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General medical history/ physical examination

1 Formulär  
Administrative data
Beskrivning

Administrative data

Alias
UMLS CUI-1
C1320722
Subject Number
Beskrivning

Subject Number

Datatyp

text

Alias
UMLS CUI [1]
C2348585
Date of Visit
Beskrivning

day month year

Datatyp

date

Alias
UMLS CUI [1]
C0011008
General Medical History/ Physical Examination
Beskrivning

General Medical History/ Physical Examination

Alias
UMLS CUI-1
C0262926
UMLS CUI-2
C0031809
Are you aware of any pre-existing conditions, signs or symptoms present prior to the start of the study?
Beskrivning

If you tick yes, please give diagnosis and tick appropriate Past/Current box(es).

Datatyp

text

Alias
UMLS CUI [1]
C0012634
UMLS CUI [2]
C0037088
MedDRA SYSTEM ORGAN CLASS
Beskrivning

MedDRA SYSTEM ORGAN CLASS

Datatyp

integer

Alias
UMLS CUI [1]
C2347091
General Medical History/ Physical examination, diagnosis
Beskrivning

Please report medication(s) as specified in the protocol and fill in the Medication section.

Datatyp

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0031809
UMLS CUI [1,3]
C0011900
Disease, signs and symptoms
Beskrivning

Disease, signs and symptoms

Datatyp

integer

Alias
UMLS CUI [1,1]
C0012634
UMLS CUI [1,2]
C0449438
UMLS CUI [2,1]
C0037088
UMLS CUI [2,2]
C0449438
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Similar models

General medical history/ physical examination

1 Formulär
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Administrative data
C1320722 (UMLS CUI-1)
Subject Number
Item
Subject Number
text
C2348585 (UMLS CUI [1])
Date of Visit
Item
Date of Visit
date
C0011008 (UMLS CUI [1])
Item Group
General Medical History/ Physical Examination
C0262926 (UMLS CUI-1)
C0031809 (UMLS CUI-2)
Item
Are you aware of any pre-existing conditions, signs or symptoms present prior to the start of the study?
text
C0012634 (UMLS CUI [1])
C0037088 (UMLS CUI [2])
Medical condition, signs and symptoms
Code List
Are you aware of any pre-existing conditions, signs or symptoms present prior to the start of the study?
CL Item
Yes (Y)
CL Item
No (N)
Item
MedDRA SYSTEM ORGAN CLASS
integer
C2347091 (UMLS CUI [1])
Physical examination
Code List
MedDRA SYSTEM ORGAN CLASS
CL Item
Skin and subcutaneous tissue (1)
CL Item
Musculoskeletal and connective tissue (2)
CL Item
Cardiac (3)
CL Item
Vascular (4)
CL Item
Respiratory, thoracic and mediastinal (5)
CL Item
Gastrointestinal (6)
CL Item
Hepatobiliary (7)
CL Item
Renal and urinary (8)
CL Item
Nervous system (9)
CL Item
Eye (10)
CL Item
Ear and labyrinth (11)
CL Item
Endocrine (12)
CL Item
Metabolism and nutrition (13)
CL Item
Blood and lymphatic system (14)
CL Item
Immune system (incl allergies, autoimmune disorders) (15)
CL Item
Infections and infestations (16)
CL Item
Neoplasms benign, malignant and unspecified (incl cysts, polyps) (17)
CL Item
Surgical and medical procedures (18)
CL Item
Other (99)
General Medical History/ Physical examination, diagnosis
Item
General Medical History/ Physical examination, diagnosis
text
C0262926 (UMLS CUI [1,1])
C0031809 (UMLS CUI [1,2])
C0011900 (UMLS CUI [1,3])
Item
Disease, signs and symptoms
integer
C0012634 (UMLS CUI [1,1])
C0449438 (UMLS CUI [1,2])
C0037088 (UMLS CUI [2,1])
C0449438 (UMLS CUI [2,2])
Examination status
Code List
Disease, signs and symptoms
CL Item
Past (1)
CL Item
Current (2)
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