Name
genere
Description | Question | Decode (Coded Value)
Tipo di dati
Alias
Item Group
Administrative Information
C1320722 (UMLS CUI-1)
Subject Identifier
Item
Subject Identifier
text
C2348585 (UMLS CUI [1])
Visit Date
Item
Visit Date
date
C1320303 (UMLS CUI [1])
Item Group
Investigational Product Discontinuation-Coartem or Placebo
C0304229 (UMLS CUI-1)
C0457454 (UMLS CUI-2)
investigational product stopped
Item
Was the investigational product stopped permanently before the end of the scheduled treatment period?
boolean
C0011008 (UMLS CUI [1,1])
C0304229 (UMLS CUI [1,2])
C0457454 (UMLS CUI [1,3])
Item
If yes, select the primary reason the investigational product was stopped:
text
C1518544 (UMLS CUI [1,1])
C0566251 (UMLS CUI [1,2])
Code List
If yes, select the primary reason the investigational product was stopped:
CL Item
Adverse Event (1)
CL Item
Lost to follow-up (2)
CL Item
Protocol Violation (3)
CL Item
Subject decided to withdraw from study (4)
CL Item
Other, specify (Z)
Item Group
Investigational Product Discontinuation-Chlorproguanil-Dapsone-Artesunate or Placebo
C0304229 (UMLS CUI-1)
C0457454 (UMLS CUI-2)
investigational product stopped
Item
Was the investigational product stopped permanently before the end of the scheduled treatment period?
boolean
C0011008 (UMLS CUI [1,1])
C0304229 (UMLS CUI [1,2])
C0457454 (UMLS CUI [1,3])
Item
If yes, select the primary reason the investigational product was stopped:
text
C1518544 (UMLS CUI [1,1])
C0566251 (UMLS CUI [1,2])
Code List
If yes, select the primary reason the investigational product was stopped:
CL Item
Adverse Event (1)
CL Item
Lost to follow-up (2)
CL Item
Protocol Violation (3)
CL Item
Subject decided to withdraw from study (4)
CL Item
Other, specify (Z)
Item Group
Status of Treatment Blind
C0749659 (UMLS CUI-1)
C2347038 (UMLS CUI-2)
blind broken
Item
Was the treatment blind broken during the study?
boolean
C3897431 (UMLS CUI [1])
If yes, complete the following
Item
Date blind broken
date
C3897431 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Item
Reason blind broken
text
C3897431 (UMLS CUI [1,1])
C0392360 (UMLS CUI [1,2])
Code List
Reason blind broken
CL Item
Medical emergency requiring identification of investigational product for further treatment. (1)
CL Item
Other, specify (2)
Item Group
Pregnancy Information
C0032961 (UMLS CUI-1)
C1533716 (UMLS CUI-2)
Item
Did the subject become pregnant during the study?
text
C0032961 (UMLS CUI [1,1])
C1533716 (UMLS CUI [1,2])
Code List
Did the subject become pregnant during the study?
CL Item
Not Applicable (not of childbearing potential or male) (X)
Item Group
Study Conclusion
C1707478 (UMLS CUI-1)
C0008972 (UMLS CUI-2)
Date of study completion or withdrawal
Item
Date of study completion or withdrawal
date
C2983670 (UMLS CUI [1])
Was the subject withdrawn from study?
Item
Was the subject withdrawn from study?
boolean
C0422727 (UMLS CUI [1])
Item
If yes, select primary reason for withdrawal
text
C0392360 (UMLS CUI [1,1])
C0422727 (UMLS CUI [1,2])
Code List
If yes, select primary reason for withdrawal
CL Item
Adverse event (Record details on the Non-Serious Adverse Events or Serious Adverse Event pages as appropriate. (1)
CL Item
Lost to follow-up (2)
CL Item
Protocol violation (3)
CL Item
Subject decided to withdraw from the study (4)
CL Item
Other, specify... (Z)
Item Group
Investigator Comment Log
C0008961 (UMLS CUI-1)
C0947611 (UMLS CUI-2)
CRF Page Number if applicable
Item
CRF Page Number if applicable
integer
C1704732 (UMLS CUI [1,1])
C1516308 (UMLS CUI [1,2])
Comment
Item
Comment
text
C0947611 (UMLS CUI [1])
Item Group
Investigator's Signature
C2346576 (UMLS CUI-1)
Investigator's Signature
Item
Investigator's Signature
text
C2346576 (UMLS CUI [1])
Date
Item
Date
date
C0011008 (UMLS CUI [1])
Investigator's Name
Item
Investigator's Name
text
C2826892 (UMLS CUI [1])