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General Medical History and Baseline Conditions Screening

1 forms  
GENERAL MEDICAL HISTORY AND BASELINE CONDITIONS (SCREENING)
Description

GENERAL MEDICAL HISTORY AND BASELINE CONDITIONS (SCREENING)

Alias
UMLS CUI-1
C0262926
Subject Number:
Description

Subject Number

Data type

text

Alias
UMLS CUI [1]
C2348585
Subject Initials:
Description

Subject Initials

Data type

text

Alias
UMLS CUI [1,1]
C1997894
UMLS CUI [1,2]
C2986440
Visit Date:
Description

Visit Date

Data type

date

Alias
UMLS CUI [1]
C1320303
Does the subject have any other medical history or baseline conditions, not specified on a Targeted Medical History CRF?
Description

Medical History

Data type

boolean

Alias
UMLS CUI [1]
C0262926
Diagnosis
Description

Diagnosis

Data type

text

Alias
UMLS CUI [1]
C0011900
Condition Currently Active?
Description

Medical condition ongoing

Data type

boolean

Alias
UMLS CUI [1,1]
C0012634
UMLS CUI [1,2]
C0549178
Onset Date / Procedure Date
Description

Onset Date

Data type

date

Alias
UMLS CUI [1]
C0574845
Date Unknown
Description

Date unknown

Data type

boolean

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C0439673
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Similar models

General Medical History and Baseline Conditions Screening

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
GENERAL MEDICAL HISTORY AND BASELINE CONDITIONS (SCREENING)
C0262926 (UMLS CUI-1)
Subject Number
Item
Subject Number:
text
C2348585 (UMLS CUI [1])
Subject Initials
Item
Subject Initials:
text
C1997894 (UMLS CUI [1,1])
C2986440 (UMLS CUI [1,2])
Visit Date
Item
Visit Date:
date
C1320303 (UMLS CUI [1])
Medical History
Item
Does the subject have any other medical history or baseline conditions, not specified on a Targeted Medical History CRF?
boolean
C0262926 (UMLS CUI [1])
Item
Diagnosis
text
C0011900 (UMLS CUI [1])
Organ system code
Code List
Diagnosis
CL Item
Neurologic/Psychiatric (Neurologic/Psychiatric)
C0027765 (UMLS CUI-1)
(Comment:en)
CL Item
Ophthalmologic (Ophthalmologic)
C0015397 (UMLS CUI-1)
(Comment:en)
CL Item
Ears, Nose, Throat (Ears, Nose, Throat)
C0150934 (UMLS CUI-1)
(Comment:en)
CL Item
Cardiovascular (Cardiovascular)
C0007222 (UMLS CUI-1)
(Comment:en)
CL Item
Respiratory (Respiratory)
C0035204 (UMLS CUI-1)
(Comment:en)
CL Item
Gastrointestinal (Gastrointestinal)
C0017178 (UMLS CUI-1)
(Comment:en)
CL Item
Genitourinary/Reproductive (Genitourinary/Reproductive)
C0080276 (UMLS CUI-1)
(Comment:en)
CL Item
Musculoskeletal (Musculoskeletal)
C0026857 (UMLS CUI-1)
(Comment:en)
CL Item
Dermatologic (Dermatologic)
C0037274 (UMLS CUI-1)
(Comment:en)
CL Item
Endocrine (Endocrine)
C0014130 (UMLS CUI-1)
(Comment:en)
CL Item
Hematologic (Hematologic)
C0018939 (UMLS CUI-1)
(Comment:en)
CL Item
Allergies / Drug Sensitivities (Allergies / Drug Sensitivities)
C0020517 (UMLS CUI-1)
(Comment:en)
CL Item
Malignancy (Malignancy)
C0006826 (UMLS CUI-1)
(Comment:en)
Medical condition ongoing
Item
Condition Currently Active?
boolean
C0012634 (UMLS CUI [1,1])
C0549178 (UMLS CUI [1,2])
Onset Date
Item
Onset Date / Procedure Date
date
C0574845 (UMLS CUI [1])
Date unknown
Item
Date Unknown
boolean
C0011008 (UMLS CUI [1,1])
C0439673 (UMLS CUI [1,2])
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