Global clinical data platform: Ebola virus disease case report form (‎CRF)‎: module 1, 29 November 2022

Overview

The CRF is designed to collect data obtained direct from patient examination and interview, and from review of hospital or clinical notes of people with probable or confirmed Ebola disease (caused by Zaire and Sudan species).

The CRF captures data from patients being managed as inpatients in Ebola Care Centres. Data may be collected prospectively or retrospectively. The data collection period is defined as the period from hospital admission, or first clinic visit, to discharge from care, transfer, death or continued hospitalization without possibility of continued data collection. This CRF has three modules:

• Module 1: To be completed on the first day of presentation or admission to the Ebola Care Centre (ECC).
• Module 2: Daily Form: To be completed on inpatient days (minimum every 3 days)
• Module 3: To be completed at last visit, either hospital discharge, transfer, last outpatient follow-up or death.