ID

41348

Descripción

Study ID: 105043/013 Clinical Study ID: 105043/013 Study Title: An Open-Label Study of Argatroban Injection to Evaluate the Safety and Effectiveness in Pediatric Patients Requiring Anticoagulant Alternatives to Heparin (Protocol SKF105043/013) Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00039858 Sponsor: GlaxoSmithKline Collaborators: Encysive Pharmaceuticals Phase: Phase 4 Study Recruitment Status: Completed Generic Name: Argatroban Trade Name: N/A Study Indication: Thrombosis This Study evaluates the safety and the efficacy of i.v. Argatroban treatment in paediatric patients which require anticoagulants but aren't suitable for Heparin treatment. The study consists of screening visit (pre-treatment examination), treatment period of maximum 14 days after reaching therapeutical dose, post-treatment visit (once the treatment is stopped or after 14 days) and a follow-up visit which follows 30 days (+/- 14 days) after clinical resolution of underlying condition or after the end of the 14-day study period. Treatment can be continued after the 14-day study period if needed but such treatment isn't part of this Study. See https://clinicaltrials.gov/ct2/show/NCT00039858 The Medical History Form has to be filled in at the screening visit. It is used to record details of medical history and prior surgical and other invasive procedures. To be completed within 7 days before treatment initiation.

Link

https://clinicaltrials.gov/ct2/show/NCT00039858

Palabras clave

Versiones (1)
  1. 2/9/20 2/9/20 -
Titular de derechos de autor

GlaxoSmithKline

Subido en

2 de septiembre de 2020

DOI

Para solicitar uno, por favor iniciar sesión.

Licencia

Creative Commons BY-NC 4.0
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Safety and Efficacy of Argatroban in Pediatric Patients, NCT00039858

Inglés

Medical History

1 formularios  
  1. StudyEvent: ODM
    1. Medical History
Administrative Data
Descripción

Administrative Data

Alias
UMLS CUI-1
C1320722
Site #
Descripción

Study centre number

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C0600091
UMLS CUI [1,2]
C0019994
Patient #
Descripción

patient ID

Tipo de datos

integer

Alias
UMLS CUI [1]
C2348585
Visit Date
Descripción

visit date

Tipo de datos

date

Alias
UMLS CUI [1]
C1320303
Investigator Name
Descripción

Investigator Name

Tipo de datos

text

Alias
UMLS CUI [1]
C2826892
Medical / Surgical / Invasive Procedure History
Descripción

Medical / Surgical / Invasive Procedure History

Alias
UMLS CUI-1
C0262926
UMLS CUI-2
C0455610
None, check box if there are no significant conditions.
Descripción

No significant medical history

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0750502
UMLS CUI [1,3]
C0332197
Ear, nose, and throat
Descripción

Medical history: Ear, nose, and throat

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0395797
Ear, nose, and throat: If ‘Yes’, specify condition(s)
Descripción

Medical history: Ear, nose, and throat - specify

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0395797
UMLS CUI [1,3]
C1521902
Eyes
Descripción

Medical history: Eyes

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0015397
Eyes: If ‘Yes’, specify condition(s)
Descripción

Medical history: Eyes - specify

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0015397
UMLS CUI [1,3]
C1521902
Respiratory
Descripción

Medical history: Respiratory

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0035204
Respiratory: If ‘Yes’, specify condition(s)
Descripción

Medical history: Respiratory - specify

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0035204
UMLS CUI [1,3]
C1521902
Cardiovascular: Congenital Heart Disease
Descripción

Medical history: Congenital Heart Disease

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0152021
Cardiovascular: Congenital Heart Disease: If ‘Yes’, specify condition(s)
Descripción

Medical history: Congenital Heart Disease - specify

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0152021
UMLS CUI [1,3]
C1521902
Cardiovascular: Cardial Arrhythmia
Descripción

Medical history: Cardiac Arrhythmia

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0003811
Cardiovascular: Cardiac Arrhythmia: If ‘Yes’, specify condition(s)
Descripción

Medical history: Cardiac Arrhythmia

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0003811
UMLS CUI [1,3]
C1521902
Cardiovascular: Hypertension
Descripción

Medical history: Hypertension

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0020538
Cardiovascular: Hypertension: If ‘Yes’, specify condition(s)
Descripción

Medical history: Hypertension - specify

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0020538
UMLS CUI [1,3]
C1521902
Cardiovascular: Other
Descripción

Medical histroy: Other cardiovascular diseases

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0007222
UMLS CUI [1,3]
C0205394
Cardiovascular: Other: If ‘Yes’, specify condition(s)
Descripción

Medical histroy: Other cardiovascular diseases - specify

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0007222
UMLS CUI [1,3]
C0205394
UMLS CUI [1,4]
C1521902
Cardiovascular: Other
Descripción

Medical histroy: Other cardiovascular diseases

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0007222
UMLS CUI [1,3]
C0205394
Cardiovascular: Other: If ‘Yes’, specify condition(s)
Descripción

Medical histroy: Other cardiovascular diseases - specify

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0007222
UMLS CUI [1,3]
C0205394
UMLS CUI [1,4]
C1521902
Gastrointestinal
Descripción

Medical history: Gastrointestinal

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0017178
Gastrointestinal: If ‘Yes’, specify condition(s)
Descripción

Medical history: Gastrointestinal - specify

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0017178
UMLS CUI [1,3]
C1521902
Hepatobiliary and pancreas
Descripción

Medical history: Hepatobiliary and pancreas

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0267792
UMLS CUI [2,1]
C0262926
UMLS CUI [2,2]
C0030286
Hepatobiliary and pancreas: If ‘Yes’, specify condition(s)
Descripción

Medical history: Hepatobiliary and pancreas - specify

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0267792
UMLS CUI [1,3]
C1521902
UMLS CUI [2,1]
C0262926
UMLS CUI [2,2]
C0030286
UMLS CUI [2,3]
C1521902
Urinary system
Descripción

Medical history: Urinary system

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0042075
Urinary system: If ‘Yes’, specify condition(s)
Descripción

Medical history: Urinary system - specify

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0042075
UMLS CUI [1,3]
C1521902
Reproductive system
Descripción

Medical history: Reproductive system

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0178829
Reproductive system: If ‘Yes’, specify condition(s)
Descripción

Medical history: Reproductive system - specify

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0178829
UMLS CUI [1,3]
C1521902
Neurologic
Descripción

Medical history: Neurologic

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0027765
Neurologic: If ‘Yes’, specify condition(s)
Descripción

Medical history: Neurologic - specify

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0027765
UMLS CUI [1,3]
C1521902
Blood and lymphatic
Descripción

Medical history: Blood and lymphatic

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0851353
Blood and lymphatic: If ‘Yes’, specify condition(s)
Descripción

Medical history: Blood and lymphatic - specify

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0851353
UMLS CUI [1,3]
C1521902
Endocrine and metabolic: Diabetes/Glucose Intolerance
Descripción

Medical history: Diabetes/Glucose Intolerance

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0271650
UMLS CUI [2,1]
C0262926
UMLS CUI [2,2]
C0011849
Endocrine and metabolic: Diabetes/Glucose Intolerance - If ‘Yes’, specify condition(s)
Descripción

Medical history: Diabetes/Glucose Intolerance - specify

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0271650
UMLS CUI [1,3]
C1521902
UMLS CUI [2,1]
C0262926
UMLS CUI [2,2]
C0011849
UMLS CUI [2,3]
C1521902
Endocrine and metabolic: Other
Descripción

Medical history: Other endocrine diseases

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0014130
UMLS CUI [1,3]
C0205394
Endocrine and metabolic: Other: If ‘Yes’, specify condition(s)
Descripción

Medical history: Other endocrine diseases - specify

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0014130
UMLS CUI [1,3]
C0205394
UMLS CUI [1,4]
C1521902
Musculoskeletal
Descripción

Medical history: Musculoskeletal

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0026857
UMLS CUI [1,2]
C0262926
Musculoskeletal: If ‘Yes’, specify condition(s)
Descripción

Medical history: Musculoskeletal - specify

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0026857
UMLS CUI [1,2]
C0262926
UMLS CUI [1,3]
C1521902
Skin
Descripción

Medical history: Skin

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0037274
Skin: If ‘Yes’, specify condition(s)
Descripción

Medical history: Skin - specify

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0037274
UMLS CUI [1,3]
C1521902
Psychiatric
Descripción

Medical history: Psychiatric

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0004936
Psychiatric: If ‘Yes’, specify condition(s)
Descripción

Medical history: Psychiatric - specify

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0004936
UMLS CUI [1,3]
C1521902
Allergies
Descripción

Medical history: Allergies

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0020517
Allergies: If ‘Yes’, specify condition(s)
Descripción

Medical history: Allergies - specify

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0020517
UMLS CUI [1,3]
C1521902
Other
Descripción

Medical history: Other

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0205394
Other: If ‘Yes’, specify condition(s)
Descripción

Medical history: Other - specify

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0205394
UMLS CUI [1,3]
C1521902
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Similar models

Medical History

1 formularios
  1. StudyEvent: ODM
    1. Medical History
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
Administrative Data
C1320722 (UMLS CUI-1)
Study centre number
Item
Site #
integer
C0600091 (UMLS CUI [1,1])
C0019994 (UMLS CUI [1,2])
patient ID
Item
Patient #
integer
C2348585 (UMLS CUI [1])
visit date
Item
Visit Date
date
C1320303 (UMLS CUI [1])
Investigator Name
Item
Investigator Name
text
C2826892 (UMLS CUI [1])
Item Group
Medical / Surgical / Invasive Procedure History
C0262926 (UMLS CUI-1)
C0455610 (UMLS CUI-2)
No significant medical history
Item
None, check box if there are no significant conditions.
boolean
C0262926 (UMLS CUI [1,1])
C0750502 (UMLS CUI [1,2])
C0332197 (UMLS CUI [1,3])
Item
Ear, nose, and throat
text
C0262926 (UMLS CUI [1,1])
C0395797 (UMLS CUI [1,2])
Medical history: Ear, nose, and throat
Code List
Ear, nose, and throat
CL Item
Yes (Yes)
CL Item
No (No)
Medical history: Ear, nose, and throat - specify
Item
Ear, nose, and throat: If ‘Yes’, specify condition(s)
text
C0262926 (UMLS CUI [1,1])
C0395797 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,3])
Item
Eyes
text
C0262926 (UMLS CUI [1,1])
C0015397 (UMLS CUI [1,2])
Medical history: Ear, nose, and throat
Code List
Eyes
CL Item
Yes (Yes)
CL Item
No (No)
Medical history: Eyes - specify
Item
Eyes: If ‘Yes’, specify condition(s)
text
C0262926 (UMLS CUI [1,1])
C0015397 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,3])
Item
Respiratory
text
C0262926 (UMLS CUI [1,1])
C0035204 (UMLS CUI [1,2])
Medical history: Ear, nose, and throat
Code List
Respiratory
CL Item
Yes (Yes)
CL Item
No (No)
Medical history: Respiratory - specify
Item
Respiratory: If ‘Yes’, specify condition(s)
text
C0262926 (UMLS CUI [1,1])
C0035204 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,3])
Item
Cardiovascular: Congenital Heart Disease
text
C0262926 (UMLS CUI [1,1])
C0152021 (UMLS CUI [1,2])
Medical history: Ear, nose, and throat
Code List
Cardiovascular: Congenital Heart Disease
CL Item
Yes (Yes)
CL Item
No (No)
Medical history: Congenital Heart Disease - specify
Item
Cardiovascular: Congenital Heart Disease: If ‘Yes’, specify condition(s)
text
C0262926 (UMLS CUI [1,1])
C0152021 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,3])
Item
Cardiovascular: Cardial Arrhythmia
text
C0262926 (UMLS CUI [1,1])
C0003811 (UMLS CUI [1,2])
Medical history: Ear, nose, and throat
Code List
Cardiovascular: Cardial Arrhythmia
CL Item
Yes (Yes)
CL Item
No (No)
Medical history: Cardiac Arrhythmia
Item
Cardiovascular: Cardiac Arrhythmia: If ‘Yes’, specify condition(s)
text
C0262926 (UMLS CUI [1,1])
C0003811 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,3])
Item
Cardiovascular: Hypertension
text
C0262926 (UMLS CUI [1,1])
C0020538 (UMLS CUI [1,2])
Medical history: Ear, nose, and throat
Code List
Cardiovascular: Hypertension
CL Item
Yes (Yes)
CL Item
No (No)
Medical history: Hypertension - specify
Item
Cardiovascular: Hypertension: If ‘Yes’, specify condition(s)
text
C0262926 (UMLS CUI [1,1])
C0020538 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,3])
Item
Cardiovascular: Other
text
C0262926 (UMLS CUI [1,1])
C0007222 (UMLS CUI [1,2])
C0205394 (UMLS CUI [1,3])
Medical history: Ear, nose, and throat
Code List
Cardiovascular: Other
CL Item
Yes (Yes)
CL Item
No (No)
Medical histroy: Other cardiovascular diseases - specify
Item
Cardiovascular: Other: If ‘Yes’, specify condition(s)
text
C0262926 (UMLS CUI [1,1])
C0007222 (UMLS CUI [1,2])
C0205394 (UMLS CUI [1,3])
C1521902 (UMLS CUI [1,4])
Item
Cardiovascular: Other
text
C0262926 (UMLS CUI [1,1])
C0007222 (UMLS CUI [1,2])
C0205394 (UMLS CUI [1,3])
Medical history: Ear, nose, and throat
Code List
Cardiovascular: Other
CL Item
Yes (Yes)
CL Item
No (No)
Medical histroy: Other cardiovascular diseases - specify
Item
Cardiovascular: Other: If ‘Yes’, specify condition(s)
text
C0262926 (UMLS CUI [1,1])
C0007222 (UMLS CUI [1,2])
C0205394 (UMLS CUI [1,3])
C1521902 (UMLS CUI [1,4])
Item
Gastrointestinal
text
C0262926 (UMLS CUI [1,1])
C0017178 (UMLS CUI [1,2])
Medical history: Ear, nose, and throat
Code List
Gastrointestinal
CL Item
Yes (Yes)
CL Item
No (No)
Medical history: Gastrointestinal - specify
Item
Gastrointestinal: If ‘Yes’, specify condition(s)
text
C0262926 (UMLS CUI [1,1])
C0017178 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,3])
Item
Hepatobiliary and pancreas
text
C0262926 (UMLS CUI [1,1])
C0267792 (UMLS CUI [1,2])
C0262926 (UMLS CUI [2,1])
C0030286 (UMLS CUI [2,2])
Medical history: Ear, nose, and throat
Code List
Hepatobiliary and pancreas
CL Item
Yes (Yes)
CL Item
No (No)
Medical history: Hepatobiliary and pancreas - specify
Item
Hepatobiliary and pancreas: If ‘Yes’, specify condition(s)
text
C0262926 (UMLS CUI [1,1])
C0267792 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,3])
C0262926 (UMLS CUI [2,1])
C0030286 (UMLS CUI [2,2])
C1521902 (UMLS CUI [2,3])
Item
Urinary system
text
C0262926 (UMLS CUI [1,1])
C0042075 (UMLS CUI [1,2])
Medical history: Ear, nose, and throat
Code List
Urinary system
CL Item
Yes (Yes)
CL Item
No (No)
Medical history: Urinary system - specify
Item
Urinary system: If ‘Yes’, specify condition(s)
text
C0262926 (UMLS CUI [1,1])
C0042075 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,3])
Item
Reproductive system
text
C0262926 (UMLS CUI [1,1])
C0178829 (UMLS CUI [1,2])
Medical history: Ear, nose, and throat
Code List
Reproductive system
CL Item
Yes (Yes)
CL Item
No (No)
Medical history: Reproductive system - specify
Item
Reproductive system: If ‘Yes’, specify condition(s)
text
C0262926 (UMLS CUI [1,1])
C0178829 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,3])
Item
Neurologic
text
C0262926 (UMLS CUI [1,1])
C0027765 (UMLS CUI [1,2])
Medical history: Ear, nose, and throat
Code List
Neurologic
CL Item
Yes (Yes)
CL Item
No (No)
Medical history: Neurologic - specify
Item
Neurologic: If ‘Yes’, specify condition(s)
text
C0262926 (UMLS CUI [1,1])
C0027765 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,3])
Item
Blood and lymphatic
text
C0262926 (UMLS CUI [1,1])
C0851353 (UMLS CUI [1,2])
Medical history: Ear, nose, and throat
Code List
Blood and lymphatic
CL Item
Yes (Yes)
CL Item
No (No)
Medical history: Blood and lymphatic - specify
Item
Blood and lymphatic: If ‘Yes’, specify condition(s)
text
C0262926 (UMLS CUI [1,1])
C0851353 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,3])
Item
Endocrine and metabolic: Diabetes/Glucose Intolerance
text
C0262926 (UMLS CUI [1,1])
C0271650 (UMLS CUI [1,2])
C0262926 (UMLS CUI [2,1])
C0011849 (UMLS CUI [2,2])
Medical history: Ear, nose, and throat
Code List
Endocrine and metabolic: Diabetes/Glucose Intolerance
CL Item
Yes (Yes)
CL Item
No (No)
Medical history: Diabetes/Glucose Intolerance - specify
Item
Endocrine and metabolic: Diabetes/Glucose Intolerance - If ‘Yes’, specify condition(s)
text
C0262926 (UMLS CUI [1,1])
C0271650 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,3])
C0262926 (UMLS CUI [2,1])
C0011849 (UMLS CUI [2,2])
C1521902 (UMLS CUI [2,3])
Item
Endocrine and metabolic: Other
text
C0262926 (UMLS CUI [1,1])
C0014130 (UMLS CUI [1,2])
C0205394 (UMLS CUI [1,3])
Medical history: Ear, nose, and throat
Code List
Endocrine and metabolic: Other
CL Item
Yes (Yes)
CL Item
No (No)
Item
Endocrine and metabolic: Other: If ‘Yes’, specify condition(s)
text
C0262926 (UMLS CUI [1,1])
C0014130 (UMLS CUI [1,2])
C0205394 (UMLS CUI [1,3])
C1521902 (UMLS CUI [1,4])
Medical history: Ear, nose, and throat
Code List
Endocrine and metabolic: Other: If ‘Yes’, specify condition(s)
Item
Musculoskeletal
text
C0026857 (UMLS CUI [1,1])
C0262926 (UMLS CUI [1,2])
Medical history: Ear, nose, and throat
Code List
Musculoskeletal
CL Item
Yes (Yes)
CL Item
No (No)
Medical history: Musculoskeletal - specify
Item
Musculoskeletal: If ‘Yes’, specify condition(s)
text
C0026857 (UMLS CUI [1,1])
C0262926 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,3])
Item
Skin
text
C0262926 (UMLS CUI [1,1])
C0037274 (UMLS CUI [1,2])
Medical history: Ear, nose, and throat
Code List
Skin
CL Item
Yes (Yes)
CL Item
No (No)
Item
Skin: If ‘Yes’, specify condition(s)
text
C0262926 (UMLS CUI [1,1])
C0037274 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,3])
Medical history: Ear, nose, and throat
Code List
Skin: If ‘Yes’, specify condition(s)
Item
Psychiatric
text
C0262926 (UMLS CUI [1,1])
C0004936 (UMLS CUI [1,2])
Medical history: Ear, nose, and throat
Code List
Psychiatric
CL Item
Yes (Yes)
CL Item
No (No)
Item
Psychiatric: If ‘Yes’, specify condition(s)
text
C0262926 (UMLS CUI [1,1])
C0004936 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,3])
Medical history: Ear, nose, and throat
Code List
Psychiatric: If ‘Yes’, specify condition(s)
Item
Allergies
text
C0262926 (UMLS CUI [1,1])
C0020517 (UMLS CUI [1,2])
Medical history: Ear, nose, and throat
Code List
Allergies
CL Item
Yes (Yes)
CL Item
No (No)
Item
Allergies: If ‘Yes’, specify condition(s)
text
C0262926 (UMLS CUI [1,1])
C0020517 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,3])
Medical history: Ear, nose, and throat
Code List
Allergies: If ‘Yes’, specify condition(s)
Item
Other
text
C0262926 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
Medical history: Ear, nose, and throat
Code List
Other
CL Item
Yes (Yes)
CL Item
No (No)
Medical history: Other - specify
Item
Other: If ‘Yes’, specify condition(s)
text
C0262926 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,3])
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