ID

16978

Beschrijving

ODM derived from: http://www.qmcr.ualberta.ca/en/ToolsandTemplates/CaseReportFormCRFTemplates.aspx. Template Name: Inclusion/Exclusion Criteria. University of Alberta, Quality Management in Clinical Research. Copyright: 2002-2016 University of Alberta.

Link

http://www.qmcr.ualberta.ca/en/ToolsandTemplates/CaseReportFormCRFTemplates.aspx

Trefwoorden

  1. 17-08-16 17-08-16 -
Geüploaded op

17 augustus 2016

DOI

Voor een aanvraag inloggen.

Licentie

Creative Commons BY-NC 3.0

Model Commentaren :

Hier kunt u commentaar leveren op het model. U kunt de tekstballonnen bij de itemgroepen en items gebruiken om er specifiek commentaar op te geven.

Itemgroep Commentaren voor :

Item Commentaren voor :

U moet ingelogd zijn om formulieren te downloaden. AUB inloggen of schrijf u gratis in.

Inclusion/Exclusion Criteria: CRF QMCR University of Alberta

Inclusion/Exclusion Criteria: CRF QMCR University of Alberta

General Information
Beschrijving

General Information

Study Name
Beschrijving

Study Name

Datatype

text

Site Number
Beschrijving

Site Number

Datatype

integer

Pt_ID
Beschrijving

Pt_ID

Datatype

integer

Visit Date
Beschrijving

Visit Date

Datatype

date

Visit Type
Beschrijving

Visit Type

Datatype

text

Inclusion Criteria
Beschrijving

Inclusion Criteria

Inclusion Description
Beschrijving

Inclusion Description

Datatype

text

Applicability of inclusion criteria (See Description)
Beschrijving

Note: All Inclusion Criteria must be answered YES, to be included in study.

Datatype

boolean

Exclusion Criteria
Beschrijving

Exclusion Criteria

Exclusion Description
Beschrijving

Exclusion Description

Datatype

text

Applicability of exclusion criteria (See Description)
Beschrijving

Note: All Exclusion Criteria must be answered NO, to be included in study.

Datatype

boolean

Result
Beschrijving

Result

Did the participant meet the eligibility requirements for this study?
Beschrijving

Did the participant meet the eligibility requirements for this study?

Datatype

boolean

Similar models

Inclusion/Exclusion Criteria: CRF QMCR University of Alberta

Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
General Information
Study Name
Item
Study Name
text
Site Number
Item
Site Number
integer
Pt_ID
Item
Pt_ID
integer
Visit Date
Item
Visit Date
date
Item
Visit Type
text
Code List
Visit Type
CL Item
Screening (1)
CL Item
Baseline (2)
Item Group
Inclusion Criteria
Inclusion Description
Item
Inclusion Description
text
Applicability of inclusion criteria
Item
Applicability of inclusion criteria (See Description)
boolean
Item Group
Exclusion Criteria
Exclusion Description
Item
Exclusion Description
text
Applicability of exclusion criteria (See Description)
Item
Applicability of exclusion criteria (See Description)
boolean
Item Group
Result
Did the participant meet the eligibility requirements for this study?
Item
Did the participant meet the eligibility requirements for this study?
boolean

Gebruik dit formulier voor feedback, vragen en verbeteringsvoorstellen.

Velden gemarkeerd met een * zijn verplicht.

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial