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Patient's Diary Card 1: Screening/Run-In Visit 1

1 forms  
Administrative data
Description

Administrative data

Alias
UMLS CUI-1
C1320722
Subject Identifier
Description

Subject Identifier

Data type

integer

Alias
UMLS CUI [1]
C2348585
Daily Assessments
Description

Daily Assessments

Alias
UMLS CUI-1
C0220825
UMLS CUI-2
C0332173
Assessment Date
Description

Date

Data type

text

Alias
UMLS CUI [1]
C2985720
Asthma symptoms score over the past 24 hours
Description

0 = No symptoms during the day or previous night 1 = Symptoms for one short period during the day or previous night 2 = Symptoms for two or more short periods during the day or previous night 3 = Symptoms for most of the day or previous night which did not affect my normal activities 4 = Symptoms for most of the day or previous night which did affect my normal activities 5 = Symptoms so severe that I could not go to work or perform normal activities Circle only one number

Data type

text

Alias
UMLS CUI [1,1]
C0004096
UMLS CUI [1,2]
C1457887
Number of puffs albuterol/salbutamol taken in the past 24 hours
Description

if nono, enter zero (0)

Data type

integer

Alias
UMLS CUI [1,1]
C1533107
UMLS CUI [1,2]
C0001927
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Similar models

Patient's Diary Card 1: Screening/Run-In Visit 1

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Administrative data
C1320722 (UMLS CUI-1)
Subject Identifier
Item
Subject Identifier
integer
C2348585 (UMLS CUI [1])
Item Group
Daily Assessments
C0220825 (UMLS CUI-1)
C0332173 (UMLS CUI-2)
Item
Assessment Date
text
C2985720 (UMLS CUI [1])
Date
Code List
Assessment Date
CL Item
Date 1 (1)
CL Item
Date 2 (2)
CL Item
Date 3 (3)
CL Item
Date 4 (4)
CL Item
Date 5 (5)
CL Item
Date 6 (6)
CL Item
Date 7 (7)
CL Item
Date 8 (8)
CL Item
Date 9 (9)
CL Item
Date 10 (10)
CL Item
Date 11 (11)
CL Item
Date 12 (12)
CL Item
Date 13 (13)
CL Item
Date 14 (14)
CL Item
Date 15 (15)
CL Item
Date 16 (16)
CL Item
Date 17 (17)
CL Item
Date 18 (18)
CL Item
Date 19 (19)
CL Item
Date 20 (20)
CL Item
Date 21 (21)
CL Item
Date 22 (22)
Item
Asthma symptoms score over the past 24 hours
text
C0004096 (UMLS CUI [1,1])
C1457887 (UMLS CUI [1,2])
Asthma symptoms score over the past 24 hours
Code List
Asthma symptoms score over the past 24 hours
CL Item
1 (1)
CL Item
2 (2)
CL Item
3 (3)
CL Item
4 (4)
CL Item
5 (5)
Number of puffs albuterol/salbutamol taken in the past 24 hours
Item
Number of puffs albuterol/salbutamol taken in the past 24 hours
integer
C1533107 (UMLS CUI [1,1])
C0001927 (UMLS CUI [1,2])
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