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Predose Drug Screening/Alcohol Breath Test

1 forms  
Administrative data
Description

Administrative data

Alias
UMLS CUI-1
C1320722
Subject No.
Description

Subject No.

Data type

text

Alias
UMLS CUI [1]
C2348585
Panel ID
Description

Panel ID

Data type

text

Alias
UMLS CUI [1]
C3846158
Visit type
Description

Visit type

Data type

integer

Alias
UMLS CUI [1]
C0545082
Visit Date
Description

day month year

Data type

date

Alias
UMLS CUI [1]
C1320303
Drug Screening
Description

Drug Screening

Alias
UMLS CUI-1
C0373483
Exact time of urine sampling
Description

00:00-23:59

Data type

time

Alias
UMLS CUI [1,1]
C0042014
UMLS CUI [1,2]
C0040223
Exact time of blood sampling
Description

00:00-23:59

Data type

time

Alias
UMLS CUI [1,1]
C0005834
UMLS CUI [1,2]
C0040223
Were there any contra-indicated drugs detected?
Description

If YES, please record all the relevant contra-indicated drugs below.

Data type

text

Alias
UMLS CUI [1,1]
C1511790
UMLS CUI [1,2]
C1444657
UMLS CUI [1,3]
C1254351
Type of drug
Description

Type of drug

Data type

text

Alias
UMLS CUI [1]
C0457591
Comment
Description

Comment

Data type

text

Alias
UMLS CUI [1]
C0947611
Alcohol breath test
Description

Alcohol breath test

Alias
UMLS CUI-1
C0202306
Exact time of test
Description

00:00-23:59

Data type

time

Alias
UMLS CUI [1]
C0429928
Alcohol breath test, result
Description

If POSITIVE, do not include the subject in the study.

Data type

text

Alias
UMLS CUI [1,1]
C0202306
UMLS CUI [1,2]
C1274040
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Similar models

Predose Drug Screening/Alcohol Breath Test

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Administrative data
C1320722 (UMLS CUI-1)
Subject No.
Item
Subject No.
text
C2348585 (UMLS CUI [1])
Panel ID
Item
Panel ID
text
C3846158 (UMLS CUI [1])
Item
Visit type
integer
C0545082 (UMLS CUI [1])
Visit type
Code List
Visit type
CL Item
Screening (1)
CL Item
Session 1 day 1 (2)
CL Item
Session 2 day 1  (3)
CL Item
Session 3 day 1 (4)
CL Item
Session 4 day 1 (5)
CL Item
Session 5 day 1 (6)
Visit Date
Item
Visit Date
date
C1320303 (UMLS CUI [1])
Item Group
Drug Screening
C0373483 (UMLS CUI-1)
Urine sampling time
Item
Exact time of urine sampling
time
C0042014 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Blood sampling time
Item
Exact time of blood sampling
time
C0005834 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Item
Were there any contra-indicated drugs detected?
text
C1511790 (UMLS CUI [1,1])
C1444657 (UMLS CUI [1,2])
C1254351 (UMLS CUI [1,3])
Contra-indicated drugs detected
Code List
Were there any contra-indicated drugs detected?
CL Item
Yes (Y)
CL Item
No (N)
Type of drug
Item
Type of drug
text
C0457591 (UMLS CUI [1])
Comment
Item
Comment
text
C0947611 (UMLS CUI [1])
Item Group
Alcohol breath test
C0202306 (UMLS CUI-1)
Time of test
Item
Exact time of test
time
C0429928 (UMLS CUI [1])
Item
Alcohol breath test, result
text
C0202306 (UMLS CUI [1,1])
C1274040 (UMLS CUI [1,2])
Alcohol breath test, result
Code List
Alcohol breath test, result
CL Item
Negative (N)
CL Item
Positive (P)
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