Publication Build: This will be filled in by the publication tooling
| LinkId | Text | Definition | Answer |
|---|---|---|---|
![]() | QuestionnaireResponse | ||
![]() ![]() | Research Study | ||
![]() ![]() ![]() | Study Title | Study of Drug A for arthritis | |
![]() ![]() ![]() | IRB Protocol Number | PRO098765 | |
![]() ![]() | Reliance Determination | ||
![]() ![]() ![]() | sIRB (Reviewing Institution) | ||
![]() ![]() ![]() ![]() | Institution | ||
![]() ![]() ![]() ![]() ![]() | sIRB (Reviewing Institution) Name | X Pharmaceutical Research IRB | |
![]() ![]() ![]() ![]() ![]() | Federal Wide Assurance (FWA) | 12345 | |
![]() ![]() ![]() | Determination Decision | Temporary Codes AR: Accepts Review | |
![]() ![]() | Lead Principal Investigator Responsible for Overall Study | ||
![]() ![]() ![]() | First Name | Jane | |
![]() ![]() ![]() | Last Name | Doe | |
![]() ![]() ![]() | Degree(s) | MD | |
![]() ![]() ![]() | drjanedoe@sampleuniversity.edu | ||
![]() ![]() | Lead Principal Investigator Institution | ||
![]() ![]() ![]() | Lead Principal Investigator Institution Name | Sample University Medical Center | |
![]() ![]() | Relying IRB | ||
![]() ![]() ![]() | Relying institution and Relying Site Principal Investigator for this Determination Letter | ||
![]() ![]() ![]() ![]() | External Data For linkId dl7.5.1 | ||
![]() ![]() ![]() ![]() | Select the relying site in order to pre-populate the relying institution and relying site principal investigator details below. | [not stated] : Test Example University | | Xi-Yang Lee, Jr., MD, PhD | Example, MA | |
![]() ![]() ![]() | Relying Institution | ||
![]() ![]() ![]() ![]() | Name | Test Example University | |
![]() ![]() ![]() ![]() | Federal Wide Assurance (FWA) | 34567 | |
![]() ![]() ![]() | Relying Site Principal Investigator | ||
![]() ![]() ![]() ![]() | First Name | Xi-Yang | |
![]() ![]() ![]() ![]() | Last Name | Lee | |
![]() ![]() ![]() ![]() | Suffix | Jr. | |
![]() ![]() ![]() ![]() | Professional Degree(s) | MD, PhD | |
![]() ![]() ![]() ![]() | XiYangLee@teu.med.edu | ||
![]() ![]() | Point of Contact for Study Participants | ||
![]() ![]() ![]() | First Name | Xi-Yang | |
![]() ![]() ![]() | Last Name | Lee | |
![]() ![]() ![]() | Suffix | Jr. | |
![]() ![]() ![]() | Professional Degree(s) | MD, PhD | |
![]() ![]() ![]() | XiYangLee@teu.med.edu | ||
![]() ![]() | Administrative Use Only | ||
![]() ![]() ![]() | Link ID prefix | dl | |
![]() ![]() ![]() | Questionnaire Response ID for the parent Questionnaire Response (such as the Initiate a Study Questionnaire Response), if any | initiate-study-populate-exampleQR | |
![]() ![]() ![]() | ID of the Research Study FHIR Resource associated with the study Questionnaire Responses, if any | ResearchStudyExample-sIRB | |