Baseline 1st cycle Trial Medication Multiple Sclerosis ALAIN01 NCT02419378

Trial Medication
Description

Trial Medication

Alias
UMLS CUI-1
C0013227
Patient ID (derived)
Description

Patient ID (derived)

Data type

text

Alias
UMLS CUI [1]
C2348585
Trial Medication: Deferral Comment
Description

Trial Medication: Deferral Comment

Data type

text

Alias
UMLS CUI [1,1]
C0205421
UMLS CUI [1,2]
C0947611
Trial Medication: Pregnancy Test
Description

Pregnancy Test

Data type

text

Alias
UMLS CUI [1]
C0032976
Trial Medication: Pregnancy Test, Kind of test
Description

Pregnancy Test, Kind of test

Data type

text

Alias
UMLS CUI [1,1]
C0032976
UMLS CUI [1,2]
C1550373
Trial Medication Pregnancy Test: Date
Description

Trial Medication Pregnancy Test: Date

Data type

date

Alias
UMLS CUI [1,1]
C0032976
UMLS CUI [1,2]
C0011008
Trial MedicationI Pregnancy Test: Result
Description

Trial MedicationI Pregnancy Test: Result

Data type

text

Alias
UMLS CUI [1,1]
C0032976
UMLS CUI [1,2]
C0243095
Trial Medication Pregnancy Test: Reason
Description

Pregnancy Test: Reason

Data type

text

Alias
UMLS CUI [1,1]
C0032976
UMLS CUI [1,2]
C0032976
Trial Medication Pregnancy Test: Reason, Text
Description

Pregnancy Test: Reason, Text

Data type

text

Alias
UMLS CUI [1,1]
C0032976
UMLS CUI [1,2]
C3146298
Trial Medication: Date of Signature
Description

Date of Signature

Data type

date

Alias
UMLS CUI [1,1]
C1519316
UMLS CUI [1,2]
C0011008
Trial Medication: Signature yes/no
Description

Signature yes/no

Data type

text

Alias
UMLS CUI [1,1]
C1519316
UMLS CUI [1,2]
C1705848
Comment Trial Medication
Description

Comment

Data type

text

Alias
UMLS CUI [1]
C0947611
Trial Medication RQG
Description

Trial Medication RQG

Trial Medication: Date of Administration
Description

Date of Administration

Data type

date

Alias
UMLS CUI [1,1]
C1533734
UMLS CUI [1,2]
C0011008
Trial Medication: Dose administered
Description

Trial Medication: Dose administered

Data type

float

Measurement units
  • mg
Alias
UMLS CUI [1]
C3174092
mg
Trial Medication: Batch No
Description

Trial Medication: Batch No

Data type

text

Alias
UMLS CUI [1]
C3641829
Trial Medication: Expiry Date
Description

Expiration

Data type

date

Alias
UMLS CUI [1]
C3669020
Trial Medication: Reason if less than 12 mg
Description

Trial Medication: Reason if less than 12 mg

Data type

text

Alias
UMLS CUI [1,1]
C3174092
UMLS CUI [1,2]
C0392360

Similar models

Baseline 1st cycle Trial Medication Multiple Sclerosis ALAIN01 NCT02419378

Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Trial Medication
C0013227 (UMLS CUI-1)
Patient ID (derived)
Item
Patient ID (derived)
text
C2348585 (UMLS CUI [1])
Trial Medication: Deferral Comment
Item
Trial Medication: Deferral Comment
text
C0205421 (UMLS CUI [1,1])
C0947611 (UMLS CUI [1,2])
Item
Trial Medication: Pregnancy Test
text
C0032976 (UMLS CUI [1])
Code List
Trial Medication: Pregnancy Test
CL Item
Test not done (0)
CL Item
Test done (1)
Item
Trial Medication: Pregnancy Test, Kind of test
text
C0032976 (UMLS CUI [1,1])
C1550373 (UMLS CUI [1,2])
Code List
Trial Medication: Pregnancy Test, Kind of test
CL Item
blood (1)
CL Item
urine (2)
Trial Medication Pregnancy Test: Date
Item
Trial Medication Pregnancy Test: Date
date
C0032976 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Item
Trial MedicationI Pregnancy Test: Result
text
C0032976 (UMLS CUI [1,1])
C0243095 (UMLS CUI [1,2])
Code List
Trial MedicationI Pregnancy Test: Result
CL Item
negative (0)
CL Item
positive (1)
Item
Trial Medication Pregnancy Test: Reason
text
C0032976 (UMLS CUI [1,1])
C0032976 (UMLS CUI [1,2])
Code List
Trial Medication Pregnancy Test: Reason
CL Item
no childbearing potential (0)
CL Item
other (9)
Pregnancy Test: Reason, Text
Item
Trial Medication Pregnancy Test: Reason, Text
text
C0032976 (UMLS CUI [1,1])
C3146298 (UMLS CUI [1,2])
Date of Signature
Item
Trial Medication: Date of Signature
date
C1519316 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Item
Trial Medication: Signature yes/no
text
C1519316 (UMLS CUI [1,1])
C1705848 (UMLS CUI [1,2])
Code List
Trial Medication: Signature yes/no
CL Item
yes (1)
CL Item
no (0)
Comment
Item
Comment Trial Medication
text
C0947611 (UMLS CUI [1])
Date of Administration
Item
Trial Medication: Date of Administration
date
C1533734 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Medication dose
Item
Trial Medication: Dose administered
float
C3174092 (UMLS CUI [1])
Batch Number
Item
Trial Medication: Batch No
text
C3641829 (UMLS CUI [1])
Expiration
Item
Trial Medication: Expiry Date
date
C3669020 (UMLS CUI [1])
Trial Medication: Reason if less than 12 mg
Item
Trial Medication: Reason if less than 12 mg
text
C3174092 (UMLS CUI [1,1])
C0392360 (UMLS CUI [1,2])