Demography Data Form

  1. StudyEvent: ODM
    1. Demography Data Form
Demography
Descrição

Demography

Date of Birth
Descrição

Date of Birth

Tipo de dados

date

Sex
Descrição

Sex

Tipo de dados

text

If Female, record child-bearing potential
Descrição

If Female, record child-bearing potential

Tipo de dados

text

Ethnicity
Descrição

Ethnicity

Tipo de dados

text

Race
Descrição

check all that apply

Tipo de dados

text

Similar models

Demography Data Form

  1. StudyEvent: ODM
    1. Demography Data Form
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de dados
Alias
Item Group
Demography
Date of Birth
Item
Date of Birth
date
Item
Sex
text
Code List
Sex
CL Item
Male (M)
CL Item
Female (F)
Item
If Female, record child-bearing potential
text
Code List
If Female, record child-bearing potential
CL Item
Pre-menarcheal (1)
CL Item
Post-menopausal (2)
CL Item
Sterile (of child-bearing age) (3)
CL Item
Potentially able to bear children (4)
Item
Ethnicity
text
Code List
Ethnicity
CL Item
Hispanic or Latino (1)
CL Item
Not Hispanic or Latino (2)
Item
Race
text
Code List
Race
CL Item
African American/African Heritage (1)
CL Item
American Indian or Alaskan Native (2)
CL Item
Asian - Central/South Asian Heritage (3)
CL Item
Asian - East Asian Heritage (4)
CL Item
Asian - Japanese Heritage (5)
CL Item
Asian - South East Asian Heritage (6)
CL Item
Native Hawaiian or Other Pacific Islander (7)
CL Item
White - Arabic/North African Heritage (8)
CL Item
White - White/Caucsian/European Heritage (9)