English

Pre- treatment status

8 forms  
PRE-TREATMENT STATUS
Description

PRE-TREATMENT STATUS

Will the subject enter the treatment phase of this study?
Description

WILL THE SUBJECT ENTER THE TREATMENT PHASE OF THIS STUDY ?

Data type

boolean

PRIMARY REASON FOR NOT ENTERING THE TREATMENT PHASE OF THIS STUDY (Fill only if study entry is denied)
Description

PRIMARY REASON FOR NOT ENTERING THE TREATMENT PHASE OF THIS STUDY (Fill only if study entry is denied)

Adverse event:
Description

ADVERSE EVENT

Data type

boolean

Alias
UMLS CUI-1
C0877248
Subject withdrew consent (specify):
Description

SUBJECT WITHDREW CONSENT (SPECIFY)

Data type

text

Alias
UMLS CUI-1
C0514044
UMLS CUI-2
C0805443
Death:
Description

DEATH

Data type

boolean

Alias
UMLS CUI-1
C0011065
Lost to Follow-up (Date of last contact):
Description

LOST TO FOLLOW-UP (DATE OF LAST CONTACT)

Data type

date

Alias
UMLS CUI-1
C0011008
Poor/ Non- compliance (specify):
Description

Poor/ Non- compliance (specify)

Data type

text

Alias
UMLS CUI-1
C1321605
Pregnancy:
Description

PREGNANCY

Data type

boolean

Alias
UMLS CUI-1
C0549206
Subject no longer meets study criteria (specify):
Description

SUBJECT NO LONGER MEETS STUDY CRITERIA (SPECIFY)

Data type

text

Administrative reason by sponsor:
Description

ADMINISTRATIVE REASON BY SPONSOR

Data type

boolean

Others (Specify):
Description

Others (Specify)

Data type

text

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Similar models

Pre- treatment status

8 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
PRE-TREATMENT STATUS
PRE-TREATMENT STATUS
Item
Will the subject enter the treatment phase of this study?
boolean
Item Group
PRIMARY REASON FOR NOT ENTERING THE TREATMENT PHASE OF THIS STUDY (Fill only if study entry is denied)
ADVERSE EVENT
Item
Adverse event:
boolean
C0877248 (UMLS CUI-1)
CONSENT
Item
Subject withdrew consent (specify):
text
C0514044 (UMLS CUI-1)
C0805443 (UMLS CUI-2)
DEATH
Item
Death:
boolean
C0011065 (UMLS CUI-1)
Date
Item
Lost to Follow-up (Date of last contact):
date
C0011008 (UMLS CUI-1)
COMPLIANCE
Item
Poor/ Non- compliance (specify):
text
C1321605 (UMLS CUI-1)
PREGNANCY
Item
Pregnancy:
boolean
C0549206 (UMLS CUI-1)
STUDY CRITERIA
Item
Subject no longer meets study criteria (specify):
text
ADMINISTRATIVE REASON BY SPONSOR
Item
Administrative reason by sponsor:
boolean
Others
Item
Others (Specify):
text
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