

Datentyp

text

Alias
UMLS CUI [1,1]
C0034510
UMLS CUI [1,2]
C3845569
CRF comment
Beschreibung

Comment

Datentyp

text

Alias
UMLS CUI [1]
C0947611
Alcohol and Smoking History
Beschreibung

Alcohol and Smoking History

Alias
UMLS CUI-1
C0038586
UMLS CUI-2
C0262926
Alcohol Usage
Beschreibung

Alcohol Usage

Datentyp

integer

Alias
UMLS CUI [1]
C0001948
Smoking status
Beschreibung

Smoking status

Datentyp

integer

Alias
UMLS CUI [1]
C1519386
Cumulative pack years
Beschreibung

Cumulative pack years

Datentyp

integer

Alias
UMLS CUI [1]
C1277691
Time since Smoking Cessation
Beschreibung

Time since Smoking Cessation

Datentyp

integer

Alias
UMLS CUI [1]
C0453997
Time unit ex-smoker
Beschreibung

Time unit ex-smoker

Datentyp

integer

Alias
UMLS CUI [1,1]
C0337671
UMLS CUI [1,2]
C1519795
UMLS CUI [1,3]
C0449238
CRF Comment
Beschreibung

Comment

Datentyp

text

Alias
UMLS CUI [1]
C0947611
Type of Substance
Beschreibung

Type of Substance

Alias
UMLS CUI-1
C0038586
UMLS CUI-2
C0332307
Type of Substance
Beschreibung

Type of Substance

Datentyp

integer

Alias
UMLS CUI [1,1]
C0038586
UMLS CUI [1,2]
C0332307
Alcohol Use
Beschreibung

Alcohol Use

Datentyp

boolean

Alias
UMLS CUI [1]
C0001948
Kind of Other Substance
Beschreibung

Kind of Other Substance

Datentyp

text

Alias
UMLS CUI [1,1]
C0439861
UMLS CUI [1,2]
C0205394
Cumulative Number of Units
Beschreibung

(1 unit = 1/2 pint beer (285mL); 125 mL wine; 25mL spirit)

Datentyp

integer

Alias
UMLS CUI [1,1]
C2986497
UMLS CUI [1,2]
C0449961
Frequency
Beschreibung

Frequency

Datentyp

integer

Alias
UMLS CUI [1,1]
C0001948
UMLS CUI [1,2]
C0439603
Eligibility determination
Beschreibung

Eligibility determination

Alias
UMLS CUI-1
C0013893
Subject complies with all inclusion / exclusion criteria
Beschreibung

In case of failed criterion, please complete 'Completion / Withdrawal form'

Datentyp

boolean

Alias
UMLS CUI [1]
C0013893
CRF Comment
Beschreibung

Comment

Datentyp

text

Alias
UMLS CUI [1]
C0947611
Failed IE criteria
Beschreibung

Failed IE criteria

Alias
UMLS CUI-1
C1516637
UMLS CUI-2
C0231175
Failed criterion
Beschreibung

e.g. 2, 3a etc.

Datentyp

text

Alias
UMLS CUI [1,1]
C1516637
UMLS CUI [1,2]
C0231175
Criteria type
Beschreibung

Criteria type

Datentyp

integer

Alias
UMLS CUI [1]
C1516637
Medical and surgical history
Beschreibung

Medical and surgical history

Alias
UMLS CUI-1
C0262926
UMLS CUI-2
C0489540
Any relevant medical and surgical history?
Beschreibung

Please give information on medical and surgical history where relevant for the disease under study, e.g. immune deficiency, intra-abdominal surgeries/ pathological findings, hepatic or renal impairment etc. Concomitant Medication (within the last two weeks prior to study start) has to be documented on the referring eCRF

Datentyp

boolean

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0489540
CRF Comment
Beschreibung

Comment

Datentyp

text

Alias
UMLS CUI [1]
C0947611
Medical / surgical event
Beschreibung

Medical / surgical event

Alias
UMLS CUI-1
C1948041
UMLS CUI-2
C0262926
Condition, Illness, Diagnosis for Surgical Procedure
Beschreibung

Diagnosis

Datentyp

text

Alias
UMLS CUI [1]
C0011900
Start Date
Beschreibung

Start Date

Datentyp

date

Alias
UMLS CUI [1]
C0808070
End Date
Beschreibung

End Date

Datentyp

date

Alias
UMLS CUI [1]
C0806020
Ongoing at screening visit
Beschreibung

Ongoing at screening visit

Datentyp

boolean

Alias
UMLS CUI [1]
C0549178
Physical Examination
Beschreibung

Physical Examination

Alias
UMLS CUI-1
C0031809
Examination performed
Beschreibung

Examination performed

Datentyp

boolean

Alias
UMLS CUI [1]
C0031809
if 'no', provide reason
Beschreibung

Not done reason

Datentyp

text

Alias
UMLS CUI [1]
C2826287
Weight
Beschreibung

Patient Weight

Datentyp

float

Maßeinheiten
  • kg
Alias
UMLS CUI [1]
C0005910
kg
Height
Beschreibung

Height

Datentyp

integer

Maßeinheiten
  • cm
Alias
UMLS CUI [1]
C0005890
cm
CRF Comment
Beschreibung

Comment

Datentyp

text

Alias
UMLS CUI [1]
C0947611
Physical examination
Beschreibung

Physical examination

Alias
UMLS CUI-1
C0031809
Body system
Beschreibung

Body system

Datentyp

integer

Alias
UMLS CUI [1,1]
C0460002
UMLS CUI [1,2]
C0031809
Result
Beschreibung

Result

Datentyp

integer

Alias
UMLS CUI [1]
C1274040
if 'abnormal', brief description
Beschreibung

Description of finding

Datentyp

text

Alias
UMLS CUI [1,1]
C0747585
UMLS CUI [1,2]
C0678257
if 'abnormal', assessment of clinical significance
Beschreibung

clinical significance

Datentyp

boolean

Alias
UMLS CUI [1]
C2826293
Kind of other examination
Beschreibung

other examination

Datentyp

text

Alias
UMLS CUI [1]
C0260879
Diagnosis of Current Intra-Abdominal Infection
Beschreibung

Diagnosis of Current Intra-Abdominal Infection

Alias
UMLS CUI-1
C1112209
UMLS CUI-2
C0521116
Study Qualifying Intra-Abdominal Diagnosis
Beschreibung

Study Qualifying Intra-Abdominal Diagnosis

Datentyp

integer

Alias
UMLS CUI [1,1]
C1514624
UMLS CUI [1,2]
C1112209
Abscess
Beschreibung

Abscess

Datentyp

integer

Alias
UMLS CUI [1]
C0000833
Was this Infection a Complication of a Previous Abdominal Surgery?
Beschreibung

Cause of Infection

Datentyp

boolean

Alias
UMLS CUI [1,1]
C3714514
UMLS CUI [1,2]
C0015127
Is this infection considered a failure of previous treatment?
Beschreibung

Cause of Infection

Datentyp

boolean

Alias
UMLS CUI [1,1]
C3714514
UMLS CUI [1,2]
C0015127
Date of Previous Surgery
Beschreibung

Date of Previous Surgery

Datentyp

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C0543467
Site of Source of Infection
Beschreibung

Site of Source of Infection

Alias
UMLS CUI-1
C0449426
UMLS CUI-2
C1515974
Site of Source of Infection
Beschreibung

Site of Source of Infection

Datentyp

integer

Alias
UMLS CUI [1,1]
C0449426
UMLS CUI [1,2]
C1515974
Other Location
Beschreibung

Other Location

Datentyp

text

Alias
UMLS CUI [1]
C1515974
Radiological Examination
Beschreibung

Radiological Examination

Alias
UMLS CUI-1
C0043299
Any Radiological Examination in Relation to the Diagnosis?
Beschreibung

Radiological Examination

Datentyp

boolean

Alias
UMLS CUI [1]
C0043299
Kind of Radiological Examination
Beschreibung

Radiological Examination

Datentyp

text

Alias
UMLS CUI [1]
C0043299
Radiological Findings
Beschreibung

Radiological Findings

Datentyp

text

Alias
UMLS CUI [1,1]
C0043299
UMLS CUI [1,2]
C0243095
CRF Comment
Beschreibung

Comment

Datentyp

text

Alias
UMLS CUI [1]
C0947611
Infection-related Examination
Beschreibung

Infection-related Examination

Alias
UMLS CUI-1
C3714514
UMLS CUI-2
C0031809
Examination performed
Beschreibung

Examination performed

Datentyp

boolean

Alias
UMLS CUI [1]
C0031809
if 'no', provide reason
Beschreibung

Not done reason

Datentyp

text

Alias
UMLS CUI [1]
C2826287
CRF Comment
Beschreibung

Comment

Datentyp

text

Alias
UMLS CUI [1]
C0947611
Infection related Signs and Symptoms
Beschreibung

Infection related Signs and Symptoms

Alias
UMLS CUI-1
C0037088
UMLS CUI-2
C3714514
Signs and Symptoms
Beschreibung

Signs and Symptoms

Datentyp

integer

Alias
UMLS CUI [1]
C0037088
Please specify Other Sign or Symptom
Beschreibung

Other Sign or Symptom

Datentyp

text

Alias
UMLS CUI [1,1]
C0037088
UMLS CUI [1,2]
C0205394
Clinical Event Intensity
Beschreibung

Clinical Event Intensity

Datentyp

integer

Alias
UMLS CUI [1]
C0518690
Vital Signs examination
Beschreibung

Vital Signs examination

Alias
UMLS CUI-1
C0518766
UMLS CUI-2
C0031809
Examination performed
Beschreibung

Examination performed

Datentyp

boolean

Alias
UMLS CUI [1]
C0031809
if 'no', provide reason
Beschreibung

Not done reason

Datentyp

text

Alias
UMLS CUI [1]
C2826287
Supine Blood Pressure Systolic
Beschreibung

Supine Blood Pressure Systolic

Datentyp

integer

Maßeinheiten
  • mmHg
Alias
UMLS CUI [1,1]
C0871470
UMLS CUI [1,2]
C0038846
mmHg
Clinically relevant?
Beschreibung

Relevance

Datentyp

boolean

Alias
UMLS CUI [1]
C2347946
Supine Blood Pressure Diastolic
Beschreibung

Supine Blood Pressure Diastolic

Datentyp

integer

Maßeinheiten
  • mmHg
Alias
UMLS CUI [1,1]
C0428883
UMLS CUI [1,2]
C0038846
mmHg
Clinically relevant?
Beschreibung

Relevance

Datentyp

boolean

Alias
UMLS CUI [1]
C2347946
Heart rate
Beschreibung

Heart rate

Datentyp

integer

Maßeinheiten
  • bpm
Alias
UMLS CUI [1]
C0018810
bpm
Clinically relevant?
Beschreibung

Relevance

Datentyp

boolean

Alias
UMLS CUI [1]
C2347946
Respiratory Rate
Beschreibung

Respiratory Rate

Datentyp

integer

Maßeinheiten
  • breaths/min
Alias
UMLS CUI [1]
C0231832
breaths/min
Clinically relevant?
Beschreibung

Relevance

Datentyp

boolean

Alias
UMLS CUI [1]
C2347946
CRF Comment
Beschreibung

Comment

Datentyp

text

Alias
UMLS CUI [1]
C0947611
Temperature
Beschreibung

Temperature

Alias
UMLS CUI-1
C0005903
Temperature
Beschreibung

Temperature

Datentyp

float

Maßeinheiten
  • °C
Alias
UMLS CUI [1]
C0039476
°C
Time of measurement
Beschreibung

HH:MM

Datentyp

time

Alias
UMLS CUI [1,1]
C0242485
UMLS CUI [1,2]
C0040223
Method of Measurement
Beschreibung

Method of Measurement

Datentyp

integer

Alias
UMLS CUI [1,1]
C1299991
UMLS CUI [1,2]
C0039476
Kind of Other Method
Beschreibung

Other Method

Datentyp

text

Alias
UMLS CUI [1,1]
C1299991
UMLS CUI [1,2]
C0205394
Clinically relevant?
Beschreibung

Relevance

Datentyp

boolean

Alias
UMLS CUI [1]
C2347946
Laboratory Tests
Beschreibung

Laboratory Tests

Alias
UMLS CUI-1
C1880016
UMLS CUI-2
C0022885
Clinical Chemistry sample collected
Beschreibung

Clinical Chemistry sample collected

Datentyp

boolean

Alias
UMLS CUI [1,1]
C0200345
UMLS CUI [1,2]
C0008000
If 'no', please provide reason
Beschreibung

Not done reason

Datentyp

integer

Alias
UMLS CUI [1]
C2826287
Other, please specify
Beschreibung

Other, please specify

Datentyp

text

Alias
UMLS CUI [1]
C3845569
Collection Date
Beschreibung

Collection Date

Datentyp

date

Alias
UMLS CUI [1]
C1302413
Collection time
Beschreibung

Collection time

Datentyp

time

Alias
UMLS CUI [1]
C4064021
Central Lab ID
Beschreibung

Central Laboratory ID

Datentyp

text

Alias
UMLS CUI [1,1]
C1880016
UMLS CUI [1,2]
C2986056
Sample sent to central lab
Beschreibung

Sample sent to central lab

Datentyp

boolean

Alias
UMLS CUI [1,1]
C0370003
UMLS CUI [1,2]
C1515023
UMLS CUI [1,3]
C1880016
If 'no', please provide reason
Beschreibung

Not done reason

Datentyp

text

Alias
UMLS CUI [1]
C2826287
Hematology sample collected
Beschreibung

Hematology sample collected

Datentyp

boolean

Alias
UMLS CUI [1,1]
C0200345
UMLS CUI [1,2]
C0018941
If 'no', please provide reason
Beschreibung

Not done reason

Datentyp

integer

Alias
UMLS CUI [1]
C2826287
Other, please specify
Beschreibung

Other, please specify

Datentyp

text

Alias
UMLS CUI [1]
C3845569
Collection Date
Beschreibung

Collection Date

Datentyp

date

Alias
UMLS CUI [1]
C1302413
Collection time
Beschreibung

Collection time

Datentyp

time

Alias
UMLS CUI [1]
C4064021
Central Lab ID
Beschreibung

Central Laboratory ID

Datentyp

text

Alias
UMLS CUI [1,1]
C1880016
UMLS CUI [1,2]
C2986056
Sample sent to central lab
Beschreibung

Sample sent to central lab

Datentyp

boolean

Alias
UMLS CUI [1,1]
C0370003
UMLS CUI [1,2]
C1515023
UMLS CUI [1,3]
C1880016
If 'no', please provide reason
Beschreibung

Not done reason

Datentyp

text

Alias
UMLS CUI [1]
C2826287
Urinalysis sample collected
Beschreibung

Urinalysis sample collected

Datentyp

boolean

Alias
UMLS CUI [1,1]
C0200345
UMLS CUI [1,2]
C0042014
If 'no', please provide reason
Beschreibung

Not done reason

Datentyp

integer

Alias
UMLS CUI [1]
C2826287
Other, please specify
Beschreibung

Other, please specify

Datentyp

text

Alias
UMLS CUI [1]
C3845569
Collection Date
Beschreibung

Collection Date

Datentyp

date

Alias
UMLS CUI [1]
C1302413
Collection time
Beschreibung

Collection time

Datentyp

time

Alias
UMLS CUI [1]
C4064021
Central Lab ID
Beschreibung

Central Laboratory ID

Datentyp

text

Alias
UMLS CUI [1,1]
C1880016
UMLS CUI [1,2]
C2986056
Sample sent to central lab
Beschreibung

Sample sent to central lab

Datentyp

boolean

Alias
UMLS CUI [1,1]
C0370003
UMLS CUI [1,2]
C1515023
UMLS CUI [1,3]
C1880016
If 'no', please provide reason
Beschreibung

Not done reason

Datentyp

text

Alias
UMLS CUI [1]
C2826287
CRF Comment
Beschreibung

Comment

Datentyp

text

Alias
UMLS CUI [1]
C0947611
Local Lab at Screening
Beschreibung

Local Lab at Screening

Alias
UMLS CUI-1
C0587081
Clinical Chemistry sample collected
Beschreibung

Clinical Chemistry sample collected

Datentyp

boolean

Alias
UMLS CUI [1,1]
C0200345
UMLS CUI [1,2]
C0008000
If 'no', please provide reason
Beschreibung

Not done reason

Datentyp

integer

Alias
UMLS CUI [1]
C2826287
Other, please specify
Beschreibung

Other, please specify

Datentyp

text

Alias
UMLS CUI [1]
C3845569
Collection Date
Beschreibung

Collection Date

Datentyp

date

Alias
UMLS CUI [1]
C1302413
Collection time
Beschreibung

Collection time

Datentyp

time

Alias
UMLS CUI [1]
C4064021
Serum Creatinine
Beschreibung

Serum Creatinine

Datentyp

float

Alias
UMLS CUI [1]
C0201976
not done
Beschreibung

not done

Datentyp

boolean

Alias
UMLS CUI [1]
C1272696
Lab unit
Beschreibung

Unit used

Datentyp

integer

Alias
UMLS CUI [1]
C1519795
other lab unit
Beschreibung

other unit

Datentyp

text

Alias
UMLS CUI [1,1]
C1519795
UMLS CUI [1,2]
C0205394
lower limit of normal
Beschreibung

lower limit of normal

Datentyp

integer

Alias
UMLS CUI [1]
C1518030
Upper limit of normal
Beschreibung

ULN

Datentyp

integer

Alias
UMLS CUI [1]
C1519815
Was this value clinically signifcant?
Beschreibung

Significance

Datentyp

boolean

Alias
UMLS CUI [1]
C2826633
AST (GOT)
Beschreibung

AST (GOT)

Datentyp

integer

Alias
UMLS CUI [1]
C0201899
not done
Beschreibung

not done

Datentyp

boolean

Alias
UMLS CUI [1]
C1272696
other lab unit
Beschreibung

other unit

Datentyp

text

Alias
UMLS CUI [1,1]
C1519795
UMLS CUI [1,2]
C0205394
lower limit of normal
Beschreibung

lower limit of normal

Datentyp

integer

Alias
UMLS CUI [1]
C1518030
Upper limit of normal
Beschreibung

ULN

Datentyp

integer

Alias
UMLS CUI [1]
C1519815
Was this value clinically signifcant?
Beschreibung

Significance

Datentyp

boolean

Alias
UMLS CUI [1]
C2826633
ALT (GPT)
Beschreibung

ALT (GPT)

Datentyp

integer

Alias
UMLS CUI [1]
C0201836
not done
Beschreibung

not done

Datentyp

boolean

Alias
UMLS CUI [1]
C1272696
other lab unit
Beschreibung

other unit

Datentyp

text

Alias
UMLS CUI [1,1]
C1519795
UMLS CUI [1,2]
C0205394
lower limit of normal
Beschreibung

lower limit of normal

Datentyp

integer

Alias
UMLS CUI [1]
C1518030
Upper limit of normal
Beschreibung

ULN

Datentyp

integer

Alias
UMLS CUI [1]
C1519815
Was this value clinically signifcant?
Beschreibung

Significance

Datentyp

boolean

Alias
UMLS CUI [1]
C2826633
ALP
Beschreibung

ALP

Datentyp

integer

Alias
UMLS CUI [1]
C0201850
not done
Beschreibung

not done

Datentyp

boolean

Alias
UMLS CUI [1]
C1272696
other lab unit
Beschreibung

other unit

Datentyp

text

Alias
UMLS CUI [1,1]
C1519795
UMLS CUI [1,2]
C0205394
lower limit of normal
Beschreibung

lower limit of normal

Datentyp

integer

Alias
UMLS CUI [1]
C1518030
Upper limit of normal
Beschreibung

ULN

Datentyp

integer

Alias
UMLS CUI [1]
C1519815
Was this value clinically signifcant?
Beschreibung

Significance

Datentyp

boolean

Alias
UMLS CUI [1]
C2826633
Total Bilirubin
Beschreibung

Total Bilirubin

Datentyp

float

Alias
UMLS CUI [1]
C0201913
not done
Beschreibung

not done

Datentyp

boolean

Alias
UMLS CUI [1]
C1272696
other lab unit
Beschreibung

other unit

Datentyp

text

Alias
UMLS CUI [1,1]
C1519795
UMLS CUI [1,2]
C0205394
lower limit of normal
Beschreibung

lower limit of normal

Datentyp

integer

Alias
UMLS CUI [1]
C1518030
Upper limit of normal
Beschreibung

ULN

Datentyp

integer

Alias
UMLS CUI [1]
C1519815
Was this value clinically signifcant?
Beschreibung

Significance

Datentyp

boolean

Alias
UMLS CUI [1]
C2826633
Creatinine Clearance
Beschreibung

Creatinine Clearance

Datentyp

float

Maßeinheiten
  • mL/min
Alias
UMLS CUI [1]
C0373595
mL/min
Was this value clinically signifcant?
Beschreibung

Significance

Datentyp

boolean

Alias
UMLS CUI [1]
C2826633
Hematology sample collected
Beschreibung

Hematology sample collected

Datentyp

boolean

Alias
UMLS CUI [1,1]
C0200345
UMLS CUI [1,2]
C0018941
If 'no', please provide reason
Beschreibung

Not done reason

Datentyp

integer

Alias
UMLS CUI [1]
C2826287
Other, please specify
Beschreibung

Other, please specify

Datentyp

text

Alias
UMLS CUI [1]
C3845569
Collection Date
Beschreibung

Collection Date

Datentyp

date

Alias
UMLS CUI [1]
C1302413
Collection time
Beschreibung

Collection time

Datentyp

time

Alias
UMLS CUI [1]
C4064021
WBC
Beschreibung

WBC

Datentyp

float

Alias
UMLS CUI [1]
C0023508
not done
Beschreibung

not done

Datentyp

boolean

Alias
UMLS CUI [1]
C1272696
other lab unit
Beschreibung

other unit

Datentyp

text

Alias
UMLS CUI [1,1]
C1519795
UMLS CUI [1,2]
C0205394
lower limit of normal
Beschreibung

lower limit of normal

Datentyp

integer

Alias
UMLS CUI [1]
C1518030
Upper limit of normal
Beschreibung

ULN

Datentyp

integer

Alias
UMLS CUI [1]
C1519815
Was this value clinically signifcant?
Beschreibung

Significance

Datentyp

boolean

Alias
UMLS CUI [1]
C2826633
Neutrophil count
Beschreibung

Neutrophil count

Datentyp

float

Alias
UMLS CUI [1]
C0948762
not done
Beschreibung

not done

Datentyp

boolean

Alias
UMLS CUI [1]
C1272696
other lab unit
Beschreibung

other unit

Datentyp

text

Alias
UMLS CUI [1,1]
C1519795
UMLS CUI [1,2]
C0205394
lower limit of normal
Beschreibung

lower limit of normal

Datentyp

integer

Alias
UMLS CUI [1]
C1518030
Upper limit of normal
Beschreibung

ULN

Datentyp

integer

Alias
UMLS CUI [1]
C1519815
Was this value clinically signifcant?
Beschreibung

Significance

Datentyp

boolean

Alias
UMLS CUI [1]
C2826633
Hematocrit
Beschreibung

Hematocrit

Datentyp

float

Alias
UMLS CUI [1]
C0518014
not done
Beschreibung

not done

Datentyp

boolean

Alias
UMLS CUI [1]
C1272696
other lab unit
Beschreibung

other unit

Datentyp

text

Alias
UMLS CUI [1,1]
C1519795
UMLS CUI [1,2]
C0205394
lower limit of normal
Beschreibung

lower limit of normal

Datentyp

integer

Alias
UMLS CUI [1]
C1518030
Upper limit of normal
Beschreibung

ULN

Datentyp

integer

Alias
UMLS CUI [1]
C1519815
Was this value clinically signifcant?
Beschreibung

Significance

Datentyp

boolean

Alias
UMLS CUI [1]
C2826633
Hemoglobin
Beschreibung

Hemoglobin

Datentyp

float

Alias
UMLS CUI [1]
C0019046
not done
Beschreibung

not done

Datentyp

boolean

Alias
UMLS CUI [1]
C1272696
other lab unit
Beschreibung

other unit

Datentyp

text

Alias
UMLS CUI [1,1]
C1519795
UMLS CUI [1,2]
C0205394
lower limit of normal
Beschreibung

lower limit of normal

Datentyp

integer

Alias
UMLS CUI [1]
C1518030
Upper limit of normal
Beschreibung

ULN

Datentyp

integer

Alias
UMLS CUI [1]
C1519815
Was this value clinically signifcant?
Beschreibung

Significance

Datentyp

boolean

Alias
UMLS CUI [1]
C2826633
Platelet count
Beschreibung

Platelets

Datentyp

float

Alias
UMLS CUI [1]
C0005821
not done
Beschreibung

not done

Datentyp

boolean

Alias
UMLS CUI [1]
C1272696
other lab unit
Beschreibung

other unit

Datentyp

text

Alias
UMLS CUI [1,1]
C1519795
UMLS CUI [1,2]
C0205394
lower limit of normal
Beschreibung

lower limit of normal

Datentyp

integer

Alias
UMLS CUI [1]
C1518030
Upper limit of normal
Beschreibung

ULN

Datentyp

integer

Alias
UMLS CUI [1]
C1519815
Was this value clinically signifcant?
Beschreibung

Significance

Datentyp

boolean

Alias
UMLS CUI [1]
C2826633
Pregnancy Test done
Beschreibung

Pregnancy Test done

Datentyp

boolean

Alias
UMLS CUI [1]
C0032976
If 'no', please provide reason
Beschreibung

Not done reason

Datentyp

integer

Alias
UMLS CUI [1]
C2826287
Other reason
Beschreibung

Other reason

Datentyp

text

Alias
UMLS CUI [1]
C3840932
Method of Testing
Beschreibung

Method of Testing

Datentyp

integer

Alias
UMLS CUI [1]
C0871511
Result of testing
Beschreibung

Result

Datentyp

integer

Alias
UMLS CUI [1]
C0427777
CRF Comment
Beschreibung

Comment

Datentyp

text

Alias
UMLS CUI [1]
C0947611
Microbiology
Beschreibung

Microbiology

Alias
UMLS CUI-1
C0085672
Was a specimen collected?
Beschreibung

Microbiology specimen collection

Datentyp

boolean

Alias
UMLS CUI [1,1]
C0200345
UMLS CUI [1,2]
C0025952
If no, please provide reason
Beschreibung

Not done reason

Datentyp

integer

Alias
UMLS CUI [1]
C2826287
Please specify inability
Beschreibung

inability

Datentyp

text

Alias
UMLS CUI [1,1]
C1299582
UMLS CUI [1,2]
C0200345
UMLS CUI [1,3]
C1521902
Please specify other reason
Beschreibung

inability

Datentyp

text

Alias
UMLS CUI [1,1]
C1299582
UMLS CUI [1,2]
C0200345
UMLS CUI [1,3]
C3845569
Date of collection
Beschreibung

Specimen collection date

Datentyp

date

Alias
UMLS CUI [1]
C1302413
Time of Collection
Beschreibung

Specimen collection time

Datentyp

time

Alias
UMLS CUI [1]
C4064021
Culture Processing Type
Beschreibung

Culture Processing Type

Datentyp

integer

Alias
UMLS CUI [1,1]
C0200949
UMLS CUI [1,2]
C0037793
UMLS CUI [1,3]
C0332307
Site of sample
Beschreibung

Specimen collection site

Datentyp

integer

Alias
UMLS CUI [1,1]
C0200345
UMLS CUI [1,2]
C1515974
Intra-Abdominal, please specify
Beschreibung

Intra-Abdominal, please specify

Datentyp

integer

Alias
UMLS CUI [1,1]
C1512910
UMLS CUI [1,2]
C1521902
Other site, please specify
Beschreibung

Other site, please specify

Datentyp

text

Alias
UMLS CUI [1,1]
C1515974
UMLS CUI [1,2]
C3845569
Culture outcome
Beschreibung

Culture outcome

Datentyp

integer

Alias
UMLS CUI [1,1]
C2242979
UMLS CUI [1,2]
C0587081
Isolate name
Beschreibung

Isolate name

Datentyp

text

Alias
UMLS CUI [1]
C1764827
Pathogen Type
Beschreibung

Pathogen Type

Datentyp

integer

Alias
UMLS CUI [1]
C0450254
Isolate Classification
Beschreibung

Isolate Classification

Datentyp

integer

Alias
UMLS CUI [1,1]
C1764827
UMLS CUI [1,2]
C0008902
Disc Zone ATM-AVI
Beschreibung

(mm, Aerobic Pathogens only)

Datentyp

text

Alias
UMLS CUI [1,1]
C1283010
UMLS CUI [1,2]
C0004521
UMLS CUI [2,1]
C1283010
UMLS CUI [2,2]
C3489748
Sample sent to Central Lab?
Beschreibung

Sample sent to Central Lab

Datentyp

boolean

Alias
UMLS CUI [1,1]
C1880016
UMLS CUI [1,2]
C0370003
UMLS CUI [1,3]
C1515023
Central Lab Accession ID Number
Beschreibung

Central Laboratory Accession ID Number

Datentyp

text

Alias
UMLS CUI [1,1]
C2826726
UMLS CUI [1,2]
C1880016
If no, reason
Beschreibung

Not done reason

Datentyp

text

Alias
UMLS CUI [1]
C2826287
Backup Sample sent to Central Lab (if necessary)?
Beschreibung

Backup Sample sent to Central Laboratory

Datentyp

boolean

Alias
UMLS CUI [1,1]
C0370003
UMLS CUI [1,2]
C1515023
UMLS CUI [1,3]
C1880016
CRF Comment
Beschreibung

Comment

Datentyp

text

Alias
UMLS CUI [1]
C0947611

Ähnliche Modelle

Screening Visit

  1. StudyEvent: ODM
    1. Screening Visit
Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
Alias
Item Group
Administrative Information
C1320722 (UMLS CUI-1)
Trial name
Item
Trial
text
C1629065 (UMLS CUI [1])
Trial version
Item
Version
text
C2985700 (UMLS CUI [1])
Study site
Item
Site
text
C2825164 (UMLS CUI [1])
Patient type
Item
Patient type
text
C1550335 (UMLS CUI [1])
Patient ID
Item
Patient
text
C1269815 (UMLS CUI [1])
CRF Version date
Item
Version date
date
C2985700 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Form generation date
Item
Date Generated
date
C3146294 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Item Group
Patient Information
C1955348 (UMLS CUI-1)
Patient Number
Item
Patient Number
text
C1830427 (UMLS CUI [1])
Patient Caption
Item
Patient Caption
text
C2825231 (UMLS CUI [1,1])
C0030705 (UMLS CUI [1,2])
Site Number
Item
Site No
integer
C2826692 (UMLS CUI [1])
Enrollment
Item
Enrolled
boolean
C2348568 (UMLS CUI [1])
Dropped
Item
Dropped
boolean
C0422727 (UMLS CUI [1])
Visit Name
Item
Visit Name
text
C2826704 (UMLS CUI [1])
Visit Number
Item
Visit Number
integer
C1549755 (UMLS CUI [1])
Visit Date
Item
Visit Date
date
C1320303 (UMLS CUI [1])
Item Group
Demography
C0011298 (UMLS CUI-1)
Informed consent date
Item
Date of informed consent
date
C0021430 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Informed Consent time
Item
Time of Informed Consent
time
C0021430 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Age
Item
Age
integer
C0001779 (UMLS CUI [1])
Age unit
Item
Age unit
text
C0001779 (UMLS CUI [1,1])
C1519795 (UMLS CUI [1,2])
Item
Gender
integer
C0079399 (UMLS CUI [1])
Code List
Gender
CL Item
male (1)
CL Item
female (2)
Item
Ethnicity
integer
C0015031 (UMLS CUI [1])
Code List
Ethnicity
CL Item
Hispanic or Latino (1)
CL Item
Not Hispanic or Latino (2)
Item
Race
integer
C0034510 (UMLS CUI [1])
Code List
Race
CL Item
White (1)
CL Item
Black or African American (2)
CL Item
Asian (3)
CL Item
Native Hawaiian or Other Pacific Islander (4)
CL Item
American Indian or Alaska Native (5)
CL Item
Other (6)
Specify other Race
Item
Specify other Race
text
C0034510 (UMLS CUI [1,1])
C3845569 (UMLS CUI [1,2])
Comment
Item
CRF comment
text
C0947611 (UMLS CUI [1])
Item Group
Alcohol and Smoking History
C0038586 (UMLS CUI-1)
C0262926 (UMLS CUI-2)
Item
Alcohol Usage
integer
C0001948 (UMLS CUI [1])
Code List
Alcohol Usage
CL Item
Never (0)
CL Item
Current (1)
CL Item
Former (2)
Item
Smoking status
integer
C1519386 (UMLS CUI [1])
Code List
Smoking status
CL Item
never smoker (1)
CL Item
ex-smoker (2)
CL Item
smoker (3)
Cumulative pack years
Item
Cumulative pack years
integer
C1277691 (UMLS CUI [1])
Time since Smoking Cessation
Item
Time since Smoking Cessation
integer
C0453997 (UMLS CUI [1])
Item
Time unit ex-smoker
integer
C0337671 (UMLS CUI [1,1])
C1519795 (UMLS CUI [1,2])
C0449238 (UMLS CUI [1,3])
Code List
Time unit ex-smoker
CL Item
Years (1)
CL Item
Months (2)
Comment
Item
CRF Comment
text
C0947611 (UMLS CUI [1])
Item Group
Type of Substance
C0038586 (UMLS CUI-1)
C0332307 (UMLS CUI-2)
Item
Type of Substance
integer
C0038586 (UMLS CUI [1,1])
C0332307 (UMLS CUI [1,2])
Code List
Type of Substance
CL Item
Wine (1)
CL Item
Beer (2)
CL Item
Spirits (3)
CL Item
Other (4)
Alcohol Use
Item
Alcohol Use
boolean
C0001948 (UMLS CUI [1])
Kind of Other Substance
Item
Kind of Other Substance
text
C0439861 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
Cumulative Number of Units
Item
Cumulative Number of Units
integer
C2986497 (UMLS CUI [1,1])
C0449961 (UMLS CUI [1,2])
Item
Frequency
integer
C0001948 (UMLS CUI [1,1])
C0439603 (UMLS CUI [1,2])
Code List
Frequency
CL Item
per Day (1)
CL Item
per Week (2)
Item Group
Eligibility determination
C0013893 (UMLS CUI-1)
Subject complies with all inclusion / exclusion criteria
Item
Subject complies with all inclusion / exclusion criteria
boolean
C0013893 (UMLS CUI [1])
Comment
Item
CRF Comment
text
C0947611 (UMLS CUI [1])
Item Group
Failed IE criteria
C1516637 (UMLS CUI-1)
C0231175 (UMLS CUI-2)
Failed eligibility criteria
Item
Failed criterion
text
C1516637 (UMLS CUI [1,1])
C0231175 (UMLS CUI [1,2])
Item
Criteria type
integer
C1516637 (UMLS CUI [1])
Code List
Criteria type
CL Item
inclusion (1)
CL Item
exclusion (2)
Item Group
Medical and surgical history
C0262926 (UMLS CUI-1)
C0489540 (UMLS CUI-2)
medical and surgical history
Item
Any relevant medical and surgical history?
boolean
C0262926 (UMLS CUI [1,1])
C0489540 (UMLS CUI [1,2])
Comment
Item
CRF Comment
text
C0947611 (UMLS CUI [1])
Item Group
Medical / surgical event
C1948041 (UMLS CUI-1)
C0262926 (UMLS CUI-2)
Diagnosis
Item
Condition, Illness, Diagnosis for Surgical Procedure
text
C0011900 (UMLS CUI [1])
Start Date
Item
Start Date
date
C0808070 (UMLS CUI [1])
End Date
Item
End Date
date
C0806020 (UMLS CUI [1])
Ongoing at screening visit
Item
Ongoing at screening visit
boolean
C0549178 (UMLS CUI [1])
Item Group
Physical Examination
C0031809 (UMLS CUI-1)
Examination performed
Item
Examination performed
boolean
C0031809 (UMLS CUI [1])
Not done reason
Item
if 'no', provide reason
text
C2826287 (UMLS CUI [1])
Patient Weight
Item
Weight
float
C0005910 (UMLS CUI [1])
Height
Item
Height
integer
C0005890 (UMLS CUI [1])
Comment
Item
CRF Comment
text
C0947611 (UMLS CUI [1])
Item Group
Physical examination
C0031809 (UMLS CUI-1)
Item
Body system
integer
C0460002 (UMLS CUI [1,1])
C0031809 (UMLS CUI [1,2])
Code List
Body system
CL Item
General Appearance (1)
CL Item
Skin (2)
CL Item
Head, Eyes, Ears, Nose, Throat (3)
CL Item
Lymph Nodes (4)
CL Item
Respiratory (5)
CL Item
Cardiovascular (6)
CL Item
Abdomen (Wound Exam. at sep.eCRF) (7)
CL Item
Musculoskeletal (8)
CL Item
Neurological (9)
CL Item
Other (10)
Item
Result
integer
C1274040 (UMLS CUI [1])
Code List
Result
CL Item
normal (1)
CL Item
abnormal (2)
CL Item
not done (3)
Description of finding
Item
if 'abnormal', brief description
text
C0747585 (UMLS CUI [1,1])
C0678257 (UMLS CUI [1,2])
clinical significance
Item
if 'abnormal', assessment of clinical significance
boolean
C2826293 (UMLS CUI [1])
other examination
Item
Kind of other examination
text
C0260879 (UMLS CUI [1])
Item Group
Diagnosis of Current Intra-Abdominal Infection
C1112209 (UMLS CUI-1)
C0521116 (UMLS CUI-2)
Item
Study Qualifying Intra-Abdominal Diagnosis
integer
C1514624 (UMLS CUI [1,1])
C1112209 (UMLS CUI [1,2])
Code List
Study Qualifying Intra-Abdominal Diagnosis
CL Item
Cholecystitis with Gangrenous Rupture or Perforation or Progression of the Infection beyond the Gallbladder Wall (1)
CL Item
Diverticular Disease with Perforation or Abscess (2)
CL Item
Appendiceal Perforation or Peri-Appendiceal Abscess (3)
CL Item
Acute Gastric and Duodenal Perforations, only if operated on > 24 Hours after Perforartion occurs (4)
CL Item
Traumatic Perforation of Intestines, only if operated > 12 Housr after Perforation occurs (5)
CL Item
Secondary Peritonitis (but not Spontaneous Bacterial Peritonitis sassociated with Cirrhosis and Chronic Ascites) (6)
CL Item
Intra-Abdominal Abscess (including of Liver and Spleen provided that there is Extension beyond the Organ with Evidence of Intraperitoneal Involvement) (7)
CL Item
cIAI Not Confirmed at Surgery (8)
Item
Abscess
integer
C0000833 (UMLS CUI [1])
Code List
Abscess
CL Item
Single Abscess (1)
CL Item
Multiple Abscesses (2)
Cause of Infection
Item
Was this Infection a Complication of a Previous Abdominal Surgery?
boolean
C3714514 (UMLS CUI [1,1])
C0015127 (UMLS CUI [1,2])
Cause of Infection
Item
Is this infection considered a failure of previous treatment?
boolean
C3714514 (UMLS CUI [1,1])
C0015127 (UMLS CUI [1,2])
Date of Previous Surgery
Item
Date of Previous Surgery
date
C0011008 (UMLS CUI [1,1])
C0543467 (UMLS CUI [1,2])
Item Group
Site of Source of Infection
C0449426 (UMLS CUI-1)
C1515974 (UMLS CUI-2)
Item
Site of Source of Infection
integer
C0449426 (UMLS CUI [1,1])
C1515974 (UMLS CUI [1,2])
Code List
Site of Source of Infection
CL Item
Stomach (1)
CL Item
Gall Bladder (2)
CL Item
Spleen (3)
CL Item
Liver (4)
CL Item
Small Intestine (5)
CL Item
Appendix (6)
CL Item
Pancreas (7)
CL Item
Large Intestine (8)
CL Item
Other (9)
Other Location
Item
Other Location
text
C1515974 (UMLS CUI [1])
Item Group
Radiological Examination
C0043299 (UMLS CUI-1)
Radiological Examination
Item
Any Radiological Examination in Relation to the Diagnosis?
boolean
C0043299 (UMLS CUI [1])
Radiological Examination
Item
Kind of Radiological Examination
text
C0043299 (UMLS CUI [1])
Radiological Findings
Item
Radiological Findings
text
C0043299 (UMLS CUI [1,1])
C0243095 (UMLS CUI [1,2])
Comment
Item
CRF Comment
text
C0947611 (UMLS CUI [1])
Item Group
Infection-related Examination
C3714514 (UMLS CUI-1)
C0031809 (UMLS CUI-2)
Examination performed
Item
Examination performed
boolean
C0031809 (UMLS CUI [1])
Not done reason
Item
if 'no', provide reason
text
C2826287 (UMLS CUI [1])
Comment
Item
CRF Comment
text
C0947611 (UMLS CUI [1])
Item Group
Infection related Signs and Symptoms
C0037088 (UMLS CUI-1)
C3714514 (UMLS CUI-2)
Item
Signs and Symptoms
integer
C0037088 (UMLS CUI [1])
Code List
Signs and Symptoms
CL Item
Abdominal Pain (1)
CL Item
Nausea (2)
CL Item
Vomiting (3)
CL Item
Tenderness to palpation (4)
CL Item
Rebound tenderness (5)
CL Item
Abdominal guarding (6)
CL Item
Abdominal mass (7)
CL Item
Ascites (8)
CL Item
Chills and rigors (9)
CL Item
Other,specify (10)
Other Sign or Symptom
Item
Please specify Other Sign or Symptom
text
C0037088 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
Item
Clinical Event Intensity
integer
C0518690 (UMLS CUI [1])
Code List
Clinical Event Intensity
CL Item
Absent (0)
CL Item
Mild (1)
CL Item
Moderate (2)
CL Item
Severe (3)
CL Item
Not Assessed (99)
Item Group
Vital Signs examination
C0518766 (UMLS CUI-1)
C0031809 (UMLS CUI-2)
Examination performed
Item
Examination performed
boolean
C0031809 (UMLS CUI [1])
Not done reason
Item
if 'no', provide reason
text
C2826287 (UMLS CUI [1])
Supine Blood Pressure Systolic
Item
Supine Blood Pressure Systolic
integer
C0871470 (UMLS CUI [1,1])
C0038846 (UMLS CUI [1,2])
Relevance
Item
Clinically relevant?
boolean
C2347946 (UMLS CUI [1])
Supine Blood Pressure Diastolic
Item
Supine Blood Pressure Diastolic
integer
C0428883 (UMLS CUI [1,1])
C0038846 (UMLS CUI [1,2])
Relevance
Item
Clinically relevant?
boolean
C2347946 (UMLS CUI [1])
Heart rate
Item
Heart rate
integer
C0018810 (UMLS CUI [1])
Relevance
Item
Clinically relevant?
boolean
C2347946 (UMLS CUI [1])
Respiratory Rate
Item
Respiratory Rate
integer
C0231832 (UMLS CUI [1])
Relevance
Item
Clinically relevant?
boolean
C2347946 (UMLS CUI [1])
Comment
Item
CRF Comment
text
C0947611 (UMLS CUI [1])
Item Group
Temperature
C0005903 (UMLS CUI-1)
Temperature
Item
Temperature
float
C0039476 (UMLS CUI [1])
Time of measurement
Item
Time of measurement
time
C0242485 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Item
Method of Measurement
integer
C1299991 (UMLS CUI [1,1])
C0039476 (UMLS CUI [1,2])
Code List
Method of Measurement
CL Item
Oral (1)
(Comment:en)
CL Item
Axillary (2)
(Comment:en)
CL Item
Rectal (3)
(Comment:en)
CL Item
Tympanic (4)
(Comment:en)
CL Item
Other (99)
(Comment:en)
Other Method
Item
Kind of Other Method
text
C1299991 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
Relevance
Item
Clinically relevant?
boolean
C2347946 (UMLS CUI [1])
Item Group
Laboratory Tests
C1880016 (UMLS CUI-1)
C0022885 (UMLS CUI-2)
Clinical Chemistry sample collected
Item
Clinical Chemistry sample collected
boolean
C0200345 (UMLS CUI [1,1])
C0008000 (UMLS CUI [1,2])
Item
If 'no', please provide reason
integer
C2826287 (UMLS CUI [1])
Code List
If 'no', please provide reason
CL Item
Insufficient amount collected (1)
CL Item
Hemolyzed sample (2)
CL Item
Unable to obtain venous access (3)
CL Item
Patient not able to provide urine sample (4)
CL Item
Missed sample collection (5)
CL Item
Other (99)
Other, please specify
Item
Other, please specify
text
C3845569 (UMLS CUI [1])
Collection Date
Item
Collection Date
date
C1302413 (UMLS CUI [1])
Collection time
Item
Collection time
time
C4064021 (UMLS CUI [1])
Central Laboratory ID
Item
Central Lab ID
text
C1880016 (UMLS CUI [1,1])
C2986056 (UMLS CUI [1,2])
Sample sent to central lab
Item
Sample sent to central lab
boolean
C0370003 (UMLS CUI [1,1])
C1515023 (UMLS CUI [1,2])
C1880016 (UMLS CUI [1,3])
Not done reason
Item
If 'no', please provide reason
text
C2826287 (UMLS CUI [1])
Hematology sample collected
Item
Hematology sample collected
boolean
C0200345 (UMLS CUI [1,1])
C0018941 (UMLS CUI [1,2])
Item
If 'no', please provide reason
integer
C2826287 (UMLS CUI [1])
Code List
If 'no', please provide reason
CL Item
Insufficient amount collected (1)
CL Item
Hemolyzed sample (2)
CL Item
Unable to obtain venous access (3)
CL Item
Patient not able to provide urine sample (4)
CL Item
Missed sample collection (5)
CL Item
Other (99)
Other, please specify
Item
Other, please specify
text
C3845569 (UMLS CUI [1])
Collection Date
Item
Collection Date
date
C1302413 (UMLS CUI [1])
Collection time
Item
Collection time
time
C4064021 (UMLS CUI [1])
Central Laboratory ID
Item
Central Lab ID
text
C1880016 (UMLS CUI [1,1])
C2986056 (UMLS CUI [1,2])
Sample sent to central lab
Item
Sample sent to central lab
boolean
C0370003 (UMLS CUI [1,1])
C1515023 (UMLS CUI [1,2])
C1880016 (UMLS CUI [1,3])
Not done reason
Item
If 'no', please provide reason
text
C2826287 (UMLS CUI [1])
Urinalysis sample collected
Item
Urinalysis sample collected
boolean
C0200345 (UMLS CUI [1,1])
C0042014 (UMLS CUI [1,2])
Item
If 'no', please provide reason
integer
C2826287 (UMLS CUI [1])
Code List
If 'no', please provide reason
CL Item
Insufficient amount collected (1)
CL Item
Hemolyzed sample (2)
CL Item
Unable to obtain venous access (3)
CL Item
Patient not able to provide urine sample (4)
CL Item
Missed sample collection (5)
CL Item
Other (99)
Other, please specify
Item
Other, please specify
text
C3845569 (UMLS CUI [1])
Collection Date
Item
Collection Date
date
C1302413 (UMLS CUI [1])
Collection time
Item
Collection time
time
C4064021 (UMLS CUI [1])
Central Laboratory ID
Item
Central Lab ID
text
C1880016 (UMLS CUI [1,1])
C2986056 (UMLS CUI [1,2])
Sample sent to central lab
Item
Sample sent to central lab
boolean
C0370003 (UMLS CUI [1,1])
C1515023 (UMLS CUI [1,2])
C1880016 (UMLS CUI [1,3])
Not done reason
Item
If 'no', please provide reason
text
C2826287 (UMLS CUI [1])
Comment
Item
CRF Comment
text
C0947611 (UMLS CUI [1])
Item Group
Local Lab at Screening
C0587081 (UMLS CUI-1)
Clinical Chemistry sample collected
Item
Clinical Chemistry sample collected
boolean
C0200345 (UMLS CUI [1,1])
C0008000 (UMLS CUI [1,2])
Item
If 'no', please provide reason
integer
C2826287 (UMLS CUI [1])
Code List
If 'no', please provide reason
CL Item
Insufficient amount collected (1)
CL Item
Hemolyzed sample (2)
CL Item
Unable to obtain venous access (3)
CL Item
Patient not able to provide urine sample (4)
CL Item
Missed sample collection (5)
CL Item
Other (99)
Other, please specify
Item
Other, please specify
text
C3845569 (UMLS CUI [1])
Collection Date
Item
Collection Date
date
C1302413 (UMLS CUI [1])
Collection time
Item
Collection time
time
C4064021 (UMLS CUI [1])
Serum Creatinine
Item
Serum Creatinine
float
C0201976 (UMLS CUI [1])
not done
Item
not done
boolean
C1272696 (UMLS CUI [1])
Item
Lab unit
integer
C1519795 (UMLS CUI [1])
Code List
Lab unit
CL Item
U/L (IU/L) (1)
CL Item
mmol/L (2)
CL Item
μmol/L (3)
CL Item
g/dL (4)
CL Item
mg/dL (5)
CL Item
g/L (6)
CL Item
L/L (7)
CL Item
microKat/L (8)
CL Item
other (99)
other unit
Item
other lab unit
text
C1519795 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
lower limit of normal
Item
lower limit of normal
integer
C1518030 (UMLS CUI [1])
ULN
Item
Upper limit of normal
integer
C1519815 (UMLS CUI [1])
Significance
Item
Was this value clinically signifcant?
boolean
C2826633 (UMLS CUI [1])
AST (GOT)
Item
AST (GOT)
integer
C0201899 (UMLS CUI [1])
not done
Item
not done
boolean
C1272696 (UMLS CUI [1])
other unit
Item
other lab unit
text
C1519795 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
lower limit of normal
Item
lower limit of normal
integer
C1518030 (UMLS CUI [1])
ULN
Item
Upper limit of normal
integer
C1519815 (UMLS CUI [1])
Significance
Item
Was this value clinically signifcant?
boolean
C2826633 (UMLS CUI [1])
ALT (GPT)
Item
ALT (GPT)
integer
C0201836 (UMLS CUI [1])
not done
Item
not done
boolean
C1272696 (UMLS CUI [1])
other unit
Item
other lab unit
text
C1519795 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
lower limit of normal
Item
lower limit of normal
integer
C1518030 (UMLS CUI [1])
ULN
Item
Upper limit of normal
integer
C1519815 (UMLS CUI [1])
Significance
Item
Was this value clinically signifcant?
boolean
C2826633 (UMLS CUI [1])
ALP
Item
ALP
integer
C0201850 (UMLS CUI [1])
not done
Item
not done
boolean
C1272696 (UMLS CUI [1])
other unit
Item
other lab unit
text
C1519795 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
lower limit of normal
Item
lower limit of normal
integer
C1518030 (UMLS CUI [1])
ULN
Item
Upper limit of normal
integer
C1519815 (UMLS CUI [1])
Significance
Item
Was this value clinically signifcant?
boolean
C2826633 (UMLS CUI [1])
Total Bilirubin
Item
Total Bilirubin
float
C0201913 (UMLS CUI [1])
not done
Item
not done
boolean
C1272696 (UMLS CUI [1])
other unit
Item
other lab unit
text
C1519795 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
lower limit of normal
Item
lower limit of normal
integer
C1518030 (UMLS CUI [1])
ULN
Item
Upper limit of normal
integer
C1519815 (UMLS CUI [1])
Significance
Item
Was this value clinically signifcant?
boolean
C2826633 (UMLS CUI [1])
Creatinine Clearance
Item
Creatinine Clearance
float
C0373595 (UMLS CUI [1])
Significance
Item
Was this value clinically signifcant?
boolean
C2826633 (UMLS CUI [1])
Hematology sample collected
Item
Hematology sample collected
boolean
C0200345 (UMLS CUI [1,1])
C0018941 (UMLS CUI [1,2])
Item
If 'no', please provide reason
integer
C2826287 (UMLS CUI [1])
Code List
If 'no', please provide reason
CL Item
Insufficient amount collected (1)
CL Item
Hemolyzed sample (2)
CL Item
Unable to obtain venous access (3)
CL Item
Patient not able to provide urine sample (4)
CL Item
Missed sample collection (5)
CL Item
Other (99)
Other, please specify
Item
Other, please specify
text
C3845569 (UMLS CUI [1])
Collection Date
Item
Collection Date
date
C1302413 (UMLS CUI [1])
Collection time
Item
Collection time
time
C4064021 (UMLS CUI [1])
WBC
Item
WBC
float
C0023508 (UMLS CUI [1])
not done
Item
not done
boolean
C1272696 (UMLS CUI [1])
other unit
Item
other lab unit
text
C1519795 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
lower limit of normal
Item
lower limit of normal
integer
C1518030 (UMLS CUI [1])
ULN
Item
Upper limit of normal
integer
C1519815 (UMLS CUI [1])
Significance
Item
Was this value clinically signifcant?
boolean
C2826633 (UMLS CUI [1])
Neutrophil count
Item
Neutrophil count
float
C0948762 (UMLS CUI [1])
not done
Item
not done
boolean
C1272696 (UMLS CUI [1])
other unit
Item
other lab unit
text
C1519795 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
lower limit of normal
Item
lower limit of normal
integer
C1518030 (UMLS CUI [1])
ULN
Item
Upper limit of normal
integer
C1519815 (UMLS CUI [1])
Significance
Item
Was this value clinically signifcant?
boolean
C2826633 (UMLS CUI [1])
Hematocrit
Item
Hematocrit
float
C0518014 (UMLS CUI [1])
not done
Item
not done
boolean
C1272696 (UMLS CUI [1])
other unit
Item
other lab unit
text
C1519795 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
lower limit of normal
Item
lower limit of normal
integer
C1518030 (UMLS CUI [1])
ULN
Item
Upper limit of normal
integer
C1519815 (UMLS CUI [1])
Significance
Item
Was this value clinically signifcant?
boolean
C2826633 (UMLS CUI [1])
Hemoglobin
Item
Hemoglobin
float
C0019046 (UMLS CUI [1])
not done
Item
not done
boolean
C1272696 (UMLS CUI [1])
other unit
Item
other lab unit
text
C1519795 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
lower limit of normal
Item
lower limit of normal
integer
C1518030 (UMLS CUI [1])
ULN
Item
Upper limit of normal
integer
C1519815 (UMLS CUI [1])
Significance
Item
Was this value clinically signifcant?
boolean
C2826633 (UMLS CUI [1])
Platelets
Item
Platelet count
float
C0005821 (UMLS CUI [1])
not done
Item
not done
boolean
C1272696 (UMLS CUI [1])
other unit
Item
other lab unit
text
C1519795 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
lower limit of normal
Item
lower limit of normal
integer
C1518030 (UMLS CUI [1])
ULN
Item
Upper limit of normal
integer
C1519815 (UMLS CUI [1])
Significance
Item
Was this value clinically signifcant?
boolean
C2826633 (UMLS CUI [1])
Pregnancy Test done
Item
Pregnancy Test done
boolean
C0032976 (UMLS CUI [1])
Item
If 'no', please provide reason
integer
C2826287 (UMLS CUI [1])
Code List
If 'no', please provide reason
CL Item
Menopausal (1)
CL Item
Other (2)
Other reason
Item
Other reason
text
C3840932 (UMLS CUI [1])
Item
Method of Testing
integer
C0871511 (UMLS CUI [1])
Code List
Method of Testing
CL Item
serum (1)
CL Item
urine (2)
Item
Result of testing
integer
C0427777 (UMLS CUI [1])
Code List
Result of testing
CL Item
negative (1)
CL Item
positive (2)
Comment
Item
CRF Comment
text
C0947611 (UMLS CUI [1])
Item Group
Microbiology
C0085672 (UMLS CUI-1)
Microbiology specimen collection
Item
Was a specimen collected?
boolean
C0200345 (UMLS CUI [1,1])
C0025952 (UMLS CUI [1,2])
Item
If no, please provide reason
integer
C2826287 (UMLS CUI [1])
Code List
If no, please provide reason
CL Item
Attempt made but unable to obtain/produce sample (1)
CL Item
Other (99)
inability
Item
Please specify inability
text
C1299582 (UMLS CUI [1,1])
C0200345 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,3])
inability
Item
Please specify other reason
text
C1299582 (UMLS CUI [1,1])
C0200345 (UMLS CUI [1,2])
C3845569 (UMLS CUI [1,3])
Specimen collection date
Item
Date of collection
date
C1302413 (UMLS CUI [1])
Specimen collection time
Item
Time of Collection
time
C4064021 (UMLS CUI [1])
Item
Culture Processing Type
integer
C0200949 (UMLS CUI [1,1])
C0037793 (UMLS CUI [1,2])
C0332307 (UMLS CUI [1,3])
Code List
Culture Processing Type
CL Item
Aerobic (1)
CL Item
Anaerobic (2)
Item
Site of sample
integer
C0200345 (UMLS CUI [1,1])
C1515974 (UMLS CUI [1,2])
Code List
Site of sample
CL Item
Intra-Abdominal  (1)
CL Item
Blood  (2)
CL Item
Other (99)
Item
Intra-Abdominal, please specify
integer
C1512910 (UMLS CUI [1,1])
C1521902 (UMLS CUI [1,2])
Code List
Intra-Abdominal, please specify
CL Item
Pus (1)
CL Item
Tissue (2)
CL Item
Peritoneal Fluid (3)
CL Item
Surgical Swab (4)
CL Item
Other (99)
Other site, please specify
Item
Other site, please specify
text
C1515974 (UMLS CUI [1,1])
C3845569 (UMLS CUI [1,2])
Item
Culture outcome
integer
C2242979 (UMLS CUI [1,1])
C0587081 (UMLS CUI [1,2])
Code List
Culture outcome
CL Item
No Growth (1)
CL Item
Growth (2)
CL Item
Not done (99)
Isolate name
Item
Isolate name
text
C1764827 (UMLS CUI [1])
Item
Pathogen Type
integer
C0450254 (UMLS CUI [1])
Code List
Pathogen Type
CL Item
Bacterial (1)
CL Item
Fungal (2)
Item
Isolate Classification
integer
C1764827 (UMLS CUI [1,1])
C0008902 (UMLS CUI [1,2])
Code List
Isolate Classification
CL Item
Pathogen (1)
CL Item
Contaminant (2)
Disc Zone ATM-AVI
Item
Disc Zone ATM-AVI
text
C1283010 (UMLS CUI [1,1])
C0004521 (UMLS CUI [1,2])
C1283010 (UMLS CUI [2,1])
C3489748 (UMLS CUI [2,2])
Sample sent to Central Lab
Item
Sample sent to Central Lab?
boolean
C1880016 (UMLS CUI [1,1])
C0370003 (UMLS CUI [1,2])
C1515023 (UMLS CUI [1,3])
Central Laboratory Accession ID Number
Item
Central Lab Accession ID Number
text
C2826726 (UMLS CUI [1,1])
C1880016 (UMLS CUI [1,2])
Not done reason
Item
If no, reason
text
C2826287 (UMLS CUI [1])
Backup Sample sent to Central Laboratory
Item
Backup Sample sent to Central Lab (if necessary)?
boolean
C0370003 (UMLS CUI [1,1])
C1515023 (UMLS CUI [1,2])
C1880016 (UMLS CUI [1,3])
Comment
Item
CRF Comment
text
C0947611 (UMLS CUI [1])

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