Protocol: S-number: Titel: Principal Investigator: Date approval Medical Ethical Commitee: Current status: The experiment has not started because: ……. The experiment started on (signature date 1st Informed Consent) ……………….. Progression of the experiment since start/ last report (date:…………………) The experiment develops according to the approved protocol design: Yes No Number of patients: Expected: ……. Screened: ……. Randomized: ……. Included: ……. Drop out/withdrawal: ….. Number of patients having terminated the experiment according to the protocol: ……. In follow up: …… Deceased: …….. The experiment is temporarily interrupted: Yes, because of: Adverse events (please specify): ……. Limited number of recruited patients: ……. The study design (please specify): ……. No The experiment is terminated: Yes, because of: Adverse events (please specify): ……. Limited number of recruited patients: ……. The study design (please specify): ……. No Stop date of inclusion: ……. Planned end date of the trial: …….
Protocol: S-number: Titel: Principal Investigator: Date approval Medical Ethical Commitee: Current status: The experiment has not started because: ……. The experiment started on ……………….. (signature date 1st Informed Consent) Progression of the experiment since start/ last report (date:…………………) The experiment develops according to the approved protocol design: Yes No Number of patients: Expected: ……. Screened: ……. Randomized: ……. Included: ……. Drop out/withdrawal: ….. Number of patients having terminated the experiment according to the protocol: ……. In follow up: …… Deceased: …….. The experiment is temporarily interrupted: Yes, because of: Adverse events (please specify): ……. Limited number of recruited patients: ……. The study design (please specify): ……. No The experiment is terminated: Yes, because of: Adverse events (please specify): ……. Limited number of recruited patients: ……. The study design (please specify): ……. No Stop date of inclusion: ……. Planned end date of the trial: …….
Annual%20progress%20report.docx