English

Dosing Information - Infusion

1 forms  
Administrative Data
Description

Administrative Data

Alias
UMLS CUI-1
C1320722
Site #
Description

Study centre number

Data type

integer

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

patient ID

Data type

integer

Alias
UMLS CUI [1]
C2348585
Visit Date
Description

visit date

Data type

date

Alias
UMLS CUI [1]
C1320303
Investigator Name
Description

Investigator Name

Data type

text

Alias
UMLS CUI [1]
C2826892
Check if (additional) supplemental instance of this form was used.
Description

Use one instance for every ten infusions. Check this box on all instances except for the last one.

Data type

boolean

Alias
UMLS CUI [1]
C1706499
Instance Number
Description

Fill in the instance number, starting from 1. On all instances except for the last one, the preceding box has to be checked.

Data type

integer

Alias
UMLS CUI [1,1]
C1516308
UMLS CUI [1,2]
C2348184
Dosing Information - Infusion
Description

Dosing Information - Infusion

Alias
UMLS CUI-1
C0678766
UMLS CUI-2
C1533716
UMLS CUI-3
C0574032
Start Date:
Description

(dd-mmm-yyyy)

Data type

date

Alias
UMLS CUI [1,1]
C0574032
UMLS CUI [1,2]
C0808070
Start Time:
Description

(0000-2359)

Data type

time

Alias
UMLS CUI [1,1]
C0574032
UMLS CUI [1,2]
C1301880
Stop Date
Description

(dd-mmm-yyyy)

Data type

date

Alias
UMLS CUI [1,1]
C0574032
UMLS CUI [1,2]
C0806020
Stop Time:
Description

(0000-2359)

Data type

time

Alias
UMLS CUI [1,1]
C0574032
UMLS CUI [1,2]
C1522314
Dose:
Description

Infusion dose

Data type

float

Measurement units
  • mcg/kg/min
Alias
UMLS CUI [1,1]
C0574032
UMLS CUI [1,2]
C0178602
mcg/kg/min
Rate of Infusion:
Description

Infusion rate

Data type

float

Measurement units
  • mL/hr
Alias
UMLS CUI [1]
C2964135
mL/hr
Back to the top of the page

Similar models

Dosing Information - Infusion

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
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])
Additional form
Item
Check if (additional) supplemental instance of this form was used.
boolean
C1706499 (UMLS CUI [1])
CRF Sequential Number
Item
Instance Number
integer
C1516308 (UMLS CUI [1,1])
C2348184 (UMLS CUI [1,2])
Item Group
Dosing Information - Infusion
C0678766 (UMLS CUI-1)
C1533716 (UMLS CUI-2)
C0574032 (UMLS CUI-3)
Infusion start date
Item
Start Date:
date
C0574032 (UMLS CUI [1,1])
C0808070 (UMLS CUI [1,2])
Infusion start time
Item
Start Time:
time
C0574032 (UMLS CUI [1,1])
C1301880 (UMLS CUI [1,2])
Infusion stop date
Item
Stop Date
date
C0574032 (UMLS CUI [1,1])
C0806020 (UMLS CUI [1,2])
Infusion stop time
Item
Stop Time:
time
C0574032 (UMLS CUI [1,1])
C1522314 (UMLS CUI [1,2])
Infusion dose
Item
Dose:
float
C0574032 (UMLS CUI [1,1])
C0178602 (UMLS CUI [1,2])
Infusion rate
Item
Rate of Infusion:
float
C2964135 (UMLS CUI [1])
Back to the top of the page