Informed consent

Informed consent
Descrizione

Informed consent

Record ID
Descrizione

record_id

Tipo di dati

text

INFORMED CONSENT
Descrizione

INFORMED CONSENT

Date of enrollment
Descrizione

ic_datenrollment

Tipo di dati

date

Informed consent
Descrizione

Informed consent

Version signed
Descrizione

ic_versionsigned

Tipo di dati

text

Patient agreed to be recontacted for the purpose of obtaining additional information or biomaterials
Descrizione

ic_recontactinfbio

Tipo di dati

integer

Patient agreed to be recontacted for the purpose of obtaining informed consent for data transfer to other medical data warehouses
Descrizione

ic_recontacticdatatrans

Tipo di dati

integer

Patient agreed to be recontacted in case scientific analysis forwarded relevant novel genetic information in the concerned family with ILD
Descrizione

ic_recontactinmild

Tipo di dati

integer

Patient agreed to be recontacted if patient's participation in a clinical trial could be possible based on the existing data set
Descrizione

ic_recontactparticltrial

Tipo di dati

integer

Patient agreed that the data collected/results from data analyses may be forwarded to third parties in pseudonymised or anonymised form, incl. potentially forwarding data to partners in industry.
Descrizione

ic_forwarddata

Tipo di dati

integer

Furthermore, I also consent to my biological samples and data being forwarded to countries outside of the EU, even if the European Commission has not adopted an adequacy decision and no agreements on data protection have been officially approved or adopted. The potential risks associated with this have been explained to me (item 6d on the information sheet).
Descrizione

ic_biosample

Tipo di dati

integer

DZL consent signed (applicable to german sites only)
Descrizione

ic_dzlconsentsigned

Tipo di dati

integer

Participation in eurIPFreg?
Descrizione

ic_partiipfreg

Tipo di dati

integer

eurIPFreg ID
Descrizione

ic_ipfregid

Tipo di dati

text

Participation in a clinical trial?
Descrizione

ic_particlintrial

Tipo di dati

integer

EUDRA CT number or clinical.trials.gov entry number
Descrizione

ic_eudractnumber

Tipo di dati

text

Please specify the investigational product:
Descrizione

ic_investigproduct

Tipo di dati

text

EUDRA CT number or clinical.trials.gov entry number
Descrizione

ic_eudractnumber_2

Tipo di dati

text

Please specify the investigational product:
Descrizione

ic_investigproduct_2

Tipo di dati

text

Similar models

Informed consent

Name
genere
Description | Question | Decode (Coded Value)
Tipo di dati
Alias
record_id
Item
Record ID
text
ic_datenrollment
Item
Date of enrollment
date
Item
Version signed
text
Code List
Version signed
CL Item
Version 2.1 eurILDreg (1)
Item
Patient agreed to be recontacted for the purpose of obtaining additional information or biomaterials
integer
Code List
Patient agreed to be recontacted for the purpose of obtaining additional information or biomaterials
CL Item
Yes (1)
CL Item
No (0)
Item
Patient agreed to be recontacted for the purpose of obtaining informed consent for data transfer to other medical data warehouses
integer
Code List
Patient agreed to be recontacted for the purpose of obtaining informed consent for data transfer to other medical data warehouses
CL Item
Yes (1)
CL Item
No (0)
Item
Patient agreed to be recontacted in case scientific analysis forwarded relevant novel genetic information in the concerned family with ILD
integer
Code List
Patient agreed to be recontacted in case scientific analysis forwarded relevant novel genetic information in the concerned family with ILD
CL Item
Yes (1)
CL Item
No (0)
Item
Patient agreed to be recontacted if patient's participation in a clinical trial could be possible based on the existing data set
integer
Code List
Patient agreed to be recontacted if patient's participation in a clinical trial could be possible based on the existing data set
CL Item
Yes (1)
CL Item
No (0)
Item
Patient agreed that the data collected/results from data analyses may be forwarded to third parties in pseudonymised or anonymised form, incl. potentially forwarding data to partners in industry.
integer
Code List
Patient agreed that the data collected/results from data analyses may be forwarded to third parties in pseudonymised or anonymised form, incl. potentially forwarding data to partners in industry.
CL Item
Yes (1)
CL Item
No (0)
Item
Furthermore, I also consent to my biological samples and data being forwarded to countries outside of the EU, even if the European Commission has not adopted an adequacy decision and no agreements on data protection have been officially approved or adopted. The potential risks associated with this have been explained to me (item 6d on the information sheet).
integer
Code List
Furthermore, I also consent to my biological samples and data being forwarded to countries outside of the EU, even if the European Commission has not adopted an adequacy decision and no agreements on data protection have been officially approved or adopted. The potential risks associated with this have been explained to me (item 6d on the information sheet).
CL Item
Yes (1)
CL Item
No (0)
Item
DZL consent signed (applicable to german sites only)
integer
Code List
DZL consent signed (applicable to german sites only)
CL Item
Yes (1)
CL Item
No (0)
Item
Participation in eurIPFreg?
integer
Code List
Participation in eurIPFreg?
CL Item
Yes (1)
CL Item
No (0)
ic_ipfregid
Item
eurIPFreg ID
text
Item
Participation in a clinical trial?
integer
Code List
Participation in a clinical trial?
CL Item
Yes (1)
CL Item
No (0)
ic_eudractnumber
Item
EUDRA CT number or clinical.trials.gov entry number
text
ic_investigproduct
Item
Please specify the investigational product:
text
ic_eudractnumber_2
Item
EUDRA CT number or clinical.trials.gov entry number
text
ic_investigproduct_2
Item
Please specify the investigational product:
text