MSK Prototyping

Screen 1: Demographics ( Fields)

Screen Details

north south

Screen Title

Screen Order

Multi-Instance of this Screen

Make multiples of screen

Friendly Label

Order of entry determines display order

Fields

First Name (first_name)	delete	north south
Last Name (last_name)	delete	north south
Birthday (date_of_birth)	delete	north south

First Name

Field Name: first_name

Type: Drop Down

Concept ID: 023482904

Display Name

Field Name

eb_age_yrs

Field Type

Description

Current age (in years) of person.

Validation

Minimum

Maximum

Description

MSK4265453

Synonyms

Age

Age - Descriptor

Age (qualifier value)

Age (years)

add Suggest Synonym

Field Notes

PHI in Field

Required Data

Field Choices

Adding new choices or changing their labels will make this field private and unvetted. Making this field public will allow you to have your newly added choice vetted by a Terminologist.

	Sort	Status	Code	Concept Id	Label	Concept Id Suggestion	Enable
		shield	4	MSKL2140001307	Kidney infection
		shield	29	MSKL2140001308	MyelodysPlastic syndrome

Screen 2: Study Questions ( Fields)

Screen Details

north south

Screen Title

Screen Order

Multi-Instance of this Screen

Make multiples of screen

Friendly Label

Order of entry determines display order

Fields

First Name

Field Name: first_name

Type: Drop Down

Concept ID: 023482904

Display Name

Field Name

eb_age_yrs

Field Type

Description

Current age (in years) of person.

Validation

Minimum

Maximum

Description

MSK4265453

Synonyms

Age

Age - Descriptor

Age (qualifier value)

Age (years)

add Suggest Synonym

Field Notes

PHI in Field

Required Data

Field Choices

Adding new choices or changing their labels will make this field private and unvetted. Making this field public will allow you to have your newly added choice vetted by a Terminologist.

	Sort	Status	Code	Concept Id	Label	Concept Id Suggestion	Enable
		shield	4	MSKL2140001307	Kidney infection
		shield	29	MSKL2140001308	MyelodysPlastic syndrome

Screen 3: Follow Up ( Fields)

Screen Details

north south

Screen Title

Screen Order

Multi-Instance of this Screen

Make multiples of screen

Friendly Label

Order of entry determines display order

Fields

First Name

Field Name: first_name

Type: Drop Down

Concept ID: 023482904

Display Name

Field Name

eb_age_yrs

Field Type

Description

Current age (in years) of person.

Validation

Minimum

Maximum

Description

MSK4265453

Synonyms

Age

Age - Descriptor

Age (qualifier value)

Age (years)

add Suggest Synonym

Field Notes

PHI in Field

Required Data

Field Choices

Adding new choices or changing their labels will make this field private and unvetted. Making this field public will allow you to have your newly added choice vetted by a Terminologist.

	Sort	Status	Code	Concept Id	Label	Concept Id Suggestion	Enable
		shield	4	MSKL2140001307	Kidney infection
		shield	29	MSKL2140001308	MyelodysPlastic syndrome

Status	Code/ Order	Label	Concept Id Suggestion	Concept ID
shield	1	Afghanistan	Lorem ipsum dolor sit amet consectetur.	MSK4199967
shield	2	Italy	Aland Islands	MSK4199967
shield	1	Afghanistan	Lorem ipsum dolor sit amet consectetur.	MSK4199967
shield	1	Afghanistan	Lorem ipsum dolor sit amet consectetur.	MSK4199967
shield	1	Afghanistan	Lorem ipsum dolor sit amet consectetur.	MSK4199967
shield	1	Afghanistan	Lorem ipsum dolor sit amet consectetur.	MSK4199967

Status	Code/ Order	Label	Concept Id Suggestion	Concept ID
shield	1	Afghanistan	Lorem ipsum dolor sit amet consectetur.	MSK4199967
shield	2	Italy	Aland Islands	MSK4199967
shield	1	Afghanistan	Lorem ipsum dolor sit amet consectetur.	MSK4199967
shield	1	Afghanistan	Lorem ipsum dolor sit amet consectetur.	MSK4199967
shield	1	Afghanistan	Lorem ipsum dolor sit amet consectetur.	MSK4199967
shield	1	Afghanistan	Lorem ipsum dolor sit amet consectetur.	MSK4199967

Test Result
Age
Date of Death

Study of High Risk for Bone Metastases

Field Details: Administrative Gender

Edit Field: Country of Birth