Informed consent

Informed consent
Descrição

Informed consent

Record ID
Descrição

record_id

Tipo de dados

text

INFORMED CONSENT
Descrição

INFORMED CONSENT

Date of enrollment
Descrição

ic_datenrollment

Tipo de dados

date

Informed consent
Descrição

Informed consent

Version signed
Descrição

ic_versionsigned

Tipo de dados

text

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

ic_recontactinfbio

Tipo de dados

integer

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

ic_recontacticdatatrans

Tipo de dados

integer

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

ic_recontactinmild

Tipo de dados

integer

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

ic_recontactparticltrial

Tipo de dados

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.
Descrição

ic_forwarddata

Tipo de dados

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).
Descrição

ic_biosample

Tipo de dados

integer

DZL consent signed (applicable to german sites only)
Descrição

ic_dzlconsentsigned

Tipo de dados

integer

Participation in eurIPFreg?
Descrição

ic_partiipfreg

Tipo de dados

integer

eurIPFreg ID
Descrição

ic_ipfregid

Tipo de dados

text

Participation in a clinical trial?
Descrição

ic_particlintrial

Tipo de dados

integer

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

ic_eudractnumber

Tipo de dados

text

Please specify the investigational product:
Descrição

ic_investigproduct

Tipo de dados

text

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

ic_eudractnumber_2

Tipo de dados

text

Please specify the investigational product:
Descrição

ic_investigproduct_2

Tipo de dados

text

Similar models

Informed consent

Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de dados
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