CDE Detailed Report
Disease: cookie-policy
Sub-Domain: Disease Related Events
CRF:

21 results.
CDE ID CDE Name Variable Name Definition Short Description Additional Notes (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 / Guideline) Sub Domain Name Domain Name Size Input Restrictions Min Value Max Value Measurement Type Source Form Set Form Field Domain CDASH Variable CDASH Definition CDASH Label Controlled Terminology Prompt Essentiality Question Text CDASH imp guidance SDTM IG target csDSR PhenX Data Type CRF Completion Inst SDTMIG Target Var SDTMIG Target Map Codelist Name PVs Pre Pop Value Query Display List Style
C58928 Organism code OrgCode Code indicating organism. Code indicating organism. Organism: B52;B53;B54;B55;B56;B57;B58;B59;B60;B99;V01;V02;V03;V04;V05;V06;V07;V08;V09;V10;V11;V12;V13;V14;V15;V16;V17;V18;V19;V20;V21;V22;P1;P2;P3;P4;P5;P6;P7;P8;O1;O2;O3;O4;F01;F02;F03;F04;F05;F06;F07;F08;F09;F10;F11;F12;F13;F14;F15;B01;B02;B03;B04;B05;B06;B07;B08;B09;B11;B12;B13;B14;B15;B16;B17;B18;B19;B20;B21;B22;B23;B24;B25;B26;B27;B28;B29;B30;B31;B32;B33;B34;B35;B36;B37;B38;B39;B40;B41;B42;B43;B44;B45;B46;B47;B48;B49;B50;B51 Staphylococcus (coag-);Staphylococcus (coag +);Staphylococcus (NOS);Stomatococcus mucilaginosis;Streptococcus (all species except Enterococcus);Treponema (syphilis);Tuberculosis (NOS, AFB, acid fast bacillus, Koch bacillus);Typical Tuberculosis (TB, Tuberculosis);Vibrio (all species);Other Bacteria;Herpes Simplex (HSV1, HSV2);Herpes Zoster (Chicken Pox, Varicella);Cytomegalovirus (CMV);Adenovirus;Enterovirus (Coxsackie, Echo, Polio);Hepatitis A (HAV);Hepatitis B (HBV, Australian antigen);Hepatitis C (includes non-A and non-B, HCV);HIV-1, HITLV-III;Influenza (Flu);Measles (Rubeola);Mumps;Papovavirus;Respiratory Syncytial virus (RSV);Rubella (German Measles);Parainfluenza;HHV-6 (Human Herpes Virus);Epstein-Barr Virus (EBV);Polyomavirus;Rotavirus;Rhinovirus (Common Cold);Other Viral;Pneumoncystis (PCP);Toxoplasma;Giardia;Cryptosporidium;Amebiasis;Echinoco ocalcyst;Trichomonas (either vaginal or gingivitis);Other Protozoal (parasite);Mycobacterium Tuberculosis;Other Mycobacterium;Mycoplasma;Other Organism;Candida Albicans;Candida Krusei;Candida Parasilosis;Candida Tropicalis;Torulopsis Galbrata (a subspecies of Candida);Candida (NOS);Asperguillus Flavus;Asperguillus Fumigatus;Asperguillus Niger;Asperguillus (NOS);Cryptococcus Species;Fusarium Species;Mucormycosis (Zygomycetes, Rhizopus);Yeast (NOS);Other Fungus;Acinetobacter (baumanii, calcoaceticus, lwoffi, other species);Agrobacterium radiobacter;Alcaligenes xylosoxidans;Anaerobic bacteria (NOS, except for Bacteroides, Clostridium);Bacillus (cereus, other species);Bacteroides (gracillis, uniformis, vulgaris, other species);Borrelia (Lyme Disease);Branhamelia or Moraxella catarrhalis (other species);Campylobacter (all species);Chlamydia;Citrobacter (freundii, other species);Clostridium (all species except difficile);Clostridium diificile;Corynebacterium (all non-diptheria species);Coxiella;Enterobacter;Enterococcus (all species);Escherichia (also E. coli);Flavimonas oryzihabitans;Flavobacterium;Fusobacterium nucleatum;Gram Negative Diplococci (NOS);Gram Negative Rod (NOS);Gram Positive Cocci (NOS);Gram Positive Rod (NOS);Haemophilus (all species including influenzae);Helicobacter pylori;Klebsiella;Lactobacillus (bulgaricus, acidophilus, other species);Legionella;Leptospira;Leptotrichia buccalis;Leuconostoc (all species);Listeria;Methylobacterium;Micrococcus (NOS);Mycobacteria (avium, bovium, haemophilum, intercellulare);Mycoplasma;Neisseria (gonorrhoea, meningitidis, other species);Nocardia;Pharyngeal/Respiratory Flora;Propionbacterium (acnes, avidum, granulosum, other species);Pseudomonas (all species except cepacia and maltophilia);Pseudomonas or Burkholderia cepacia;Pseudomonas or Stenotrophomonas or Xanthomonas maltophilia;Rhodococcus;Rickettsia;Salmonella (all species);Serratia marcescens;Shigella Alphanumeric Adult;Pediatric Proposed 1.00 2018-12-19 13:21:14.0 Infection Form (IFN) Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Infection Form (IFN) FN1ORGN
C58940 Specific event type SpecEvntTyp Specific event type that lead to an advanced care intervention or Intensive Care Unit admission/transfer as outlined in the AE reporting section of chapter 4 of the protocol. Specific event type that lead to an advanced care intervention or Intensive Care Unit admission/transfer as outlined in the AE reporting section of chapter 4 of the protocol. Specify event(s): Alphanumeric Adult;Pediatric Proposed 1.00 2019-01-03 15:24:38.0 Infection Form (IFN) Disease Related Events History of Disease Event 255

Free-Form Entry

BMTCTN 1507A Release 5.10 Infection Form (IFN) IFNAESP
C58929 Infection severity code InfectionSeverityCode Code indicating the severity of the infection. Code indicating the severity of the infection. Severity of infection: 2;3 Grade 2;Grade 3 Numeric Values Adult;Pediatric Proposed 1.00 2018-12-19 13:25:56.0 Infection Form (IFN) Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Infection Form (IFN) IFN1SVRT
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 Proposed 3.00 2013-07-16 14:01:43.01 Infection Form (IFN) Disease Related Events History of Disease Event 4000

Free-Form Entry

DeBaun Forms
C58930 Specific other infection type SpecificOtherInfectionTyp The specific type of infection if not otherwise listed. The specific type of infection if not otherwise listed. Specify other organism: Alphanumeric Adult;Pediatric Proposed 1.00 2018-12-19 13:34:53.0 Infection Form (IFN) Disease Related Events History of Disease Event 255

Free-Form Entry

BMTCTN 1507A Release 5.10 Infection Form (IFN) IFN1OTSP
C58915 Nonmicrobiologically defined infection code NonmcblgyDfnIfnCode Code indicating whether infection is nonmicrobiologically defined. Code indicating whether infection is nonmicrobiologically defined. Is the infection a nonmicrobiologically defined infection? 1;2;1;2 Yes;No;Yes;No Numeric Values Adult;Pediatric Proposed 1.00 2018-12-17 15:35:14.0 Infection Form (IFN) Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Infection Form (IFN) IFN1NMCR
C58931 Sepsis evidence code SepsisEvdnceCode Code indicating whether there was evidence of sepsis. Code indicating whether there was evidence of sepsis. Was there evidence of sepsis? 1;2;1;2 Yes;No;Yes;No Numeric Values Adult;Pediatric Proposed 1.00 2018-12-19 14:44:13.0 Infection Form (IFN) Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Infection Form (IFN) IFN1EVSP)
C58917 Infection related to pneumonia or bronchopneumonia code IfnRltdToPneuOrBrnpneuCode Code indicating whether the patient has evidence of pneumonia or bronchopneumonia related to an infection. Code indicating whether the patient has evidence of pneumonia or bronchopneumonia related to an infection. Did the patient have evidence of pneumonia or bronchopneumonia related to an infection? 1;2;1;2 Yes;No;Yes;No Numeric Values Adult;Pediatric Proposed 1.00 2018-12-17 15:39:31.0 Infection Form (IFN) Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Infection Form (IFN) IFN1PTPN
C58932 New or worsening infiltrates evidence infection time code NOWInfltrtsEvInfTmCode Code indicating whether there was evidence of new or worsening infiltrates at the time of infection. Code indicating whether there was evidence of new or worsening infiltrates at the time of infection. Was there evidence of new or worsening infiltrates at the tie of the infection? 1;2;1;2 Yes;No;Yes;No Numeric Values Adult;Pediatric Proposed 1.00 2018-12-24 10:39:43.0 Infection Form (IFN) Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Infection Form (IFN) IFN1EVIN
C58919 Mechanical ventilation required code MechnclVentlnReqCode Code indicating whether the patient required mechanical ventilation. Code indicating whether the patient required mechanical ventilation. Did the patient require mechanical ventilation? 1;2;1;2 Yes;No;Yes;No Numeric Values Adult;Pediatric Proposed 1.00 2018-12-17 15:43:39.0 Infection Form (IFN) Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Infection Form (IFN) IFN1PTVT
C58933 Infection treated by administered agent code InfnTrtByAdminAgntCode Code indicating whether an agent(s) was administered to treat infection(s). Code indicating whether an agent(s) was administered to treat infection(s). Was an agent(s) administered to treat the infection? 1;2;1;2 Yes;No;Yes;No Numeric Values

Agents administered for prophylaxis should not be reported.

Adult;Pediatric Proposed 1.00 2018-12-24 11:27:48.0 Infection Form (IFN) Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Infection Form (IFN) IFNAGTRT
C58923 Patient typhlitis code PtntTyphlitisCode Code indicating whether the patient had typhlitis. Code indicating whether the patient had typlitis. Did the patient have typhlitis? 1;2;1;2 Yes;No;Yes;No Numeric Values Adult;Pediatric Proposed 1.00 2018-12-17 15:52:21.0 Infection Form (IFN) Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Infection Form (IFN) IFN1PTTY
C58934 Infection administered agent name InfcnAdminAgentName Name indicating the agent(s) administered for the infection(s). Name indicating the agent(s) administered for the infection(s). Provide agent(s) administered to treat the infection(s): Abacavir (Ziagen);Acyclovir (Zovirax);Albendazole (Albenza);Amantadine (Symmetrel, Symadine);Amikacin (Amikin);Amoxicillin/clavulanate (Augmentin);Amphotericin b (Abelcet, Amphotec, Fungizone);Ampicillin (Omnipen, Polycillin);Ampicillin/Sulbactam (Unasyn);Amprenavir (Agenerase);Atovaquone (Meprone);Azithromycin (Zithromax, Z-Pack);Cefaclor (Ceclor);Cefadroxil (Duricef, Ultracef);Cefazolin (Ancef, Kefzol);Cefdinir (Omnicef);Cefepime (Maxipime);Cefixime (Suprax);Cefoperazone (Cefobid);Cefotaxime (Claforan);Cefotetan (Cefotan);Cefoxitin (Mefoxin);Cefpodoxime (Vantin);Cefprozil (Cefzil);Ceftazidime (Fortaz, Tazicef);Ceftriaxone (Rocephin);Cefuroxime (Ceftin, Kefurox, Zinacef);Cephalexin (Keflet, Keflex, Keftab);Chloramphenicol (Chloromycetin);Cidofovir (Vistide);Ciprofloxacin (Cipro);Clarithromycin (Biaxin);Clindamycin (Cleocin);Clotrimazole (Mycelex, Lotrimin);Clotrimoxazole/betamethasone (Lotrisone);Co-trimoxazole (Bactrim, Septra, Sulfamethoprim);Dapsone (DDS);Dicloxacillin (Dycill, Dynapen, Pathocil);Didanosine (Videx, ddl);Doxycycline (Vibramycin);Efavirenz (Sustiva);Erythromycin (Ery-Tab, llosone, Pediamycin);Erythromycin ethyl/sulfisoxazole (Pediazole);Erythromycin topical (Akne-mycin, Eryderm);Ethambutol (Myambutol);Famciclovir (Famvir);Fluconazole (Diflucan);Flucytosine (Ancobon);Foscarnet (Foscavir);Ganciclovir (Cytovene);Gatifloxican (Tequin);Gentamicin (Garamycin, Gentacidin);Grepafloxacin (Raxar);Hepatitis A Vaccine (Havrix, Vaqta);Hepatitis B Vaccine (Recombivax HB, Energix-B);Hepatitis C Vaccine;Imipenem/Cilastatin (Primaxin);Imiquimod (Aldara);Indinavir (Crixivan);Interferon Alfacon-1 (Infergen);Interferon beta-1a (Avonex);Interferon beta-1b (Betaseron);Isoniazid (INH, Lanizid, Nydrazid);Itraconazole (Sporonox);Ivermectin (Stromectol);Kanamycin (Kantrex);Ketoconazole (Nizoral);Lamivudine (Epivir, 3TC);Levofloxacin (Levaquin);Linezolid (Zyvox);Lopinavir/Ritonavir (Kaletra);Mefloquine (Larium);Meropenem (Merrem I.V.);Metronidazole (Flagyl, Protostat);Minocycline (Arestin);Moxifloxacin hydrochloride (Avelox);Mupirocin (Bactroban);Nafcillin (Nallpen, Unipen);Nelfinavir (Viracept);Neomycin (Mycifradin, Myciguent);Neomycin/Polymxin/Hydrocortisone (Cortisporin);Nevirapine (Viramune);Nitrofurantoin (Macrobid);Nystatin (Mycostatin);Oseltamivir (Tamiflu);Oxacillin (Bactocill);Palivizumab (Synagis);Penicillin G (Bicillin);Penicillin vk (V-Cillin K, Veetids);Pentamidine (Pentam 300);Piperacillin (Pipracil);Piperacillin/Tazobactam (Zosyn);Podofilox (Condylox);Polymyxin (Ak-Spore H.C., Cortisporin Opthalmic Suspension);PPD Skin test (Mantoux Test, Tine Test);Pyrazinamide (Rifater);Pyrimethamine (Daraprim);Quinidine gluconate (Duraquin, Cardioqiuin);Quinupristin/Dalfopristin (Synercid);Respiratory syncytial immune globulin (Respigam);Ribavirin (Virazole);Rifampin (Rifadin, Rimactane);Rifampin/Isoniazid (Rifamate, Rimactane/INH);Rifampin/isoniazid/Pyrazinamide (Rifater);Rimantadine (Flumadine);Ritonavir (Norvir);Saquinavir mesylate (Fortovase, Invirase);Stavudine (d4T, Zerit);Streptomycin (Streptomycin sulfate);Sulfamethoxazole/Trimethoprim (Bactrim);Terbinafine (Lamisil);Terconazole (Terazol);Tetracycline (Achromycin);Ticarcillin/Clavulanate (Ticar, Timentin);Tobramycin (Nebcin, Tobrex, TobraDex);Trimethoprim/Sulfamethoxazole (Bactrim, Spetra, Co-trimoxazole);Valganciclovir (Valtrex);Valganciclovir (Valcyte);Vancomycin (Vancocin);Zidovudine (AZT, Retrovir);Other Abacavir (Ziagen);Acyclovir (Zovirax);Albendazole (Albenza);Amantadine (Symmetrel, Symadine);Amikacin (Amikin);Amoxicillin/clavulanate (Augmentin);Amphotericin b (Abelcet, Amphotec, Fungizone);Ampicillin (Omnipen, Polycillin);Ampicillin/Sulbactam (Unasyn);Amprenavir (Agenerase);Atovaquone (Meprone);Azithromycin (Zithromax, Z-Pack);Cefaclor (Ceclor);Cefadroxil (Duricef, Ultracef);Cefazolin (Ancef, Kefzol);Cefdinir (Omnicef);Cefepime (Maxipime);Cefixime (Suprax);Cefoperazone (Cefobid);Cefotaxime (Claforan);Cefotetan (Cefotan);Cefoxitin (Mefoxin);Cefpodoxime (Vantin);Cefprozil (Cefzil);Ceftazidime (Fortaz, Tazicef);Ceftriaxone (Rocephin);Cefuroxime (Ceftin, Kefurox, Zinacef);Cephalexin (Keflet, Keflex, Keftab);Chloramphenicol (Chloromycetin);Cidofovir (Vistide);Ciprofloxacin (Cipro);Clarithromycin (Biaxin);Clindamycin (Cleocin);Clotrimazole (Mycelex, Lotrimin);Clotrimoxazole/betamethasone (Lotrisone);Co-trimoxazole (Bactrim, Septra, Sulfamethoprim);Dapsone (DDS);Dicloxacillin (Dycill, Dynapen, Pathocil);Didanosine (Videx, ddl);Doxycycline (Vibramycin);Efavirenz (Sustiva);Erythromycin (Ery-Tab, llosone, Pediamycin);Erythromycin ethyl/sulfisoxazole (Pediazole);Erythromycin topical (Akne-mycin, Eryderm);Ethambutol (Myambutol);Famciclovir (Famvir);Fluconazole (Diflucan);Flucytosine (Ancobon);Foscarnet (Foscavir);Ganciclovir (Cytovene);Gatifloxican (Tequin);Gentamicin (Garamycin, Gentacidin);Grepafloxacin (Raxar);Hepatitis A Vaccine (Havrix, Vaqta);Hepatitis B Vaccine (Recombivax HB, Energix-B);Hepatitis C Vaccine;Imipenem/Cilastatin (Primaxin);Imiquimod (Aldara);Indinavir (Crixivan);Interferon Alfacon-1 (Infergen);Interferon beta-1a (Avonex);Interferon beta-1b (Betaseron);Isoniazid (INH, Lanizid, Nydrazid);Itraconazole (Sporonox);Ivermectin (Stromectol);Kanamycin (Kantrex);Ketoconazole (Nizoral);Lamivudine (Epivir, 3TC);Levofloxacin (Levaquin);Linezolid (Zyvox);Lopinavir/Ritonavir (Kaletra);Mefloquine (Larium);Meropenem (Merrem I.V.);Metronidazole (Flagyl, Protostat);Minocycline (Arestin);Moxifloxacin hydrochloride (Avelox);Mupirocin (Bactroban);Nafcillin (Nallpen, Unipen);Nelfinavir (Viracept);Neomycin (Mycifradin, Myciguent);Neomycin/Polymxin/Hydrocortisone (Cortisporin);Nevirapine (Viramune);Nitrofurantoin (Macrobid);Nystatin (Mycostatin);Oseltamivir (Tamiflu);Oxacillin (Bactocill);Palivizumab (Synagis);Penicillin G (Bicillin);Penicillin vk (V-Cillin K, Veetids);Pentamidine (Pentam 300);Piperacillin (Pipracil);Piperacillin/Tazobactam (Zosyn);Podofilox (Condylox);Polymyxin (Ak-Spore H.C., Cortisporin Opthalmic Suspension);PPD Skin test (Mantoux Test, Tine Test);Pyrazinamide (Rifater);Pyrimethamine (Daraprim);Quinidine gluconate (Duraquin, Cardioqiuin);Quinupristin/Dalfopristin (Synercid);Respiratory syncytial immune globulin (Respigam);Ribavirin (Virazole);Rifampin (Rifadin, Rimactane);Rifampin/Isoniazid (Rifamate, Rimactane/INH);Rifampin/isoniazid/Pyrazinamide (Rifater);Rimantadine (Flumadine);Ritonavir (Norvir);Saquinavir mesylate (Fortovase, Invirase);Stavudine (d4T, Zerit);Streptomycin (Streptomycin sulfate);Sulfamethoxazole/Trimethoprim (Bactrim);Terbinafine (Lamisil);Terconazole (Terazol);Tetracycline (Achromycin);Ticarcillin/Clavulanate (Ticar, Timentin);Tobramycin (Nebcin, Tobrex, TobraDex);Trimethoprim/Sulfamethoxazole (Bactrim, Spetra, Co-trimoxazole);Valganciclovir (Valtrex);Valganciclovir (Valcyte);Vancomycin (Vancocin);Zidovudine (AZT, Retrovir);Other Alphanumeric Adult;Pediatric Proposed 1.00 2018-12-24 11:31:56.0 Infection Form (IFN) Disease Related Events History of Disease Event

Multiple Pre-Defined Values Selected

BMTCTN 1507A Release 5.10 Infection Form (IFN) IFN1AGNT
C58924 Severe sepsis patient no identified organism code SvreSpsPntNoIdnfdOrgansmCode Code indicating whether the patient had severe sepsis without an identified organism. Code indicating whether the patient had severe sepsis without an identified organism. Did the patient have severe sepsis without an identified organism? 1;2;1;2 Yes;No;Yes;No Numeric Values Adult;Pediatric Proposed 1.00 2018-12-17 15:59:42.0 Infection Form (IFN) Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Infection Form (IFN) IFN1PSEP
C58935 Infection required additional agents administered code InfcnReqAddAgntsAdmnCode Code indicating whether additional agents were administered for infection(s). Code indicating whether additional agents were administered for infection(s). Were additional agents administered for the infection(s): 1;2;1;2 Yes;No;Yes;No Numeric Values Adult;Pediatric Proposed 1.00 2018-12-24 15:08:51.0 Infection Form (IFN) Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Infection Form (IFN) IFNADDAG)
C58925 Infection type InfectionTyp Type of infection. Type of infection. Type of infection: B;F;V;P;O Bacterial;Fungal;Viral;Protozoal;Other Alphanumeric Adult;Pediatric Proposed 1.00 2018-12-17 16:03:14.0 Infection Form (IFN) Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Infection Form (IFN) IFN1TYPE
C58936 Advanced care intervention ICU required code AdvCareIntvnICUReqCode Code indicating whether the reported event lead to an advanced care intervention or Intensive Care Unit admission/transfer. Code indicating whether the reported event lead to an advanced care intervention or Intensive Care Unit admission/transfer. Did any of the events reported above lead to an advanced care intervention or Intensive Care Unit admission/transfer as outlined in the AE reporting section of chapter 4 of the protocol? 1;2;1;2 Yes;No;Yes;No Numeric Values Adult;Pediatric Proposed 1.00 2018-12-24 15:12:43.0 Infection Form (IFN) Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Infection Form (IFN) IFNAEICU
C58926 Infection site code InfectionSiteCode Code indicating the site of infection. Code indicating the site of infection. Infection site 01;02;03;04;05;06;07;08;09;10;11;12;13;14;15;16;17;18;19;20;21;22;23;24;25;26;27;28;29;30;31;32;33;34;35;36;37;38;39;40;41;42;43;99 Blood/Buffy Coat;Disseminated - Generalized, Isolated at 2 or More Distinct Sites;Brain;Spinal Cord;Meninges and CSF;Central Nervous System Unspecified;Lips;Tongue, Oral Cavity, and Oro-Pharynx;Esophagus;Stomach;Gallbladder and Billary Tree (Not Hepatitis), Pancreas;Small Intestine;Large Intestine;Feces/Stool;Peritoneum;Liver;Gastrointestinal Tract Unspecified;Upper Airway and Nasopharynx;Larynx;Lower Respiratory Tract (Lung);Pleural Cavity, Pleural Fluid;Sinuses;Respiratory Tract Unspecified;Kidneys, Renal Pelvis, Ureters and Bladder;Prostate;Testes;Fallopian Tubes, Uterus, Cervix;Vagina;Genito-Urinary Tract Unspecified;Genital Area;Rash, Pustules, or Abscesses Not Typical of Any of the Above;Skin Unspecified;Woundsite;Catheter Tip;Eyes;Ears;Joints;Bone Marrow;Bone Cortex (Osteomyelitis);Muscle (Excluding Cardiac);Cardiac (Endocardium, Myocardium, Pericardium);Lymph Nodes;Spleen;Other Unspecified Numeric Values Adult;Pediatric Proposed 1.00 2018-12-17 16:10:26.0 Infection Form (IFN) Disease Related Events History of Disease Event

Single Pre-Defined Value Selected

BMTCTN 1507A Release 5.10 Infection Form (IFN) INFSITE
C58938 Specify other agent type SpcfyOthAgntTyp Type of agent specified if agent is not listed. Type of agent specified if agent is not listed. Specify other agent: Alphanumeric Adult;Pediatric Proposed 1.00 2019-01-03 15:11:51.0 Infection Form (IFN) Disease Related Events History of Disease Event 255

Free-Form Entry

BMTCTN 1507A Release 5.10 Infection Form (IFN) IFN1AGSP
C58927 Infection start date InfectionStartDate Date indicating the start of the infection. Date indicating the start of the infection. Infection start date: Date or Date & Time

Data sharing instructions: When date/time data are prepared for aggregation or sharing, they should be converted to the format specified by ISO 8601; YYYY-MM-DD T:hh:mm:ss.

Adult;Pediatric Proposed 1.00 2018-12-17 16:12:14.0 Infection Form (IFN) Disease Related Events History of Disease Event

Free-Form Entry

BMTCTN 1507A Release 5.10 Infection Form (IFN) INFSTDT
C58939 Additional agents administered type AddlAgntAdminTyp Type of specific additional agent administered for an infection. Type of specific additional agent administered for an infection. If yes, specify additional agents administered: Alphanumeric Adult;Pediatric Proposed 1.00 2019-01-03 15:21:49.0 Infection Form (IFN) Disease Related Events History of Disease Event 255

Free-Form Entry

BMTCTN 1507A Release 5.10 Infection Form (IFN) IFNADDSP
21 results.
CSV