Engelsk

Inform screening and enrolment

1 Formulär  
Administrative Data
Beskrivning

Administrative Data

Alias
UMLS CUI-1
C1320722
Subject Number
Beskrivning

Subject Number

Datatyp

integer

Alias
UMLS CUI [1]
C2348585
Date of Visit
Beskrivning

Day month year

Datatyp

date

Alias
UMLS CUI [1]
C1320303
Infrom screening
Beskrivning

Infrom screening

Alias
UMLS CUI-1
C0220908
UMLS CUI-2
C1533716
Subject initials
Beskrivning

In the original form this item is hidden.

Datatyp

text

Alias
UMLS CUI [1,1]
C1997894
UMLS CUI [1,2]
C2986440
Date of birth
Beskrivning

Day month year. Only to fill in if subject is a screen failure. If subject participates the study the date of birth has to be mapped to the demography form.

Datatyp

date

Alias
UMLS CUI [1]
C0421451
Was this subject a screen failure?
Beskrivning

If you tick yes, please provide reason in the following item.

Datatyp

text

Alias
UMLS CUI [1]
C1710476
If subject is a screen failure, please provide reason
Beskrivning

Reason for screen failure

Datatyp

text

Alias
UMLS CUI [1,1]
C1710476
UMLS CUI [1,2]
C0566251
Inform Enrolment
Beskrivning

Inform Enrolment

Alias
UMLS CUI-1
C1552002
UMLS CUI-2
C4041024
Subject Number
Beskrivning

Subject Number

Datatyp

integer

Alias
UMLS CUI [1]
C2348585
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Similar models

Inform screening and enrolment

1 Formulär
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Administrative Data
C1320722 (UMLS CUI-1)
Subject Number
Item
Subject Number
integer
C2348585 (UMLS CUI [1])
Date of Visit
Item
Date of Visit
date
C1320303 (UMLS CUI [1])
Item Group
Infrom screening
C0220908 (UMLS CUI-1)
C1533716 (UMLS CUI-2)
Subject initials
Item
Subject initials
text
C1997894 (UMLS CUI [1,1])
C2986440 (UMLS CUI [1,2])
Date of birth
Item
Date of birth
date
C0421451 (UMLS CUI [1])
Item
Was this subject a screen failure?
text
C1710476 (UMLS CUI [1])
Screen failure
Code List
Was this subject a screen failure?
CL Item
No (N)
CL Item
Yes (Y)
Reason for screen failure
Item
If subject is a screen failure, please provide reason
text
C1710476 (UMLS CUI [1,1])
C0566251 (UMLS CUI [1,2])
Item Group
Inform Enrolment
C1552002 (UMLS CUI-1)
C4041024 (UMLS CUI-2)
Subject Number
Item
Subject Number
integer
C2348585 (UMLS CUI [1])
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