ID
13225
Description
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
Mots-clés
Versions (3)
- 11/01/2016 11/01/2016 -
- 13/01/2016 13/01/2016 -
- 25/01/2016 25/01/2016 - Julian Varghese
Téléchargé le
25 janvier 2016
DOI
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Licence
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
Description
neurological preliminary assessment
Description
If any one of the following is answered with yes, the patient may not be included.
Type de données
text
Alias
- UMLS CUI [1]
- C0027765
Description
otorhinolaryngologic preliminary assessment
Description
Eligibility
Description
central nervous vertigo
Type de données
boolean
Alias
- UMLS CUI [1]
- C0155503
Description
Inclusion
Type de données
boolean
Alias
- UMLS CUI [1]
- C1512693
Description
date
Type de données
date
Alias
- UMLS CUI [1]
- C0011008
Description
Signature
Type de données
text
Alias
- UMLS CUI [1]
- C1550483
Description
Inclusion criteria
Description
central nervous vertigo
Type de données
boolean
Description
Patient age and gender
Type de données
boolean
Alias
- UMLS CUI [1]
- C0150831
- UMLS CUI [2]
- C0001779
Description
Informed consent
Type de données
boolean
Alias
- UMLS CUI [1]
- C0021430
Description
Compliance behavior
Type de données
boolean
Alias
- UMLS CUI [1]
- C1321605
Description
Exclusion criteria
Description
Inclusion criteria
Type de données
boolean
Alias
- UMLS CUI [1]
- C1512693
Description
Concomitant agent
Type de données
boolean
Alias
- UMLS CUI [1]
- C2347852
Description
Compliance behavior
Type de données
boolean
Alias
- UMLS CUI [1,1]
- C1321605
- UMLS CUI [1,2]
- C0439801
- UMLS CUI [1,3]
- C0009488
Description
Hypersensitivity
Type de données
boolean
Alias
- UMLS CUI [1,1]
- C0020517
- UMLS CUI [1,2]
- C0129044
Description
vestibular or cerebellar vertigo
Type de données
boolean
Alias
- UMLS CUI [1]
- C0151222
- UMLS CUI [2]
- C0234756
Description
asymmetric hearing impairment
Type de données
boolean
Alias
- UMLS CUI [1]
- C1997086
Description
vestibular evaluation with caloric testing
Type de données
boolean
Alias
- UMLS CUI [1]
- C2189441
Description
Comorbidity
Type de données
boolean
Alias
- UMLS CUI [1]
- C0009488
Description
Patient medical history
Type de données
boolean
Alias
- UMLS CUI [1]
- C0262926
Description
Comorbidity
Type de données
boolean
Alias
- UMLS CUI [1]
- C0009488
Description
Compliance behavior
Type de données
boolean
Alias
- UMLS CUI [1]
- C1321605
Description
Study Subject Participation Status
Type de données
boolean
Alias
- UMLS CUI [1]
- C2348568
Description
pregnancy or breastfeeding, contraceptive methods
Type de données
boolean
Alias
- UMLS CUI [1]
- C0700589
- UMLS CUI [2]
- C0032961
- UMLS CUI [3]
- C0006147
Description
Substance use disorder
Type de données
boolean
Alias
- UMLS CUI [1]
- C0038586
Description
Informed consent
Type de données
boolean
Alias
- UMLS CUI [1,1]
- C0021430
- UMLS CUI [1,2]
- C0439801
- UMLS CUI [1,3]
- C0009488
Description
Date
Type de données
date
Alias
- UMLS CUI [1]
- C0011008
Description
Signature
Type de données
text
Alias
- UMLS CUI [1]
- C1550483
Description
otorhinolaryngologic examination
Description
Otoscopy
Type de données
text
Alias
- UMLS CUI [1]
- C0419361
Description
Otoscopy
Type de données
text
Alias
- UMLS CUI [1]
- C0419361
Description
Rinne test
Type de données
text
Alias
- UMLS CUI [1]
- C0278245
Description
Rinne test
Type de données
text
Alias
- UMLS CUI [1]
- C0278245
Description
Webers test
Type de données
text
Alias
- UMLS CUI [1]
- C0278247
Description
Webers test
Type de données
text
Alias
- UMLS CUI [1]
- C0278247
Description
Nystagmus testing with frenzel-lens eyeglasses
Type de données
boolean
Alias
- UMLS CUI [1]
- C2721529
Description
Nystagmus testing with frenzel-lens eyeglasses
Type de données
text
Alias
- UMLS CUI [1]
- C0339666
Description
Nystagmus testing with frenzel-lens eyeglasses
Type de données
text
Alias
- UMLS CUI [1,1]
- C0028738
- UMLS CUI [1,2]
- C2346753
Description
Nystagmus testing with frenzel-lens eyeglasses
Type de données
text
Alias
- UMLS CUI [1,1]
- C0028738
- UMLS CUI [1,2]
- C0439603
Description
Nystagmus testing with frenzel-lens eyeglasses
Type de données
text
Alias
- UMLS CUI [1]
- C0012833
Description
Posturography
Description
Computerized dynamic posturography procedure
Type de données
boolean
Alias
- UMLS CUI [1]
- C0519978
Description
Computerized dynamic posturography procedure report has to be enclosed
Type de données
text
Alias
- UMLS CUI [1]
- C0519978
Description
Tasks of investigator during this visit
Description
Questionnaire
Type de données
boolean
Alias
- UMLS CUI [1]
- C0034394
Description
Patient identification card
Type de données
boolean
Alias
- UMLS CUI [1]
- C0030692
Description
Medication dispensed
Type de données
boolean
Alias
- UMLS CUI [1]
- C0947323
Description
Patient questions
Type de données
boolean
Alias
- UMLS CUI [1]
- C0547398
Description
Date
Type de données
date
Alias
- UMLS CUI [1]
- C0011008
Description
Signature
Type de données
text
Alias
- UMLS CUI [1]
- C1519316
Description
Comorbidities and concomitant Medication
Description
Comorbidities
Type de données
boolean
Alias
- UMLS CUI [1]
- C0009488
Description
Comorbidities
Type de données
text
Alias
- UMLS CUI [1]
- C0009488
Description
prohibited medication: -aminoglycoside antibiotics -vasoactive agents -stimulants to the central nervous system -tranquilizer -agents aiming at cell metabolism -antihistamines -Antiplatelet Agents -anticoagulants
Type de données
boolean
Alias
- UMLS CUI [1]
- C2347852
Description
Concomitant Agent
Type de données
text
Alias
- UMLS CUI [1]
- C2347852
Description
additional comments
Type de données
text
Alias
- UMLS CUI [1]
- C1830770
Description
Date
Type de données
date
Alias
- UMLS CUI [1]
- C0011008
Description
Signature
Type de données
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])
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