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Status of Treatment Blind

1 forms  
Status of treatment blind
Description

Status of treatment blind

Was the treatment blind broken during the study?
Description

if yes, complete the SAE, Ae, and/or Investigational Product forms as appropriate

Data type

boolean

If YES, complete the following:
Description

If YES, complete the following:

Date blind broken
Description

Date blind broken

Data type

date

Reason blind broken
Description

Reason blind broken

Data type

text

If OTHER, specify
Description

If OTHER, specify

Data type

text

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Similar models

Status of Treatment Blind

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Status of treatment blind
Was the treatment blind broken during the study?
Item
Was the treatment blind broken during the study?
boolean
Item Group
If YES, complete the following:
Date blind broken
Item
Date blind broken
date
Item
Reason blind broken
text
Reason blind broken
Code List
Reason blind broken
CL Item
Medical emergency requiring identification of investigational product for further treatment (1)
CL Item
Progressive disease (2)
CL Item
Other (3)
If OTHER, specify
Item
text
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