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Concomitant Medication

12 forms  
  1. StudyEvent: combicare trial
    1. Screening
    2. Intervention
    3. POD 3
    4. POD 7
    5. POD 14 / Discharge
    6. POD 30
    7. POD 60/Discontinuation
    8. Signature
  2. StudyEvent: Readmission To Hospital
    1. Readmission To Hospital
  3. StudyEvent: Adverse Events
    1. Adverse Events
  4. StudyEvent: Concomitant Medication
    1. Concomitant Medication
  5. StudyEvent: Protocol Violation
    1. Protocol violation
Concomitant Medication
Description

Concomitant Medication

Alias
UMLS CUI [1,1]
C2347852
Medication Name (preferably generic name /INN, or trade name)
Description

Medication Name

Data type

text

Alias
UMLS CUI [1,1]
C2360065
Daily Dose
Description

Daily Dose

Data type

float

Alias
UMLS CUI [1,1]
C2348070
Unit (Daily Dose)
Description

Unit

Data type

text

Alias
UMLS CUI [1,1]
C0869039
Unit, if other
Description

specify unit

Data type

text

Alias
UMLS CUI [1,1]
C1519795
UMLS CUI [1,2]
C1521902
Route of administration
Description

Route of administration

Data type

text

Alias
UMLS CUI [1,1]
C2826730
If other route of administration, please specify
Description

specify administration

Data type

text

Alias
UMLS CUI [1,1]
C1521902
Form of application
Description

Form of application

Data type

text

Alias
UMLS CUI [1,1]
C2826720
If other form of application, please specify
Description

specify application

Data type

text

Alias
UMLS CUI [1,1]
C1521902
Indication
Description

Indication

Data type

text

Alias
UMLS CUI [1,1]
C2826696
Dosage schedule
Description

Dosage schedule

Alias
UMLS CUI [1,1]
C2826811
UMLS CUI [1,2]
C4716519
morning
Description

morning

Data type

boolean

Alias
UMLS CUI [1,1]
C0332170
noon
Description

noon

Data type

boolean

Alias
UMLS CUI [1,1]
C0585020
evening
Description

evening

Data type

boolean

Alias
UMLS CUI [1,1]
C0587117
other
Description

other

Data type

boolean

Alias
UMLS CUI [1,1]
C0205394
If other dosage schedule, please specify
Description

specify dosage schedule

Data type

text

Alias
UMLS CUI [1,1]
C1521902
Medication Period
Description

Medication Period

Alias
UMLS CUI [1,1]
C2826814
Is 'Start Date Medication' completely available?
Description

start available

Data type

boolean

Alias
UMLS CUI [1,1]
C0470187
UMLS CUI [1,2]
C2826734
Start Date Medication
Description

Start Date

Data type

date

Alias
UMLS CUI [1,1]
C2826734
Start Date Medication (month)
Description

month

Data type

text

Alias
UMLS CUI [1,1]
C2826734
UMLS CUI [1,2]
C0439231
Start Date Medication (year)
Description

year

Data type

integer

Alias
UMLS CUI [1,1]
C2826734
UMLS CUI [1,2]
C0439234
Ongoing (at end of study)
Description

Ongoing

Data type

boolean

Alias
UMLS CUI [1,1]
C2826666
Is 'Stop Date Medication' completely available?
Description

stop available

Data type

boolean

Alias
UMLS CUI [1,1]
C0470187
UMLS CUI [1,2]
C2826744
Stop Date Medication
Description

Stop Date

Data type

date

Alias
UMLS CUI [1,1]
C2826744
Stop Date Medication (month)
Description

month

Data type

text

Alias
UMLS CUI [1,1]
C2826744
UMLS CUI [1,2]
C0439231
Stop Date Medication (year)
Description

year

Data type

integer

Alias
UMLS CUI [1,1]
C2826744
UMLS CUI [1,2]
C0439234
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Similar models

Concomitant Medication

12 forms
  1. StudyEvent: combicare trial
    1. Screening
    2. Intervention
    3. POD 3
    4. POD 7
    5. POD 14 / Discharge
    6. POD 30
    7. POD 60/Discontinuation
    8. Signature
  2. StudyEvent: Readmission To Hospital
    1. Readmission To Hospital
  3. StudyEvent: Adverse Events
    1. Adverse Events
  4. StudyEvent: Concomitant Medication
    1. Concomitant Medication
  5. StudyEvent: Protocol Violation
    1. Protocol violation
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Concomitant Medication
C2347852 (UMLS CUI [1,1])
Medication Name
Item
Medication Name (preferably generic name /INN, or trade name)
text
C2360065 (UMLS CUI [1,1])
Daily Dose
Item
Daily Dose
float
C2348070 (UMLS CUI [1,1])
Item
Unit (Daily Dose)
text
C0869039 (UMLS CUI [1,1])
CL.28
Code List
Unit (Daily Dose)
CL Item
mg (1)
CL Item
μg (2)
CL Item
g (3)
CL Item
mL (4)
CL Item
IU (5)
CL Item
other (6)
specify unit
Item
Unit, if other
text
C1519795 (UMLS CUI [1,1])
C1521902 (UMLS CUI [1,2])
Item
Route of administration
text
C2826730 (UMLS CUI [1,1])
CL.29
Code List
Route of administration
CL Item
oral (1)
C0442027 (UMLS CUI [1,1])
CL Item
intravenous (2)
C0348016 (UMLS CUI [1,1])
CL Item
subcutaneous (3)
C0443315 (UMLS CUI [1,1])
CL Item
other (4)
C0205394 (UMLS CUI [1,1])
specify administration
Item
If other route of administration, please specify
text
C1521902 (UMLS CUI [1,1])
Item
Form of application
text
C2826720 (UMLS CUI [1,1])
CL.30
Code List
Form of application
CL Item
tablet (1)
C2826720 (UMLS CUI [1,1])
CL Item
solution (2)
C1382100 (UMLS CUI [1,1])
CL Item
ointment (3)
C0028912 (UMLS CUI [1,1])
CL Item
other (4)
C0205394 (UMLS CUI [1,1])
specify application
Item
If other form of application, please specify
text
C1521902 (UMLS CUI [1,1])
Indication
Item
Indication
text
C2826696 (UMLS CUI [1,1])
Item Group
Dosage schedule
C2826811 (UMLS CUI [1,1])
C4716519 (UMLS CUI [1,2])
morning
Item
morning
boolean
C0332170 (UMLS CUI [1,1])
noon
Item
noon
boolean
C0585020 (UMLS CUI [1,1])
evening
Item
evening
boolean
C0587117 (UMLS CUI [1,1])
other
Item
other
boolean
C0205394 (UMLS CUI [1,1])
specify dosage schedule
Item
If other dosage schedule, please specify
text
C1521902 (UMLS CUI [1,1])
Item Group
Medication Period
C2826814 (UMLS CUI [1,1])
start available
Item
Is 'Start Date Medication' completely available?
boolean
C0470187 (UMLS CUI [1,1])
C2826734 (UMLS CUI [1,2])
Start Date
Item
Start Date Medication
date
C2826734 (UMLS CUI [1,1])
Item
Start Date Medication (month)
text
C2826734 (UMLS CUI [1,1])
C0439231 (UMLS CUI [1,2])
CL.7
Code List
Start Date Medication (month)
CL Item
01 (1)
CL Item
02 (2)
CL Item
03 (3)
CL Item
04 (4)
CL Item
05 (5)
CL Item
06 (6)
CL Item
07 (7)
CL Item
08 (8)
CL Item
09 (9)
CL Item
10 (10)
CL Item
11 (11)
CL Item
12 (12)
CL Item
unknown (13)
year
Item
Start Date Medication (year)
integer
C2826734 (UMLS CUI [1,1])
C0439234 (UMLS CUI [1,2])
Ongoing
Item
Ongoing (at end of study)
boolean
C2826666 (UMLS CUI [1,1])
stop available
Item
Is 'Stop Date Medication' completely available?
boolean
C0470187 (UMLS CUI [1,1])
C2826744 (UMLS CUI [1,2])
Stop Date
Item
Stop Date Medication
date
C2826744 (UMLS CUI [1,1])
Item
Stop Date Medication (month)
text
C2826744 (UMLS CUI [1,1])
C0439231 (UMLS CUI [1,2])
CL.7
Code List
Stop Date Medication (month)
CL Item
01 (1)
CL Item
02 (2)
CL Item
03 (3)
CL Item
04 (4)
CL Item
05 (5)
CL Item
06 (6)
CL Item
07 (7)
CL Item
08 (8)
CL Item
09 (9)
CL Item
10 (10)
CL Item
11 (11)
CL Item
12 (12)
CL Item
unknown (13)
year
Item
Stop Date Medication (year)
integer
C2826744 (UMLS CUI [1,1])
C0439234 (UMLS CUI [1,2])
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