Anglais

Demography Data Form

1 Formulaires  
  1. StudyEvent: ODM
    1. Demography Data Form
Demography
Description

Demography

Date of Birth
Description

Date of Birth

Type de données

date

Sex
Description

Sex

Type de données

text

If Female, record child-bearing potential
Description

If Female, record child-bearing potential

Type de données

text

Ethnicity
Description

Ethnicity

Type de données

text

Race
Description

check all that apply

Type de données

text

Retour au début de la page

Similar models

Demography Data Form

1 Formulaires
  1. StudyEvent: ODM
    1. Demography Data Form
Name
Type
Description | Question | Decode (Coded Value)
Type de données
Alias
Item Group
Demography
Date of Birth
Item
Date of Birth
date
Item
Sex
text
Sex
Code List
Sex
CL Item
Male (M)
CL Item
Female (F)
Item
If Female, record child-bearing potential
text
If Female, record child-bearing potential
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
Ethnicity
Code List
Ethnicity
CL Item
Hispanic or Latino (1)
CL Item
Not Hispanic or Latino (2)
Item
Race
text
Race
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)
Retour au début de la page