Información:
Error:
ID
17005
Descripción
ODM derived from: http://www.qmcr.ualberta.ca/en/ToolsandTemplates/CaseReportFormCRFTemplates.aspx. Template Name: Visit Checklist. University of Alberta, Quality Management in Clinical Research. Copyright: 2002-2016 University of Alberta.
Link
http://www.qmcr.ualberta.ca/en/ToolsandTemplates/CaseReportFormCRFTemplates.aspx
Palabras clave
Versiones (1)
- 20/8/16 20/8/16 -
Subido en
20 de agosto de 2016
DOI
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Licencia
Creative Commons BY-NC 3.0
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Visit Checklist: CRF QMCR University of Alberta
Visit Checklist: CRF QMCR University of Alberta
- StudyEvent: ODM
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Visit Checklist: CRF QMCR University of Alberta
- StudyEvent: ODM
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Study Name
Item
Study Name
text
Site Number
Item
Site Number
integer
Pt_ID
Item
Pt_ID
integer
Visit Date
Item
Visit Date
date
CL Item
Yes (If yes, continue) (1)
CL Item
No (2)
2. Please check all the assessments completed at this visit
Item
2. Please check all the assessments completed at this visit: Demographics
boolean
Assessments completed at this visit
Item
Assessments completed at this visit: Medical History
boolean
Assessments completed at this visit
Item
Assessments completed at this visit: Vital Signs
boolean
Assessments completed at this visit
Item
Assessments completed at this visit: Physical Exam
boolean
Assessments completed at this visit
Item
Assessments completed at this visit: Prior and Concomitant Medication
boolean
Assessments completed at this visit
Item
Assessments completed at this visit: Inclusion/Exclusion Criteria
boolean
Assessments completed at this visit
Item
Assessments completed at this visit: Randomization and Enrollment
boolean
Item
3. Is the participant continuing in the study?
text
Code List
3. Is the participant continuing in the study?
CL Item
Yes (schedule next visit) (1)
CL Item
No (remember to complete a study completion form) (2)
Comments
Item
Comments
text