English

Pharmacogenetic Research

1 forms  
Administrative Data
Description

Administrative Data

Alias
UMLS CUI-1
C1320722
subject ID
Description

subject ID

Data type

text

Alias
UMLS CUI [1]
C2348585
date of visit
Description

date of visit

Data type

date

Alias
UMLS CUI [1]
C1320303
PGx-Pharmacogenetic Research Consent
Description

PGx-Pharmacogenetic Research Consent

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

informed consent for pharmacogenetic research

Data type

boolean

Alias
UMLS CUI [1,1]
C0021430
UMLS CUI [1,2]
C2347500
if yes, please provide the date informed consent obtained for PGx-Pharmacogenetic research
Description

pharmacogenetic research consent, date

Data type

date

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

pharmacogenetic research, blood sample

Data type

boolean

Alias
UMLS CUI [1,1]
C1277698
UMLS CUI [1,2]
C2347500
if blood sample taken, please record date
Description

date blood sample taken, pharmacogenetic test

Data type

date

Alias
UMLS CUI [1,1]
C1277698
UMLS CUI [1,2]
C0011008
UMLS CUI [1,3]
C2347500
if no, please check reason:
Description

pharmacogenetic tests, no consent, reason

Data type

text

Alias
UMLS CUI [1,1]
C2347500
UMLS CUI [1,2]
C0021430
UMLS CUI [1,3]
C0332197
UMLS CUI [1,4]
C0566251
if other, please specify:
Description

pharmacogenetic tests, no consent, other reason

Data type

text

Alias
UMLS CUI [1,1]
C2347500
UMLS CUI [1,2]
C0021430
UMLS CUI [1,3]
C0332197
UMLS CUI [1,4]
C3840932
PGx-Pharmacogenetic Research Withdrawal of Consent
Description

PGx-Pharmacogenetic Research Withdrawal of Consent

Alias
UMLS CUI-1
C2347500
UMLS CUI-2
C0021430
UMLS CUI-3
C2349954
has subject withdrawn consent for PGx-Pharmacogenetic research?
Description

withdrawn consent for PGx-Pharmacogenetic research

Data type

boolean

Alias
UMLS CUI [1,1]
C2347500
UMLS CUI [1,2]
C0021430
UMLS CUI [1,3]
C2349954
if yes, please record the date the informed consent has been withdrawn
Description

pharmacogenetic tests, date informed consent has been withdrawn

Data type

date

Alias
UMLS CUI [1,1]
C2347500
UMLS CUI [1,2]
C0021430
UMLS CUI [1,3]
C2349954
UMLS CUI [1,4]
C0011008
has a request been made for sample destruction?
Description

pharmacogenetic research, request for sample destruction

Data type

boolean

Alias
UMLS CUI [1,1]
C2347500
UMLS CUI [1,2]
C1948029
UMLS CUI [1,3]
C1272683
if yes, please check reason:
Description

pharmacogenetic research, request for sample destruction, reason

Data type

text

Alias
UMLS CUI [1,1]
C2347500
UMLS CUI [1,2]
C1948029
UMLS CUI [1,3]
C1272683
UMLS CUI [1,4]
C0566251
if other, please specify:
Description

pharmacogenetic research, request for sample destruction, other reason

Data type

text

Alias
UMLS CUI [1,1]
C2347500
UMLS CUI [1,2]
C1948029
UMLS CUI [1,3]
C1272683
UMLS CUI [1,4]
C3840932
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Similar models

Pharmacogenetic Research

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Administrative Data
C1320722 (UMLS CUI-1)
subject ID
Item
subject ID
text
C2348585 (UMLS CUI [1])
date of visit
Item
date of visit
date
C1320303 (UMLS CUI [1])
Item Group
PGx-Pharmacogenetic Research Consent
C2347500 (UMLS CUI-1)
C0021430 (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])
pharmacogenetic research consent, date
Item
if yes, please provide the date informed consent obtained for PGx-Pharmacogenetic research
date
C0021430 (UMLS CUI [1,1])
C2347500 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
pharmacogenetic research, blood sample
Item
if yes, has a blood sample been collected for PGx-pharmacogenetic (DNA) research?
boolean
C1277698 (UMLS CUI [1,1])
C2347500 (UMLS CUI [1,2])
date blood sample taken, pharmacogenetic test
Item
if blood sample taken, please record date
date
C1277698 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C2347500 (UMLS CUI [1,3])
Item
if no, please check reason:
text
C2347500 (UMLS CUI [1,1])
C0021430 (UMLS CUI [1,2])
C0332197 (UMLS CUI [1,3])
C0566251 (UMLS CUI [1,4])
pharmacogenetic research, no consent, reason
Code List
if no, please check reason:
CL Item
subject declined (1)
CL Item
subject not asked by Investigator (2)
CL Item
other (z)
pharmacogenetic tests, no consent, other reason
Item
if other, please specify:
text
C2347500 (UMLS CUI [1,1])
C0021430 (UMLS CUI [1,2])
C0332197 (UMLS CUI [1,3])
C3840932 (UMLS CUI [1,4])
Item Group
PGx-Pharmacogenetic Research Withdrawal of Consent
C2347500 (UMLS CUI-1)
C0021430 (UMLS CUI-2)
C2349954 (UMLS CUI-3)
withdrawn consent for PGx-Pharmacogenetic research
Item
has subject withdrawn consent for PGx-Pharmacogenetic research?
boolean
C2347500 (UMLS CUI [1,1])
C0021430 (UMLS CUI [1,2])
C2349954 (UMLS CUI [1,3])
pharmacogenetic tests, date informed consent has been withdrawn
Item
if yes, please record the date the informed consent has been withdrawn
date
C2347500 (UMLS CUI [1,1])
C0021430 (UMLS CUI [1,2])
C2349954 (UMLS CUI [1,3])
C0011008 (UMLS CUI [1,4])
pharmacogenetic research, request for sample destruction
Item
has a request been made for sample destruction?
boolean
C2347500 (UMLS CUI [1,1])
C1948029 (UMLS CUI [1,2])
C1272683 (UMLS CUI [1,3])
Item
if yes, please check reason:
text
C2347500 (UMLS CUI [1,1])
C1948029 (UMLS CUI [1,2])
C1272683 (UMLS CUI [1,3])
C0566251 (UMLS CUI [1,4])
pharmacogenetic research, request for sample destruction, reason
Code List
if yes, please check reason:
CL Item
subject withdrew consent for PGx (3)
CL Item
other (Z)
pharmacogenetic research, request for sample destruction, other reason
Item
if other, please specify:
text
C2347500 (UMLS CUI [1,1])
C1948029 (UMLS CUI [1,2])
C1272683 (UMLS CUI [1,3])
C3840932 (UMLS CUI [1,4])
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