Inglés

Pharmacogenetic Research (PGx)

1 formularios  
Administrative Data
Descripción

Administrative Data

Alias
UMLS CUI-1
C1320722
Subject Identifier
Descripción

Subject Identifier

Tipo de datos

text

Alias
UMLS CUI [1]
C2348585
Consent for PGx Research (DNA)
Descripción

Consent for PGx Research (DNA)

Alias
UMLS CUI-1
C0021430
UMLS CUI-2
C2347500
Has informed consent been obtained for PGx research?
Descripción

Consent for Pharmacogenetic Research

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0021430
UMLS CUI [1,2]
C2347500
If Yes, record the date informed consent obtained for PGx research
Descripción

Date of consent for Pharmacogenetic Research

Tipo de datos

date

Alias
UMLS CUI [1,1]
C0031325
UMLS CUI [1,2]
C0021430
UMLS CUI [1,3]
C0011008
If No, pick one reason:
Descripción

Reason no consent for Pharmacogenetic research

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0031325
UMLS CUI [1,2]
C0021430
UMLS CUI [1,3]
C0392360
Other Reason for no consent for PGx research, specify
Descripción

Other Reason no consent for Pharmacogenetic research

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0031325
UMLS CUI [1,2]
C0021430
UMLS CUI [1,3]
C0392360
UMLS CUI [1,4]
C0205394
Sample Collection
Descripción

Sample Collection

Alias
UMLS CUI-1
C0005834
UMLS CUI-2
C0031325
Has a sample been collected for PGx research?
Descripción

Sample for Pharmacogenetic research

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0005834
UMLS CUI [1,2]
C0031325
If Yes, record the date sample taken
Descripción

Date sample taken

Tipo de datos

date

Alias
UMLS CUI [1,1]
C1302413
UMLS CUI [1,2]
C0031325
Withdrawal of consent
Descripción

Withdrawal of consent

Alias
UMLS CUI-1
C1707492
UMLS CUI-2
C0031325
Has subject withdrawn consent for PGx research?
Descripción

Withdrawal of consent for pharmacogenetic research

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1707492
UMLS CUI [1,2]
C0031325
If Yes, record the date informed consent withdrawn for PGx research
Descripción

Date of consent withdrawal

Tipo de datos

date

Alias
UMLS CUI [1,1]
C1707492
UMLS CUI [1,2]
C0011008
UMLS CUI [1,3]
C0031325
Sample Destruction
Descripción

Sample Destruction

Alias
UMLS CUI-1
C1948029
UMLS CUI-2
C0178913
UMLS CUI-3
C0031325
Has a request been made for sample destruction?
Descripción

Request for sample destruction

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1272683
UMLS CUI [1,2]
C1948029
UMLS CUI [1,3]
C0178913
UMLS CUI [1,4]
C0031325
If Yes, pick one reason:
Descripción

Reason for sample destruction request

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0566251
UMLS CUI [1,2]
C1272683
UMLS CUI [1,3]
C1948029
UMLS CUI [1,4]
C0178913
UMLS CUI [1,5]
C0031325
Other reason, specify
Descripción

Other Reason for sample destruction request

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0566251
UMLS CUI [1,2]
C1272683
UMLS CUI [1,3]
C1948029
UMLS CUI [1,4]
C0178913
UMLS CUI [1,5]
C0031325
UMLS CUI [1,6]
C0205394
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Similar models

Pharmacogenetic Research (PGx)

1 formularios
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
Administrative Data
C1320722 (UMLS CUI-1)
Item
Subject Identifier
text
C2348585 (UMLS CUI [1])
Visit
Code List
Subject Identifier
Item Group
Consent for PGx Research (DNA)
C0021430 (UMLS CUI-1)
C2347500 (UMLS CUI-2)
Item
Has informed consent been obtained for PGx research?
text
C0021430 (UMLS CUI [1,1])
C2347500 (UMLS CUI [1,2])
Relative Time
Code List
Has informed consent been obtained for PGx research?
CL Item
Yes (Y)
CL Item
No (N)
Date of consent for Pharmacogenetic Research
Item
If Yes, record the date informed consent obtained for PGx research
date
C0031325 (UMLS CUI [1,1])
C0021430 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
Item
If No, pick one reason:
text
C0031325 (UMLS CUI [1,1])
C0021430 (UMLS CUI [1,2])
C0392360 (UMLS CUI [1,3])
Reason no consent for Pharmacogenetic research
Code List
If No, pick one reason:
CL Item
Subject declined (1)
CL Item
Subject not asked by investigator (2)
CL Item
Other (Z)
Other Reason no consent for Pharmacogenetic research
Item
Other Reason for no consent for PGx research, specify
text
C0031325 (UMLS CUI [1,1])
C0021430 (UMLS CUI [1,2])
C0392360 (UMLS CUI [1,3])
C0205394 (UMLS CUI [1,4])
Item Group
Sample Collection
C0005834 (UMLS CUI-1)
C0031325 (UMLS CUI-2)
Item
Has a sample been collected for PGx research?
text
C0005834 (UMLS CUI [1,1])
C0031325 (UMLS CUI [1,2])
Sample for Pharmacogenetic research
Code List
Has a sample been collected for PGx research?
CL Item
Yes (Y)
CL Item
No (N)
Date sample taken
Item
If Yes, record the date sample taken
date
C1302413 (UMLS CUI [1,1])
C0031325 (UMLS CUI [1,2])
Item Group
Withdrawal of consent
C1707492 (UMLS CUI-1)
C0031325 (UMLS CUI-2)
Item
Has subject withdrawn consent for PGx research?
text
C1707492 (UMLS CUI [1,1])
C0031325 (UMLS CUI [1,2])
Relative Time
Code List
Has subject withdrawn consent for PGx research?
CL Item
Yes (Y)
CL Item
No (N)
Date of consent withdrawal
Item
If Yes, record the date informed consent withdrawn for PGx research
date
C1707492 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C0031325 (UMLS CUI [1,3])
Item Group
Sample Destruction
C1948029 (UMLS CUI-1)
C0178913 (UMLS CUI-2)
C0031325 (UMLS CUI-3)
Item
Has a request been made for sample destruction?
text
C1272683 (UMLS CUI [1,1])
C1948029 (UMLS CUI [1,2])
C0178913 (UMLS CUI [1,3])
C0031325 (UMLS CUI [1,4])
Relative Time
Code List
Has a request been made for sample destruction?
CL Item
Yes (Y)
CL Item
No (N)
Item
If Yes, pick one reason:
text
C0566251 (UMLS CUI [1,1])
C1272683 (UMLS CUI [1,2])
C1948029 (UMLS CUI [1,3])
C0178913 (UMLS CUI [1,4])
C0031325 (UMLS CUI [1,5])
Reason for sample destruction request
Code List
If Yes, pick one reason:
CL Item
Subject withdrew consent for PGx (3)
CL Item
Screen failure (2)
CL Item
Other (Z)
Item
Other reason, specify
text
C0566251 (UMLS CUI [1,1])
C1272683 (UMLS CUI [1,2])
C1948029 (UMLS CUI [1,3])
C0178913 (UMLS CUI [1,4])
C0031325 (UMLS CUI [1,5])
C0205394 (UMLS CUI [1,6])
Reason for sample destruction request
Code List
Other reason, specify
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