ID

12026

Description

A Cross-Over, Multi-Center Trial to Evaluate the Diagnostic Efficacy and Safety of [123I]NAV5001 as an Imaging Agent to Aid in the Diagnosis of Parkinsonian Syndromes; ODM derived from: https://clinicaltrials.gov/show/NCT01950468 Principal Investigator: Stephen Flitman, M.D and Ira Goodman, M.D

Link

https://clinicaltrials.gov/show/NCT01950468

Keywords

Versions (1)
  1. 9/1/15 9/1/15 -
Uploaded on

September 1, 2015

DOI

To request one please log in.

License

Creative Commons BY 4.0
Model comments :

You can comment on the data model here. Via the speech bubbles at the itemgroups and items you can add comments to those specificially.

Back to model comments
Itemgroup comments for :

Item comments for :

In order to download data models you must be logged in. Please log in or register for free.

Eligibility Parkinson's Syndrome NCT01950468

English

Eligibility Parkinson's Syndrome NCT01950468

1 forms  
Inclusion Criteria
Description

Inclusion Criteria

Alias
UMLS CUI-1
C1512693
Subject has provided written informed consent before the initiation of any study related procedures and continues to give willing consent for participation
Description

Subject has provided written informed consent before the initiation of any study related procedures and continues to give willing consent for participation

Data type

boolean

Alias
UMLS CUI [1]
C0021430
Age ≥ 40 years
Description

Age ≥ 40 years

Data type

boolean

Alias
UMLS CUI [1]
C0001779
Have had upper extremity tremor for < 3 years duration, regardless of presumed diagnosis or etiology
Description

Have had upper extremity tremor for < 3 years duration, regardless of presumed diagnosis or etiology

Data type

boolean

Alias
UMLS CUI [1]
C0239412
Have a UPDRS part III score upon entry of ≤ 16
Description

UPDRS score

Data type

boolean

Alias
UMLS CUI [1]
C3827698
Exclusion Criteria
Description

Exclusion Criteria

Alias
UMLS CUI-1
C0680251
Any clinically significant or unstable physical or psychological illness based on medical history or physical examination at screening, as determined by the investigator
Description

Any clinically significant or unstable physical or psychological illness based on medical history or physical examination at screening, as determined by the investigator

Data type

boolean

Alias
UMLS CUI [1]
C0205485
UMLS CUI [2]
C1658764
Structural brain abnormality affecting the entire brain (e.g., normal pressure hydrocephalus) or the striatum (e.g., local tumor or stroke)
Description

Structural brain abnormality affecting the entire brain (e.g., normal pressure hydrocephalus) or the striatum (e.g., local tumor or stroke)

Data type

boolean

Alias
UMLS CUI [1]
C0006111
Any clinically significant abnormal laboratory results obtained at screening and as determined by the investigator
Description

Any clinically significant abnormal laboratory results obtained at screening and as determined by the investigator

Data type

boolean

Alias
UMLS CUI [1]
C1254595
UMLS CUI [2]
C0205161
Any clinically significant abnormal electrocardiogram (ECG) results obtained at screening and as determined by the investigator
Description

Any clinically significant abnormal electrocardiogram (ECG) results obtained at screening and as determined by the investigator

Data type

boolean

Alias
UMLS CUI [1]
C2826714
UMLS CUI [2]
C0205161
Any history of drug, narcotic, or alcohol abuse within 2 years before the date of informed consent, as defined by the Diagnostic and Statistical Manual of the American Psychiatric Association, Fourth Edition, revised (DSM-IV-TR [American Psychiatric Association, 1994])
Description

Any history of drug, narcotic, or alcohol abuse within 2 years before the date of informed consent, as defined by the Diagnostic and Statistical Manual of the American Psychiatric Association, Fourth Edition, revised (DSM-IV-TR [American Psychiatric Association, 1994])

Data type

boolean

Alias
UMLS CUI [1]
C0013146
Positive urine drug screen for opiates, cocaine, or amphetamines at screening
Description

Positive urine drug screen for opiates, cocaine, or amphetamines at screening

Data type

boolean

Alias
UMLS CUI [1]
C0743300
Positive pregnancy test before imaging
Description

Positive pregnancy test before imaging

Data type

boolean

Alias
UMLS CUI [1]
C0240802
Participation in an investigational drug or device clinical trial within 30 days before the date of informed consent
Description

Participation in an investigational drug or device clinical trial within 30 days before the date of informed consent

Data type

boolean

Alias
UMLS CUI [1]
C0679823
UMLS CUI [2]
C0008976
Previous scan with any DAT imaging agent (e.g. [123I]NAV5001, Altropane, DaTscan, DOPASCAN)
Description

Previous scan with any DAT imaging agent (e.g. [123I]NAV5001, Altropane, DaTscan, DOPASCAN)

Data type

boolean

Alias
UMLS CUI [1]
C1512628
Any exposure to radiopharmaceuticals within 30 days before the date of informed consent
Description

Any exposure to radiopharmaceuticals within 30 days before the date of informed consent

Data type

boolean

Alias
UMLS CUI [1]
C0182638
Breast-feeding
Description

Breast-feeding

Data type

boolean

Alias
UMLS CUI [1]
C0006147
Inability to lie supine for 1 hour
Description

Inability to lie supine for 1 hour

Data type

boolean

Alias
UMLS CUI [1]
C0038846
Any thyroid disease other than adequately treated hypothyroidism
Description

Any thyroid disease other than adequately treated hypothyroidism

Data type

boolean

Alias
UMLS CUI [1]
C0040128
Known sensitivity or allergy to iodine or iodine containing products
Description

Known sensitivity or allergy to iodine or iodine containing products

Data type

boolean

Alias
UMLS CUI [1]
C0571818
UMLS CUI [2]
C0571817
Treatment within the 30 days before the date of imaging with amoxapine, amphetamine, benztropine, bupropion, buspirone, cocaine, mazindol, methamphetamine, methylphenidate, norephedrine, phentermine, phenylpropanolamine, selegiline, and sertraline, paroxetine, or citalopram.
Description

Treatment within the 30 days before the date of imaging with amoxapine, amphetamine, benztropine, bupropion, buspirone, cocaine, mazindol, methamphetamine, methylphenidate, norephedrine, phentermine, phenylpropanolamine, selegiline, and sertraline, paroxetine, or citalopram.

Data type

boolean

Alias
UMLS CUI [1]
C1323365
UMLS CUI [2]
C1254351
Back to the top of the page

Similar models

Eligibility Parkinson's Syndrome NCT01950468

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Inclusion Criteria
C1512693 (UMLS CUI-1)
informed consent
Item
Subject has provided written informed consent before the initiation of any study related procedures and continues to give willing consent for participation
boolean
C0021430 (UMLS CUI [1])
age
Item
Age ≥ 40 years
boolean
C0001779 (UMLS CUI [1])
EXTREMITY TREMOR, UPPER
Item
Have had upper extremity tremor for < 3 years duration, regardless of presumed diagnosis or etiology
boolean
C0239412 (UMLS CUI [1])
UPDRS score
Item
Have a UPDRS part III score upon entry of ≤ 16
boolean
C3827698 (UMLS CUI [1])
Item Group
Exclusion Criteria
C0680251 (UMLS CUI-1)
physical;psychological disease
Item
Any clinically significant or unstable physical or psychological illness based on medical history or physical examination at screening, as determined by the investigator
boolean
C0205485 (UMLS CUI [1])
C1658764 (UMLS CUI [2])
Brain Diseases
Item
Structural brain abnormality affecting the entire brain (e.g., normal pressure hydrocephalus) or the striatum (e.g., local tumor or stroke)
boolean
C0006111 (UMLS CUI [1])
laboratory results;Abnormal
Item
Any clinically significant abnormal laboratory results obtained at screening and as determined by the investigator
boolean
C1254595 (UMLS CUI [1])
C0205161 (UMLS CUI [2])
electrocardiogram results; abnormal
Item
Any clinically significant abnormal electrocardiogram (ECG) results obtained at screening and as determined by the investigator
boolean
C2826714 (UMLS CUI [1])
C0205161 (UMLS CUI [2])
drug abuse
Item
Any history of drug, narcotic, or alcohol abuse within 2 years before the date of informed consent, as defined by the Diagnostic and Statistical Manual of the American Psychiatric Association, Fourth Edition, revised (DSM-IV-TR [American Psychiatric Association, 1994])
boolean
C0013146 (UMLS CUI [1])
Urine drug screen positive
Item
Positive urine drug screen for opiates, cocaine, or amphetamines at screening
boolean
C0743300 (UMLS CUI [1])
positive pregnancy test
Item
Positive pregnancy test before imaging
boolean
C0240802 (UMLS CUI [1])
Participation; Clinical Trials
Item
Participation in an investigational drug or device clinical trial within 30 days before the date of informed consent
boolean
C0679823 (UMLS CUI [1])
C0008976 (UMLS CUI [2])
Imaging Agent
Item
Previous scan with any DAT imaging agent (e.g. [123I]NAV5001, Altropane, DaTscan, DOPASCAN)
boolean
C1512628 (UMLS CUI [1])
radiopharmaceuticals
Item
Any exposure to radiopharmaceuticals within 30 days before the date of informed consent
boolean
C0182638 (UMLS CUI [1])
Breast-feeding
Item
Breast-feeding
boolean
C0006147 (UMLS CUI [1])
Supine Position
Item
Inability to lie supine for 1 hour
boolean
C0038846 (UMLS CUI [1])
thyroid disease;
Item
Any thyroid disease other than adequately treated hypothyroidism
boolean
C0040128 (UMLS CUI [1])
Iodine allergy; Iodine compounds allergy
Item
Known sensitivity or allergy to iodine or iodine containing products
boolean
C0571818 (UMLS CUI [1])
C0571817 (UMLS CUI [2])
dopamine receptor binding;Pharmacologic Substance
Item
Treatment within the 30 days before the date of imaging with amoxapine, amphetamine, benztropine, bupropion, buspirone, cocaine, mazindol, methamphetamine, methylphenidate, norephedrine, phentermine, phenylpropanolamine, selegiline, and sertraline, paroxetine, or citalopram.
boolean
C1323365 (UMLS CUI [1])
C1254351 (UMLS CUI [2])
Back to the top of the page 

Contact

Please use this form for feedback, questions and suggestions for improvements.

Fields marked with * are required.

Help

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial