1. StudyEvent: ODM
    1. Form D
Administrative Data
Description

Administrative Data

Alias
UMLS CUI-1
C1320722
Center number
Description

Study Coordinating Center, Identification number

Data type

integer

Alias
UMLS CUI [1,1]
C2825181
UMLS CUI [1,2]
C1300638
Patient Number
Description

Patient number

Data type

integer

Alias
UMLS CUI [1]
C1830427
Patient Initials
Description

Person Initials

Data type

text

Alias
UMLS CUI [1]
C2986440
Form D
Description

Form D

Alias
UMLS CUI-1
C0011065
Cause of Death
Description

Cause of Death

Data type

text

Alias
UMLS CUI [1]
C0007465
Specify
Description

Cause of Death

Data type

text

Alias
UMLS CUI [1]
C0007465
Date of Death
Description

Date of death

Data type

date

Alias
UMLS CUI [1]
C1148348
Was a post-mortem done?
Description

Cessation of life, Autopsy

Data type

boolean

Alias
UMLS CUI [1,1]
C0011065
UMLS CUI [1,2]
C0004398
If 'Yes' please summarize findings (include diagnosis)
Description

Cessation of life, Autopsy, Finding

Data type

text

Alias
UMLS CUI [1,1]
C0011065
UMLS CUI [1,2]
C0004398
UMLS CUI [1,3]
C0243095
Physician's Signature
Description

Cessation of life, Signature of responsible attending physician on file

Data type

text

Alias
UMLS CUI [1,1]
C0011065
UMLS CUI [1,2]
C0807938
Date
Description

Cessation of life, Signature of responsible attending physician on file, Date in time

Data type

date

Alias
UMLS CUI [1,1]
C0011065
UMLS CUI [1,2]
C0807938
UMLS CUI [1,3]
C0011008

Similar models

Form D

  1. StudyEvent: ODM
    1. Form D
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Administrative Data
C1320722 (UMLS CUI-1)
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])
Item Group
Form D
C0011065 (UMLS CUI-1)
Item
Cause of Death
text
C0007465 (UMLS CUI [1])
Code List
Cause of Death
CL Item
Progressive Disease (1)
CL Item
Toxicity: Hematologic (2)
CL Item
Toxicity: Non-Hematologic (3)
CL Item
Other, specify (4)
Cause of Death
Item
Specify
text
C0007465 (UMLS CUI [1])
Date of death
Item
Date of Death
date
C1148348 (UMLS CUI [1])
Cessation of life, Autopsy
Item
Was a post-mortem done?
boolean
C0011065 (UMLS CUI [1,1])
C0004398 (UMLS CUI [1,2])
Cessation of life, Autopsy, Finding
Item
If 'Yes' please summarize findings (include diagnosis)
text
C0011065 (UMLS CUI [1,1])
C0004398 (UMLS CUI [1,2])
C0243095 (UMLS CUI [1,3])
Cessation of life, Signature of responsible attending physician on file
Item
Physician's Signature
text
C0011065 (UMLS CUI [1,1])
C0807938 (UMLS CUI [1,2])
Cessation of life, Signature of responsible attending physician on file, Date in time
Item
Date
date
C0011065 (UMLS CUI [1,1])
C0807938 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])