Tuberculosis Skin Response


This CRF collects questions about a tuberculosis skin response test.


This CRF is from the CDASHIG v2.2.


Tuberculosis Skin Response
Skin Test
Skin Response Category
Skin Response Test Performed? No  Yes  
What was the reason the test was not done?
Intervention Performed
What was the date of the intervention performed to elicit the skin response?
 01 Jan 2000
What was the time of the intervention performed to elicit the skin response?
 12:00
What was the date of the skin response measurement?
 01 Jan 2000
What was the time of the skin response measurement?
 12:00
Anatomical Location Arm  Leg  
Side Right  Left  
Directionality Upper  Lower  Anterior  
Skin Response Test Name
Result
What was the unit of the skin response measurement? mm  cm  
Who was the evaluator? Investigator  Health Care Professional  Study Subject  
* Mandatory field

Package(s)
TB_Skin_Response_2023-01-31.zip