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Liver Event Form: Medical Conditions

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Administrative data
Beschrijving

Administrative data

Study Name
Beschrijving

Study Name

Datatype

text

Site
Beschrijving

Site

Datatype

text

Subject
Beschrijving

Subject

Datatype

text

Visit Name
Beschrijving

Visit Name

Datatype

text

DCI Name/Shortname
Beschrijving

DCI Name/Shortname

Datatype

text

Status
Beschrijving

Status

Datatype

text

Doc#
Beschrijving

Doc#

Datatype

integer

Visit #
Beschrijving

Visit #

Datatype

float

Liver Disease Medical Conditions
Beschrijving

Liver Disease Medical Conditions

Acute Viral Hepatitis A
Beschrijving

Check one

Datatype

text

Chronic Hepatitis B
Beschrijving

Chronic Hepatitis B

Datatype

text

Chronic Hepatitis C
Beschrijving

Chronic Hepatitis C

Datatype

text

Cytomegalovirus Hepatitis
Beschrijving

Cytomegalovirus Hepatitis

Datatype

text

Epstein Barr Virus Infectious Mononucleosis
Beschrijving

Epstein Barr Virus Infectious Mononucleosis

Datatype

text

Herpes Simplex Hepatitis
Beschrijving

Herpes Simplex Hepatitis

Datatype

text

Alcoholic Liver Disease
Beschrijving

Alcoholic Liver Disease

Datatype

text

Non-Alcoholic Steatohepatitis
Beschrijving

Non-Alcoholic Steatohepatitis

Datatype

text

Fatty Liver
Beschrijving

Fatty Liver

Datatype

text

Hepatic Cirrhosis
Beschrijving

Hepatic Cirrhosis

Datatype

text

Hemochromatosis
Beschrijving

Hemochromatosis

Datatype

text

Autoimmune Hepatitis
Beschrijving

Autoimmune Hepatitis

Datatype

text

Gallibladder Disease or Biliary Disease
Beschrijving

Gallibladder Disease or Biliary Disease

Datatype

text

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Similar models

Liver Event Form: Medical Conditions

1 Formulieren
Name
Type
Description | Question | Decode (Coded Value)
Datatype
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
Item Group
Liver Disease Medical Conditions
Item
Acute Viral Hepatitis A
text
Acute Viral Hepatitis A
Code List
Acute Viral Hepatitis A
CL Item
Current (1)
CL Item
Past (2)
CL Item
No medical condition (3)
Item
Chronic Hepatitis B
text
Chronic Hepatitis B
Code List
Chronic Hepatitis B
CL Item
Current (1)
CL Item
Past (2)
CL Item
No medical condition (3)
Item
Chronic Hepatitis C
text
Chronic Hepatitis C
Code List
Chronic Hepatitis C
CL Item
Current (1)
CL Item
Past (2)
CL Item
No medical condition (3)
Item
Cytomegalovirus Hepatitis
text
Cytomegalovirus Hepatitis
Code List
Cytomegalovirus Hepatitis
CL Item
Current (1)
CL Item
Past (2)
CL Item
No medical condition (3)
Item
Epstein Barr Virus Infectious Mononucleosis
text
Epstein Barr Virus Infectious Mononucleosis
Code List
Epstein Barr Virus Infectious Mononucleosis
CL Item
Current (1)
CL Item
Past (2)
CL Item
No medical condition (3)
Item
Herpes Simplex Hepatitis
text
Herpes Simplex Hepatitis
Code List
Herpes Simplex Hepatitis
CL Item
Current (1)
CL Item
Past (2)
CL Item
No medical condition (3)
Item
Alcoholic Liver Disease
text
Alcoholic Liver Disease
Code List
Alcoholic Liver Disease
CL Item
Current (1)
CL Item
Past (2)
CL Item
No medical condition (3)
Item
Non-Alcoholic Steatohepatitis
text
Non-Alcoholic Steatohepatitis
Code List
Non-Alcoholic Steatohepatitis
CL Item
Current (1)
CL Item
Past (2)
CL Item
No medical condition (3)
Item
Fatty Liver
text
Fatty Liver
Code List
Fatty Liver
CL Item
Current (1)
CL Item
Past (2)
CL Item
No medical condition (3)
Item
Hepatic Cirrhosis
text
Hepatic Cirrhosis
Code List
Hepatic Cirrhosis
CL Item
Current (1)
CL Item
Past (2)
CL Item
No medical condition (3)
Item
Hemochromatosis
text
Hemochromatosis
Code List
Hemochromatosis
CL Item
Current (1)
CL Item
Past (2)
CL Item
No medical condition (3)
Item
Autoimmune Hepatitis
text
Autoimmune Hepatitis
Code List
Autoimmune Hepatitis
CL Item
Current (1)
CL Item
Past (2)
CL Item
No medical condition (3)
Item
Gallibladder Disease or Biliary Disease
text
Gallibladder Disease or Biliary Disease
Code List
Gallibladder Disease or Biliary Disease
CL Item
Current (1)
CL Item
Past (2)
CL Item
No medical condition (3)
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