ID
13049
Beschreibung
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
Stichworte
Versionen (2)
- 12.01.16 12.01.16 -
- 13.01.16 13.01.16 -
Hochgeladen am
13. Januar 2016
DOI
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Lizenz
Creative Commons BY-NC 3.0
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Moxaverine 200mg p.o. in patients with central nervous vertigo 2
Case report form Visit 2
- StudyEvent: ODM
Beschreibung
otorhinolaryngologic examination
Beschreibung
Otoscopy
Datentyp
text
Alias
- UMLS CUI [1]
- C0419361
Beschreibung
Rinne test
Datentyp
text
Alias
- UMLS CUI [1]
- C0278245
Beschreibung
Webers test
Datentyp
text
Alias
- UMLS CUI [1]
- C0278247
Beschreibung
Nystagmus testing with frenzel lens eyeglasses
Datentyp
text
Alias
- UMLS CUI [1]
- C0028738
Beschreibung
Nystagmus testing with frenzel lens eyeglasses
Datentyp
text
Alias
- UMLS CUI [1]
- C0028738
Beschreibung
Nystagmus testing with frenzel lens eyeglasses
Datentyp
text
Alias
- UMLS CUI [1]
- C0028738
Beschreibung
Nystagmus testing with frenzel lens eyeglasses
Datentyp
text
Alias
- UMLS CUI [1]
- C0012833
Beschreibung
Otoscopy
Datentyp
text
Alias
- UMLS CUI [1]
- C0419361
Beschreibung
Rinne test
Datentyp
text
Alias
- UMLS CUI [1]
- C0278245
Beschreibung
Webers test
Datentyp
text
Alias
- UMLS CUI [1]
- C0278247
Beschreibung
Posturography
Beschreibung
Computerized dynamic posturography procedure
Datentyp
text
Alias
- UMLS CUI [1]
- C0519978
Beschreibung
Computerized dynamic posturography procedure report has to be enclosed
Datentyp
text
Alias
- UMLS CUI [1]
- C0519978
Beschreibung
Tasks of investigator during this visit
Beschreibung
Questionnaire
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0034394
Beschreibung
Trial medication
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0013227
Beschreibung
Trial medication
Datentyp
integer
Alias
- UMLS CUI [1]
- C0013227
Beschreibung
Trial medication
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0013227
Beschreibung
Patient questions
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0547398
Beschreibung
Patient questions
Datentyp
text
Alias
- UMLS CUI [1]
- C0547398
Beschreibung
Date
Datentyp
date
Alias
- UMLS CUI [1]
- C0011008
Beschreibung
Signature
Datentyp
text
Alias
- UMLS CUI [1]
- C1519316
Beschreibung
Comorbidities and concomitant Medication
Beschreibung
Comorbidities
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0009488
Beschreibung
Comorbidities
Datentyp
text
Alias
- UMLS CUI [1]
- C0009488
Beschreibung
prohibited medication: -aminoglycoside antibiotics -vasoactive agents -stimulants to the central nervous system -tranquilizer -agents aiming at cell metabolism -antihistamines -Antiplatelet Agents -anticoagulants
Datentyp
boolean
Alias
- UMLS CUI [1]
- C2347852
Beschreibung
Concomitant Agent
Datentyp
text
Alias
- UMLS CUI [1]
- C2347852
Beschreibung
additional comments
Datentyp
text
Alias
- UMLS CUI [1]
- C1830770
Beschreibung
General impression regarding the trial
Beschreibung
Tolerance
Datentyp
text
Alias
- UMLS CUI [1]
- C0556444
Beschreibung
Therapeutic effectiveness
Datentyp
text
Alias
- UMLS CUI [1]
- C0087113
Beschreibung
Date
Datentyp
date
Alias
- UMLS CUI [1]
- C0011008
Beschreibung
Signature
Datentyp
text
Alias
- UMLS CUI [1]
- C1519316
Beschreibung
Adverse reactions
Beschreibung
If yes, please give further detailed information below
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0559546
Beschreibung
Adverse event
Datentyp
text
Alias
- UMLS CUI [1]
- C0877248
Beschreibung
In case of severe or life-threatening AE, please notify URSAPHARM GmbH (ASAP< 24h) and fill in the enclosed pharmacovigilance form. Phone 06805-9292130, Fax 06805-929288
Datentyp
text
Alias
- UMLS CUI [1]
- C1710066
Beschreibung
If patient has been discontinued from trial,please enclose final report.
Datentyp
text
Alias
- UMLS CUI [1]
- C0087111
Beschreibung
Development
Datentyp
text
Alias
- UMLS CUI [1]
- C0243107
Beschreibung
Drug association
Datentyp
text
Alias
- UMLS CUI [1]
- C0544075
Beschreibung
additional comments
Datentyp
text
Alias
- UMLS CUI [1]
- C1830770
Beschreibung
Date
Datentyp
date
Alias
- UMLS CUI [1]
- C0011008
Beschreibung
Signature
Datentyp
text
Alias
- UMLS CUI [1]
- C1519316
Ähnliche Modelle
Case report form Visit 2
- StudyEvent: ODM