This eCRF in XForms format demonstrates how XForms can be made dynamic.
In this form, for entering the start and stop date of the concomitant medication, there are two possibilities: First of all,
if the exact start or stop date is known, the date can simply be entered using a Calendar. Secondly, if the start or stop date is not
exactly known, three fields pop up, which allow to enter the approximate date: day, month and year. As such, after the data has been returned
to the server, from the stored data, it will always be clear whether the entered date was an exact or approximate one.
Also remark that when you tick that the Adverse Event is 'ongoing', all questions about the stop date disappear.
Group: Concom Meds
Compound
Maximum length is 8 characters.
Therapeutic Area
Oncology
ONC
Protocol Code
Maximum length is 15 characters.
Country Code
United States
USA
France
FR
Germany
DE
Record status
Source verified, not queried
S
Source verified, queried
V
Line Number
Must be an integer. Maximum length is 2 characters.
Medication For Conmed
Maximum length is 200 characters.
Exact start date is
known
true
unknown
false
Start Date
Correct format is yyyy-mm-dd e.g. 2004-01-27 Maximum length is 10 characters.
Start Day - Enter Two Digits 01-31, or leave blank if unknown
Must be an integer. Maximum value is 31.
Start Month - Enter Two Digits 01-12, or leave blank if unknown
Must be an integer. Maximum value is 12
Start Year - Enter Four Digit Year, or leave blank if unknown
Must be an integer. Maximum value is 2010.
Ongoing
Yes
Y
No
N
Exact stop date is
known
true
unknown
false
Stop Date
Correct format is yyyy-mm-dd e.g. 2004-01-27 Maximum length is 10 characters.
Stop Day - Enter Two Digits 01-31, or leave blank if unknown
Must be an integer. Maximum value is 31.
Stop Month - Enter Two Digits 01-12, or leave blank if unknown
Must be an integer. Maximum value is 12.
Stop Year - Enter Four Digit Year, or leave blank if unknown
Must be an integer. Maximum value is 2010.
Dose and Unit
Maximum length is 20 characters.
Conmed Route
IV
1
IM
2
PO
3
SC
4
PV
5
PR
6
Sublingual
7
Inhaled
8
Topical
9
If not in list
10
Conmed Regimen
q.d.
1
b.i.d.
2
t.i.d.
3
q.i.d.
4
q.o.d.
5
q.h.s.
6
cont. IV
7
prn
8
If not in list, record as Other
9
Conmed Indication
Maximum length is 100 characters.
Taken for AE
None
0
Unlikely
1
Possible
2
Probable
3