Variables in Adverse Event Form (AEF)
Question# Question Field name  Response nature Response options
1 PID Number     aef_A ###  
2 Initials of the participation aef_B XX  
3 Researcher Code  aef_C ##  
4 Today's Date
(According to English calender)
aef_D ##-XXX-## dd-mmm-yy
5 What is the adverse event? aef_1 # 1=Illness/hospitalization, 2=Miscarriage, 3=Abortion/medical termination, 4=Still birth, 5=Accident/injury, 6=Others
6 If others, specify. aef_1txt TXT TEXT if aef_1=6
NA if aef_1ǂ6
7 Did the adverse event result in death? aef_2 # 1=Yes, 2=No
8 Date of adverse event
(According to English calender)
aef_3 ##-XXX-## dd-mmm-yy
9 Date of event resolved  (if applicable)
(According to English calender)
aef_4 ##-XXX-## dd-mmm-yy
10 Is the adverse event possibly study related? aef_5 # 1=Yes, 2=No, 3=Unknown
11 Description of event   TXT  
lab _11 If other investigation, specify result