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LBCAT
Pre-populated
HEMATOLOGY
LBSCAT
Pre-populated
COAGULATION
Indicate whether or not lab specimen was collected or measurement performed.Was the lab performed?
LBPERF LBSTAT = "NOT DONE" where LBPERF = "N" and LBSTAT = null where LBPERF = "Y"
<NY codelist>
Record the date of specimen collection using this format (DD-MON-YYYY).
LBDAT LBDTC
_ _ / _ _ _ / _ _ _ _
Record time of collection (as complete as possible).
LBTIM LBDTC
_ _ : _ _ : _ _
Record condition of specimen.What was the condition of the specimen?
LBSPCCND
<SPECCOND codelist>
Record the laboratory name.
LBNAM
_________________
Record the name of the lab measurement or finding, if not pre-printed on the CRF. If collected on the CRF, the sponsor may provide additional instructions to ensure the data is entered as intended.Lab Test Name
LBTEST LBTEST and LBTESTCD
<LBTEST codelist>
Record the method of the test or examination.What was the method used for the lab test or examination?
LBMETHOD
<METHOD codelist>
Record laboratory test result.
LBORRES
_________________
Record or select the original unit in which these data were collected, if not pre-printed on CRF.Unit
LBORRESU
<UNIT codelist>
Record the lower limit of the reference range of the lab test.
LBORNRLO
_________________
Record the upper limit of the reference range of the lab test.
LBORNRHI
_________________
Record where the lab result fell with respect to the reference range (i.e., HIGH, NORMAL, LOW).Comparison to Reference Range
LBNRIND
<NRIND codelist>
Record whether lab results were clinically significant.Was this result clinically significant?
LBCLSIG SUPPLB.QVAL where SUPPLB.QNAM = "LBCLSIG" and SUPPLB.QLABEL = "Clinically Significant"
<NY codelist>
Record the toxicity grade.What is the Toxicity Grade?
LBTOXGR
Record the description of the toxicity.
LBTOX
_________________
CDASH   VariableOrderQuestion TextPromptCRF Completion InstructionsTypeSDTMIG Target VariableSDTMIG Target MappingControlled Terminology Code List NamePermissible ValuesPre-Populated ValueQuery DisplayList StyleHidden
LBCAT1What was the name of the lab   panel?Lab Panel NameRecord the lab test category, if not pre-printed on the CRF.TextLBCAT


HEMATOLOGYPrompt

LBSCAT2What was name of the lab sub-panel?Lab Sub-Panel NameRecord the lab test subcategory, if not pre-printed on the CRF.TextLBSCAT


COAGULATIONPrompt

LBPERF3Was the lab performed?Lab PerformedIndicate whether or not lab specimen was collected or measurement performed.TextLBSTATLBSTAT = "NOT DONE" where LBPERF = "N" and LBSTAT = null where LBPERF = "Y"(NY)Yes; No

Radio
LBDAT4What was the date of the lab specimen collection?Specimen Collection DateRecord the date of specimen collection using this format (DD-MON-YYYY).DateLBDTC



Prompt

LBTIM5What was the time of the lab specimen collection?Specimen Collection TimeRecord time of collection (as complete as possible).TimeLBDTC



Prompt

LBSPCCND6What was the condition of the   specimen?Specimen ConditionRecord condition of specimen.TextLBSPCCND
(SPECCOND)FRESH; FROZEN; REFRIGERATED

Radio
LBNAM7What was the name of the laboratory used?Laboratory NameRecord the laboratory name.TextLBNAM






LBTEST8What is the lab test name?Lab Test NameRecord the name of the lab measurement or finding, if not pre-printed on the CRF. If collected on the CRF, the sponsor may provide additional instructions to ensure the data is entered as intended.TextLBTEST;   LBTESTCDLBTEST and  LBTESTCD(LBTEST)Prothrombin Intl. Normalized Ratio; Activated Partial Thromboplastin Time; Prothrombin Time; Thrombin Time; Fibrinogen; D-Dimer; Factor V; Factor VIII
PromptRadio
LBMETHOD9What was the method used for the lab test or examination?Method of TestRecord the method of the test or examination.TextLBMETHOD
(METHOD)CLAUSS METHOD; CLOT DETECTION; MANUAL CLOT DETECTION; MECHANICAL CLOT DETECTION; PHOTOMETRIC CLOT DETECTION

Radio
LBORRES10What was the result of the lab test?ResultRecord laboratory test result.TextLBORRES



Prompt

LBORRESU11What was the unit of the lab result?UnitRecord or select the original unit in which these data were collected, if not pre-printed on CRF.TextLBORRESU
(UNIT)g/L; mg/dL; mg/L; U/mL; ug/L; sec; RATIO
PromptRadio
LBORNRLO12What was the lower limit of the reference range for this lab test?Normal Range Lower LimitRecord the lower limit of the reference range of the lab test.TextLBORNRLO



Prompt

LBORNRHI13What was the high limit of the reference range for this lab test?Normal Range Upper LimitRecord the upper limit of the reference range of the lab test.TextLBORNRHI



Prompt

LBNRIND14How do the reported values   compare within the reference range?Comparison to Reference RangeRecord where the lab result fell with respect to the reference range (i.e., HIGH, NORMAL, LOW).TextLBNRIND
(NRIND)High; Normal; Low
PromptRadio
LBCLSIG15Was this result clinically significant?Clinically SignificantRecord whether lab results were clinically significant.TextSUPPLB.QVALSUPPLB.QVAL where SUPPLB.QNAM =   "LBCLSIG" and SUPPLB.QLABEL = "Clinically Significant"(NY)Yes; No

Radio
LBTOXGR16What is the Toxicity Grade?Toxicity GradeRecord the toxicity grade.TextLBTOXGR

0; 1; 2; 3; 4

Radio
LBTOX17What is the description of the toxicity?ToxicityRecord the description of the toxicity.TextLBTOX






Rows 1, 9: 
Rows 8, 16: 
Rows 2-7, 10-15: 

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STUDYID

DOMAIN

USUBJID

LBSEQ

LBTESTCD

LBTEST

LBCAT

LBORRES

LBORRESU

LBSTRESC

LBSTRESN

LBSTRESU

LBSPECLBMETHODLBANMETH

VISITNUM

VISIT

VISITDY

LBDTC

LBENDTC

LBDY

LBENDY
LBCOLSRT
1



CHOLCholesterolCLINICAL CHEMISTRY
















2



ALBAlbuminCLINICAL CHEMISTRY
















3



WBCWBCHEMATOLOGY
















4





URINALYSIS
















5

Row
CREATCreatinineCLINICAL CHEMISTRY
















6























7























Dataset Debug Message

Please remove extraneous empty columns.

LB NSV Metadata

Dataset Wrapper Debug Message

Please add a row column to your dataset.

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