Datacapt - New eCRF Design

New eCRF Design

Datacapt - Studies

01-D0001
 
Enrolled (default)
Randomization ID: R-0001
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Screening Visit
93%
Queries
11 Sep 2025
Visit Information
Demographics
Inclusion Criteria
Exclusion Criteria
Eligibility
Medical History
Physical Examination
Vital Sign
Laboratory Assessment
LB - Local Processing
Randomization and dispense
Questions type
Linked to ePRO
Visit D30 +-2 days
9%
In progress
11 Sep 2025
Visit D60 +-2 days
88%
In progress
12 Sep 2025
End of Study
18%
In progress
11 Sep 2025
Common Forms
11%
In progress
11 Sep 2025
Visit
0%
Completed
Screening Visit
Demographics
Birth Date *
Data validation = We don't accept future date
Age (in years)
1
Age is automatically calculated by the system
Height (in CM) *
Range from 0 to 250 cm
	CM
Weight (in KG) *
Range from 0 to 300 KG
	KG
Sex *
Automatic query if AGE less than 100 and answer is UNKNOWN ---->
FEMALE
MALE
UNKNOWN
UNDIFFERENCIATED
BMI (calculated)
Randomization
Participant randomized
ID: R-0001
Treatment arm: Medication
2025-26-11 by Florentin ORY
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Screening Visit
Exclusion Criteria
Exclusion Critera
Is the participant currently enrolled in another clinical trial? *
2
YES
NO
Please check your answer. If the answer is correct the patient can't be enrolled.
4 days ago
 
Open
Is the participant pregnant or breastfeeding? *
1
YES
NO
Does the participant have a history of substance abuse within the past 12 months? *
1
YES
NO
Please check your answer. If the answer is correct the patient can't be enrolled.
4 days ago
 
Open
Does the participant have any significant comorbid conditions (e.g., uncontrolled hypertension, severe cardiovascular disease) that could interfere with study participation? *
1
YES
NO
Please check your answer. If the answer is correct the patient can't be enrolled.
4 days ago
 
Open
Does the participant have any significant comorbid conditions (e.g., uncontrolled hypertension, severe cardiovascular disease) that could interfere with study participation? *
YES
NO
Does the participant have an active infection, active immunosuppression, or any condition that compromises the immune system (e.g., HIV)? *
YES
NO
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1 answer unsaved
Saving 1 answer

Screening Visit
Demographics
Form was locked on 15.09.2025 at 20:06 by Florentin ORY
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Subsection was reviewed on 15.09.2025 at 20:06 by Florentin ORY
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Birth Date *
Data validation = We don't accept future date
Age (in years)
1
Age is automatically calculated by the system
Height (in CM) *
Range from 0 to 250 cm
	CM
Weight (in KG) *
Range from 0 to 300 KG
	KG
Sex *
Automatic query if AGE less than 100 and answer is UNKNOWN ---->
FEMALE
MALE
UNKNOWN
UNDIFFERENCIATED
BMI (calculated)
Randomization
Participant randomized
ID: R-0001
Treatment arm: Medication
2025-26-11 by Florentin ORY