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Check-In Form

1 forms  
  1. StudyEvent: ODM
    1. Check-In Form
Administrative Data
Description

Administrative Data

Alias
UMLS CUI-1
C1320722
Visit Date
Description

Visit Date

Data type

date

Alias
UMLS CUI [1]
C1320303
Subject Identifier
Description

Subject Identifier

Data type

text

Alias
UMLS CUI [1]
C2348585
Study Period
Description

Study Period

Data type

integer

Alias
UMLS CUI [1]
C2347804
Vital Signs
Description

Vital Signs

Alias
UMLS CUI-1
C0518766
Blood pressure (Systolic)
Description

Sitting

Data type

integer

Measurement units
  • mmHg
Alias
UMLS CUI [1]
C0871470
mmHg
Blood pressure (Diastolic)
Description

Sitting

Data type

integer

Measurement units
  • mmHg
Alias
UMLS CUI [1]
C0428883
mmHg
Heart rate
Description

Sitting

Data type

integer

Measurement units
  • beats/minute
Alias
UMLS CUI [1]
C0018810
beats/minute
Randomisation Number (Only Period 1)
Description

Randomisation Number (Only Period 1)

Alias
UMLS CUI-1
C0034656
UMLS CUI-2
C0237753
Record randomisation number.
Description

Randomisation number

Data type

text

Alias
UMLS CUI [1,1]
C0034656
UMLS CUI [1,2]
C0237753
Drug And Alcohol Screen Including Cotinine
Description

Drug And Alcohol Screen Including Cotinine

Alias
UMLS CUI-1
C0373483
UMLS CUI-2
C3863708
UMLS CUI-3
C1697737
Date Sample Taken
Description

Date Sample Taken

Data type

date

Alias
UMLS CUI [1]
C1302413
Alcohol
Description

If positive, exclude subject from the study

Data type

integer

Alias
UMLS CUI [1]
C0001948
Amphetamines
Description

If positive, exclude subject from the study

Data type

integer

Alias
UMLS CUI [1]
C0002667
Barbiturates
Description

If positive, exclude subject from the study

Data type

integer

Alias
UMLS CUI [1]
C0004745
Benzodiazepines
Description

If positive, exclude subject from the study

Data type

integer

Alias
UMLS CUI [1]
C0005064
Cocaine Metabolite
Description

If positive, exclude subject from the study

Data type

integer

Alias
UMLS CUI [1]
C0009170
Ethanol
Description

If positive, exclude subject from the study

Data type

integer

Alias
UMLS CUI [1]
C0001962
Marijuana
Description

If positive, exclude subject from the study

Data type

integer

Alias
UMLS CUI [1]
C0024808
Methadone
Description

If positive, exclude subject from the study

Data type

integer

Alias
UMLS CUI [1]
C0025605
Methaqualone
Description

If positive, exclude subject from the study

Data type

integer

Alias
UMLS CUI [1]
C0025627
Opiates
Description

If positive, exclude subject from the study

Data type

integer

Alias
UMLS CUI [1]
C0376196
Phencyclidine
Description

If positive, exclude subject from the study

Data type

integer

Alias
UMLS CUI [1]
C0031381
Propoxyphene
Description

If positive, exclude subject from the study

Data type

integer

Alias
UMLS CUI [1]
C0202458
Cotinine
Description

If positive, exclude subject from the study

Data type

integer

Alias
UMLS CUI [1]
C0202363
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Similar models

Check-In Form

1 forms
  1. StudyEvent: ODM
    1. Check-In Form
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Administrative Data
C1320722 (UMLS CUI-1)
Visit Date
Item
Visit Date
date
C1320303 (UMLS CUI [1])
Subject Identifier
Item
Subject Identifier
text
C2348585 (UMLS CUI [1])
Item
Study Period
integer
C2347804 (UMLS CUI [1])
Visit Type
Code List
Study Period
CL Item
Period 1 (1)
CL Item
Period 2 (2)
CL Item
Period 3 (3)
Item Group
Vital Signs
C0518766 (UMLS CUI-1)
Systolic blood pressure
Item
Blood pressure (Systolic)
integer
C0871470 (UMLS CUI [1])
Diastolic blood pressure
Item
Blood pressure (Diastolic)
integer
C0428883 (UMLS CUI [1])
Heart rate
Item
Heart rate
integer
C0018810 (UMLS CUI [1])
Item Group
Randomisation Number (Only Period 1)
C0034656 (UMLS CUI-1)
C0237753 (UMLS CUI-2)
Randomisation number
Item
Record randomisation number.
text
C0034656 (UMLS CUI [1,1])
C0237753 (UMLS CUI [1,2])
Item Group
Drug And Alcohol Screen Including Cotinine
C0373483 (UMLS CUI-1)
C3863708 (UMLS CUI-2)
C1697737 (UMLS CUI-3)
Date Sample Taken
Item
Date Sample Taken
date
C1302413 (UMLS CUI [1])
Item
Alcohol
integer
C0001948 (UMLS CUI [1])
Alcohol
Code List
Alcohol
CL Item
Positive (1)
CL Item
Negative (2)
Item
Amphetamines
integer
C0002667 (UMLS CUI [1])
Amphetamines
Code List
Amphetamines
CL Item
Positive (1)
CL Item
Negative (2)
Item
Barbiturates
integer
C0004745 (UMLS CUI [1])
Barbiturates
Code List
Barbiturates
CL Item
Positive (1)
CL Item
Negative (2)
Item
Benzodiazepines
integer
C0005064 (UMLS CUI [1])
Benzodiazepines
Code List
Benzodiazepines
CL Item
Positive (1)
CL Item
Negative (2)
Item
Cocaine Metabolite
integer
C0009170 (UMLS CUI [1])
Cocaine Metabolite
Code List
Cocaine Metabolite
CL Item
Positive (1)
CL Item
Negative (2)
Item
Ethanol
integer
C0001962 (UMLS CUI [1])
Ethanol
Code List
Ethanol
CL Item
Positive (1)
CL Item
Negative (2)
Item
Marijuana
integer
C0024808 (UMLS CUI [1])
Marijuana
Code List
Marijuana
CL Item
Positive (1)
CL Item
Negative (2)
Item
Methadone
integer
C0025605 (UMLS CUI [1])
Methadone
Code List
Methadone
CL Item
Positive (1)
CL Item
Negative (2)
Item
Methaqualone
integer
C0025627 (UMLS CUI [1])
Methaqualone
Code List
Methaqualone
CL Item
Positive (1)
CL Item
Negative (2)
Item
Opiates
integer
C0376196 (UMLS CUI [1])
Opiates
Code List
Opiates
CL Item
Positive (1)
CL Item
Negative (2)
Item
Phencyclidine
integer
C0031381 (UMLS CUI [1])
Phencyclidine
Code List
Phencyclidine
CL Item
Positive (1)
CL Item
Negative (2)
Item
Propoxyphene
integer
C0202458 (UMLS CUI [1])
Propoxyphene
Code List
Propoxyphene
CL Item
Positive (1)
CL Item
Negative (2)
Item
Cotinine
integer
C0202363 (UMLS CUI [1])
Cotinine
Code List
Cotinine
CL Item
Positive (1)
CL Item
Negative (2)
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