Englisch

Randomization and Enrollment: CRF QMCR University of Alberta

1 Formulare  
General Information
Beschreibung

General Information

Study Name
Beschreibung

Study Name

Datentyp

text

Site Number
Beschreibung

Site Number

Datentyp

integer

Pt_ID
Beschreibung

Pt_ID

Datentyp

integer

Visit Date
Beschreibung

Visit Date

Datentyp

date

Visit Type
Beschreibung

Visit Type

Datentyp

text

Randomization and Enrollment Form
Beschreibung

Randomization and Enrollment Form

Is the participant eligible for the study based on Inclusion and Exclusion Criteria?
Beschreibung

Is the participant eligible for the study based on Inclusion and Exclusion Criteria?

Datentyp

text

1. Date enrolled (meet all eligibility criteria)
Beschreibung

1. Date enrolled (meet all eligibility criteria)

Datentyp

date

2. Date randomized if different from enrolled
Beschreibung

2. Date randomized if different from enrolled

Datentyp

date

3. If eligible and not randomized, indicate reason (optional)
Beschreibung

either Question 2 or 3

Datentyp

text

If Other, please specify
Beschreibung

If Other, please specify

Datentyp

text

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Ähnliche Modelle

Randomization and Enrollment: CRF QMCR University of Alberta

1 Formulare
Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
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
Visit Type
Code List
Visit Type
CL Item
Baseline (1)
CL Item
Randomization (2)
Item Group
Randomization and Enrollment Form
Item
Is the participant eligible for the study based on Inclusion and Exclusion Criteria?
text
Is the participant eligible for the study based on Inclusion and Exclusion Criteria?
Code List
Is the participant eligible for the study based on Inclusion and Exclusion Criteria?
CL Item
Yes  (1)
CL Item
No (leave the rest of the form blank) (2)
1. Date enrolled (meet all eligibility criteria)
Item
1. Date enrolled (meet all eligibility criteria)
date
2. Date randomized if different from enrolled
Item
2. Date randomized if different from enrolled
date
Item
3. If eligible and not randomized, indicate reason (optional)
text
3. If eligible and not randomized, indicate reason (optional)
Code List
3. If eligible and not randomized, indicate reason (optional)
CL Item
Failed to return (1)
CL Item
Declined participation (2)
CL Item
Other (specify) (3)
If Other, please specify
Item
If Other, please specify
text
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