Inglese

Pharmacogenetic Research Consent

1 moduli  
Administrative Data
Descrizione

Administrative Data

Alias
UMLS CUI-1
C1320722
Date of Visit/Assessment
Descrizione

Date of Visit/Assessment

Tipo di dati

date

Alias
UMLS CUI [1]
C1320303
UMLS CUI [2]
C2985720
Site
Descrizione

Study site

Tipo di dati

text

Alias
UMLS CUI [1]
C2825164
Patient
Descrizione

Patient

Tipo di dati

text

Alias
UMLS CUI [1]
C1299487
Patient No.
Descrizione

Subject No.

Tipo di dati

text

Alias
UMLS CUI [1]
C2348585
PGx-Pharmacogenetic research consent
Descrizione

PGx-Pharmacogenetic research consent

Alias
UMLS CUI-1
C0021430
UMLS CUI-2
C2347500
Has informed consent been obtained for PGx-Pharmacogenetic research?
Descrizione

If Yes, please fill in the Date informed consent obtained for PGx-Pharmacogenetic research and if a blood sample has been collected in the following items. If No, record reason.

Tipo di dati

boolean

Alias
UMLS CUI [1,1]
C0021430
UMLS CUI [1,2]
C2347500
Date informed consent obtained for PGx-Pharmacogenetic research
Descrizione

Date informed consent obtained for Pharmacogenetic research

Tipo di dati

date

Alias
UMLS CUI [1,1]
C0021430
UMLS CUI [1,2]
C2347500
UMLS CUI [1,3]
C0011008
Has a blood sample been collected for PGx-pharmacogenetic (DNA) research?
Descrizione

If Yes, please record the date sample taken in the following item.

Tipo di dati

boolean

Alias
UMLS CUI [1,1]
C0005834
UMLS CUI [1,2]
C2347500
Record date sample taken
Descrizione

Date of sample taken of Pharmacogenetic research

Tipo di dati

date

Alias
UMLS CUI [1,1]
C1302413
UMLS CUI [1,2]
C2347500
Check reason no informed consent obtained for PGx
Descrizione

If other, specify

Tipo di dati

text

Alias
UMLS CUI [1,1]
C0566251
UMLS CUI [1,2]
C1882120
UMLS CUI [1,3]
C0021430
UMLS CUI [1,4]
C2347500
Other reason for no informed consent obtained, specify
Descrizione

Other reason for no informed consent obtained

Tipo di dati

text

Alias
UMLS CUI [1,1]
C0205394
UMLS CUI [1,2]
C0566251
UMLS CUI [1,3]
C0021430
UMLS CUI [1,4]
C2347500
UMLS CUI [1,5]
C1882120
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Similar models

Pharmacogenetic Research Consent

1 moduli
Name
genere
Description | Question | Decode (Coded Value)
Tipo di dati
Alias
Item Group
Administrative Data
C1320722 (UMLS CUI-1)
Date of Visit/Assessment
Item
Date of Visit/Assessment
date
C1320303 (UMLS CUI [1])
C2985720 (UMLS CUI [2])
Study site
Item
Site
text
C2825164 (UMLS CUI [1])
Patient
Item
Patient
text
C1299487 (UMLS CUI [1])
Subject No.
Item
Patient No.
text
C2348585 (UMLS CUI [1])
Item Group
PGx-Pharmacogenetic research consent
C0021430 (UMLS CUI-1)
C2347500 (UMLS CUI-2)
Informed consent for Pharmacogenetic research
Item
Has informed consent been obtained for PGx-Pharmacogenetic research?
boolean
C0021430 (UMLS CUI [1,1])
C2347500 (UMLS CUI [1,2])
Date informed consent obtained for Pharmacogenetic research
Item
Date informed consent obtained for PGx-Pharmacogenetic research
date
C0021430 (UMLS CUI [1,1])
C2347500 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
Blood sample for Pharmacogenetic research
Item
Has a blood sample been collected for PGx-pharmacogenetic (DNA) research?
boolean
C0005834 (UMLS CUI [1,1])
C2347500 (UMLS CUI [1,2])
Date of sample taken of Pharmacogenetic research
Item
Record date sample taken
date
C1302413 (UMLS CUI [1,1])
C2347500 (UMLS CUI [1,2])
Item
Check reason no informed consent obtained for PGx
text
C0566251 (UMLS CUI [1,1])
C1882120 (UMLS CUI [1,2])
C0021430 (UMLS CUI [1,3])
C2347500 (UMLS CUI [1,4])
No informed consent obtained for PGx, reason
Code List
Check reason no informed consent obtained for PGx
CL Item
Subject declined (Subject declined)
CL Item
Subject not asked by Investigator (Subject not asked by Investigator)
CL Item
Other (Other)
Other reason for no informed consent obtained
Item
Other reason for no informed consent obtained, specify
text
C0205394 (UMLS CUI [1,1])
C0566251 (UMLS CUI [1,2])
C0021430 (UMLS CUI [1,3])
C2347500 (UMLS CUI [1,4])
C1882120 (UMLS CUI [1,5])
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