Versions Compared

Key

  • This line was added.
  • This line was removed.
  • Formatting was changed.

This is an example CRF used to collect Subject Inclusion/Exclusion Criteria. 

Excerpt

Image Added

Controlled Terminology Code List
Expand
titleCDASH IE Metadata Specifications

Section 1 

Metadataspec
OrderQuestion TextPromptCRF Case Report Form Completion InstructionsTypeCDASH Collection Variable Name SDTMIG Target VariableSDTM Target MappingTabulation Target  Mapping Instructions  Controlled Terminology CodeList Controlled Terminology Code List NamePermissible ValuesPre-Populated Value
1Were 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.IEYNTextIEYNWere 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.
Not Submitted


Section 2

OrderQuestion TextPrompt
CRF
Case Report Form Completion InstructionsType
CDASH
Collection Variable
Name 
SDTMIG Target VariableSDTM Target Mapping
Tabulation Target  Mapping Instructions  Controlled Terminology CodeList NamePermissible ValuesPre-Populated Value
2
Were all eligibility criteria met?Met Criteria3
Record 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.TextIEYNIEYNWere 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.
What was the category of the criterion?Criterion TypeRecord whether the criterion exception was Inclusion or Exclusion.TextIECATIECAT
What was the category of the criterion?Criterion TypeRecord whether the criterion exception was Inclusion or Exclusion.4




3What 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.TextIETESTCDIETESTCD
What 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.