0 Valutazioni
ID

13669

Descrizione

Coronary Artery Bypass graft surgery in patients with Asymptomatic Carotid Stenosis. A randomized controlled clinical trial. Short title: "CABACS" DRKS Number:DRKS00000521 IRSCTN Number:ISRCTN13486906 Phase:Therapeutic confirmatory(Phase III) Head of clinical trial: Prof. Dr. med. Christian Weimar University Duisburg-Essen Phone: 0201/723-6503 Fax: 0201/723-6948 e-mail: christian.weimar@uk-essen.de University Hospital Essen Hospital for Neurology Hufelandstr. 55 45122 Essen Trial coordinator: Dr. med. Stephan Knipp Phone: 0201/723-4915 Fax: 0201/723-5451 e-mail: stephan.knipp@uk-essen.de University Duisburg-Essen University Hospital Essen Hospital for thoracic- and cardiovascular surgery Hufelandstr. 55 45122 Essen Data Management: Anja Marr Phone: 0201/92239-257 Fax: 0201/92239-333 o. 0201/723-5933 e-mail: anja.marr@uk-essen.de University Hospital Essen Center for clinical trials Essen c/o IMIBE Hufelandstr. 55 45122 Essen Monitoring: Dipl.-Biol. Konstantinos Bilbilis Phone: 0201/92239-252 Fax: 0201/92239-310 e-mail: konstantinos.bilbilis@uk-essen.de University Hospital Essen Center for clinical trials Essen c/o IMIBE Hufelandstr. 55 45122 Essen

Keywords

versioni (1)
  1. 26/02/16 26/02/16 -
Caricato su

26 febbraio 2016

DOI

Per favore, per richiedere un accesso.

Licenza

Creative Commons BY-NC 3.0
Commenti del modello :

Puoi commentare il modello dati qui. Tramite i fumetti nei gruppi di articoli e articoli è possibile aggiungere commenti a quelli in modo specifico.

Torna ai commenti del modello
Commenti del gruppo di articoli per :

Commenti dell'articolo per :

  • i più nuovi
  • i più vecchi
  • Popolare
  • i più nuovi
    • i più nuovi
    • i più vecchi
    • Popolare

    Non ci sono commenti

    Per scaricare i modelli di dati devi essere registrato. Per favore accesso o registrati GRATIS.

    Patient randomization form Coronary Artery Bypass graft surgery in patients with Asymptomatic Carotid Stenosis DRKS00000521

    Inglese

    CABACS Case Report Form [Patient randomization form]

    1 moduli  
    Patient randomization form
    Descrizione

    Patient randomization form

    Patient ID
    Descrizione

    Patient Study ID

    Tipo di dati

    text

    Alias
    UMLS CUI [1]
    C2348585 (Clinical Trial Subject Unique Identifier)
    Are all inclusion criteria met?
    Descrizione

    Verification of eligibility criteria

    Tipo di dati

    boolean

    Alias
    UMLS CUI [1,1]
    C1516637 (Clinical Trial Eligibility Criteria)
    UMLS CUI [1,2]
    C1711411 (Verification)
    Have any exclusion criteria been answered with yes?
    Descrizione

    Verification of eligibility criteria

    Tipo di dati

    boolean

    Alias
    UMLS CUI [1,1]
    C1516637 (Clinical Trial Eligibility Criteria)
    UMLS CUI [1,2]
    C1711411 (Verification)
    Informed consent signed
    Descrizione

    Informed consent

    Tipo di dati

    boolean

    Alias
    UMLS CUI [1]
    C0021430 (Informed Consent)
    Date of informed consent
    Descrizione

    Date of informed consent

    Tipo di dati

    date

    Alias
    UMLS CUI [1,1]
    C0011008 (Date in time)
    SNOMED
    410671006
    UMLS CUI [1,2]
    C0021430 (Informed Consent)
    Study site number
    Descrizione

    Study site

    Tipo di dati

    integer

    Alias
    UMLS CUI [1]
    C2825164 (Study Site)
    Age
    Descrizione

    Age

    Tipo di dati

    text

    Alias
    UMLS CUI [1]
    C0001779 (Age)
    SNOMED
    424144002
    LOINC
    LP28815-6
    Gender
    Descrizione

    Gender

    Tipo di dati

    integer

    Alias
    UMLS CUI [1]
    C0079399 (Gender)
    SNOMED
    263495000
    LOINC
    LP61312-2
    Modified rankin scale score
    Descrizione

    Modified rankin scale

    Tipo di dati

    text

    Alias
    UMLS CUI [1]
    C2984908 (Modified Rankin Scale)
    SNOMED
    840352000
    Please enter a phone number for further questions that might occur
    Descrizione

    Phone contact

    Tipo di dati

    integer

    Alias
    UMLS CUI [1]
    C3476398 (Primary contact phone number)
    LOINC
    MTHU061006
    Please enter a valid fax number
    Descrizione

    Fax number

    Tipo di dati

    integer

    Alias
    UMLS CUI [1]
    C1549619 (Fax Number)
    Date of Randomization
    Descrizione

    Date of Randomization

    Tipo di dati

    date

    Alias
    UMLS CUI [1,1]
    C0034656 (Randomization)
    UMLS CUI [1,2]
    C0011008 (Date in time)
    SNOMED
    410671006
    Signature by investigator
    Descrizione

    Signature

    Tipo di dati

    text

    Alias
    UMLS CUI [1]
    C1519316 (Signature)
    LOINC
    LP248948-4
    Name of Investigator
    Descrizione

    Name of Investigator

    Tipo di dati

    text

    Alias
    UMLS CUI [1]
    C0008961 (Clinical Investigators)
    Patient has been randomized into following group
    Descrizione

    Please send this form via FAX 049-201-92239-310 or 049-201-723-5933. Office time from 9AM until 4PM. You will receive the result of randomization within three hours if form is sent before 4PM. Otherwise the next morning. Shouldn´t you receive an answer after 3 hours, please give us a call. Anja Marr,Center for clinical trials in Essen, c/o Institute for medical informatics,biometrics and epidemiology, University Hospital Essen, Hufelandstraße 55, 45122 Essen,Germany

    Tipo di dati

    text

    Alias
    UMLS CUI [1]
    C0034656 (Randomization)
    Date of Randomization
    Descrizione

    Date of Randomization

    Tipo di dati

    date

    Alias
    UMLS CUI [1,1]
    C0034656 (Randomization)
    UMLS CUI [1,2]
    C0011008 (Date in time)
    SNOMED
    410671006
    Signature by randomizing Person
    Descrizione

    Signature

    Tipo di dati

    text

    Alias
    UMLS CUI [1]
    C1519316 (Signature)
    LOINC
    LP248948-4
    Name of randomizing person
    Descrizione

    Name

    Tipo di dati

    text

    Alias
    UMLS CUI [1]
    C0027365 (Name)
    SNOMED
    703503000
    LOINC
    LP72974-6
    Ritorna all'inizio della pagina

    Similar models

    CABACS Case Report Form [Patient randomization form]

    1 moduli
    Name
    genere
    Description | Question | Decode (Coded Value)
    Tipo di dati
    Alias
    Item Group
    Patient randomization form
    Patient Study ID
    Item
    Patient ID
    text
    C2348585 (UMLS CUI [1])
    Verification of eligibility criteria
    Item
    Are all inclusion criteria met?
    boolean
    C1516637 (UMLS CUI [1,1])
    C1711411 (UMLS CUI [1,2])
    Verification of eligibility criteria
    Item
    Have any exclusion criteria been answered with yes?
    boolean
    C1516637 (UMLS CUI [1,1])
    C1711411 (UMLS CUI [1,2])
    Informed consent
    Item
    Informed consent signed
    boolean
    C0021430 (UMLS CUI [1])
    Date of informed consent
    Item
    Date of informed consent
    date
    C0011008 (UMLS CUI [1,1])
    C0021430 (UMLS CUI [1,2])
    Study site
    Item
    Study site number
    integer
    C2825164 (UMLS CUI [1])
    Item
    Age
    text
    C0001779 (UMLS CUI [1])
    Age
    Code List
    Age
    CL Item
    <60years (1)
    CL Item
    ≥ 60 Jahre (2)
    Item
    Gender
    integer
    C0079399 (UMLS CUI [1])
    Gender
    Code List
    Gender
    CL Item
    male (1)
    CL Item
    female (2)
    Item
    Modified rankin scale score
    text
    C2984908 (UMLS CUI [1])
    Modified rankin scale
    Code List
    Modified rankin scale score
    CL Item
    0-1 (1)
    CL Item
    2-3 (2)
    Phone contact
    Item
    Please enter a phone number for further questions that might occur
    integer
    C3476398 (UMLS CUI [1])
    Fax number
    Item
    Please enter a valid fax number
    integer
    C1549619 (UMLS CUI [1])
    Date of Randomization
    Item
    Date of Randomization
    date
    C0034656 (UMLS CUI [1,1])
    C0011008 (UMLS CUI [1,2])
    Signature
    Item
    Signature by investigator
    text
    C1519316 (UMLS CUI [1])
    Name of Investigator
    Item
    Name of Investigator
    text
    C0008961 (UMLS CUI [1])
    Item
    Patient has been randomized into following group
    text
    C0034656 (UMLS CUI [1])
    Randomization
    Code List
    Patient has been randomized into following group
    CL Item
    CABG with CEA (1)
    CL Item
    CABG without CEA (2)
    Date of Randomization
    Item
    Date of Randomization
    date
    C0034656 (UMLS CUI [1,1])
    C0011008 (UMLS CUI [1,2])
    Signature
    Item
    Signature by randomizing Person
    text
    C1519316 (UMLS CUI [1])
    Name
    Item
    Name of randomizing person
    text
    C0027365 (UMLS CUI [1])
    Ritorna all'inizio della pagina 

    Aiuto

    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