CDE Detailed Report

Disease: General (For all diseases)
Subdomain Name: Study Management
CRF: Visit Checklist

Displaying 1 - 5 of 5
CDE ID CDE Name Variable Name Definition Short Description Question Text Permissible Values Description Data Type Disease Specific Instructions Disease Specific Reference Population Classification (e.g., Core) Version Number Version Date CRF Name (CRF Module / Guidance) Subdomain Name Domain Name Size Input Restrictions Min Value Max Value Measurement Type External Id Loinc External Id Snomed External Id caDSR External Id CDISC
C18027 Comment text CmmntTxt Provide any additional information that pertains to the question Provide any additional information that pertains to the question Comments Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Visit Checklist Study Management Protocol Experience 4000

Free-Form Entry

C21108 Visit present indicator VisitPresentInd Indicator for the presence of the subject at the visit Indicator for the presence of the subject at the visi Did the subject attend this visit? No;Yes No;If Yes, continue Alphanumeric Adult;Pediatric Supplemental 1.00 2015-06-12 13:44:45.0 Visit Checklist Study Management Protocol Experience

Single Pre-Defined Value Selected

C21109 Visit assessment complete type VisitAssessmentCompleteTyp Type of assessment completed during visit Type of assessment completed during visi Please check all assessments completed at this visit: Adverse Events;Form A;Form B;Form C;Form D;Form E;Form F;Prior and Concomitant Medications Adverse Events;Form A;Form B;Form C;Form D;Form E;Form F;Prior and Concomitant Medications Alphanumeric Adult;Pediatric Supplemental 1.00 2015-06-12 13:52:25.0 Visit Checklist Study Management Protocol Experience

Multiple Pre-Defined Values Selected

C21110 Last visit indicator LastVisitInd Indicator for the visit being the last one Indicator for the visit being the last on Is this the last visit? No;Yes No;Yes (If Yes, complete Subject Status form) Alphanumeric Adult;Pediatric Supplemental 1.00 2015-06-12 14:05:44.0 Visit Checklist Study Management Protocol Experience

Single Pre-Defined Value Selected

C21111 Form not completed indicator FormNotCompleteInd Indicator for the incompletion of the form Indicator for the incompletion of the form Check here if form not completed Yes Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2015-06-12 14:15:59.0 Visit Checklist Study Management Protocol Experience

Single Pre-Defined Value Selected

CSV