ID
13225
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 (3)
- 11.01.16 11.01.16 -
- 13.01.16 13.01.16 -
- 25.01.16 25.01.16 - Julian Varghese
Hochgeladen am
25. 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
Case report form Visit 1
- StudyEvent: ODM
Beschreibung
neurological preliminary assessment
Beschreibung
If any one of the following is answered with yes, the patient may not be included.
Datentyp
text
Alias
- UMLS CUI [1]
- C0027765
Beschreibung
otorhinolaryngologic preliminary assessment
Beschreibung
Eligibility
Beschreibung
central nervous vertigo
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0155503
Beschreibung
Inclusion
Datentyp
boolean
Alias
- UMLS CUI [1]
- C1512693
Beschreibung
date
Datentyp
date
Alias
- UMLS CUI [1]
- C0011008
Beschreibung
Signature
Datentyp
text
Alias
- UMLS CUI [1]
- C1550483
Beschreibung
Inclusion criteria
Beschreibung
central nervous vertigo
Datentyp
boolean
Beschreibung
Patient age and gender
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0150831
- UMLS CUI [2]
- C0001779
Beschreibung
Informed consent
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0021430
Beschreibung
Compliance behavior
Datentyp
boolean
Alias
- UMLS CUI [1]
- C1321605
Beschreibung
Exclusion criteria
Beschreibung
Inclusion criteria
Datentyp
boolean
Alias
- UMLS CUI [1]
- C1512693
Beschreibung
Concomitant agent
Datentyp
boolean
Alias
- UMLS CUI [1]
- C2347852
Beschreibung
Compliance behavior
Datentyp
boolean
Alias
- UMLS CUI [1,1]
- C1321605
- UMLS CUI [1,2]
- C0439801
- UMLS CUI [1,3]
- C0009488
Beschreibung
Hypersensitivity
Datentyp
boolean
Alias
- UMLS CUI [1,1]
- C0020517
- UMLS CUI [1,2]
- C0129044
Beschreibung
vestibular or cerebellar vertigo
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0151222
- UMLS CUI [2]
- C0234756
Beschreibung
asymmetric hearing impairment
Datentyp
boolean
Alias
- UMLS CUI [1]
- C1997086
Beschreibung
vestibular evaluation with caloric testing
Datentyp
boolean
Alias
- UMLS CUI [1]
- C2189441
Beschreibung
Comorbidity
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0009488
Beschreibung
Patient medical history
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0262926
Beschreibung
Comorbidity
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0009488
Beschreibung
Compliance behavior
Datentyp
boolean
Alias
- UMLS CUI [1]
- C1321605
Beschreibung
Study Subject Participation Status
Datentyp
boolean
Alias
- UMLS CUI [1]
- C2348568
Beschreibung
pregnancy or breastfeeding, contraceptive methods
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0700589
- UMLS CUI [2]
- C0032961
- UMLS CUI [3]
- C0006147
Beschreibung
Substance use disorder
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0038586
Beschreibung
Informed consent
Datentyp
boolean
Alias
- UMLS CUI [1,1]
- C0021430
- UMLS CUI [1,2]
- C0439801
- UMLS CUI [1,3]
- C0009488
Beschreibung
Date
Datentyp
date
Alias
- UMLS CUI [1]
- C0011008
Beschreibung
Signature
Datentyp
text
Alias
- UMLS CUI [1]
- C1550483
Beschreibung
otorhinolaryngologic examination
Beschreibung
Otoscopy
Datentyp
text
Alias
- UMLS CUI [1]
- C0419361
Beschreibung
Otoscopy
Datentyp
text
Alias
- UMLS CUI [1]
- C0419361
Beschreibung
Rinne test
Datentyp
text
Alias
- UMLS CUI [1]
- C0278245
Beschreibung
Rinne test
Datentyp
text
Alias
- UMLS CUI [1]
- C0278245
Beschreibung
Webers test
Datentyp
text
Alias
- UMLS CUI [1]
- C0278247
Beschreibung
Webers test
Datentyp
text
Alias
- UMLS CUI [1]
- C0278247
Beschreibung
Nystagmus testing with frenzel-lens eyeglasses
Datentyp
boolean
Alias
- UMLS CUI [1]
- C2721529
Beschreibung
Nystagmus testing with frenzel-lens eyeglasses
Datentyp
text
Alias
- UMLS CUI [1]
- C0339666
Beschreibung
Nystagmus testing with frenzel-lens eyeglasses
Datentyp
text
Alias
- UMLS CUI [1,1]
- C0028738
- UMLS CUI [1,2]
- C2346753
Beschreibung
Nystagmus testing with frenzel-lens eyeglasses
Datentyp
text
Alias
- UMLS CUI [1,1]
- C0028738
- UMLS CUI [1,2]
- C0439603
Beschreibung
Nystagmus testing with frenzel-lens eyeglasses
Datentyp
text
Alias
- UMLS CUI [1]
- C0012833
Beschreibung
Posturography
Beschreibung
Computerized dynamic posturography procedure
Datentyp
boolean
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
Patient identification card
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0030692
Beschreibung
Medication dispensed
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0947323
Beschreibung
Patient questions
Datentyp
boolean
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
Date
Datentyp
date
Alias
- UMLS CUI [1]
- C0011008
Beschreibung
Signature
Datentyp
text
Alias
- UMLS CUI [1]
- C1519316
Ähnliche Modelle
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])
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