ID

13692

Beskrivning

Treatment Resistant Depression (Pilot); ODM derived from: https://clinicaltrials.gov/show/NCT01179009

Länk

https://clinicaltrials.gov/show/NCT01179009

Nyckelord

Versioner (1)
  1. 2016-02-28 2016-02-28 -
Uppladdad den

28 februari 2016

DOI

För en begäran logga in.

Licens

Creative Commons BY 4.0
Modellkommentarer :

Här kan du kommentera modellen. Med hjälp av pratbubblor i Item-grupperna och Item kan du lägga in specifika kommentarer.

Tillbaka till modellkommentarer
Itemgroup-kommentar för :

Item-kommentar för :

Du måste vara inloggad för att kunna ladda ner formulär. Var vänlig logga in eller registrera dig utan kostnad.

Eligibility Depressive Disorder, Treatment-Resistant NCT01179009

Engelsk

Eligibility Depressive Disorder, Treatment-Resistant NCT01179009

1 Formulär  
Inclusion Criteria
Beskrivning

Inclusion Criteria

Alias
UMLS CUI
C1512693
1. males and females aged 18-65 years;
Beskrivning

gender; age

Datatyp

boolean

Alias
UMLS CUI [1]
C0079399
UMLS CUI [2]
C0001779
2. diagnostic and statistical manual (dsm) iv diagnosis of major depressive disorder, recurrent, severe;
Beskrivning

dsm iv; major depressive disorder

Datatyp

boolean

Alias
UMLS CUI [1]
C0220952
UMLS CUI [2]
C1269683
3. depression must be considered treatment refractory as defined by montgomery asberg depression rating scale (madrs) score of 22 or above which is consistent with other studies;
Beskrivning

depression therapy refractory

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0011581
UMLS CUI [1,2]
C1846625
4. on a stable dose of permitted antidepressant medication or no medication pre-infusion;
Beskrivning

antidepressant agents

Datatyp

boolean

Alias
UMLS CUI [1]
C0003289
5. not currently psychotic and no history of psychosis within the previous 12 months; psychosis reported in the distant past may not be exclusionary if brief, per pi's judgment;
Beskrivning

medical history Psychotic Disorders

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0262926
UMLS CUI [1,2]
C0033975
6. no history of significant clinical or intolerable side effects or complications from clonidine;
Beskrivning

hypersensitivity clonidine

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0020517
UMLS CUI [1,2]
C0009014
7. if a female of child-bearing potential: not pregnant or breast feeding and agrees to use birth control during the time of pre-dosing and infusions; and
Beskrivning

Contraception status

Datatyp

boolean

Alias
UMLS CUI [1]
C0420837
8. able to give informed consent.
Beskrivning

informed consent

Datatyp

boolean

Alias
UMLS CUI [1]
C0021430
Exclusion Criteria
Beskrivning

Exclusion Criteria

Alias
UMLS CUI
C0680251
1. confirmed bipolar disorder, schizophrenia, or schizoaffective disorder;
Beskrivning

bipolar disorder; schizophrenia

Datatyp

boolean

Alias
UMLS CUI [1]
C0005586
UMLS CUI [2]
C0036341
2. current or recent substance abuse/dependence (or any lifetime recreational ketamine or pcp use);
Beskrivning

substance abuse disorder

Datatyp

boolean

Alias
UMLS CUI [1]
C1537075
3. any severe axis ii personality disorder or schizophrenia spectrum disorder that, in the pi's judgment, could confound diagnosis or adherence to treatment;
Beskrivning

axis ii disorder; personality disorder; Schizophrenia

Datatyp

boolean

Alias
UMLS CUI [1]
C0741358
UMLS CUI [2]
C0031212
UMLS CUI [3]
C0036341
4. the presence of any abnormal laboratory findings or serious medical disorder or condition that may, in the judgment of the pi, confound the assessment of relevant biologic measures or diagnoses including: clinically significant organ system dysfunction; significant and uncontrolled endocrine disease, including diabetes mellitus; hypothyroidism; cardiovascular disease; coagulopathy; significant anemia; significant acute infection; glaucoma; dehydration; epilepsy; any diagnosed cardiac condition causing documented hemodynamic compromise or dysfunction of the sa or av node; any diagnosed respiratory condition causing documented or clinically recognized hypoxia (e.g., chronic obstructive or restrictive pulmonary disease); after evaluation, anyone determined to have a potentially compromised airway that could be difficult to intubate; fever; bmi less than 14.5; or any medical condition known to interfere with cognitive performance; medication-related exclusions include memantine, or any medication that could be considered contraindicated ketamine;
Beskrivning

Compliance behavior Limited Comorbidity

Datatyp

boolean

Alias
UMLS CUI [1,1]
C1321605
UMLS CUI [1,2]
C0439801
UMLS CUI [1,3]
C0009488
5. current treatment with any medication contraindicated with ketamine or clonidine;
Beskrivning

concomitant medication

Datatyp

boolean

Alias
UMLS CUI [1]
C2347852
6. lifetime illegal use of pcp or ketamine; no clinical use of ketamine for past 3 months
Beskrivning

Ketamine abuse

Datatyp

boolean

Alias
UMLS CUI [1]
C3824685
7. meets dsm-iv criteria for mental retardation;
Beskrivning

dsm-iv mental retardation

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0220952
UMLS CUI [1,2]
C0025362
8. currently hospitalized;
Beskrivning

hospitalization

Datatyp

boolean

Alias
UMLS CUI [1]
C0019993
9. acutely suicidal or homicidal (i.e., in imminent danger with plan, urges and intent to harm oneself or others) including any prior serious attempts (e.g., those requiring hospitalization) at the pi's discretion;
Beskrivning

suicidal; homicidal

Datatyp

boolean

Alias
UMLS CUI [1]
C0438696
UMLS CUI [2]
C0745031
10. is pregnant or breast-feeding; unwilling to use birth control if female of child bearing potential
Beskrivning

pregnancy; lactating

Datatyp

boolean

Alias
UMLS CUI [1]
C0032961
UMLS CUI [2]
C0006147
11. unable to provide informed consent.
Beskrivning

informed consent

Datatyp

boolean

Alias
UMLS CUI [1]
C0021430
12. for participants in the neuroimaging subset: history of claustrophobia, serious head injuries, seizures disorder, developmental delays, pacemaker, metal implants, permanent metal piercings or anything else that would preclude having an mri.
Beskrivning

neuroimaging; mri; claustrophobia

Datatyp

boolean

Alias
UMLS CUI [1]
C0679575
UMLS CUI [2]
C0024485
UMLS CUI [3]
C0008909
Tillbaka till toppen

Similar models

Eligibility Depressive Disorder, Treatment-Resistant NCT01179009

1 Formulär
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
C1512693 (UMLS CUI)
gender; age
Item
1. males and females aged 18-65 years;
boolean
C0079399 (UMLS CUI [1])
C0001779 (UMLS CUI [2])
dsm iv; major depressive disorder
Item
2. diagnostic and statistical manual (dsm) iv diagnosis of major depressive disorder, recurrent, severe;
boolean
C0220952 (UMLS CUI [1])
C1269683 (UMLS CUI [2])
depression therapy refractory
Item
3. depression must be considered treatment refractory as defined by montgomery asberg depression rating scale (madrs) score of 22 or above which is consistent with other studies;
boolean
C0011581 (UMLS CUI [1,1])
C1846625 (UMLS CUI [1,2])
antidepressant agents
Item
4. on a stable dose of permitted antidepressant medication or no medication pre-infusion;
boolean
C0003289 (UMLS CUI [1])
medical history Psychotic Disorders
Item
5. not currently psychotic and no history of psychosis within the previous 12 months; psychosis reported in the distant past may not be exclusionary if brief, per pi's judgment;
boolean
C0262926 (UMLS CUI [1,1])
C0033975 (UMLS CUI [1,2])
hypersensitivity clonidine
Item
6. no history of significant clinical or intolerable side effects or complications from clonidine;
boolean
C0020517 (UMLS CUI [1,1])
C0009014 (UMLS CUI [1,2])
Contraception status
Item
7. if a female of child-bearing potential: not pregnant or breast feeding and agrees to use birth control during the time of pre-dosing and infusions; and
boolean
C0420837 (UMLS CUI [1])
informed consent
Item
8. able to give informed consent.
boolean
C0021430 (UMLS CUI [1])
Item Group
C0680251 (UMLS CUI)
bipolar disorder; schizophrenia
Item
1. confirmed bipolar disorder, schizophrenia, or schizoaffective disorder;
boolean
C0005586 (UMLS CUI [1])
C0036341 (UMLS CUI [2])
substance abuse disorder
Item
2. current or recent substance abuse/dependence (or any lifetime recreational ketamine or pcp use);
boolean
C1537075 (UMLS CUI [1])
axis ii disorder; personality disorder; Schizophrenia
Item
3. any severe axis ii personality disorder or schizophrenia spectrum disorder that, in the pi's judgment, could confound diagnosis or adherence to treatment;
boolean
C0741358 (UMLS CUI [1])
C0031212 (UMLS CUI [2])
C0036341 (UMLS CUI [3])
Compliance behavior Limited Comorbidity
Item
4. the presence of any abnormal laboratory findings or serious medical disorder or condition that may, in the judgment of the pi, confound the assessment of relevant biologic measures or diagnoses including: clinically significant organ system dysfunction; significant and uncontrolled endocrine disease, including diabetes mellitus; hypothyroidism; cardiovascular disease; coagulopathy; significant anemia; significant acute infection; glaucoma; dehydration; epilepsy; any diagnosed cardiac condition causing documented hemodynamic compromise or dysfunction of the sa or av node; any diagnosed respiratory condition causing documented or clinically recognized hypoxia (e.g., chronic obstructive or restrictive pulmonary disease); after evaluation, anyone determined to have a potentially compromised airway that could be difficult to intubate; fever; bmi less than 14.5; or any medical condition known to interfere with cognitive performance; medication-related exclusions include memantine, or any medication that could be considered contraindicated ketamine;
boolean
C1321605 (UMLS CUI [1,1])
C0439801 (UMLS CUI [1,2])
C0009488 (UMLS CUI [1,3])
concomitant medication
Item
5. current treatment with any medication contraindicated with ketamine or clonidine;
boolean
C2347852 (UMLS CUI [1])
Ketamine abuse
Item
6. lifetime illegal use of pcp or ketamine; no clinical use of ketamine for past 3 months
boolean
C3824685 (UMLS CUI [1])
dsm-iv mental retardation
Item
7. meets dsm-iv criteria for mental retardation;
boolean
C0220952 (UMLS CUI [1,1])
C0025362 (UMLS CUI [1,2])
hospitalization
Item
8. currently hospitalized;
boolean
C0019993 (UMLS CUI [1])
suicidal; homicidal
Item
9. acutely suicidal or homicidal (i.e., in imminent danger with plan, urges and intent to harm oneself or others) including any prior serious attempts (e.g., those requiring hospitalization) at the pi's discretion;
boolean
C0438696 (UMLS CUI [1])
C0745031 (UMLS CUI [2])
pregnancy; lactating
Item
10. is pregnant or breast-feeding; unwilling to use birth control if female of child bearing potential
boolean
C0032961 (UMLS CUI [1])
C0006147 (UMLS CUI [2])
informed consent
Item
11. unable to provide informed consent.
boolean
C0021430 (UMLS CUI [1])
neuroimaging; mri; claustrophobia
Item
12. for participants in the neuroimaging subset: history of claustrophobia, serious head injuries, seizures disorder, developmental delays, pacemaker, metal implants, permanent metal piercings or anything else that would preclude having an mri.
boolean
C0679575 (UMLS CUI [1])
C0024485 (UMLS CUI [2])
C0008909 (UMLS CUI [3])
Tillbaka till toppen 

Kontakt

Använd detta formulär för feedback, frågor och förslag på förbättringar.

Fält markerade med * är obligatoriska.

Hjälp

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