Englisch

Form D

1 Formulare  
  1. StudyEvent: ODM
    1. Form D
Administrative Data
Beschreibung

Administrative Data

Alias
UMLS CUI-1
C1320722
Subject number
Beschreibung

Subject number

Datentyp

integer

Alias
UMLS CUI [1]
C2348585
FORM D
Beschreibung

FORM D

Alias
UMLS CUI-1
C1306577
Certified cause of death
Beschreibung

Complete Adverse Event Form

Datentyp

text

Alias
UMLS CUI [1]
C0007465
Date of death
Beschreibung

day month year

Datentyp

date

Alias
UMLS CUI [1]
C1148348
Was an autopsy done?
Beschreibung

Autopsy performance

Datentyp

text

Alias
UMLS CUI [1,1]
C0004398
UMLS CUI [1,2]
C1518965
If an autopsy was performed, please summarize findings (including diagnosis)
Beschreibung

Findings autopsy

Datentyp

text

Alias
UMLS CUI [1,1]
C0243095
UMLS CUI [1,2]
C0004398
Physician’s signature
Beschreibung

Physician signature

Datentyp

text

Alias
UMLS CUI [1]
C1519316
Date of signature
Beschreibung

day month year

Datentyp

date

Alias
UMLS CUI [1,1]
C2346576
UMLS CUI [1,2]
C0011008
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Ähnliche Modelle

Form D

1 Formulare
  1. StudyEvent: ODM
    1. Form D
Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
Alias
Item Group
Administrative Data
C1320722 (UMLS CUI-1)
Subject number
Item
Subject number
integer
C2348585 (UMLS CUI [1])
Item Group
FORM D
C1306577 (UMLS CUI-1)
Cause of death
Item
Certified cause of death
text
C0007465 (UMLS CUI [1])
Date of death
Item
Date of death
date
C1148348 (UMLS CUI [1])
Item
Was an autopsy done?
text
C0004398 (UMLS CUI [1,1])
C1518965 (UMLS CUI [1,2])
Autopsy performance
Code List
Was an autopsy done?
CL Item
Yes (Y)
CL Item
No (N)
Findings autopsy
Item
If an autopsy was performed, please summarize findings (including diagnosis)
text
C0243095 (UMLS CUI [1,1])
C0004398 (UMLS CUI [1,2])
Physician signature
Item
Physician’s signature
text
C1519316 (UMLS CUI [1])
Date of signature
Item
Date of signature
date
C2346576 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
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