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This is an example of CRF. .

Example CRF:  Vital Signs 


Xformpusher
CDASH VariableOrderQuestion TextPromptCRF Completion InstructionsTypeSDTMIG Target Variable

SDTMIG Target Mapping

Controlled Terminology Code List NamePermissible ValuesPre-Populated ValueQuery DisplayList StyleHidden
VSDAT1What was the date of the measurements?DateRecord date of measurements using this format (DD-MON-YYYY).DateVSDTC



Prompt

VSTIM2What was the time of the measurements?TimeRecord time of measurement.TimeVSDTC



Prompt

HEIGHT3What was the result of the height measurement?HeightRecord the height result.FloatVSORRES;  VSTEST;  VSTESTCDVSORRES where VSTESTCD = "HEIGHT"


Prompt

HEIGHTU4What was the unit of the height measurement?Height UnitRecord or select the original unit in which these data were collected, if not pre-printed on CRF.TextVSORRESUVSORRESU where VSTESTCD = "HEIGHT"(VSRESU)cm; in
Prompt

WEIGHT5What was the result of the weight measurement?WeightRecord the weight result.FloatVSORRES;  VSTEST;  VSTESTCDVSORRES where VSTESTCD = "WEIGHT"


Prompt

WEIGHTU6What was the unit of the weight measurement?Weight UnitRecord or select the original unit in which these data were collected, if not pre-printed on CRF.TextVSORRESUVSORRESU where VSTESTCD = "WEIGHT"(VSRESU)kg; LB
Prompt

TEMP7What was the result of the temperature measurement?TemperatureRecord the temperature result.FloatVSORRES;  VSTEST;  VSTESTCDVSORRES where VSTESTCD = "TEMP"


Prompt

TEMPU8What was the unit of the temperature measurement?Temperature UnitRecord or select the original unit in which these data were collected, if not pre-printed on CRF.TextVSORRESUVSORRESU where VSTESTCD = "TEMP"(VSRESU)C; F
Prompt

RESP9What was the result of the respiratory rate measurement?Respiratory RateRecord the respiratory rate result.IntegerVSORRES;  VSTEST;  VSTESTCDVSORRES where VSTESTCD = "RESP"


Prompt

RESPU10What was the unit of the respiratory rate measurement?Respiratory Rate UnitRecord or select the original unit in which these data were collected, if not pre-printed on CRF.TextVSORRESUVSORRESU where VSTESTCD = "RESP"(VSRESU)
breaths/minPrompt

SYSBP11What was the result of the systolic blood pressure measurement?Systolic Blood PressureRecord the systolic blood pressure result.IntegerVSORRES;  VSTEST;  VSTESTCDVSORRES where VSTESTCD = "SYSBP"


Prompt

SYSBPU12What was the unit of the systolic blood pressure measurement?Systolic Blood Pressure UnitRecord or select the original unit in which these data were collected, if not pre-printed on CRF.TextVSORRESUVSORRESU where VSTESTCD = "SYSBP"(VSRESU)
mmHgPrompt

DIABP13What was the result of the diastolic blood pressure measurement?Diastolic Blood PressureRecord the diastolic blood pressure result.IntegerVSORRES;  VSTEST;  VSTESTCDVSORRES where VSTESTCD = "DIABP"


Prompt

DIABPU14What was the unit of the diastolic blood pressure measurement?Diastolic Blood Pressure UnitRecord or select the original unit in which these data were collected, if not pre-printed on CRF.TextVSORRESUVSORRESU where VSTESTCD = "DIABP"(VSRESU)
mmHgPrompt

PULSE15What was the result of the pulse measurement?Pulse RateRecord the pulse rate result.IntegerVSORRES;  VSTEST;  VSTESTCDVSORRES where VSTESTCD = "PULSE"


Prompt

PULSEU16What was the unit of the pulse rate measurement?Pulse Rate UnitRecord or select the original unit in which these data were collected, if not pre-printed on CRF.TextVSORRESUVSORRESU where VSTESTCD = "PULSE"(VSRESU)
beats/minPrompt

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