Study Coordinating Center, Identification number
Item
Center number
integer
C2825181 (UMLS CUI [1,1])
C1300638 (UMLS CUI [1,2])
Patient number
Item
Patient Number
integer
C1830427 (UMLS CUI [1])
Person Initials
Item
Patient Initials
text
C2986440 (UMLS CUI [1])
Clinical Trials, Complete
Item
Did the patient complete the study as planned?
boolean
C0008976 (UMLS CUI [1,1])
C0205197 (UMLS CUI [1,2])
Item
If 'No', mark the Primary cause of withdrawal.
text
C0008976 (UMLS CUI [1,1])
C2349954 (UMLS CUI [1,2])
C0566251 (UMLS CUI [1,3])
Code List
If 'No', mark the Primary cause of withdrawal.
CL Item
Adverse Experience (1)
CL Item
Insufficient therapeutic effect (2)
CL Item
Protocol deviation (including non-compliance) (3)
CL Item
Lost to follow-up (4)
CL Item
Other - specify (5)
Clinical Trials, Withdraw, Reason and justification
Item
Other - specify
text
C0008976 (UMLS CUI [1,1])
C2349954 (UMLS CUI [1,2])
C0566251 (UMLS CUI [1,3])
Clinical Trials, Withdraw, Reason and justification, Comment
Item
Comment on the reason for withdrawal
text
C0008976 (UMLS CUI [1,1])
C2349954 (UMLS CUI [1,2])
C0566251 (UMLS CUI [1,3])
C0947611 (UMLS CUI [1,4])
Clinical Trials, Evaluation, Final, Date in time
Item
Date of Final Study Evaluation
date
C0008976 (UMLS CUI [1,1])
C0220825 (UMLS CUI [1,2])
C3853528 (UMLS CUI [1,3])
C0011008 (UMLS CUI [1,4])
Investigator Signature
Item
Investigator's Signature
text
C2346576 (UMLS CUI [1])
Investigator Signature, Date in time
Item
Date
date
C2346576 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])