Englisch

Pharmacogenetics Research Consent Withdrawal

1 Formulare  
Administrative data
Beschreibung

Administrative data

Site
Beschreibung

Site

Datentyp

text

Patient
Beschreibung

Patient

Datentyp

text

Patient Number
Beschreibung

Patient Number

Datentyp

integer

Date of Visit/Assessment
Beschreibung

Date of Visit/Assessment

Datentyp

date

Date of Visit/Assessment
Beschreibung

Date of Visit/Assessment

Date
Beschreibung

Date

Datentyp

date

PGx Research Withdrawal of Consent
Beschreibung

PGx Research Withdrawal of Consent

Has subject withdrawn consent for PGx-Pharmacogenetic research?
Beschreibung

Has subject withdrawn consent for PGx-Pharmacogenetic research?

Datentyp

boolean

Has a request been made for sample destruction?
Beschreibung

Has a request been made for sample destruction?

Datentyp

boolean

If YES, check reason
Beschreibung

If YES, check reason

Datentyp

text

If Other, specify
Beschreibung

If Other, specify

Datentyp

text

Genetic Type
Beschreibung

Genetic Type

Datentyp

text

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Ähnliche Modelle

Pharmacogenetics Research Consent Withdrawal

1 Formulare
Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
Alias
Item Group
Administrative data
Site
Item
Site
text
Patient
Item
Patient
text
Patient Number
Item
Patient Number
integer
Date of Visit/Assessment
Item
Date of Visit/Assessment
date
Item Group
Date of Visit/Assessment
Date
Item
Date
date
Item Group
PGx Research Withdrawal of Consent
Has subject withdrawn consent for PGx-Pharmacogenetic research?
Item
Has subject withdrawn consent for PGx-Pharmacogenetic research?
boolean
Has a request been made for sample destruction?
Item
Has a request been made for sample destruction?
boolean
Item
If YES, check reason
text
If YES, check reason
Code List
If YES, check reason
CL Item
Subject requested (1)
CL Item
Screen failure (2)
CL Item
Other (3)
If Other, specify
Item
If Other, specify
text
Genetic Type
Item
Genetic Type
text
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