Inglés

Inclusion/Exclusion Criteria: UIC Quality Improvement CRF

1 formularios  
General Information
Descripción

General Information

Protocol Title
Descripción

Protocol Title

Tipo de datos

text

Site Number
Descripción

Site Number

Tipo de datos

integer

Subject ID
Descripción

Subject ID

Tipo de datos

integer

Visit Date
Descripción

Visit Date

Tipo de datos

date

Study Visit
Descripción

Study Visit

Tipo de datos

text

Inclusion Criteria
Descripción

Inclusion Criteria

Inclusion Description
Descripción

Inclusion Description

Tipo de datos

text

Inclusion description fulfilled
Descripción

Inclusion Description

Tipo de datos

boolean

Exclusion Criteria
Descripción

Exclusion Criteria

Exclusion Description
Descripción

Exclusion Description

Tipo de datos

text

Exclusion description fulfilled
Descripción

Exclusion Description

Tipo de datos

boolean

Results
Descripción

Results

Did the subject meet the eligibility requirements for this study?
Descripción

Did the subject meet the eligibility requirements for this study?

Tipo de datos

boolean

Signature
Descripción

Signature

Tipo de datos

text

Date
Descripción

Date

Tipo de datos

date

Printed Name
Descripción

Printed Name

Tipo de datos

text

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Similar models

Inclusion/Exclusion Criteria: UIC Quality Improvement CRF

1 formularios
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
General Information
Protocol Title
Item
Protocol Title
text
Site Number
Item
Site Number
integer
Subject ID
Item
Subject ID
integer
Visit Date
Item
Visit Date
date
Item
Study Visit
text
Study Visit
Code List
Study Visit
CL Item
Screening (1)
CL Item
Baseline (2)
Item Group
Inclusion Criteria
Inclusion Description
Item
Inclusion Description
text
Inclusion Description
Item
Inclusion description fulfilled
boolean
Item Group
Exclusion Criteria
Exclusion Description
Item
Exclusion Description
text
Exclusion Description
Item
Exclusion description fulfilled
boolean
Item Group
Results
Did the subject meet the eligibility requirements for this study?
Item
Did the subject meet the eligibility requirements for this study?
boolean
Signature
Item
Signature
text
Date
Item
Date
date
Printed Name
Item
Printed Name
text
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