Death aCRF

Illustrates Domains

DD
 

Illustrates Variables

DDYN
DDDAT
DTHDAT
DDORRES

Content

Indicate if the death details are known. If Yes, include the appropriate details where indicated on the CRF. Were any death detail assessments collected?
DDYN Not submitted

<From NY codelist>
Record the date of collection using this format (DD-MON-YYYY).
DDDAT DDDTC
_ _ / _ _ _ / _ _ _ _
Record the date of death.
DTHDAT DM.DTHDTC
_ _ / _ _ _ / _ _ _ _
Record the primary cause of death.
PRCDTH_DDORRES DDORRES WHERE DDTESTCD = "PRCDTH"
_________________
Record the secondary cause of death, if applicable.
SECDTH_DDORRES DDORRES WHERE DDTESTCD = "SECDTH"
_________________
Record the physical location where the subject died. What is the location of death?
LOCDTH_DDORRES DDORRES WHERE DDTESTCD = "LOCDTH"
Indicate if the death was witnessed, using NY codelist format. Was the death witnessed?
DTHWIND_DDORRES DDORRES WHERE DDTESTCD = "DTHWIND"
View CRF Metadata
CDASH VariableOrderQuestion TextPromptCRF Completion InstructionsTypeSDTMIG TargetSDTMIG Variable MappingControlled Terminology Code List NamePermissible ValuesPre-specified ValueQuery DisplayList StyleHidden
DDYN1

Were any death detail assessments collected?

Any Death Detail AssessmentsIndicate if the death details are known. If Yes, include the appropriate details where indicated on the CRF.TextN/A

(NY) No;Yes







DDDAT2What was the date death detail assessments were collected?Collection DateRecord the date of collection using this format (DD-MON-YYYY).DateDDDTC













DTHDAT3What was the subject’s date of death?Death DateRecord the date of death.DateDM.DTHDTC







prompt



PRCDTH_DDORRES4What is the primary cause of death?ResultRecord the primary cause of death.TextDDORRES;  DDTEST;  DDTESTCD;DDORRES WHERE DDTESTCD = "PRCDTH"











SECDTH_DDORRES5What is the secondary cause of death?ResultRecord the secondary cause of death, if applicable.TextDDORRES;  DDTEST;  DDTESTCD;DDORRES WHERE DDTESTCD = "SECDTH"











LOCDTH_DDORRES6What is the location of death?ResultRecord the physical location where the subject died.TextDDORRES;  DDTEST;  DDTESTCD;DDORRES WHERE DDTESTCD = "LOCDTH"

Home;Hospital;Nursing/Rehabilitation Home









DTHWIND_DDORRES7

Was the death witnessed?

WitnessIndicate if the death was witnessed, using NY codelist format.

TextDDORRES;  DDTEST;  DDTESTCD;DDORRES WHERE DDTESTCD = "DTHWIND"

Yes;No