Study Identifier
Item
Protocol Identifier: AVA100193
boolean
C2826693 (UMLS CUI [1])
Subject Identifier
Item
Subject Identifier
integer
C2348585 (UMLS CUI [1])
Informed Consent
Item
Has informed consent been obtained for PGx-Pharmacogenetic/PGm-Transcriptomic/PGm-Proteomic Research?
boolean
C0021430 (UMLS CUI [1])
Date informed consent
Item
If yes, record the date informed consent obtained for PGx-Pharmacogenetic/PGm-Transcriptomic/PGm-Proteomic research
date
C0011008 (UMLS CUI [1,1])
C0021430 (UMLS CUI [1,2])
Item
If no, select one reason
text
C0021430 (UMLS CUI [1,1])
C0566251 (UMLS CUI [1,2])
Code List
If no, select one reason
CL Item
Subject declined (1)
CL Item
Subject not asked by Investigator (2)
CL Item
Other (specify) (3)
Reason Informed Consent Obtained Specification
Item
If Other, please specify
text
C0021430 (UMLS CUI [1,1])
C0566251 (UMLS CUI [1,2])
C2348235 (UMLS CUI [1,3])
Has a blood sample been collected for PGx-pharmacogenetic research?
Item
Has a blood sample been collected for PGx-pharmacogenetic research?
boolean
C0005834 (UMLS CUI [1])
Date sample taken
Item
If yes, record the date samples taken.
date
C1302413 (UMLS CUI [1])
Has subject withdrawn consent for PGx-Pharmacogenetic/PGm-Transcriptomic/PGm-Proteomic research?
Item
Has subject withdrawn consent for PGx-Pharmacogenetic/PGm-Transcriptomic/PGm-Proteomic research?
boolean
C1707492 (UMLS CUI [1,1])
C0013216 (UMLS CUI [1,2])
Request for sample destruction
Item
Has a request been made for sample destruction?
boolean
C1272683 (UMLS CUI [1,1])
C1948029 (UMLS CUI [1,2])
C0178913 (UMLS CUI [1,3])
Item
If yes, specify reason
text
C1272683 (UMLS CUI [1,1])
C1948029 (UMLS CUI [1,2])
C0178913 (UMLS CUI [1,3])
C0392360 (UMLS CUI [1,4])
Code List
If yes, specify reason
CL Item
Subject requested (1)
CL Item
Other (specify) (2)
Request for sample destruction other
Item
If other, please specify
text
C1272683 (UMLS CUI [1,1])
C1948029 (UMLS CUI [1,2])
C0178913 (UMLS CUI [1,3])
C2348235 (UMLS CUI [1,4])