Anglais

Screening Visit: General Medical History

1 Formulaires  
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

Relevant Medical Conditions
Description

Relevant Medical Conditions

Specific Condition
Description

Specific Condition

Type de données

text

Status
Description

Status

Type de données

text

Start Date
Description

Start Date

Type de données

date

End Date
Description

End Date

Type de données

date

Body System Code
Description

check the corresponding option

Type de données

text

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Similar models

Screening Visit: General Medical History

1 Formulaires
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
Relevant Medical Conditions
Specific Condition
Item
Specific Condition
text
Item
Status
text
Status
Code List
Status
CL Item
Current (1)
CL Item
Past (2)
CL Item
No medical condition (3)
Start Date
Item
Start Date
date
End Date
Item
End Date
date
Item
Body System Code
text
Body System Code
Code List
Body System Code
CL Item
blood and lymphatic system disorders (1)
CL Item
ear and labyrinth disorders (2)
CL Item
endocrine disorders (3)
CL Item
eye disorders (4)
CL Item
immune system disorders (including allergies) (5)
CL Item
metabolism and nutrition disorders  (6)
CL Item
musculoskeletal and connective tissue disorders (7)
CL Item
neoplasms benign, malignant and unspecified (including cysts and polyps) (8)
CL Item
nervous system disorders (9)
CL Item
psychiatric disorders (10)
CL Item
renal and urinary disorders (11)
CL Item
reproductive system and breast disorders (12)
CL Item
respiratory, thoracic, and mediastinal disorders (including asthma) (13)
CL Item
infections and Infestations (14)
CL Item
congenital, familial and genetic disorders (15)
CL Item
general disorders and administration site conditions (16)
CL Item
injury, poisoning, and procedural complications (17)
CL Item
cardiovascular disorder (18)
CL Item
gastrointestinal disorder (19)
CL Item
hepatobiliary disorders (20)
CL Item
skin and subcutaneous tissue disorders (21)
CL Item
vascular disorders (22)
CL Item
vascular disorders (23)
CL Item
Other (24)
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