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- StudyEvent: AMC-058 Missed Visit Form (F35)
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
HospitalAdmissionOrdinalNumber
Item
Visit number
integer
C25337 (NCI Thesaurus ValueDomain)
C16696 (NCI Thesaurus ObjectClass)
C25385 (NCI Thesaurus Property)
C1549755 (UMLS CUI-1)
C16696 (NCI Thesaurus ObjectClass)
C25385 (NCI Thesaurus Property)
C1549755 (UMLS CUI-1)
ResearchCommentsText
Item
Comments
text
C25704 (NCI Thesaurus ValueDomain)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C0947611 (UMLS CUI-1)
Item Group
Missed Visit Information
C1705492 (UMLS CUI-1)
C1512346 (UMLS CUI-2)
C1512346 (UMLS CUI-2)
Missed Visit Date
Item
Missed Visit Date
date
C25164 (NCI Thesaurus ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C48190 (NCI Thesaurus Property)
C25716 (NCI Thesaurus Property-2)
C1705492 (UMLS CUI-1)
C1512346 (UMLS CUI-2)
C0011008 (UMLS CUI-3)
C16960 (NCI Thesaurus ObjectClass)
C48190 (NCI Thesaurus Property)
C25716 (NCI Thesaurus Property-2)
C1705492 (UMLS CUI-1)
C1512346 (UMLS CUI-2)
C0011008 (UMLS CUI-3)
Item
Reason patient missed visit
text
C25638 (NCI Thesaurus ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C48190 (NCI Thesaurus Property)
C25716 (NCI Thesaurus Property-2)
C0392360 (UMLS CUI-1)
C0030705 (UMLS CUI-2)
C0332197 (UMLS CUI-3)
C0545082 (UMLS CUI-4)
C16960 (NCI Thesaurus ObjectClass)
C48190 (NCI Thesaurus Property)
C25716 (NCI Thesaurus Property-2)
C0392360 (UMLS CUI-1)
C0030705 (UMLS CUI-2)
C0332197 (UMLS CUI-3)
C0545082 (UMLS CUI-4)
CL Item
Patient Forgot (1)
CL Item
Health Reasons (2)
CL Item
Patient Could Not Get Off Work (3)
CL Item
Patient Unable To Obtain Dependent Care (4)
CL Item
Patient Had Transportation Problems (5)
CL Item
Patient Unhappy With Frequency Of Visits (6)
CL Item
Scheduling Difficulties (7)
CL Item
Patient Decided To Discontinue Study (8)
CL Item
Patient Experienced An Adverse Event (9)
CL Item
Other (10)
Patient Absent Visit Specify
Item
Other, specify
text
C25685 (NCI Thesaurus ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C48190 (NCI Thesaurus Property)
C25716 (NCI Thesaurus Property-2)
C1521902 (UMLS CUI-1)
C0030705 (UMLS CUI-2)
C0332197 (UMLS CUI-3)
C0545082 (UMLS CUI-4)
C16960 (NCI Thesaurus ObjectClass)
C48190 (NCI Thesaurus Property)
C25716 (NCI Thesaurus Property-2)
C1521902 (UMLS CUI-1)
C0030705 (UMLS CUI-2)
C0332197 (UMLS CUI-3)
C0545082 (UMLS CUI-4)
Patient follow-up planned and scheduled
Item
Next visit scheduled (Items missed will be made up at the new visit.)
boolean
C16960 (NCI Thesaurus ObjectClass)
C53286 (NCI Thesaurus Property)
C25211 (NCI Thesaurus Property-2)
C25716 (NCI Thesaurus Property-3)
C38147 (NCI Thesaurus ValueDomain)
C0184760 (UMLS CUI-1)
C53286 (NCI Thesaurus Property)
C25211 (NCI Thesaurus Property-2)
C25716 (NCI Thesaurus Property-3)
C38147 (NCI Thesaurus ValueDomain)
C0184760 (UMLS CUI-1)