Protocol
Item
Protocol
integer
C1507394 (UMLS CUI [1])
Center
Item
Center
integer
C1301943 (UMLS CUI [1,1])
C0805701 (UMLS CUI [1,2])
Date of Visit
Item
Date of Visit
date
C1320303 (UMLS CUI [1])
Subject Number
Item
Subject Number
integer
C2348585 (UMLS CUI [1])
Informed Consent Date
Item
I certify that Informed Consent has been obtained prior to any study procedure.
date
C2985782 (UMLS CUI [1])
Subject Initials
Item
Subject Initials
text
C1997894 (UMLS CUI [1,1])
C2986440 (UMLS CUI [1,2])
Date of birth
Item
Date of birth
date
C0421451 (UMLS CUI [1])
Item
Gender
integer
C0079399 (UMLS CUI [1])
Item
Race
text
C0034510 (UMLS CUI [1])
CL Item
Other, please specify: ____________________________________________ ((OT))
Blood sample
Item
Has a blood sample been taken?
boolean
C0005834 (UMLS CUI [1])
Item
Is the subject eligible for the study, according to the criteria listed hereby?
integer
C1302261 (UMLS CUI [1])
Code List
Is the subject eligible for the study, according to the criteria listed hereby?
CL Item
No, please give the corresponding criterion number(s): _______________________ (2)