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Patient's Diary Card 1: Screening/Run-In Visit 1

1 forms  
Administrative data
Description

Administrative data

Subject Identifier
Description

Subject Identifier

Data type

integer

Daily Assessments
Description

Daily Assessments

Date
Description

Date

Data type

text

Asthma symptoms score over the past 24 hours
Description

0 = No symptoms during the day or previous night 1 = Symptoms for one short period during the day or previous night 2 = Symptoms for two or more short periods during the day or previous night 3 = Symptoms for most of the day or previous night which did not affect my normal activities 4 = Symptoms for most of the day or previous night which did affect my normal activities 5 = Symptoms so severe that I could not go to work or perform normal activities Circle only one number

Data type

text

Number of puffs albuterol/salbutamol taken in the past 24 hours
Description

if nono, enter zero (0)

Data type

integer

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Patient's Diary Card 1: Screening/Run-In Visit 1

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Administrative data
Subject Identifier
Item
Subject Identifier
integer
Item Group
Daily Assessments
Item
Date
text
Date
Code List
Date
CL Item
Date 1 (1)
CL Item
Date 2 (2)
CL Item
Date 3 (3)
CL Item
Date 4 (4)
CL Item
Date 5 (5)
CL Item
Date 6 (6)
CL Item
Date 7 (7)
CL Item
Date 8 (8)
CL Item
Date 9 (9)
CL Item
Date 10 (10)
CL Item
Date 11 (11)
CL Item
Date 12 (12)
CL Item
Date 13 (13)
CL Item
Date 14 (14)
CL Item
Date 15 (15)
CL Item
Date 16 (16)
CL Item
Date 17 (17)
CL Item
Date 18 (18)
CL Item
Date 19 (19)
CL Item
Date 20 (20)
CL Item
Date 21 (21)
CL Item
Date 22 (22)
Item
Asthma symptoms score over the past 24 hours
text
Asthma symptoms score over the past 24 hours
Code List
Asthma symptoms score over the past 24 hours
CL Item
1 (1)
CL Item
2 (2)
CL Item
3 (3)
CL Item
4 (4)
CL Item
5 (5)
Number of puffs albuterol/salbutamol taken in the past 24 hours
Item
Number of puffs albuterol/salbutamol taken in the past 24 hours
integer
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