Study Coordinating Center, Identification number
Item
Centre Number
integer
C2825181 (UMLS CUI [1,1])
C1300638 (UMLS CUI [1,2])
Clinical Trial Subject Unique Identifier
Item
Patient Number
integer
C2348585 (UMLS CUI [1])
Person Initials
Item
Patient Initials
text
C2986440 (UMLS CUI [1])
Concomitant Agent, No status change
Item
Please mark if no new or change in concomitant medication since the previous visit.
boolean
C2347852 (UMLS CUI [1,1])
C0442739 (UMLS CUI [1,2])
Concomitant Agent, Medication name
Item
Drug Name (Trade Name Preferred)
text
C2347852 (UMLS CUI [1,1])
C2360065 (UMLS CUI [1,2])
Concomitant Medication Daily Dose, Total
Item
Total Daily Dose
text
C2826638 (UMLS CUI [1,1])
C0439810 (UMLS CUI [1,2])
Concomitant Agent, Disease
Item
Medical Illness/ Diagnosis (or symptom in absence of diagnosis)
text
C2347852 (UMLS CUI [1,1])
C0012634 (UMLS CUI [1,2])
Concomitant Medication Start Date
Item
Start Date (be as precise as possible)
date
C2826734 (UMLS CUI [1])
Concomitant Medication End Date
Item
End Date
date
C2826744 (UMLS CUI [1])
Concomitant Medication Ongoing
Item
If Continuing mark box
boolean
C2826666 (UMLS CUI [1])