ID

16195

Descripción

NCT02669589 EudraCT-Nr. 2014-004854-33 REGIONAL CITRATE VERSUS SYSTEMIC HEPARIN ANTICOAGULATION FOR CONTINUOUS RENAL REPLACEMENT THERAPY IN CRITICALLY ILL PATIENTS WITH ACUTE KIDNEY INJURY Study Chair: Alexander Zarbock, MD University Hospital Muenster

Palabras clave

Versiones (1)
  1. 4/7/16 4/7/16 -
Subido en

4 de julio de 2016

DOI

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Licencia

Creative Commons BY-NC-ND 3.0
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Consent RICH study NCT02669589

Inglés

Consent RICH study NCT02669589

1 formularios  
Patient Information
Descripción

Patient Information

Alias
UMLS CUI-1
C1955348
ID of Center
Descripción

Center ID

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0600091
UMLS CUI [1,2]
C0019994
ID of patient
Descripción

Patient ID

Tipo de datos

text

Alias
UMLS CUI [1]
C2348585
Subsequent consent - please fill in for patients who are primary not able to give consent
Descripción

Subsequent consent - please fill in for patients who are primary not able to give consent

Alias
UMLS CUI-1
C0021430
UMLS CUI-2
C0332282
Subsequent consent given by patient (has the patient given written consent for participation to clinical trial subsequently?)
Descripción

Subsequent consent given by patient

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0021430
UMLS CUI [1,2]
C0332282
UMLS CUI [1,3]
C0030705
If patient gave subsequent consent, specify date:
Descripción

Date of subsequent consent given by patient

Tipo de datos

date

Alias
UMLS CUI [1,1]
C0332282
UMLS CUI [1,2]
C0030705
UMLS CUI [1,3]
C2985782
Subsequent consent given by representative (has the representative given written consent for participation to clinical trial subsequently?)
Descripción

Subsequent consent given by representative

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0021430
UMLS CUI [1,2]
C0332282
UMLS CUI [1,3]
C0030701
If representative gave subsequent consent, specify date:
Descripción

Date of subsequent consent given by representative

Tipo de datos

date

Alias
UMLS CUI [1,1]
C0332282
UMLS CUI [1,2]
C0030701
UMLS CUI [1,3]
C2985782
Lawsuit for legal caregiver applied?
Descripción

Lawsuit: caregiver

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0085537
UMLS CUI [1,2]
C2136079
Lawsuit for legal caregiver: If yes, completed?
Descripción

Lawsuit completed: caregiver

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0085537
UMLS CUI [1,2]
C2136079
UMLS CUI [1,3]
C0205197
Date of deployment of caregiver:
Descripción

Date of deployment of caregiver

Tipo de datos

date

Alias
UMLS CUI [1,1]
C0085537
UMLS CUI [1,2]
C0011008
UMLS CUI [1,3]
C2825812
Subsequent consent given by caregiver (has the caregiver given written consent for participation to clinical trial subsequently?)
Descripción

Subsequent consent given by caregiver

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0021430
UMLS CUI [1,2]
C0332282
UMLS CUI [1,3]
C0085537
If caregiver gave subsequent consent, specify date:
Descripción

Date of subsequent consent given by caregiver

Tipo de datos

date

Alias
UMLS CUI [1,1]
C0332282
UMLS CUI [1,2]
C0085537
UMLS CUI [1,3]
C2985782
Withdrawal of consent
Descripción

Withdrawal of consent

Alias
UMLS CUI-1
C2349954
UMLS CUI-2
C0021430
Withdrawal of consent (fill in, if patients wants withdrawal of consent)
Descripción

Withdrawal of consent

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C2349954
UMLS CUI [1,2]
C0021430
Reason for withdrawal of consent: (fill in, if patients wants withdrawal of consent)
Descripción

Reason for withdrawal of consent

Tipo de datos

text

Alias
UMLS CUI [1,1]
C2349954
UMLS CUI [1,2]
C0021430
UMLS CUI [1,3]
C0392360
Date of withdrawal of consent by patient (fill in, if patients wants withdrawal of consent)
Descripción

Date of withdrawal of consent by patient

Tipo de datos

date

Alias
UMLS CUI [1,1]
C2349954
UMLS CUI [1,2]
C0021430
UMLS CUI [1,3]
C0011008
UMLS CUI [1,4]
C0030705
Date of withdrawal of consent by representative (fill in, if representative wants withdrawal of consent)
Descripción

Date of withdrawal of consent by representative

Tipo de datos

date

Alias
UMLS CUI [1,1]
C2349954
UMLS CUI [1,2]
C0021430
UMLS CUI [1,3]
C0011008
UMLS CUI [1,4]
C0030701
Date of withdrawal of consent by caregiver (fill in, if caregiver wants withdrawal of consent)
Descripción

Date of withdrawal of consent by caregiver

Tipo de datos

date

Alias
UMLS CUI [1,1]
C2349954
UMLS CUI [1,2]
C0021430
UMLS CUI [1,3]
C0011008
UMLS CUI [1,4]
C2985782
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Similar models

Consent RICH study NCT02669589

1 formularios
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
Patient Information
C1955348 (UMLS CUI-1)
Center ID
Item
ID of Center
text
C0600091 (UMLS CUI [1,1])
C0019994 (UMLS CUI [1,2])
Patient ID
Item
ID of patient
text
C2348585 (UMLS CUI [1])
Item Group
Subsequent consent - please fill in for patients who are primary not able to give consent
C0021430 (UMLS CUI-1)
C0332282 (UMLS CUI-2)
Subsequent consent given by patient
Item
Subsequent consent given by patient (has the patient given written consent for participation to clinical trial subsequently?)
boolean
C0021430 (UMLS CUI [1,1])
C0332282 (UMLS CUI [1,2])
C0030705 (UMLS CUI [1,3])
Date of subsequent consent given by patient
Item
If patient gave subsequent consent, specify date:
date
C0332282 (UMLS CUI [1,1])
C0030705 (UMLS CUI [1,2])
C2985782 (UMLS CUI [1,3])
Subsequent consent given by representative
Item
Subsequent consent given by representative (has the representative given written consent for participation to clinical trial subsequently?)
boolean
C0021430 (UMLS CUI [1,1])
C0332282 (UMLS CUI [1,2])
C0030701 (UMLS CUI [1,3])
Date of subsequent consent given by representative
Item
If representative gave subsequent consent, specify date:
date
C0332282 (UMLS CUI [1,1])
C0030701 (UMLS CUI [1,2])
C2985782 (UMLS CUI [1,3])
Lawsuit: caregiver
Item
Lawsuit for legal caregiver applied?
boolean
C0085537 (UMLS CUI [1,1])
C2136079 (UMLS CUI [1,2])
Lawsuit completed: caregiver
Item
Lawsuit for legal caregiver: If yes, completed?
boolean
C0085537 (UMLS CUI [1,1])
C2136079 (UMLS CUI [1,2])
C0205197 (UMLS CUI [1,3])
Date of deployment of caregiver
Item
Date of deployment of caregiver:
date
C0085537 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C2825812 (UMLS CUI [1,3])
Subsequent consent given by caregiver
Item
Subsequent consent given by caregiver (has the caregiver given written consent for participation to clinical trial subsequently?)
boolean
C0021430 (UMLS CUI [1,1])
C0332282 (UMLS CUI [1,2])
C0085537 (UMLS CUI [1,3])
Date of subsequent consent given by caregiver
Item
If caregiver gave subsequent consent, specify date:
date
C0332282 (UMLS CUI [1,1])
C0085537 (UMLS CUI [1,2])
C2985782 (UMLS CUI [1,3])
Item Group
Withdrawal of consent
C2349954 (UMLS CUI-1)
C0021430 (UMLS CUI-2)
Withdrawal of consent
Item
Withdrawal of consent (fill in, if patients wants withdrawal of consent)
boolean
C2349954 (UMLS CUI [1,1])
C0021430 (UMLS CUI [1,2])
Reason for withdrawal of consent
Item
Reason for withdrawal of consent: (fill in, if patients wants withdrawal of consent)
text
C2349954 (UMLS CUI [1,1])
C0021430 (UMLS CUI [1,2])
C0392360 (UMLS CUI [1,3])
Date of withdrawal of consent by patient
Item
Date of withdrawal of consent by patient (fill in, if patients wants withdrawal of consent)
date
C2349954 (UMLS CUI [1,1])
C0021430 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
C0030705 (UMLS CUI [1,4])
Date of withdrawal of consent by representative
Item
Date of withdrawal of consent by representative (fill in, if representative wants withdrawal of consent)
date
C2349954 (UMLS CUI [1,1])
C0021430 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
C0030701 (UMLS CUI [1,4])
Date of withdrawal of consent by caregiver
Item
Date of withdrawal of consent by caregiver (fill in, if caregiver wants withdrawal of consent)
date
C2349954 (UMLS CUI [1,1])
C0021430 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
C2985782 (UMLS CUI [1,4])
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