Form:GLNE 007 Ineligibility 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: 1066)
* 1066Date participant was determined to be ineligible (MM/DD/YYYY): (Go To: 2186)
* 2186Reason(s) for ineligibility: (Go To: 1097)
 
Permissible Values (value):Chronic Hepatitis (21)
 
 FAP or HNPCC (22)
 
 HIV (23)
 
 Inflammatory Bowel Disease (24)
 
 No serum and no stool sample (32)
 
 Participant did not meet age requirement (45)
 
 No colonoscopy performed (139)
 
 Prior non-CRC cancer within 3 years of consent (144)
 
 Active chemotherapy or radiation treatment for any condition (145)
 
 CRC Surgery, chemotherapy, or radiation prior to sample collection (146)
 
 Other, specify: (97) (Go To: 2184)
* 2184Reason for ineligibility (Other, specify): (Go To: 1097)
   1097Comments (do not include any participant identifiers) (Go To: End of Form)