Vitiligo Research Study

AI-Agent Screening Question Guide Knowledge-Base 

 Participant eligibility screening. For client review.

BASICS

  1. 01

    Are you willing and able to read, understand, and sign a consent form before taking part?

  2. 02

    What is your age?

  3. 03

    Let's work out your BMI — what is your weight in pounds (lbs)?

  4. 04

    What is your height in inches?

About your vitiligo

  1. 05

    Have you been diagnosed by a doctor with vitiligo?

  2. 06

    How long ago were you diagnosed as having vitiligo by a doctor?

  3. 07

    What type of vitiligo do you have, if you know? (Segmental — one area or one side; Non-segmental — both sides of the body) 

  4. 08

    What % of your body is affected?

  5. 09

    Do you have any white or grey hair growing within your vitiligo patches on your face or body?

  6. 10

    Do you have any vitiligo patches on your face?

  7. 11

    Have you been diagnosed with any other condition that causes pale, white, or discolored skin patches?

Treatment history

  1. 12

    Have you tried any approved vitiligo treatments before?

  2. 13

    Did these treatments not work well enough, or are you unable to use them (e.g. side effects, another medical reason)?

  3. 14

    Are you willing to stop all current vitiligo treatments from the start of screening until the end of the study?

Recent health history

  1. 15

    In the recent past, have you had any of the following? (serious infection requiring hospitalization, TB or positive TB test, shingles, major surgery, cancer, blood clots, heart attack or stroke)

  2. 16

    Have you been vaccinated against shingles (herpes zoster)?

  3. 17

    If not already vaccinated, are you willing to get the shingles vaccine before the study begins?

  4. 18

    Do you currently have, or have you been told you have, any of the following? (diabetes, high blood pressure, liver disease, kidney disease, heart disease, autoimmune disease other than vitiligo, HIV)

  5. 19

    Have you had a chest X-ray that showed an abnormal result?

Medications

  1. 20

    Are you currently taking any medications that affect your immune system, or any other ongoing prescription medications?

  2. 21

    Which other medications are you on?

  3. 22

    Do you have any other medical conditions?

About you

  1. 23

    Are you currently pregnant or breastfeeding?

  2. 24

    If relevant, are you willing to use effective contraception during the study?

  3. 25

    Let's find your nearest clinic — where do you live?

  4. 26

    What day and time works best for the nurse to call about the study?

  5. 27

    Please confirm you have read and agree with the following privacy assurance.