Englisch

Pharmacogenetic research GSK study Chronic Coronary Heart Disease NCT00799903

1 Formulare  
Pharmacogenetic (PGx) research consent / Blood sample collection
Beschreibung

Pharmacogenetic (PGx) research consent / Blood sample collection

1. Has informed consent been obtained for PGx research?
Beschreibung

Informed consent

Datentyp

boolean

If yes, record: Date informed consent obtained for PGx research
Beschreibung

Informed consent date

Datentyp

date

Has sample been collected for PGx research?
Beschreibung

Answer only if informed consent was obtained for PGx research.

Datentyp

boolean

If yes, record date sample taken
Beschreibung

date sample taken

Datentyp

date

If no informed consent for PGx research was obtained, check reason
Beschreibung

reason absence informed consent

Datentyp

text

If other reason, specify:
Beschreibung

reason absence informed consent specification

Datentyp

text

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Ähnliche Modelle

Pharmacogenetic research GSK study Chronic Coronary Heart Disease NCT00799903

1 Formulare
Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
Alias
Item Group
Pharmacogenetic (PGx) research consent / Blood sample collection
Informed consent
Item
1. Has informed consent been obtained for PGx research?
boolean
Informed consent date
Item
If yes, record: Date informed consent obtained for PGx research
date
sample collection
Item
Has sample been collected for PGx research?
boolean
date sample taken
Item
If yes, record date sample taken
date
Item
If no informed consent for PGx research was obtained, check reason
text
reason absence informed consent
Code List
If no informed consent for PGx research was obtained, check reason
CL Item
Subject declined (1)
CL Item
Subject not asked by Investigator (2)
CL Item
Other (Z)
reason absence informed consent specification
Item
If other reason, specify:
text
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