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Follow-Up: Study Conclusion

1 forms  
Study Conclusion Data
Description

Study Conclusion Data

Date of subject completion or withdrawal
Description

Date of subject completion or withdrawal

Data type

date

Time of subject completion or withdrawal
Description

Time of subject completion or withdrawal

Data type

time

Was the subject withdrawn from the study?
Description

Was the subject withdrawn from the study?

Data type

boolean

If YES, specify primary reason for withdrawal
Description

If YES, specify primary reason for withdrawal

Data type

text

If OTHER, specify
Description

If OTHER, specify

Data type

text

Case book ready for signature
Description

Data owner should check the box when data cleaning is complete

Data type

text

Office Use 1
Description

Office Use 1

Data type

boolean

Office Use 2
Description

Office Use 2

Data type

text

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Follow-Up: Study Conclusion

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Study Conclusion Data
Date of subject completion or withdrawal
Item
Date of subject completion or withdrawal
date
Time of subject completion or withdrawal
Item
Time of subject completion or withdrawal
time
Was the subject withdrawn from the study?
Item
Was the subject withdrawn from the study?
boolean
Item
If YES, specify primary reason for withdrawal
text
If YES, specify primary reason for withdrawal
Code List
If YES, specify primary reason for withdrawal
CL Item
Adverse event (1)
CL Item
Lost to follow-up (2)
CL Item
Protocol violation (3)
CL Item
Subject decided to withdraw from the study (4)
CL Item
Sponsor terminated study (5)
CL Item
Other (6)
If OTHER, specify
Item
If OTHER, specify
text
Item
Case book ready for signature
text
Case book ready for signature
Code List
Case book ready for signature
CL Item
Yes (1)
Office Use 1
Item
Office Use 1
boolean
Item
Office Use 2
text
Office Use 2
Code List
Office Use 2
CL Item
1 (1)
CL Item
2 (2)
CL Item
3 (3)
CL Item
4 (4)
CL Item
5 (5)
CL Item
6 (6)
CL Item
7 (7)
CL Item
8 (8)
CL Item
9 (9)
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