Liver Imaging Form 1

  1. StudyEvent: ODM
    1. Liver Imaging Form 1
Administrative data
Beskrivning

Administrative data

Study Name
Beskrivning

Study Name

Datatyp

text

Site
Beskrivning

Site

Datatyp

text

Subject
Beskrivning

Subject

Datatyp

text

Visit Name
Beskrivning

Visit Name

Datatyp

text

DCI Name/Shortname
Beskrivning

DCI Name/Shortname

Datatyp

text

Status
Beskrivning

Status

Datatyp

text

Doc#
Beskrivning

Doc#

Datatyp

integer

Visit #
Beskrivning

Visit #

Datatyp

float

Complete a separate form for each individual imaging test performed.
Beskrivning

Complete a separate form for each individual imaging test performed.

Date of hepatic or liver imaging test
Beskrivning

Date of hepatic or liver imaging test

Datatyp

date

What method was used for this imaging test?
Beskrivning

check one; if more than one imaging tet was performed, complete a separate form for each test.

Datatyp

text

If Other, specify
Beskrivning

If Other, specify

Datatyp

text

Image Quality
Beskrivning

Image Quality

Are images technically adequate?
Beskrivning

check one

Datatyp

text

If Other, specify
Beskrivning

If Other, specify

Datatyp

text

Similar models

Liver Imaging Form 1

  1. StudyEvent: ODM
    1. Liver Imaging Form 1
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
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
Complete a separate form for each individual imaging test performed.
Date of hepatic or liver imaging test
Item
Date of hepatic or liver imaging test
date
Item
What method was used for this imaging test?
text
Code List
What method was used for this imaging test?
CL Item
Ultrasound - transabdominal (1)
CL Item
Ultrasound - endoscopic (2)
CL Item
Magnetic Resonance Imaging (MRI) (3)
CL Item
Computerised Tomography (CT) (4)
CL Item
Endoscopic Retrograde Cholangiopancreatography (ERCP) (5)
CL Item
Positron Emission Tomography (PET) (6)
CL Item
Positron Emission Tomography/Computed Tomography (PET/CT) (7)
CL Item
Other (8)
If Other, specify
Item
If Other, specify
text
Item Group
Image Quality
Item
Are images technically adequate?
text
Code List
Are images technically adequate?
CL Item
Optimal (1)
CL Item
Readable, but not optimal (2)
CL Item
Not readable (3)
CL Item
Other (4)
If Other, specify
Item
If Other, specify
text