Inglés

Pharmacogenetics Research Consent Withdrawal

1 formularios  
Administrative data
Descripción

Administrative data

Site
Descripción

Site

Tipo de datos

text

Patient
Descripción

Patient

Tipo de datos

text

Patient Number
Descripción

Patient Number

Tipo de datos

integer

Date of Visit/Assessment
Descripción

Date of Visit/Assessment

Tipo de datos

date

Date of Visit/Assessment
Descripción

Date of Visit/Assessment

Date
Descripción

Date

Tipo de datos

date

PGx Research Withdrawal of Consent
Descripción

PGx Research Withdrawal of Consent

Has subject withdrawn consent for PGx-Pharmacogenetic research?
Descripción

Has subject withdrawn consent for PGx-Pharmacogenetic research?

Tipo de datos

boolean

Has a request been made for sample destruction?
Descripción

Has a request been made for sample destruction?

Tipo de datos

boolean

If YES, check reason
Descripción

If YES, check reason

Tipo de datos

text

If Other, specify
Descripción

If Other, specify

Tipo de datos

text

Genetic Type
Descripción

Genetic Type

Tipo de datos

text

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Similar models

Pharmacogenetics Research Consent Withdrawal

1 formularios
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
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Has subject withdrawn consent for PGx-Pharmacogenetic research?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Has subject withdrawn consent for PGx-Pharmacogenetic research?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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