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HIV Screening Consent and Sample

1 forms  
Administrative data
Description

Administrative data

Alias
UMLS CUI-1
C1320722
Subject Identifier
Description

Clinical Trial Subject Unique Identifier

Data type

integer

Alias
UMLS CUI [1]
C2348585
Date of Visit
Description

Date of Visit

Data type

date

Alias
UMLS CUI [1]
C1320303
Screening Informed Consent
Description

Screening Informed Consent

Alias
UMLS CUI-1
C0021430
Informed Consent Date
Description

I certify that Informed Consent has been obtained prior to any study procedure.

Data type

date

Alias
UMLS CUI [1]
C2985782
HIV test consent not applicable
Description

Subjects who have already performed a HIV DNA test before the study screening phase

Data type

boolean

Alias
UMLS CUI [1,1]
C1272460
UMLS CUI [1,2]
C1321876
UMLS CUI [1,3]
C0021430
Laboratory Test Blood Sample
Description

Laboratory Test Blood Sample

Alias
UMLS CUI-1
C0005834
Has a blood sample been taken for HIV DNA testing?
Description

if yes, answer subsequent questions

Data type

boolean

Alias
UMLS CUI [1,1]
C1277698
UMLS CUI [1,2]
C0486959
UMLS CUI [1,3]
C0022885
Date of Blood Sample (if different from visit date)
Description

if applicable

Data type

date

Alias
UMLS CUI [1,1]
C1277698
UMLS CUI [1,2]
C0011008
HIV test result
Description

HIV test result

Data type

integer

Alias
UMLS CUI [1,1]
C1321876
UMLS CUI [1,2]
C1274040
Which lab did the test?
Description

Performing laboratory

Data type

integer

Alias
UMLS CUI [1]
C1882331
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Similar models

HIV Screening Consent and Sample

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Administrative data
C1320722 (UMLS CUI-1)
Clinical Trial Subject Unique Identifier
Item
Subject Identifier
integer
C2348585 (UMLS CUI [1])
Date of Visit
Item
Date of Visit
date
C1320303 (UMLS CUI [1])
Item Group
Screening Informed Consent
C0021430 (UMLS CUI-1)
Informed Consent Date
Item
Informed Consent Date
date
C2985782 (UMLS CUI [1])
HIV test consent not applicable
Item
HIV test consent not applicable
boolean
C1272460 (UMLS CUI [1,1])
C1321876 (UMLS CUI [1,2])
C0021430 (UMLS CUI [1,3])
Item Group
Laboratory Test Blood Sample
C0005834 (UMLS CUI-1)
Blood sample taken for HIV DNA testing?
Item
Has a blood sample been taken for HIV DNA testing?
boolean
C1277698 (UMLS CUI [1,1])
C0486959 (UMLS CUI [1,2])
C0022885 (UMLS CUI [1,3])
Date of Blood Sample
Item
Date of Blood Sample (if different from visit date)
date
C1277698 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Item
HIV test result
integer
C1321876 (UMLS CUI [1,1])
C1274040 (UMLS CUI [1,2])
HIV test result
Code List
HIV test result
CL Item
positive (1)
CL Item
negative (0)
Item
Which lab did the test?
integer
C1882331 (UMLS CUI [1])
performing laboratory
Code List
Which lab did the test?
CL Item
Local laboratory (1)
CL Item
Central laboratory (2)
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