Engelsk

Follow-Up: Pregnancy Information

1 Formulär  
Administrative data
Beskrivning

Administrative data

Site
Beskrivning

Site

Datatyp

text

Patient
Beskrivning

Patient

Datatyp

text

Patient Number
Beskrivning

Patient Number

Datatyp

integer

Pregnancy Information
Beskrivning

Pregnancy Information

Did the subject become pregnant during the study?
Beskrivning

For each study session Pregnancy test should be done at Predose

Datatyp

boolean

If YES, complete the paper Pregnancy Notification form
Beskrivning

If YES, complete the paper Pregnancy Notification form

Datatyp

text

Pregnancy Information Part 2
Beskrivning

Pregnancy Information Part 2

Did a female partner of the male subject become pregnant during the study?
Beskrivning

If YES, complete the paper Pregnancy Notification form

Datatyp

text

Tillbaka till toppen

Similar models

Follow-Up: Pregnancy Information

1 Formulär
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Administrative data
Site
Item
Site
text
Patient
Item
Patient
text
Patient Number
Item
Patient Number
integer
Item Group
Pregnancy Information
Did the subject become pregnant during the study?
Item
Did the subject become pregnant during the study?
boolean
If YES, complete the paper Pregnancy Notification form
Item
If YES, complete the paper Pregnancy Notification form
text
Item Group
Pregnancy Information Part 2
Item
Did a female partner of the male subject become pregnant during the study?
text
Did a female partner of the male subject become pregnant during the study?
Code List
Did a female partner of the male subject become pregnant during the study?
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not Applicable (Check Not Applicable if female partner not of childbearing or no female partner) (3)
Tillbaka till toppen