Description:

AMC-046 Screen Failure Form Cidofovir in Treating HIV-Infected Patients With High-Grade Squamous Intraepithelial Lesions of the Skin Near the Anus Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=3BEAAEF0-A692-3FA8-E044-0003BA3F9857 NCT00550589

Link:

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=3BEAAEF0-A692-3FA8-E044-0003BA3F9857

Versions (3)
  1. 8/26/12 8/26/12 -
  2. 5/22/15 5/22/15 -
  3. 6/3/15 6/3/15 - Julian Varghese
Uploaded on:

June 3, 2015

DOI:
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License :
Creative Commons BY-NC 3.0 Legacy
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AMC-046 Screen Failure Form NCT00550589

English
Details

No Instruction available.

1 forms  
  1. StudyEvent: AMC-046 Screen Failure Form
    1. No Instruction available.
Biopsy/Cytology Status
Anal cytology performed
Most Severe Anal Cytology Result (If yes Please record the result from the cytology form)
High-resolution anoscopy performed
Perianal biopsy performed
Perianal biopsy result (If yes)
4 more items in the detailed view.
Screen Failure
Primary reason for screen failure
5 more items in the detailed view.
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