Form:MSA Study Termination v1.1


CDE IDCDE Description
* 421EDRN Participant ID (Go To: 899)
* 899Date of participant's study termination: (Go To: 422)
* 422EDRN Site ID (Go To: 423)
* 423EDRN Protocol ID (Go To: 929)
* 929EDRN Staff ID of the person who collected the data: (Go To: 900)
* 1102Reason(s) for study termination: (Check all that apply.) (Go To: End of Form)
 
Permissible Values (value):Participant completed study as expected (1)
 
 Participant's F24 visit window has ended and a Missed Visit form has been completed (2)
 
 Participant refused all future contact (3)
 
 Participant's bladder cancer has progressed to Stage T2 or greater (invaded the musculature) (4)
 
 Participant deceased (5)
 
 Protocol deviation (6)
 
 Other, specify: (97)
   1695Other termination reason, specify: (Go To: End of Form)