SAE Additional/Follow-Up Information

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Administrative data
C1320722 (UMLS CUI-1)
Clinical Trial Subject Unique Identifier
Item
Subject Identifier
integer
C2348585 (UMLS CUI [1])
Identifier, Hospitals
Item
Centre Number
integer
C0600091 (UMLS CUI [1,1])
C0019994 (UMLS CUI [1,2])
Randomization, Numbers
Item
Randomisation Number
integer
C0034656 (UMLS CUI [1,1])
C0237753 (UMLS CUI [1,2])
Item Group
Serious Adverse Event - Additional/Follow-Up Information
C1519255 (UMLS CUI-1)
Serious Adverse Event, Details
Item
Use this page to provide any additional details on the SAE not already captured on the previous pages
text
C1519255 (UMLS CUI [1,1])
C1522508 (UMLS CUI [1,2])
Investigator Signature
Item
Investigator's signature
text
C2346576 (UMLS CUI [1])
Investigator Name
Item
Investigator's name (print)
text
C2826892 (UMLS CUI [1])
Date in time
Item
Date
date
C0011008 (UMLS CUI [1])
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