| CDE ID | CDE Description | | * 421 | EDRN Participant ID (Go To: 1899) |
| * 1899 | Adverse Event onset date (MM/DD/YYYY): (Go To: 423) |
| * 423 | EDRN Protocol ID (Go To: 422) |
| * 422 | EDRN Site ID (Go To: 929) |
| * 929 | EDRN Staff ID of the person who collected the data: (Go To: 2204) |
| * 2204 | Adverse Event: (Go To: 1898) |
| | | Permissible Values (value): | Bleeding (1) |
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| | |
| | | | Urinary retention (difficulty completely emptying the bladder) (4) |
|
| | | | Other, specify: (97) (Go To: 2203) |
|
| * 2203 | Adverse Event (Other, specify): (Go To: 1898) |
| * 1898 | Is this a Serious AE? (Go To: 1901) |
| | | Permissible Values (value): | No (0) |
|
| | |
| * 1901 | Adverse Event Status: (Go To: 973) |
| | | Permissible Values (value): | Ongoing (1) |
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| | |
| 1900 | Adverse Event stop date (MM/DD/YYYY): (Go To: 973) |
| * 973 | Date of prostate biopsy (MM/DD/YYYY): (Go To: 1097) |
| 1097 | Comments (do not include any participant identifiers) (Go To: End of Form) |
| 2572 | Principal Investigator signature: (Go To: End of Form) |