Form:GLNE 007 Consent Documentation v9.0


CDE IDCDE Description
* 421EDRN Participant ID (Go To: 2176)
* 2176Visit code (Go To: 423)
 
Permissible Values (value):BLN1 (1)
 
 BLN2 (2)
* 423EDRN Protocol ID (Go To: 422)
* 422EDRN Site ID (Go To: 929)
* 929EDRN Staff ID of the person who collected the data: (Go To: 1319)
* 1319Date participant signed consent form (MM/DD/YYYY): (Go To: 2603)
* 2603Study group: (Go To: 4947)
 
Permissible Values (value):Scheduled for colonoscopy (0)
 
 Cancer diagnosed by a recent colonoscopy (1)
 
 Adenoma diagnosed by a recent colonoscopy (2)
* 4947Did the participant agree to the researchers having extra tissue from endoscopy after clinical use? (Go To: 4948)
 
Permissible Values (value):No (0)
 
 Yes (1)
 
 Not collected (2)
 
 Refused (88)
 
 Unknown (99)
* 4948Did the participant agree to the researchers having extra tissue from surgery after clinical use? (Go To: 4949)
 
Permissible Values (value):No (0)
 
 Yes (1)
 
 Not collected (2)
 
 Refused (88)
 
 Unknown (99)
* 4949Did the participant agree to the researchers having extra tissue from biopsy of normal sigmoid colon? (Go To: 2492)
 
Permissible Values (value):No (0)
 
 Yes (1)
 
 Not collected (2)
 
 Refused (88)
 
 Unknown (99)
* 2492Has the participant authorized the use of their specimens for future research? (Go To: 1097)
 
Permissible Values (value):No (0)
 
 Yes (1)
 
 Not collected (2)
 
 Refused (88)
 
 Unknown (99)
* 1097Comments (do not include any participant identifiers) (Go To: End of Form)