Engelsk

Follow-Up: Vital Signs, Electrocardiogram, Laboratory Tests

1 Formulär  
Administrative data
Beskrivning

Administrative data

Site
Beskrivning

Site

Datatyp

text

Subject
Beskrivning

Subject

Datatyp

text

Visit Name
Beskrivning

Visit Name

Datatyp

text

Visit Number
Beskrivning

Visit Number

Datatyp

text

Status
Beskrivning

Status

Datatyp

text

Document Number
Beskrivning

Document Number

Datatyp

text

Visit Date
Beskrivning

Visit Date

Datatyp

date

Vital Signs - Duplicate 1
Beskrivning

Vital Signs - Duplicate 1

Date of Vital Signs
Beskrivning

Date of Vital Signs

Datatyp

date

Time of Vital Signs
Beskrivning

Time of Vital Signs

Datatyp

time

Blood Pressure - Systolic
Beskrivning

Blood Pressure - Systolic

Datatyp

float

Måttenheter
  • mmHg
mmHg
Blood Pressure - Diastolic
Beskrivning

Blood Pressure - Diastolic

Datatyp

float

Måttenheter
  • mmHg
mmHg
Heart Rate
Beskrivning

Heart Rate

Datatyp

integer

Måttenheter
  • bpm
bpm
Temperature
Beskrivning

Temperature

Datatyp

float

Måttenheter
  • °C
°C
Body Position
Beskrivning

e.g., Sitting

Datatyp

text

Comment
Beskrivning

Comment

Datatyp

text

Duplicate 2
Beskrivning

Duplicate 2

Time of Vital Signs
Beskrivning

Time of Vital Signs

Datatyp

time

Blood Pressure - Systolic
Beskrivning

Blood Pressure - Systolic

Datatyp

float

Måttenheter
  • mmHg
mmHg
Blood Pressure - Diastolic
Beskrivning

Blood Pressure - Diastolic

Datatyp

float

Måttenheter
  • mmHg
mmHg
Heart Rate
Beskrivning

Heart Rate

Datatyp

integer

Måttenheter
  • bpm
bpm
Body Position
Beskrivning

e.g., Sitting

Datatyp

text

Comment
Beskrivning

Comment

Datatyp

text

Physical Examination
Beskrivning

Physical Examination

Date of Physical Examination
Beskrivning

Date of Physical Examination

Datatyp

date

Skin including Injection Site
Beskrivning

Skin including Injection Site

Datatyp

text

Specify Abnormality
Beskrivning

if applies

Datatyp

text

Lungs
Beskrivning

Lungs

Datatyp

text

Specify Abnormality
Beskrivning

if applies

Datatyp

text

Cardiovascular
Beskrivning

Cardiovascular

Datatyp

text

Specify Abnormality
Beskrivning

if applies

Datatyp

text

Abdomen (Liver and Spleen)
Beskrivning

Abdomen (Liver and Spleen)

Datatyp

text

Specify Abnormality
Beskrivning

if applies

Datatyp

text

Other
Beskrivning

Other

Datatyp

text

Specify details and possible abnormalities
Beskrivning

Specify details and possible abnormalities

Datatyp

text

Electrocardiogram
Beskrivning

Electrocardiogram

Date of ECG
Beskrivning

Date of ECG

Datatyp

date

Time of ECG
Beskrivning

Time of ECG

Datatyp

time

Heart Rate
Beskrivning

Heart Rate

Datatyp

integer

Måttenheter
  • bpm
bpm
PR Interval
Beskrivning

PR Interval

Datatyp

float

Måttenheter
  • msec
msec
QRS Duration
Beskrivning

QRS Duration

Datatyp

float

Måttenheter
  • msec
msec
QT Interval
Beskrivning

QT Interval

Datatyp

float

Måttenheter
  • msec
msec
QTcB Interval
Beskrivning

QTcB Interval

Datatyp

float

Måttenheter
  • msec
msec
QTcF Interval
Beskrivning

QTcF Interval

Datatyp

float

Måttenheter
  • msec
msec
RR Interval
Beskrivning

RR Interval

Datatyp

float

Måttenheter
  • msec
msec
Normal Sinus Rhythm
Beskrivning

Normal Sinus Rhythm

Datatyp

boolean

Overall Interpretation of ECG
Beskrivning

Overall Interpretation of ECG

check the result
Beskrivning

check the result

Datatyp

text

If Abnormal, please specify
Beskrivning

If Abnormal, please specify

Datatyp

text

Hematologic Test
Beskrivning

Hematologic Test

Was the laboratory sample collected?
Beskrivning

Was the laboratory sample collected?

Datatyp

boolean

Sample Date
Beskrivning

Sample Date

Datatyp

date

Sample Time
Beskrivning

Sample Time

Datatyp

time

Comment
Beskrivning

Comment

Datatyp

text

Chemistry Test
Beskrivning

Chemistry Test

Was the laboratory sample collected?
Beskrivning

Was the laboratory sample collected?

Datatyp

boolean

Sample Date
Beskrivning

Sample Date

Datatyp

date

Sample Time
Beskrivning

Sample Time

Datatyp

time

Comment
Beskrivning

Comment

Datatyp

text

UA / Urine Chemistry Test
Beskrivning

UA / Urine Chemistry Test

Was the laboratory sample collected?
Beskrivning

Was the laboratory sample collected?

Datatyp

boolean

Sample Date
Beskrivning

Sample Date

Datatyp

date

Sample Time
Beskrivning

Sample Time

Datatyp

time

Comment
Beskrivning

Comment

Datatyp

text

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Similar models

Follow-Up: Vital Signs, Electrocardiogram, Laboratory Tests

1 Formulär
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Administrative data
Site
Item
Site
text
Subject
Item
Subject
text
Item
Visit Name
text
Visit Name
Code List
Visit Name
CL Item
Follow-Up (1)
Item
Visit Number
text
Visit Number
Code List
Visit Number
CL Item
290 (1)
Status
Item
Status
text
Document Number
Item
Document Number
text
Visit Date
Item
Visit Date
date
Item Group
Vital Signs - Duplicate 1
Date of Vital Signs
Item
Date of Vital Signs
date
Time of Vital Signs
Item
Time of Vital Signs
time
Blood Pressure - Systolic
Item
Blood Pressure - Systolic
float
Blood Pressure - Diastolic
Item
Blood Pressure - Diastolic
float
Heart Rate
Item
Heart Rate
integer
Temperature
Item
Temperature
float
Body Position
Item
Body Position
text
Comment
Item
Comment
text
Item Group
Duplicate 2
Time of Vital Signs
Item
Time of Vital Signs
time
Blood Pressure - Systolic
Item
Blood Pressure - Systolic
float
Blood Pressure - Diastolic
Item
Blood Pressure - Diastolic
float
Heart Rate
Item
Heart Rate
integer
Body Position
Item
Body Position
text
Comment
Item
Comment
text
Item Group
Physical Examination
Date of Physical Examination
Item
Date of Physical Examination
date
Item
Skin including Injection Site
text
Skin including Injection Site
Code List
Skin including Injection Site
CL Item
Normal (1)
CL Item
Abnormal (2)
CL Item
Not Done (3)
Specify Abnormality
Item
Specify Abnormality
text
Item
Lungs
text
Lungs
Code List
Lungs
CL Item
Normal (1)
CL Item
Abnormal (2)
CL Item
Not Done (3)
Specify Abnormality
Item
Specify Abnormality
text
Item
Cardiovascular
text
Cardiovascular
Code List
Cardiovascular
CL Item
Normal (1)
CL Item
Abnormal (2)
CL Item
Not Done (3)
Specify Abnormality
Item
Specify Abnormality
text
Item
Abdomen (Liver and Spleen)
text
Abdomen (Liver and Spleen)
Code List
Abdomen (Liver and Spleen)
CL Item
Normal (1)
CL Item
Abnormal (2)
CL Item
Not Done (3)
Specify Abnormality
Item
Specify Abnormality
text
Item
Other
text
Other
Code List
Other
CL Item
Normal (1)
CL Item
Abnormal (2)
CL Item
Not Done (3)
Specify details and possible abnormalities
Item
Specify details and possible abnormalities
text
Item Group
Electrocardiogram
Date of ECG
Item
Date of ECG
date
Time of ECG
Item
Time of ECG
time
Heart Rate
Item
Heart Rate
integer
PR Interval
Item
PR Interval
float
QRS Duration
Item
QRS Duration
float
QT Interval
Item
QT Interval
float
QTcB Interval
Item
QTcB Interval
float
QTcF Interval
Item
QTcF Interval
float
RR Interval
Item
RR Interval
float
Normal Sinus Rhythm
Item
Normal Sinus Rhythm
boolean
Item Group
Overall Interpretation of ECG
Item
check the result
text
check the result
Code List
check the result
CL Item
Normal (1)
CL Item
Abnormal; Not Clinically Significant (2)
CL Item
Abnormal; Clinically Significant (3)
If Abnormal, please specify
Item
If Abnormal, please specify
text
Item Group
Hematologic Test
Was the laboratory sample collected?
Item
Was the laboratory sample collected?
boolean
Sample Date
Item
Sample Date
date
Sample Time
Item
Sample Time
time
Comment
Item
Comment
text
Item Group
Chemistry Test
Was the laboratory sample collected?
Item
Was the laboratory sample collected?
boolean
Sample Date
Item
Sample Date
date
Sample Time
Item
Sample Time
time
Comment
Item
Comment
text
Was the laboratory sample collected?
Item
Was the laboratory sample collected?
boolean
Sample Date
Item
Sample Date
date
Sample Time
Item
Sample Time
time
Comment
Item
Comment
text
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