eg CRFs

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Example Case Report Forms for EG domain

Ex 1: cv_echo
Ex 2: ecg

Form: MUGA or Echocardiogram

Question	Response
Date of assessment
Method	MUGA ECHOCARDIOGRAM
LVEF Result	"CV.CVORRES when CV.CVTESTCD=""LVEF"""
LVEF Unit	"CV.CVORRESU when CV.CVTESTCD=""LVEF"""

Form: Electrocardiogram

Question	Response
Date Performed	EG.EGDTC
Subject position	Sitting Standing Supine EG.EGPOS
PR Interval (msecs	"EG.EGORRES when EG.EGTESTCD=""PR"""
QRS Interval (msec	"EG.EGORRES when EG.EGTESTCD=""QRS"""
QT Interval (msecs	"EG.EGORRES when EG.EGTESTCD=""QT"""
QTc Interval (msec	"EG.EGORRES when EG.EGTESTCD=""QTC"""
Heart Rate (cycle/	"EG.EGORRES when EG.EGTESTCD=""HR"""
ECG Result Interpr	Normal Abnormal Not Clinically Significant Abnormal Clinically Significant "EG.EGORRES when EG.EGTESTCD=""INTP"",SUPPEG.QNAM.EGCLSIG"
Specify ECG Abnorm	SUPPEG.QNAM.EGABNSP