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CRF3C
Mathew Thorpe edited this page Aug 30, 2021
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1 revision
Variable / Field Name | Section Header | Field Type | Field Label | Choices or Calculations |
---|---|---|---|---|
crf3c_version | radio | CRF3 Version Completed | 1, Unversioned ; 2, 1.0 ; 3, 1.1 ; 4, 1.2 ; 5, 1.3 ; 6, 1.4 ; 7, 1.5 ; 8, 1.6 ; 9, 2.0 | |
crf3c_psqi | Questionnaires | yesno | Pittsburgh Sleep Quality Index (PSQI) | 1, Yes ; 0, No |
crf3c_meq | yesno | Morningness-Eveningness Questionnaire (MEQ) | 1, Yes ; 0, No | |
crf3c_lcq | yesno | Leicester Cough Questionnaire (LCQ) | 1, Yes ; 0, No | |
crf3c_other_quest | yesno | Other questionnaire(s) | 1, Yes ; 0, No | |
crf3c_quest_other_detail | notes | Other questionnaire(s) completed | ||
crf3c_t3_qmus | Tier 3 studies | radio | Quadriceps muscles ultrasound (US) performed | 1, Yes ; 0, No |
crf3c_t3_mb | radio | Muscle biopsy performed | 1, Yes ; 0, No | |
crf3c_t3_bs | radio | Breath samples | 1, Yes ; 0, No | |
crf3c_t3_genomicc | radio | Consent to participate in GenOMICC | 1, Yes ; 0, No | |
crf3c_t3_lir_turtle | radio | Longitudinal immune responses to SARS-CoV-2 in recovered hospitalised patients [PI: Turtle] | 1, Yes ; 0, No | |
crf3c_t3_other | radio | Other | 1, Yes ; 0, No | |
crf3c_genomicc_consent | dropdown | GenOMICC Consent Version | 1, v2.4 | |
crf3c_t3_other_detail | notes | Other tests completed | ||
crf3c_gen_coenrol_yn | yesno | Has the participant already been recruited to the GenOMICC Study? | 1, Yes ; 0, No | |
crf3c_gen_id_yn | yesno | Is the GenOMICC study ID known? | 1, Yes ; 0, No | |
crf3c_gen_id | text | GenOMICC study ID | ||
crf3c_gen_coenrol_consent | yesno | Has the patient consented to co-enrolment in the GenOMICC Study? | 1, Yes ; 0, No | |
crf3c_gen_consent_ver | text | If yes, please document the GenOMICC consent form version number: | ||
crf3c_genomicc_withdrawal | checkbox | GenOMICC Withdrawal Status | 1, Partial withdrawal ; 2, Full withdrawal | |
crf3c_genomicc_p_with_date | text | GenOMICC Partial Withdrawal Date | ||
crf3c_genomicc_f_with_date | text | GenOMICC Full Withdrawal Date |
Contents
Case Report Form Definitions
- Forms
- Timepoints
- PHOSP ID
- eConsent Tier 1
- eConsent Tier 2
- Informed Consent Form
- Split Tier Consent
- Eligibility Checklist
- CRF1A Part 1
- CRF1A Part 2
- CRF1A Part 3
- CRF1B
- CRF2A
- CRF2B
- CRF3A
- CRF3B
- CRF3C
- CRF4A
- CRF4B
- CRF Emergency Visit
- Adverse Event Log
- Withdrawals
- CRF Early Termination
- CRF Tier 2 Withdrawal
- Medications Log
- Activity Monitor Log
- Mental Health Assessment
- Nutrition
- Social History
- EQ-5D-5L
- GAD-7
- PHQ-9
- MRC Dyspnoea
- SARC-F
- GPPAQ
- Dyspnoea-12
- FACIT Fatigue
- PCL-5
- BPI
- NEADL
- MoCA
- Rockwood Clinical Frailty
- PSQI
- MEQ
- LCQ
- PFTs
- Walk Tests
- Tier 2 Core Test Checklist
- Tier 2 Research Samples
- Tier 2 Notification - Blood
- Tier 2 Notification - Oral Wash
- Tier 2 Notification - Sputum
- Tier 2 Notification - Urine
- QRISK3
- BIA
- DXA
- Muscle Strength
- SPPB
- Pre-PSQ
- PSQ
- Lab Log - Routine Blood
- Lab Log - Urine
- Lab Log - Immuno
- Lab Log - Additional Tests
- PCR Swab Tests