Inglés

Investigatioinal Product Use and Status of Treatment Blind

1 formularios  
Administrative Data
Descripción

Administrative Data

Alias
UMLS CUI-1
C1320722
Visit Date
Descripción

Visit Date

Tipo de datos

date

Alias
UMLS CUI [1]
C1320303
Subject Identifier
Descripción

Subject Identifier

Tipo de datos

text

Alias
UMLS CUI [1]
C2348585
Investigational Product Use
Descripción

Investigational Product Use

Alias
UMLS CUI-1
C0304229
Did the subject take investigational product?
Descripción

Did the subject take investigational product?

Tipo de datos

text

Alias
UMLS CUI [1]
C0304229
Status of Treatment Blind
Descripción

Status of Treatment Blind

Alias
UMLS CUI-1
C0749659
UMLS CUI-2
C2347038
Was the treatment blind broken during the study?
Descripción

Was the treatment blind broken during the study?

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0749659
UMLS CUI [1,2]
C2347038
Date blind broken
Descripción

If the treatment blind was broken, complete the following

Tipo de datos

date

Alias
UMLS CUI [1,1]
C3897431
UMLS CUI [1,2]
C0011008
Reason blind broken, ✔one
Descripción

If the treatment blind was broken, complete the following Complete Non-Serious Adverse Events, Serious Adverse Event and/or Investigational Product pages, as appropriate.

Tipo de datos

text

Alias
UMLS CUI [1,1]
C3897431
UMLS CUI [1,2]
C0392360
If "Other" was checked: Specify
Descripción

Other reason blind broken, specification

Tipo de datos

text

Alias
UMLS CUI [1,1]
C3897431
UMLS CUI [1,2]
C0392360
UMLS CUI [1,3]
C3845569
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Similar models

Investigatioinal Product Use and Status of Treatment Blind

1 formularios
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
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 Group
Investigational Product Use
C0304229 (UMLS CUI-1)
Item
Did the subject take investigational product?
text
C0304229 (UMLS CUI [1])
Did the subject take investigational product?
Code List
Did the subject take investigational product?
CL Item
Yes (Y)
CL Item
No (N)
Item Group
Status of Treatment Blind
C0749659 (UMLS CUI-1)
C2347038 (UMLS CUI-2)
Item
Was the treatment blind broken during the study?
text
C0749659 (UMLS CUI [1,1])
C2347038 (UMLS CUI [1,2])
Was the treatment blind broken during the study?
Code List
Was the treatment blind broken during the study?
CL Item
Yes (Y)
CL Item
No (N)
Date blind broken
Item
Date blind broken
date
C3897431 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Item
Reason blind broken, ✔one
text
C3897431 (UMLS CUI [1,1])
C0392360 (UMLS CUI [1,2])
Reason blind broken
Code List
Reason blind broken, ✔one
CL Item
Medical emergency requiring identification of investigational product for further treatment  (1)
CL Item
Other (Z)
Other reason blind broken, specification
Item
If "Other" was checked: Specify
text
C3897431 (UMLS CUI [1,1])
C0392360 (UMLS CUI [1,2])
C3845569 (UMLS CUI [1,3])
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