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Mechanical Prophylaxis and Physical Therapy

1 forms  
Administrative data
Description

Administrative data

Alias
UMLS CUI-1
C1320722
Country No.
Description

Country No.

Data type

integer

Alias
UMLS CUI [1,1]
C0454664
UMLS CUI [1,2]
C0600091
Centre No.
Description

Centre No.

Data type

integer

Alias
UMLS CUI [1,1]
C1301943
UMLS CUI [1,2]
C0600091
Subject No.
Description

Clinical Trial Subject Unique Identifier

Data type

integer

Alias
UMLS CUI [1]
C2348585
Mechanical Prophylaxis and Physical Therapy
Description

Mechanical Prophylaxis and Physical Therapy

Alias
UMLS CUI-1
C0199176
UMLS CUI-2
C0443254
UMLS CUI-3
C0949766
Intermittent Pneumatic Compression: knee-high?
Description

Intermittent Pneumatic Compression: knee-high?

Data type

boolean

Alias
UMLS CUI [1,1]
C1998430
UMLS CUI [1,2]
C0022742
UMLS CUI [1,3]
C0441889
Intermittent Pneumatic Compression: thigh-high?
Description

Intermittent Pneumatic Compression: thigh-high?

Data type

boolean

Alias
UMLS CUI [1,1]
C1998430
UMLS CUI [1,2]
C0039866
UMLS CUI [1,3]
C0441889
Duration of Application: Start Date
Description

Intermittent Pneumatic Compression: Start Date

Data type

date

Alias
UMLS CUI [1,1]
C1998430
UMLS CUI [1,2]
C0808070
Duration of Application: Date of removal
Description

Intermittent Pneumatic Compression: End date

Data type

date

Alias
UMLS CUI [1,1]
C1998430
UMLS CUI [1,2]
C0806020
Did the subject wear elastic stockings (TED HOSE) for thrombosis prevention during the treatment period?
Description

If yes, record start/removal date

Data type

boolean

Alias
UMLS CUI [1,1]
C0038348
UMLS CUI [1,2]
C0347984
UMLS CUI [1,3]
C2347804
Compression stockings: Start date
Description

if applicable

Data type

date

Alias
UMLS CUI [1,1]
C0038348
UMLS CUI [1,2]
C0808070
Compression stockings: Date of removal
Description

if applicable

Data type

date

Alias
UMLS CUI [1,1]
C0038348
UMLS CUI [1,2]
C0806020
Did the subject receive physical therapy during the treatment period?
Description

Physical therapy?

Data type

boolean

Alias
UMLS CUI [1]
C0949766
What day did the subject first ambulate?
Description

Day first ambulate

Data type

date

Alias
UMLS CUI [1,1]
C4036205
UMLS CUI [1,2]
C0808070
Investigator's Signature
Description

Investigator's Signature

Alias
UMLS CUI-1
C2346576
Investigator's Signature
Description

"I, the undersigned, certify that I have carefully examined all entries on the CRF for this subject. To the best of my knowledge, all information is correct."

Data type

text

Alias
UMLS CUI [1]
C2346576
Investigator's Signature Date
Description

Investigator's Signature Date

Data type

date

Alias
UMLS CUI [1,1]
C2346576
UMLS CUI [1,2]
C0011008
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Similar models

Mechanical Prophylaxis and Physical Therapy

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Administrative data
C1320722 (UMLS CUI-1)
Country No.
Item
Country No.
integer
C0454664 (UMLS CUI [1,1])
C0600091 (UMLS CUI [1,2])
Centre No.
Item
Centre No.
integer
C1301943 (UMLS CUI [1,1])
C0600091 (UMLS CUI [1,2])
Clinical Trial Subject Unique Identifier
Item
Subject No.
integer
C2348585 (UMLS CUI [1])
Item Group
Mechanical Prophylaxis and Physical Therapy
C0199176 (UMLS CUI-1)
C0443254 (UMLS CUI-2)
C0949766 (UMLS CUI-3)
Intermittent Pneumatic Compression: knee-high?
Item
Intermittent Pneumatic Compression: knee-high?
boolean
C1998430 (UMLS CUI [1,1])
C0022742 (UMLS CUI [1,2])
C0441889 (UMLS CUI [1,3])
Intermittent Pneumatic Compression: thigh-high?
Item
Intermittent Pneumatic Compression: thigh-high?
boolean
C1998430 (UMLS CUI [1,1])
C0039866 (UMLS CUI [1,2])
C0441889 (UMLS CUI [1,3])
Intermittent Pneumatic Compression: Start Date
Item
Duration of Application: Start Date
date
C1998430 (UMLS CUI [1,1])
C0808070 (UMLS CUI [1,2])
Intermittent Pneumatic Compression: End date
Item
Duration of Application: Date of removal
date
C1998430 (UMLS CUI [1,1])
C0806020 (UMLS CUI [1,2])
Compression stockings during trial period?
Item
Did the subject wear elastic stockings (TED HOSE) for thrombosis prevention during the treatment period?
boolean
C0038348 (UMLS CUI [1,1])
C0347984 (UMLS CUI [1,2])
C2347804 (UMLS CUI [1,3])
Compression stockings: Start date
Item
Compression stockings: Start date
date
C0038348 (UMLS CUI [1,1])
C0808070 (UMLS CUI [1,2])
Compression stockings: End date
Item
Compression stockings: Date of removal
date
C0038348 (UMLS CUI [1,1])
C0806020 (UMLS CUI [1,2])
Physical therapy?
Item
Did the subject receive physical therapy during the treatment period?
boolean
C0949766 (UMLS CUI [1])
Day first ambulate
Item
What day did the subject first ambulate?
date
C4036205 (UMLS CUI [1,1])
C0808070 (UMLS CUI [1,2])
Item Group
Investigator's Signature
C2346576 (UMLS CUI-1)
Investigator's Signature
Item
Investigator's Signature
text
C2346576 (UMLS CUI [1])
Investigator's Signature Date
Item
Investigator's Signature Date
date
C2346576 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
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