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Xformpusher
CDASH VariableOrderQuestion TextPromptCRF Completion InstructionsTypeSDTMIG Target VariableSDTMIG Target MappingControlled Terminology Code List NamePermissible ValuesPre-Populated ValueQuery DisplayList StyleHidden
IEYN1Were all eligibility criteria met?Met CriteriaRecord Yes if all eligibility criteria were met at the time the subject was enrolled. Record No if the subject did not meet all criteria at the time the subject was enrolled.TextN/A
(NY)Yes; No

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IECAT2What was the category of the criterion?Criterion TypeRecord whether the criterion exception was Inclusion or Exclusion.TextIECAT
(IECAT)Inclusion; Exclusion

radio
IETESTCD3What was the identifier of the inclusion criterion the subject did not meet or the exclusion criterion the subject met?Exception Criterion IdentifierIf the subject was not eligible, record the identifying code for each criterion that was an exception.TextIETESTCD







This is an example of data that was collected on a protocol-deviations CRF. The DVDECOD column is for controlled terminology, whereas the DVTERM is free text. 

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Rowcaps
Rows 1, 3:Show examples of a TREATMENT DEVIATION type of protocol deviation.
Row 2:Shows an example of a deviation due to the subject taking a prohibited concomitant medication.
Row 4:Shows an example of a medication that should not be taken during the study.
Dataset2
RowSTUDYIDDOMAINUSUBJIDDVSEQDVTERMDVDECODEPOCHDVSTDTC
1ABC123DV1231011IVRS PROCESS DEVIATION - NO DOSE CALL PERFORMED.TREATMENT DEVIATIONTREATMENT2003-09-21
2ABC123DV1231031DRUG XXX ADMINISTERED DURING STUDY TREATMENT PERIODEXCLUDED CONCOMITANT MEDICATIONTREATMENT2003-10-30
3ABC123DV1231032VISIT 3 DOSE <15 MGTREATMENT DEVIATIONTREATMENT2003-10-30
4ABC123DV1231041TOOK ASPIRINPROHIBITED MEDSTREATMENT2003-11-30