Inglés

End of study contact GSK study Chronic Coronary Heart Disease NCT00799903

1 formularios  
End of study contact form
Descripción

End of study contact form

1. Was subject contacted?
Descripción

subject contact

Tipo de datos

boolean

Type of contact
Descripción

Type of contact

Tipo de datos

integer

If telephone: Time of contact
Descripción

Time of contact

Tipo de datos

time

If telephone: Site staff who conducted call
Descripción

ensure documented in source notes

Tipo de datos

text

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

Reason visit was not perfomed in clinic

Tipo de datos

text

Other, specify
Descripción

Reason visit was not perfomed in clinic specification

Tipo de datos

text

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Similar models

End of study contact GSK study Chronic Coronary Heart Disease NCT00799903

1 formularios
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
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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