Engelsk

Status of treatment blind GSK study Chronic Coronary Heart Disease NCT00799903

1 Formulär  
Status of treatment blind
Beskrivning

Status of treatment blind

1. Was the treatment blind broken during the study?
Beskrivning

If yes, complete Non-Serious Adverse Events, Serious Adverse Event and/or Investigational Product forms as appropriate

Datatyp

boolean

If treatment blind was broken, complete the following: Date blind broken
Beskrivning

Date blind broken

Datatyp

date

If treatment blind was broken, complete the following: Time blind broken
Beskrivning

Time blind broken is optional

Datatyp

time

If treatment blind was broken, complete the following: Reason blind broken
Beskrivning

Reason blind broken

Datatyp

text

If treatment blind was broken, due to "other" reason, specifiy
Beskrivning

Reason blind broken other

Datatyp

text

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Similar models

Status of treatment blind GSK study Chronic Coronary Heart Disease NCT00799903

1 Formulär
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Status of treatment blind
treatment blind broken during the study
Item
1. Was the treatment blind broken during the study?
boolean
Date blind broken
Item
If treatment blind was broken, complete the following: Date blind broken
date
Time blind broken
Item
If treatment blind was broken, complete the following: Time blind broken
time
Item
If treatment blind was broken, complete the following: Reason blind broken
text
Reason blind broken
Code List
If treatment blind was broken, complete the following: Reason blind broken
CL Item
Medical emergency requiring identification of investigational product for further treatment (1)
CL Item
Other (Z)
Item
If treatment blind was broken, due to "other" reason, specifiy
text
Reason blind broken
Code List
If treatment blind was broken, due to "other" reason, specifiy
CL Item
Medical emergency requiring identification of investigational product for further treatment (1)
CL Item
Other (Z)
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