Engelsk

Part 2: Treatment Period 1 - Urine Screen

1 Formulär  
Administrative data
Beskrivning

Administrative data

Subject Identifier
Beskrivning

Subject Identifier

Datatyp

integer

Urine Drug, Alcohol and Cotinine Screen
Beskrivning

Urine Drug, Alcohol and Cotinine Screen

Date of sample taken
Beskrivning

Date of sample taken

Datatyp

date

Time of sample taken
Beskrivning

Time of sample taken

Datatyp

time

Mark appropriate box(es)
Beskrivning

Mark appropriate box(es)

Cocaine
Beskrivning

Cocaine

Datatyp

text

Amphetamines
Beskrivning

Amphetamines

Datatyp

text

Benzodiazepines
Beskrivning

Benzodiazepines

Datatyp

text

Cannabinoids
Beskrivning

Cannabinoids

Datatyp

text

Opiates
Beskrivning

Opiates

Datatyp

text

Barbiturates
Beskrivning

Barbiturates

Datatyp

text

Alcohol
Beskrivning

Alcohol

Datatyp

text

Cotinine
Beskrivning

Cotinine

Datatyp

text

If any of the above are positive, exclude subject from the study.
Beskrivning

If any of the above are positive, exclude subject from the study.

Datatyp

text

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Similar models

Part 2: Treatment Period 1 - Urine Screen

1 Formulär
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Administrative data
Subject Identifier
Item
Subject Identifier
integer
Item Group
Urine Drug, Alcohol and Cotinine Screen
Date of sample taken
Item
Date of sample taken
date
Time of sample taken
Item
Time of sample taken
time
Item Group
Mark appropriate box(es)
Item
Cocaine
text
Cocaine
Code List
Cocaine
CL Item
Positive (1)
CL Item
Negative (2)
Item
Amphetamines
text
Amphetamines
Code List
Amphetamines
CL Item
Positive (1)
CL Item
Negative (2)
Item
Benzodiazepines
text
Benzodiazepines
Code List
Benzodiazepines
CL Item
Positive (1)
CL Item
Negative (2)
Item
Cannabinoids
text
Cannabinoids
Code List
Cannabinoids
CL Item
Positive (1)
CL Item
Negative (2)
Item
Opiates
text
Opiates
Code List
Opiates
CL Item
Positive (1)
CL Item
Negative (2)
Item
Barbiturates
text
Barbiturates
Code List
Barbiturates
CL Item
Positive (1)
CL Item
Negative (2)
Item
Alcohol
text
Alcohol
Code List
Alcohol
CL Item
Positive (1)
CL Item
Negative (2)
Item
Cotinine
text
Cotinine
Code List
Cotinine
CL Item
Positive (1)
CL Item
Negative (2)
If any of the above are positive, exclude subject from the study.
Item
If any of the above are positive, exclude subject from the study.
text
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