ID
13225
Beschrijving
Placebo controlled,double blind and randomized parallel group trial to verify effectivity and tolerability of moxaverine p.o. in patients with central nervous vertigo. Sponsor: URSAPHARM Industriestrasse 66129 Saarbrücken Phone 06805-9292-0 Fax 06805- 929288 Head of clinical trial: Univ.-Prof.Dr.med. Ralph Mösges Medical Faculty, University of Cologne Phone 0221-4783456 Fax 0221-4783465
Trefwoorden
Versies (3)
- 11-01-16 11-01-16 -
- 13-01-16 13-01-16 -
- 25-01-16 25-01-16 - Julian Varghese
Geüploaded op
25 januari 2016
DOI
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Licentie
Creative Commons BY-NC 3.0
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Moxaverine 200mg p.o. in patients with central nervous vertigo
Case report form Visit 1
- StudyEvent: ODM
Beschrijving
neurological preliminary assessment
Beschrijving
If any one of the following is answered with yes, the patient may not be included.
Datatype
text
Alias
- UMLS CUI [1]
- C0027765
Beschrijving
otorhinolaryngologic preliminary assessment
Beschrijving
Eligibility
Beschrijving
central nervous vertigo
Datatype
boolean
Alias
- UMLS CUI [1]
- C0155503
Beschrijving
Inclusion
Datatype
boolean
Alias
- UMLS CUI [1]
- C1512693
Beschrijving
date
Datatype
date
Alias
- UMLS CUI [1]
- C0011008
Beschrijving
Signature
Datatype
text
Alias
- UMLS CUI [1]
- C1550483
Beschrijving
Inclusion criteria
Beschrijving
central nervous vertigo
Datatype
boolean
Beschrijving
Patient age and gender
Datatype
boolean
Alias
- UMLS CUI [1]
- C0150831
- UMLS CUI [2]
- C0001779
Beschrijving
Informed consent
Datatype
boolean
Alias
- UMLS CUI [1]
- C0021430
Beschrijving
Compliance behavior
Datatype
boolean
Alias
- UMLS CUI [1]
- C1321605
Beschrijving
Exclusion criteria
Beschrijving
Inclusion criteria
Datatype
boolean
Alias
- UMLS CUI [1]
- C1512693
Beschrijving
Concomitant agent
Datatype
boolean
Alias
- UMLS CUI [1]
- C2347852
Beschrijving
Compliance behavior
Datatype
boolean
Alias
- UMLS CUI [1,1]
- C1321605
- UMLS CUI [1,2]
- C0439801
- UMLS CUI [1,3]
- C0009488
Beschrijving
Hypersensitivity
Datatype
boolean
Alias
- UMLS CUI [1,1]
- C0020517
- UMLS CUI [1,2]
- C0129044
Beschrijving
vestibular or cerebellar vertigo
Datatype
boolean
Alias
- UMLS CUI [1]
- C0151222
- UMLS CUI [2]
- C0234756
Beschrijving
asymmetric hearing impairment
Datatype
boolean
Alias
- UMLS CUI [1]
- C1997086
Beschrijving
vestibular evaluation with caloric testing
Datatype
boolean
Alias
- UMLS CUI [1]
- C2189441
Beschrijving
Comorbidity
Datatype
boolean
Alias
- UMLS CUI [1]
- C0009488
Beschrijving
Patient medical history
Datatype
boolean
Alias
- UMLS CUI [1]
- C0262926
Beschrijving
Comorbidity
Datatype
boolean
Alias
- UMLS CUI [1]
- C0009488
Beschrijving
Compliance behavior
Datatype
boolean
Alias
- UMLS CUI [1]
- C1321605
Beschrijving
Study Subject Participation Status
Datatype
boolean
Alias
- UMLS CUI [1]
- C2348568
Beschrijving
pregnancy or breastfeeding, contraceptive methods
Datatype
boolean
Alias
- UMLS CUI [1]
- C0700589
- UMLS CUI [2]
- C0032961
- UMLS CUI [3]
- C0006147
Beschrijving
Substance use disorder
Datatype
boolean
Alias
- UMLS CUI [1]
- C0038586
Beschrijving
Informed consent
Datatype
boolean
Alias
- UMLS CUI [1,1]
- C0021430
- UMLS CUI [1,2]
- C0439801
- UMLS CUI [1,3]
- C0009488
Beschrijving
Date
Datatype
date
Alias
- UMLS CUI [1]
- C0011008
Beschrijving
Signature
Datatype
text
Alias
- UMLS CUI [1]
- C1550483
Beschrijving
otorhinolaryngologic examination
Beschrijving
Otoscopy
Datatype
text
Alias
- UMLS CUI [1]
- C0419361
Beschrijving
Otoscopy
Datatype
text
Alias
- UMLS CUI [1]
- C0419361
Beschrijving
Rinne test
Datatype
text
Alias
- UMLS CUI [1]
- C0278245
Beschrijving
Rinne test
Datatype
text
Alias
- UMLS CUI [1]
- C0278245
Beschrijving
Webers test
Datatype
text
Alias
- UMLS CUI [1]
- C0278247
Beschrijving
Webers test
Datatype
text
Alias
- UMLS CUI [1]
- C0278247
Beschrijving
Nystagmus testing with frenzel-lens eyeglasses
Datatype
boolean
Alias
- UMLS CUI [1]
- C2721529
Beschrijving
Nystagmus testing with frenzel-lens eyeglasses
Datatype
text
Alias
- UMLS CUI [1]
- C0339666
Beschrijving
Nystagmus testing with frenzel-lens eyeglasses
Datatype
text
Alias
- UMLS CUI [1,1]
- C0028738
- UMLS CUI [1,2]
- C2346753
Beschrijving
Nystagmus testing with frenzel-lens eyeglasses
Datatype
text
Alias
- UMLS CUI [1,1]
- C0028738
- UMLS CUI [1,2]
- C0439603
Beschrijving
Nystagmus testing with frenzel-lens eyeglasses
Datatype
text
Alias
- UMLS CUI [1]
- C0012833
Beschrijving
Posturography
Beschrijving
Computerized dynamic posturography procedure
Datatype
boolean
Alias
- UMLS CUI [1]
- C0519978
Beschrijving
Computerized dynamic posturography procedure report has to be enclosed
Datatype
text
Alias
- UMLS CUI [1]
- C0519978
Beschrijving
Tasks of investigator during this visit
Beschrijving
Questionnaire
Datatype
boolean
Alias
- UMLS CUI [1]
- C0034394
Beschrijving
Patient identification card
Datatype
boolean
Alias
- UMLS CUI [1]
- C0030692
Beschrijving
Medication dispensed
Datatype
boolean
Alias
- UMLS CUI [1]
- C0947323
Beschrijving
Patient questions
Datatype
boolean
Alias
- UMLS CUI [1]
- C0547398
Beschrijving
Date
Datatype
date
Alias
- UMLS CUI [1]
- C0011008
Beschrijving
Signature
Datatype
text
Alias
- UMLS CUI [1]
- C1519316
Beschrijving
Comorbidities and concomitant Medication
Beschrijving
Comorbidities
Datatype
boolean
Alias
- UMLS CUI [1]
- C0009488
Beschrijving
Comorbidities
Datatype
text
Alias
- UMLS CUI [1]
- C0009488
Beschrijving
prohibited medication: -aminoglycoside antibiotics -vasoactive agents -stimulants to the central nervous system -tranquilizer -agents aiming at cell metabolism -antihistamines -Antiplatelet Agents -anticoagulants
Datatype
boolean
Alias
- UMLS CUI [1]
- C2347852
Beschrijving
Concomitant Agent
Datatype
text
Alias
- UMLS CUI [1]
- C2347852
Beschrijving
additional comments
Datatype
text
Alias
- UMLS CUI [1]
- C1830770
Beschrijving
Date
Datatype
date
Alias
- UMLS CUI [1]
- C0011008
Beschrijving
Signature
Datatype
text
Alias
- UMLS CUI [1]
- C1519316
Similar models
Case report form Visit 1
- StudyEvent: ODM
C0001779 (UMLS CUI [2])
C0439801 (UMLS CUI [1,2])
C0009488 (UMLS CUI [1,3])
C0129044 (UMLS CUI [1,2])
C0234756 (UMLS CUI [2])
C0032961 (UMLS CUI [2])
C0006147 (UMLS CUI [3])
C0439801 (UMLS CUI [1,2])
C0009488 (UMLS CUI [1,3])
C2346753 (UMLS CUI [1,2])
C0439603 (UMLS CUI [1,2])