Procedure Agents Used for Imaging
Procedure Agents Related to Imaging Procedures
*
Were any procedure agents administered to or taken by the subject?
No
Yes
Procedure Agents Related to Imaging Procedures
[No information given about how to repeat this Field Group]
What was the agent name?
What was the identifier for the procedure(s) associated with this intervention?
What was the individual dose of the agent per administration?
What is the unit of the agent per administration?
What was the route of administration of the agent?
What was the agent start date?
What was the agent start time?
Choose
CAPSULE
g
IU
mg
mL
PUFF
TABLET
ug
Choose
INTRALESIONAL
INTRAMUSCULAR
INTRAOCULAR
INTRAPERITONEAL
NASAL
ORAL
RECTAL
RESPIRATORY (INHALATION)
SUBCUTANEOUS
TOPICAL
TRANSDERMAL
VAGINAL
01 Jan 2000
12:00
*
Mandatory field