Screening Visit: Demographic Data

Administrative data
Description

Administrative data

Study Name
Description

Study Name

Type de données

text

Site
Description

Site

Type de données

text

Subject
Description

Subject

Type de données

text

Visit Name
Description

Visit Name

Type de données

text

DCI Name/Shortname
Description

DCI Name/Shortname

Type de données

text

Status
Description

Status

Type de données

text

Doc#
Description

Doc#

Type de données

integer

Visit #
Description

Visit #

Type de données

float

Visit Date
Description

Visit Date

Type de données

date

Demographics
Description

Demographics

Date of Birth
Description

Date of Birth

Type de données

date

Sex
Description

Sex

Type de données

text

Race
Description

Race

Type de données

text

If Other, specify
Description

If Other, specify

Type de données

text

Ethnicity
Description

Ethnicity

Type de données

text

Is the subject of childbearing potential?
Description

Is the subject of childbearing potential?

Type de données

boolean

Similar models

Screening Visit: Demographic Data

Name
Type
Description | Question | Decode (Coded Value)
Type de données
Alias
Item Group
Administrative data
Study Name
Item
Study Name
text
Site
Item
Site
text
Subject
Item
Subject
text
Visit Name
Item
Visit Name
text
DCI Name/Shortname
Item
DCI Name/Shortname
text
Status
Item
Status
text
Doc#
Item
Doc#
integer
Visit #
Item
Visit #
float
Visit Date
Item
Visit Date
date
Item Group
Demographics
Date of Birth
Item
Date of Birth
date
Item
Sex
text
Code List
Sex
CL Item
Male (1)
CL Item
Female (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/Caucasian/European Heritage (9)
CL Item
Other (10)
If Other, specify
Item
If Other, specify
text
Item
Ethnicity
text
Code List
Ethnicity
CL Item
Hispanic or Latino (1)
CL Item
Not Hispanic or Latino ()
Is the subject of childbearing potential?
Item
Is the subject of childbearing potential?
boolean