Pharmacogenetic Test, Informed Consent
Item
Has consent been obtained for PGx Research?
boolean
C2347500 (UMLS CUI [1,1])
C0021430 (UMLS CUI [1,2])
Pharmacogenetic Test, Informed Consent, Date in time
Item
If YES, record the date informed consent obtained for PGx Research
date
C2347500 (UMLS CUI [1,1])
C0021430 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
Item
If NO, choose ONE reason:
text
C0031325 (UMLS CUI [1,1])
C0021430 (UMLS CUI [1,2])
C0392360 (UMLS CUI [1,3])
Code List
If NO, choose ONE reason:
CL Item
Subject declined (1)
CL Item
Subject not asked by Investigator (2)
CL Item
Other, specify_______________ (3)
Pharmacogenetic Test, Sampling
Item
Has a Sample been collected for PGx Research?
boolean
C2347500 (UMLS CUI [1,1])
C0870078 (UMLS CUI [1,2])
Pharmacogenetic Test, Sampling, Date in time
Item
If YES, record a date sample taken
date
C2347500 (UMLS CUI [1,1])
C0870078 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
Pharmacogenetic Test, Consent withdrawn
Item
Has subject withdrawn consent for PGx Research?
boolean
C2347500 (UMLS CUI [1,1])
C1707492 (UMLS CUI [1,2])
Pharmacogenetic Test, Consent withdrawn, Date in time
Item
If YES, record the date informed consentwithdrawn for PGx research
date
C2347500 (UMLS CUI [1,1])
C1707492 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
Pharmacogenetic Test, Blood Specimen, Destruction
Item
Has a request been made for sample destruction?
boolean
C2347500 (UMLS CUI [1,1])
C0178913 (UMLS CUI [1,2])
C1948029 (UMLS CUI [1,3])
Item
If YES, choose one reason:
text
C2347500 (UMLS CUI [1,1])
C0178913 (UMLS CUI [1,2])
C1948029 (UMLS CUI [1,3])
C0392360 (UMLS CUI [1,4])
Code List
If YES, choose one reason:
CL Item
[1] Subject requested (1)
CL Item
[z] Other, specify_____________ (2)