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Bleeding Adjudication

1 forms  
  1. StudyEvent: ODM
    1. Bleeding Adjudication
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
Subject Initials
Description

Subject Initials

Data type

text

Alias
UMLS CUI [1,1]
C1997894
UMLS CUI [1,2]
C2986440
Bleeding Event Adjudication Form
Description

Bleeding Event Adjudication Form

Alias
UMLS CUI-1
C0680730
UMLS CUI-2
C0019080
CRF page number
Description

CRF page number

Data type

float

Alias
UMLS CUI [1,1]
C1704732
UMLS CUI [1,2]
C1516308
Date of onset
Description

Date of bleeding onset

Data type

date

Alias
UMLS CUI [1,1]
C0574845
UMLS CUI [1,2]
C0019080
Adverse event reference number(s)
Description

Adverse event reference number(s)

Alias
UMLS CUI-1
C0877248
UMLS CUI-2
C0600091
Adverse event reference number
Description

Adverse event reference number

Data type

integer

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C0600091
This is the main AE reference number
Description

(only applicable if more than AE reference No. recorded)

Data type

boolean

Alias
UMLS CUI [1,1]
C1542147
UMLS CUI [1,2]
C0600091
UMLS CUI [1,3]
C0877248
Provide a response to each of the following bleeding criteria:
Description

Provide a response to each of the following bleeding criteria:

Alias
UMLS CUI-1
C0019080
UMLS CUI-2
C0243161
Clinically overt
Description

Bleeding clinically overt?

Data type

boolean

Alias
UMLS CUI [1,1]
C0019080
UMLS CUI [1,2]
C0205379
Non-surgical site bleeding at a critical site
Description

If yes, select locations in next 6 items.

Data type

boolean

Alias
UMLS CUI [1,1]
C0019080
UMLS CUI [1,2]
C1511545
UMLS CUI [1,3]
C1515974
UMLS CUI [1,4]
C1705847
UMLS CUI [1,5]
C0741556
Intracranial bleeding
Description

Only applicable if non-surgical site bleeding at a critical site

Data type

boolean

Alias
UMLS CUI [1]
C0151699
Retroperitoneal bleeding
Description

Only applicable if non-surgical site bleeding at a critical site

Data type

boolean

Alias
UMLS CUI [1]
C0151705
Intraocular bleeding
Description

Only applicable if non-surgical site bleeding at a critical site

Data type

boolean

Alias
UMLS CUI [1]
C0015402
Spinal bleeding
Description

Only applicable if non-surgical site bleeding at a critical site

Data type

boolean

Alias
UMLS CUI [1]
C0018949
Pericardial bleeding
Description

Only applicable if non-surgical site bleeding at a critical site

Data type

boolean

Alias
UMLS CUI [1]
C0019064
Adrenal glands bleeding
Description

Only applicable if non-surgical site bleeding at a critical site

Data type

boolean

Alias
UMLS CUI [1,1]
C0001625
UMLS CUI [1,2]
C0019080
Non-surgical site bleeding leading to an intervention
Description

Non-surgical site bleeding leading to intervention

Data type

boolean

Alias
UMLS CUI [1,1]
C0019080
UMLS CUI [1,2]
C0332294
UMLS CUI [1,3]
C0184661
UMLS CUI [2,1]
C1705847
UMLS CUI [2,2]
C0741556
Non-surgical site bleeding with a bleeding index ≥2.0
Description

Bleeding index = hemoglobin decrease (value determined before and after the bleeding episode) + number of units transfused

Data type

boolean

Alias
UMLS CUI [1,1]
C0019080
UMLS CUI [1,2]
C1709793
UMLS CUI [2,1]
C1705847
UMLS CUI [2,2]
C0741556
Surgical bleeding leading to an intervention
Description

Surgical bleeding leading to intervention

Data type

boolean

Alias
UMLS CUI [1,1]
C0741556
UMLS CUI [1,2]
C0332294
UMLS CUI [1,3]
C0184661
Fatal bleed
Description

Fatal bleed

Data type

boolean

Alias
UMLS CUI [1,1]
C0019080
UMLS CUI [1,2]
C1302234
Classification Status
Description

Classification Status

Alias
UMLS CUI-1
C0008902
UMLS CUI-2
C0680730
UMLS CUI-3
C1274040
Bleeding Classification
Description

Bleeding Classification

Data type

text

Alias
UMLS CUI [1,1]
C0019080
UMLS CUI [1,2]
C0008902
Comment
Description

Bleeding Comment

Data type

text

Alias
UMLS CUI [1,1]
C0947611
UMLS CUI [1,2]
C0019080
Adjudicators
Description

Adjudicators

Alias
UMLS CUI-1
C0401783
Adjudicator Signature 1
Description

Adjudicator Signature 1

Data type

text

Alias
UMLS CUI [1,1]
C0401783
UMLS CUI [1,2]
C1519316
Adjudicator Signature 2
Description

Adjudicator Signature 2

Data type

text

Alias
UMLS CUI [1,1]
C0401783
UMLS CUI [1,2]
C1519316
Date of adjudication
Description

Date of adjudication

Data type

text

Alias
UMLS CUI [1]
C4740194
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Similar models

Bleeding Adjudication

1 forms
  1. StudyEvent: ODM
    1. Bleeding Adjudication
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])
Subject Initials
Item
Subject Initials
text
C1997894 (UMLS CUI [1,1])
C2986440 (UMLS CUI [1,2])
Item Group
Bleeding Event Adjudication Form
C0680730 (UMLS CUI-1)
C0019080 (UMLS CUI-2)
CRF page number
Item
CRF page number
float
C1704732 (UMLS CUI [1,1])
C1516308 (UMLS CUI [1,2])
Date of bleeding onset
Item
Date of onset
date
C0574845 (UMLS CUI [1,1])
C0019080 (UMLS CUI [1,2])
Item Group
Adverse event reference number(s)
C0877248 (UMLS CUI-1)
C0600091 (UMLS CUI-2)
Adverse event reference number
Item
Adverse event reference number
integer
C0877248 (UMLS CUI [1,1])
C0600091 (UMLS CUI [1,2])
Main AE reference number?
Item
This is the main AE reference number
boolean
C1542147 (UMLS CUI [1,1])
C0600091 (UMLS CUI [1,2])
C0877248 (UMLS CUI [1,3])
Item Group
Provide a response to each of the following bleeding criteria:
C0019080 (UMLS CUI-1)
C0243161 (UMLS CUI-2)
Bleeding clinically overt?
Item
Clinically overt
boolean
C0019080 (UMLS CUI [1,1])
C0205379 (UMLS CUI [1,2])
Non-surgical site bleeding at critical site?
Item
Non-surgical site bleeding at a critical site
boolean
C0019080 (UMLS CUI [1,1])
C1511545 (UMLS CUI [1,2])
C1515974 (UMLS CUI [1,3])
C1705847 (UMLS CUI [1,4])
C0741556 (UMLS CUI [1,5])
Intracranial bleeding
Item
Intracranial bleeding
boolean
C0151699 (UMLS CUI [1])
Retroperitoneal bleeding
Item
Retroperitoneal bleeding
boolean
C0151705 (UMLS CUI [1])
Intraocular bleeding
Item
Intraocular bleeding
boolean
C0015402 (UMLS CUI [1])
Spinal bleeding
Item
Spinal bleeding
boolean
C0018949 (UMLS CUI [1])
Pericardial bleeding
Item
Pericardial bleeding
boolean
C0019064 (UMLS CUI [1])
Adrenal glands bleeding
Item
Adrenal glands bleeding
boolean
C0001625 (UMLS CUI [1,1])
C0019080 (UMLS CUI [1,2])
Non-surgical site bleeding leading to intervention
Item
Non-surgical site bleeding leading to an intervention
boolean
C0019080 (UMLS CUI [1,1])
C0332294 (UMLS CUI [1,2])
C0184661 (UMLS CUI [1,3])
C1705847 (UMLS CUI [2,1])
C0741556 (UMLS CUI [2,2])
Non-surgical site bleeding by bleeding index
Item
Non-surgical site bleeding with a bleeding index ≥2.0
boolean
C0019080 (UMLS CUI [1,1])
C1709793 (UMLS CUI [1,2])
C1705847 (UMLS CUI [2,1])
C0741556 (UMLS CUI [2,2])
Surgical bleeding leading to intervention
Item
Surgical bleeding leading to an intervention
boolean
C0741556 (UMLS CUI [1,1])
C0332294 (UMLS CUI [1,2])
C0184661 (UMLS CUI [1,3])
Fatal bleed
Item
Fatal bleed
boolean
C0019080 (UMLS CUI [1,1])
C1302234 (UMLS CUI [1,2])
Item Group
Classification Status
C0008902 (UMLS CUI-1)
C0680730 (UMLS CUI-2)
C1274040 (UMLS CUI-3)
Item
Bleeding Classification
text
C0019080 (UMLS CUI [1,1])
C0008902 (UMLS CUI [1,2])
Bleeding Classification
Code List
Bleeding Classification
CL Item
Major Bleed (Major Bleed)
CL Item
Minor Bleed (Minor Bleed)
CL Item
Criteria for Bleeding event not satisfied (Criteria for Bleeding event not satisfied)
Bleeding Comment
Item
Comment
text
C0947611 (UMLS CUI [1,1])
C0019080 (UMLS CUI [1,2])
Item Group
Adjudicators
C0401783 (UMLS CUI-1)
Adjudicator Signature 1
Item
Adjudicator Signature 1
text
C0401783 (UMLS CUI [1,1])
C1519316 (UMLS CUI [1,2])
Adjudicator Signature 2
Item
Adjudicator Signature 2
text
C0401783 (UMLS CUI [1,1])
C1519316 (UMLS CUI [1,2])
Date of adjudication
Item
Date of adjudication
text
C4740194 (UMLS CUI [1])
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