CDE Detailed Report

Disease: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
Sub-Domain: Drugs
CRF: Medication and Other Treatments

Displaying 1 - 17 of 17
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 / Guideline) Sub Domain Name Domain Name Size Input Restrictions Min Value Max Value Measurement Type External Id Loinc External Id Snomed External Id caDSR External Id CDISC
C19500 Assessment performed date AssessmentPerformedDate The date of assessment of the examination being performed. The date of assessment of the examination being performed. Date: Date or Date & Time Adult;Pediatric Supplemental-Highly Recommended 1.00 2014-06-18 08:10:12.0 Medication and Other Treatments Drugs Treatment/Intervention Data

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C02006 Medication prior or concomitant dose MedctnPriorConcomDose Dose of prior/concomitant medication taken per administration. Dose of prior/concomitant medication taken per administration. Dose Numeric Values Adult;Pediatric Supplemental-Highly Recommended 3.00 2013-08-28 16:08:00.453 Medication and Other Treatments Drugs Treatment/Intervention Data

Free-Form Entry

3162729
C58129 Other treatments reason type OtherTreatmentsReasonTyp Type of reason for other treatments given to subject/participant.. Type of reason for other treatments given to subject/participant Treatment Gradual exercise program;Dietary changes;Cognitive/Behavioral therapy;Other, specify: Gradual exercise program;Dietary changes;Cognitive/Behavioral therapy;Other, specify: Alphanumeric Adult;Pediatric Supplemental-Highly Recommended 1.00 2018-02-02 15:57:52.0 Medication and Other Treatments Drugs Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C02011 Medication prior or concomitant dose frequency MedctnPriorConcmtntDoseFreq Frequency of use of a prior/concomitant medication. Frequency of use of a prior/concomitant medication. Prescribe dosing schedule BID;TID;QID;q2h;q4h;q6h;q8h;QAM;QPM;QD;alt. d.;HS;PRN;OTH;UNK;NA twice a day;three times a day;four times a day;every 2 hours;every 4 hours;every 6 hours;every 8 hours;every morning;every evening;one a day;every other day (on alternate days);at bedtime;as needed;Other, specify;unknown;Not applicable Alphanumeric Adult;Pediatric Supplemental-Highly Recommended 3.00 2013-07-24 21:00:23.88 Medication and Other Treatments Drugs Treatment/Intervention Data

Single Pre-Defined Value Selected

3162733
C58130 Other treatments date OtherTreatmentDate Date(s) when other treatments were given to subject/participant. Date(s) when other treatments were given to subject/participant. Date(s) When Treated Date or Date & Time Adult;Pediatric Supplemental-Highly Recommended 1.00 2018-02-02 16:07:33.0 Medication and Other Treatments Drugs Treatment/Intervention Data

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C02013 Medication prior or concomitant dose unit of measure UCUM code MedctnPriorConcmDseUOMUCUMCode Code that represents the dosage unit of measure of the prior or concomitant medication administered. Unified Code for Units of Measure (UCUM). Code that represents the dosage unit of measure of the prior or concomitant medication administered. Unified Code for Units of Measure (UCUM). Dose units Alphanumeric Adult;Pediatric Supplemental-Highly Recommended 3.00 2013-08-28 16:08:00.453 Medication and Other Treatments Drugs Treatment/Intervention Data 255

Free-Form Entry

C58131 Other treatments result type OtherTreatmentResultTyp Type of treatment result experienced by the subject/participant. Type of treatment result experienced by the subject/participant. Result of Treatment Helped;Hurt;No effect Helped;Hurt;No effect Alphanumeric

Circle one

Adult;Pediatric Supplemental-Highly Recommended 1.00 2018-02-02 16:10:06.0 Medication and Other Treatments Drugs Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C02014 Medication prior or concomitant name MedctnPriorConcomName Name of the prior/concomitant agent or drug administered. Name of the prior/concomitant agent or drug administered. Medication/supplement name Alphanumeric

Please list ALL medications (including prescription drugs, over the counter drugs, dietary supplements (including vitamins), herbal, homeopathic and health food preparations) taken routinely or in the last four weeks.

Adult;Pediatric Supplemental-Highly Recommended 3.00 2013-08-28 16:08:00.453 Medication and Other Treatments Drugs Treatment/Intervention Data 4000

Free-Form Entry

3162728
C58389 Medication actual use schedule frequency MedActualUseScheduleFreq Actual frequency of use of medication. Actual frequency of use of medication. Actual usage schedule Numeric Values

Write 'same' or write how often you are actually taking

Adult;Pediatric Supplemental-Highly Recommended 1.00 2018-02-08 15:06:56.0 Medication and Other Treatments Drugs Treatment/Intervention Data

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C02015 Medication prior or concomitant route type MedctnPriorConcomRteTyp Type of access route for the administration of the prior/concomitant medication. Type of access route for the administration of the prior/concomitant medication. Route of Administration Buccal;Inhaled;Intramuscular;Intravenous;Nasal;Oral;Rectal;By ear;Topical;Subcutaneous;Sublingual;Transdermal;Unknown;Other, specify Buccal;Inhaled;Intramuscular;Intravenous;Nasal;Oral;Rectal;By Ear;Topical;Subcutaneous;Sublingual;Transdermal;Unknown;Other, specify Alphanumeric Adult;Pediatric Supplemental-Highly Recommended 3.00 2013-08-28 16:08:00.453 Medication and Other Treatments Drugs Treatment/Intervention Data

Single Pre-Defined Value Selected

3162743
C58390 Medication symptom status MedicationSymptomStat Status of symptoms with medication use. Status of symptoms with medication use. If this medicine was prescribed for your ME/CFS, list symptoms that the medicine has improved, and list those (if any) the medicine has made worse. If medicine not prescribed for ME/CFS, write "NA" (not applicable) Alphanumeric Adult;Pediatric Supplemental-Highly Recommended 1.00 2018-02-08 15:09:52.0 Medication and Other Treatments Drugs Treatment/Intervention Data 255

Free-Form Entry

C02016 Medication prior or concomitant start date and time MedctnPriorConcomStrtDateTime The date (and time, if applicable and known) on which the prior/concomitant medication usage began. The date (and time, if applicable and known) on which the prior/concomitant medication usage began. Taking since when? Date or Date & Time

Enter start date began medication, dietary supplement, etc….

Adult;Pediatric Supplemental-Highly Recommended 3.00 2013-08-28 16:08:00.453 Medication and Other Treatments Drugs Treatment/Intervention Data

Free-Form Entry

3162752
C58395 Other treatments reason type text OthrTreatmntsReasonTypeTxt Text specifying other subject/participant treatments. Text specifying other subject/participant treatments. Other (Specify): Alphanumeric Adult;Pediatric Supplemental-Highly Recommended 1.00 2018-02-08 15:35:54.0 Medication and Other Treatments Drugs Treatment/Intervention Data 500

Free-Form Entry

C02024 Medication prior or concomitant indication text MedctnPriorConcomIndTxt Text describing reason for administration of a prior/concomitant (nonstudy) agent or measure. This is not the pharmacologic classification of an agent (antibiotic, analgesic, etc.), but the reason for its administration to the participant/subject. Text describing reason for administration of a prior/concomitant (nonstudy) agent or measure. This is not the pharmacologic classification of an agent (antibiotic, analgesic, etc.), but the reason for its administration to the participant/subject. Reason for taking? Alphanumeric Adult;Pediatric Supplemental-Highly Recommended 3.00 2013-08-28 16:08:00.453 Medication and Other Treatments Drugs Treatment/Intervention Data 4000

Free-Form Entry

3158920
C17402 Site name SiteName The name of the site for the study The name of the site for the study Site Name Alphanumeric Adult;Pediatric Supplemental-Highly Recommended 3.00 2013-06-21 00:00:00.0 Medication and Other Treatments Drugs Treatment/Intervention Data 255

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C19247 Subject ID SubIDNam Subject identification ID Subject identification ID Subject ID Alphanumeric Adult;Pediatric Supplemental-Highly Recommended 1.00 2014-06-05 13:10:49.0 Medication and Other Treatments Drugs Treatment/Intervention Data 255

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C19256 Study protocol name StudyProtocolName Name of study protocol Name of study protocol Study Name Alphanumeric Adult;Pediatric Supplemental-Highly Recommended 1.00 2014-06-05 16:38:14.0 Medication and Other Treatments Drugs Treatment/Intervention Data 4000

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CSV