STATUS OF TREATMENT BLIND

9 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Status
Was the treatment blind broken during the study?
Item
Was the treatment blind broken during the study?
boolean
C0749659 (UMLS CUI [1,1])
C2347038 (UMLS CUI [1,2])
Date blind broken
Item
Date blind broken
datetime
C0011008 (UMLS CUI [1,1])
C2347038 (UMLS CUI [1,2])
Item
Reason blind broken
integer
C0392360 (UMLS CUI [1])
Reason blind broken
Code List
Reason blind broken
CL Item
Medical emergency requiring identification of investigation al product for further treatment (1)
C0013961 (UMLS CUI-1)
(Comment:en)
CL Item
Other, specify (2)
C1521902 (UMLS CUI-1)
(Comment:en)
Item Group
PGx-PHARMACOGENETIC RESEARCH INSTRUCTIONS
PGx-PHARMACOGENETIC RESEARCH INSTRUCTIONS
Item
PGx-PHARMACOGENETIC RESEARCH INSTRUCTIONS
text
C0031325 (UMLS CUI [1,1])
C1442085 (UMLS CUI [1,2])
Item Group
PGx-PHARMACOGENETIC RESEARCH
CONSENT FOR PGx-PHARMACOGENETIC RESEARCH
Item
CONSENT FOR PGx-PHARMACOGENETIC RESEARCH
boolean
C0021430 (UMLS CUI [1,1])
C2347500 (UMLS CUI [1,2])
If Yes, record the date informed consent obtained for PGx-Pharmacogenetic research
Item
If Yes, record the date informed consent obtained for PGx-Pharmacogenetic research
date
C2985782 (UMLS CUI [1])
Item
Informed consent if no
text
C0021430 (UMLS CUI [1])
Informed consent if no
Code List
Informed consent if no
CL Item
Subject declined (Subject declined)
CL Item
Subject not asked by Investigator (Subject not asked by Investigator)
CL Item
Other, specify (Other, specify)
BLOOD SAMPLE COLLECTION
Item
Has a blood sample been collected for PGx-pharmacogenetic research?
boolean
C0005834 (UMLS CUI [1])
If Yes, record the date sample taken
Item
If Yes, record the date sample taken
date
C0005834 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
WITHDRAWAL OF CONSENT
Item
Has subject withdrawn consent for PGx-Pharmacogenetic research?
boolean
C1707492 (UMLS CUI [1])
BLOOD SAMPLE DESTRUCTION
Item
BLOOD SAMPLE DESTRUCTION
boolean
C1948029 (UMLS CUI [1,1])
C0178913 (UMLS CUI [1,2])
Item
If Yes: BLOOD SAMPLE DESTRUCTION
integer
C1948029 (UMLS CUI [1,1])
C0178913 (UMLS CUI [1,2])
If Yes: BLOOD SAMPLE DESTRUCTION
Code List
If Yes: BLOOD SAMPLE DESTRUCTION
CL Item
Subject requested (1)
CL Item
Other, specify (2)
CONCOMITANT MEDICATIONS
Item
CONCOMITANT MEDICATIONS
text
C2347852 (UMLS CUI [1])
Item
UNITS
text
C1519795 (UMLS CUI [1])
UNITS
Code List
UNITS
CL Item
Tablet (TAB)
C0039225 (UMLS CUI-1)
(Comment:en)
CL Item
Micro litre (MCL)
C1519795 (UMLS CUI-1)
(Comment:en)
CL Item
Millilitre (ML)
(Comment:en)
CL Item
Litre (L)
(Comment:en)
CL Item
Microgram (MCG)
(Comment:en)
CL Item
Milligram (MG)
(Comment:en)
CL Item
Gram (G)
(Comment:en)
CL Item
Optional therapeutic specific code (?)
(Comment:en)
CL Item
Optional therapeutic specific code (?)
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