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