Inglese

End of study contact GSK study Chronic Coronary Heart Disease NCT00799903

1 moduli  
End of study contact form
Descrizione

End of study contact form

1. Was subject contacted?
Descrizione

subject contact

Tipo di dati

boolean

Type of contact
Descrizione

Type of contact

Tipo di dati

integer

If telephone: Time of contact
Descrizione

Time of contact

Tipo di dati

time

If telephone: Site staff who conducted call
Descrizione

ensure documented in source notes

Tipo di dati

text

If telephone: Reason why visit was not perfomed in the clinic
Descrizione

Reason visit was not perfomed in clinic

Tipo di dati

text

Other, specify
Descrizione

Reason visit was not perfomed in clinic specification

Tipo di dati

text

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Similar models

End of study contact GSK study Chronic Coronary Heart Disease NCT00799903

1 moduli
Name
genere
Description | Question | Decode (Coded Value)
Tipo di dati
Alias
Item Group
End of study contact form
subject contact
Item
1. Was subject contacted?
boolean
Item
Type of contact
integer
Type of contact
Code List
Type of contact
CL Item
Clinic visit (1)
CL Item
Telephone (2)
Time of contact
Item
If telephone: Time of contact
time
Item
If telephone: Site staff who conducted call
text
Site staff who conducted call
Code List
If telephone: Site staff who conducted call
CL Item
Physician (34)
CL Item
Nurse (35)
CL Item
Other (OT)
Item
If telephone: Reason why visit was not perfomed in the clinic
text
Reason visit was not perfomed in clinic
Code List
If telephone: Reason why visit was not perfomed in the clinic
CL Item
Subject refused (1)
CL Item
Subject not able to visit clinic (2)
CL Item
Other (OT)
Reason visit was not perfomed in clinic specification
Item
Other, specify
text
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