Autopsy Form

  1. StudyEvent: ODM
    1. Autopsy Form
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
Autopsy Form
Description

Autopsy Form

Alias
UMLS CUI-1
C0004398
Was an autopsy performed?
Description

If yes, complete form.

Data type

boolean

Alias
UMLS CUI [1]
C0004398
Date of Autopsy
Description

Date of Autopsy

Data type

date

Alias
UMLS CUI [1]
C3864942
Pulmonary Embolism
Description

If yes, specify location

Data type

boolean

Alias
UMLS CUI [1]
C0034065
Left pulmonary artery
Description

Pulmonary Embolism in Left pulmonary artery

Data type

boolean

Alias
UMLS CUI [1,1]
C0034065
UMLS CUI [1,2]
C0226069
Right pulmonary artery
Description

Pulmonary Embolism in Right pulmonary artery

Data type

boolean

Alias
UMLS CUI [1,1]
C0034065
UMLS CUI [1,2]
C0226054
Left lobar arteries
Description

Pulmonary Embolism in Left lobar arteries

Data type

boolean

Alias
UMLS CUI [1,1]
C0034065
UMLS CUI [1,2]
C0503867
UMLS CUI [1,3]
C0205091
Right lobar arteries
Description

Pulmonary Embolism in Right lobar arteries

Data type

boolean

Alias
UMLS CUI [1,1]
C0034065
UMLS CUI [1,2]
C0503867
UMLS CUI [1,3]
C0205090
Left segmental arteries
Description

Pulmonary Embolism in Left segmental arteries

Data type

boolean

Alias
UMLS CUI [1,1]
C0034065
UMLS CUI [1,2]
C0503402
UMLS CUI [1,3]
C0205091
Right segmental arteries
Description

Pulmonary Embolism in Right segmental arteries

Data type

boolean

Alias
UMLS CUI [1,1]
C0034065
UMLS CUI [1,2]
C0503402
UMLS CUI [1,3]
C0205090
Main pulmonary trunk
Description

Pulmonary Embolism in Main pulmonary trunk

Data type

boolean

Alias
UMLS CUI [1,1]
C0034065
UMLS CUI [1,2]
C2954153
Deep Vein Thrombosis
Description

If yes, specify location

Data type

boolean

Alias
UMLS CUI [1]
C0149871
Left calf vein
Description

Deep Vein Thrombosis in Left calf

Data type

boolean

Alias
UMLS CUI [1,1]
C0149871
UMLS CUI [1,2]
C0230445
UMLS CUI [1,3]
C0205091
Right calf vein
Description

Deep Vein Thrombosis in Right calf

Data type

boolean

Alias
UMLS CUI [1,1]
C0149871
UMLS CUI [1,2]
C0230445
UMLS CUI [1,3]
C0205090
Left popliteal vein
Description

Deep Vein Thrombosis in Left popliteal vein

Data type

boolean

Alias
UMLS CUI [1,1]
C0149871
UMLS CUI [1,2]
C0835016
Right popliteal vein
Description

Deep Vein Thrombosis in Right popliteal vein

Data type

boolean

Alias
UMLS CUI [1,1]
C0149871
UMLS CUI [1,2]
C0835015
Left femoral vein
Description

Deep Vein Thrombosis in Left femoral vein

Data type

boolean

Alias
UMLS CUI [1,1]
C0149871
UMLS CUI [1,2]
C0739301
Right femoral vein
Description

Deep Vein Thrombosis in Right femoral vein

Data type

boolean

Alias
UMLS CUI [1,1]
C0149871
UMLS CUI [1,2]
C0739300
Left iliac vein
Description

Deep Vein Thrombosis in Left iliac vein

Data type

boolean

Alias
UMLS CUI [1,1]
C0149871
UMLS CUI [1,2]
C4520258
Right iliac vein
Description

Deep Vein Thrombosis in Right iliac vein

Data type

boolean

Alias
UMLS CUI [1,1]
C0149871
UMLS CUI [1,2]
C4520257
Inferior vena cava
Description

Deep Vein Thrombosis in Inferior vena cava

Data type

boolean

Alias
UMLS CUI [1,1]
C0149871
UMLS CUI [1,2]
C0042458
Other Thrombosis (venous and/or arterial)
Description

If yes, specify

Data type

boolean

Alias
UMLS CUI [1,1]
C0205394
UMLS CUI [1,2]
C0042487
UMLS CUI [2,1]
C0151942
UMLS CUI [2,2]
C0205394
Specify other venous/arterial thrombosis
Description

if applicable

Data type

text

Alias
UMLS CUI [1,1]
C1521902
UMLS CUI [1,2]
C0205394
UMLS CUI [1,3]
C0042487
UMLS CUI [2,1]
C1521902
UMLS CUI [2,2]
C0205394
UMLS CUI [2,3]
C0151942
Hemorrhage(s)
Description

if yes specify

Data type

boolean

Alias
UMLS CUI [1]
C0019080
Specify Hemorrhage(s)
Description

if applicable

Data type

text

Alias
UMLS CUI [1,1]
C0019080
UMLS CUI [1,2]
C1521902
Other Findings
Description

if yes specify

Data type

boolean

Alias
UMLS CUI [1]
C1335151
Specify other Findings
Description

if applicable

Data type

text

Alias
UMLS CUI [1,1]
C1521902
UMLS CUI [1,2]
C1335151
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

Similar models

Autopsy Form

  1. StudyEvent: ODM
    1. Autopsy Form
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
Autopsy Form
C0004398 (UMLS CUI-1)
Autopsy?
Item
Was an autopsy performed?
boolean
C0004398 (UMLS CUI [1])
Date of Autopsy
Item
Date of Autopsy
date
C3864942 (UMLS CUI [1])
Pulmonary Embolism
Item
Pulmonary Embolism
boolean
C0034065 (UMLS CUI [1])
Pulmonary Embolism in Left pulmonary artery
Item
Left pulmonary artery
boolean
C0034065 (UMLS CUI [1,1])
C0226069 (UMLS CUI [1,2])
Pulmonary Embolism in Right pulmonary artery
Item
Right pulmonary artery
boolean
C0034065 (UMLS CUI [1,1])
C0226054 (UMLS CUI [1,2])
Pulmonary Embolism in Left lobar arteries
Item
Left lobar arteries
boolean
C0034065 (UMLS CUI [1,1])
C0503867 (UMLS CUI [1,2])
C0205091 (UMLS CUI [1,3])
Pulmonary Embolism in Right lobar arteries
Item
Right lobar arteries
boolean
C0034065 (UMLS CUI [1,1])
C0503867 (UMLS CUI [1,2])
C0205090 (UMLS CUI [1,3])
Pulmonary Embolism in Left segmental arteries
Item
Left segmental arteries
boolean
C0034065 (UMLS CUI [1,1])
C0503402 (UMLS CUI [1,2])
C0205091 (UMLS CUI [1,3])
Pulmonary Embolism in Right segmental arteries
Item
Right segmental arteries
boolean
C0034065 (UMLS CUI [1,1])
C0503402 (UMLS CUI [1,2])
C0205090 (UMLS CUI [1,3])
Pulmonary Embolism in Main pulmonary trunk
Item
Main pulmonary trunk
boolean
C0034065 (UMLS CUI [1,1])
C2954153 (UMLS CUI [1,2])
Deep Vein Thrombosis
Item
Deep Vein Thrombosis
boolean
C0149871 (UMLS CUI [1])
Deep Vein Thrombosis in Left calf
Item
Left calf vein
boolean
C0149871 (UMLS CUI [1,1])
C0230445 (UMLS CUI [1,2])
C0205091 (UMLS CUI [1,3])
Deep Vein Thrombosis in Right calf
Item
Right calf vein
boolean
C0149871 (UMLS CUI [1,1])
C0230445 (UMLS CUI [1,2])
C0205090 (UMLS CUI [1,3])
Deep Vein Thrombosis in Left popliteal vein
Item
Left popliteal vein
boolean
C0149871 (UMLS CUI [1,1])
C0835016 (UMLS CUI [1,2])
Deep Vein Thrombosis in Right popliteal vein
Item
Right popliteal vein
boolean
C0149871 (UMLS CUI [1,1])
C0835015 (UMLS CUI [1,2])
Deep Vein Thrombosis in Left femoral vein
Item
Left femoral vein
boolean
C0149871 (UMLS CUI [1,1])
C0739301 (UMLS CUI [1,2])
Deep Vein Thrombosis in Right femoral vein
Item
Right femoral vein
boolean
C0149871 (UMLS CUI [1,1])
C0739300 (UMLS CUI [1,2])
Deep Vein Thrombosis in Left iliac vein
Item
Left iliac vein
boolean
C0149871 (UMLS CUI [1,1])
C4520258 (UMLS CUI [1,2])
Deep Vein Thrombosis in Right iliac vein
Item
Right iliac vein
boolean
C0149871 (UMLS CUI [1,1])
C4520257 (UMLS CUI [1,2])
Deep Vein Thrombosis in Inferior vena cava
Item
Inferior vena cava
boolean
C0149871 (UMLS CUI [1,1])
C0042458 (UMLS CUI [1,2])
Other venous/arterial thrombosis
Item
Other Thrombosis (venous and/or arterial)
boolean
C0205394 (UMLS CUI [1,1])
C0042487 (UMLS CUI [1,2])
C0151942 (UMLS CUI [2,1])
C0205394 (UMLS CUI [2,2])
Specify other venous/arterial thrombosis
Item
Specify other venous/arterial thrombosis
text
C1521902 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
C0042487 (UMLS CUI [1,3])
C1521902 (UMLS CUI [2,1])
C0205394 (UMLS CUI [2,2])
C0151942 (UMLS CUI [2,3])
Hemorrhage
Item
Hemorrhage(s)
boolean
C0019080 (UMLS CUI [1])
Specify Hemorrhage
Item
Specify Hemorrhage(s)
text
C0019080 (UMLS CUI [1,1])
C1521902 (UMLS CUI [1,2])
Other findings
Item
Other Findings
boolean
C1335151 (UMLS CUI [1])
Specify other findings
Item
Specify other Findings
text
C1521902 (UMLS CUI [1,1])
C1335151 (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])