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ID

44062

Description

modified from http://www.cdisc.org

Link

http://www.cdisc.org

Keywords

  1. 3/29/14 3/29/14 - Martin Dugas
  2. 3/31/14 3/31/14 - Martin Dugas
  3. 6/20/18 6/20/18 - Julian Varghese
  4. 9/20/21 9/20/21 -
Copyright Holder

CDISC

Uploaded on

September 20, 2021

DOI

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License

Creative Commons BY-NC 3.0

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  • Although this is a CDASH form I see a problem with the sequence of the responses, i.e. first response = yes, second response = no. Usually, the order is just the other way round. This will make life of those that have to complete the forms difficult. I recommend to agree upon one (and only one) way of displaying the response options. This, of course, does not apply to validated scales
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    CDASH Demographics

    Demographics

    1. StudyEvent: SE
      1. Demographics
    Demographics
    Description

    Demographics

    Alias
    UMLS CUI-1
    C1704791
    Birth Date
    Description

    A subject’s date of birth (with or without the time of birth). The complete Date of Birth is made from the temporal components of Birth Year, Birth Month, Birth Day and Birth Time.

    Data type

    partialDate

    Alias
    CDASH
    BRTHDAT
    UMLS CUI-1
    C0421451
    Sex
    Description

    The assemblage of physical properties or qualities by which male is distinguished from female; the physical difference between male and female; the distinguishing peculiarity of male or female (NCI – CDISC Definition). {SEX} (See Section 2.2.)

    Data type

    text

    Alias
    CDASH
    SEX
    CDASH/SDTM
    SEX
    UMLS CUI-1
    C0079399
    Ethnicity
    Description

    A social group characterized by a distinctive social and cultural tradition maintained from generation to generation, a common history and origin and a sense of identification with the group; members of the group have distinctive features in their way of life, shared experiences and often a common genetic heritage; these features may be reflected in their experience of health and disease (NCI – CDISC Definition). {ETHNIC} (See Section 2.2.)

    Data type

    text

    Alias
    CDASH
    ETHNIC
    CDASH/SDTM
    ETHNIC
    UMLS CUI-1
    C0015031
    American Indian or Alaska Native
    Description

    CDISC SDTM Race Terminology An arbitrary classification based on physical characteristics; a group of persons related by common descent or heredity (U.S. Center for Disease Control). {RACE} (See Section 2.2.)

    Data type

    boolean

    Alias
    CDASH
    RACE.AMERICAN_INDIAN_OR_ALASKA_NATIVE
    CDASH/SDTM
    SUPPDM.QNAM
    UMLS CUI-1
    C0683984
    Asian
    Description

    An arbitrary classification based on physical characteristics; a group of persons related by common descent or heredity (U.S. Center for Disease Control). {RACE} (See Section 2.2.)

    Data type

    boolean

    Alias
    CDASH
    RACE.ASIAN
    CDASH/SDTM
    SUPPDM.QNAM
    UMLS CUI-1
    C0078988
    Black or African American
    Description

    An arbitrary classification based on physical characteristics; a group of persons related by common descent or heredity (U.S. Center for Disease Control). {RACE} (See Section 2.2.)

    Data type

    boolean

    Alias
    CDASH
    RACE.BLACK_OR_ AFRICAN_AMERICAN
    CDASH/SDTM
    SUPPDM.QNAM
    UMLS CUI-1
    C0085756
    Native Hawaiian or Other Pacific Islander
    Description

    An arbitrary classification based on physical characteristics; a group of persons related by common descent or heredity (U.S. Center for Disease Control). {RACE} (See Section 2.2.)

    Data type

    boolean

    Alias
    CDASH
    RACE.NATIVE_HAWAIIAN_OR_OTHER_PACIFIC_ISLANDER
    CDASH/SDTM
    SUPPDM.QNAM
    UMLS CUI-1
    CL025738
    White
    Description

    An arbitrary classification based on physical characteristics; a group of persons related by common descent or heredity (U.S. Center for Disease Control). {RACE} (See Section 2.2.)

    Data type

    boolean

    Alias
    CDASH
    RACE.WHITE
    CDASH/SDTM
    SUPPDM.QNAM
    UMLS CUI-1
    C0007457
    Specify Other
    Description

    A free-text field to be used when none of the pre-printed values for RACE are applicable or if another, unprinted selection needs to be added to those pre-printed values.

    Data type

    text

    Alias
    CDASH
    RACEOTH
    CDASH/SDTM
    SUPPDM.QNAM
    UMLS CUI-1
    C0034510

    Similar models

    Demographics

    1. StudyEvent: SE
      1. Demographics
    Name
    Type
    Description | Question | Decode (Coded Value)
    Data type
    Alias
    Item Group
    C1704791 (UMLS CUI-1)
    Birth Date
    Item
    Birth Date
    partialDate
    BRTHDAT (CDASH)
    C0421451 (UMLS CUI-1)
    Item
    Sex
    text
    SEX (CDASH)
    SEX (CDASH/SDTM)
    C0079399 (UMLS CUI-1)
    Code List
    Sex
    CL Item
    FEMALE (F)
    C0086287 (UMLS CUI-1)
    CL Item
    MALE (M)
    C0086582 (UMLS CUI-1)
    Item
    Ethnicity
    text
    ETHNIC (CDASH)
    ETHNIC (CDASH/SDTM)
    C0015031 (UMLS CUI-1)
    Code List
    Ethnicity
    CL Item
    NOT HISPANIC OR LATINO (NOT HISPANIC OR LATINO)
    CL Item
    HISPANIC OR LATINO (HISPANIC OR LATINO)
    CL Item
    NOT REPORTED (NOT REPORTED)
    CL Item
    UNKNOWN (UNKNOWN)
    American Indian or Alaska Native
    Item
    American Indian or Alaska Native
    boolean
    RACE.AMERICAN_INDIAN_OR_ALASKA_NATIVE (CDASH)
    SUPPDM.QNAM (CDASH/SDTM)
    C0683984 (UMLS CUI-1)
    Asian
    Item
    Asian
    boolean
    RACE.ASIAN (CDASH)
    SUPPDM.QNAM (CDASH/SDTM)
    C0078988 (UMLS CUI-1)
    Black or African American
    Item
    Black or African American
    boolean
    RACE.BLACK_OR_ AFRICAN_AMERICAN (CDASH)
    SUPPDM.QNAM (CDASH/SDTM)
    C0085756 (UMLS CUI-1)
    Native Hawaiian or Other Pacific Islander
    Item
    Native Hawaiian or Other Pacific Islander
    boolean
    RACE.NATIVE_HAWAIIAN_OR_OTHER_PACIFIC_ISLANDER (CDASH)
    SUPPDM.QNAM (CDASH/SDTM)
    CL025738 (UMLS CUI-1)
    White (Caucasian)
    Item
    White
    boolean
    RACE.WHITE (CDASH)
    SUPPDM.QNAM (CDASH/SDTM)
    C0007457 (UMLS CUI-1)
    Other racial group
    Item
    Specify Other
    text
    RACEOTH (CDASH)
    SUPPDM.QNAM (CDASH/SDTM)
    C0034510 (UMLS CUI-1)

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