Centre Number
Item
Centre Number
text
C0600091 (UMLS CUI [1,1])
C0019994 (UMLS CUI [1,2])
Patient Number
Item
Patient Number
text
C2348585 (UMLS CUI [1])
Patient Initials
Item
Patient Initials
text
C2986440 (UMLS CUI [1])
Visit Date
Item
Visit Date
date
C1320303 (UMLS CUI [1])
Item
Visit Type
integer
C0545082 (UMLS CUI [1,1])
C0332307 (UMLS CUI [1,2])
CL Item
Early withdrawal (15)
Study Medication Record
Item
Please complete the study medication record in the Study Medication and Compliance Section
boolean
C2734539 (UMLS CUI [1,1])
C0008972 (UMLS CUI [1,2])
Dose reduction
Item
If the patient requires a dose reduction between this and the next visit please complete Dose Reductions Due To Adverse Experiences pages
boolean
C1707814 (UMLS CUI [1])