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ID

13805

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

  1. 07/03/16 07/03/16 -
Caricato su

7 marzo 2016

DOI

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Licenza

Creative Commons BY-NC 3.0

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    Follow up completion form Coronary Artery Bypass graft surgery in patients with Asymptomatic Carotid Stenosis DRKS00000521

    CABACS Case Report Form [follow up completion form]

    Follow up completion
    Descrizione

    Follow up completion

    Patient ID
    Descrizione

    Patient Study ID

    Tipo di dati

    text

    Alias
    UMLS CUI [1]
    C2348585 (Clinical Trial Subject Unique Identifier)
    Study end date
    Descrizione

    Study end date

    Tipo di dati

    date

    Alias
    UMLS CUI [1]
    C2983670 (Study End Date)
    Type of trial completion
    Descrizione

    Type of trial completion

    Tipo di dati

    integer

    Alias
    UMLS CUI [1]
    C2732579 (Completion of clinical trial)
    SNOMED
    443729008
    If premature end of study, specify reason
    Descrizione

    Premature end of study

    Tipo di dati

    integer

    Alias
    UMLS CUI [1]
    C2732579 (Completion of clinical trial)
    SNOMED
    443729008
    Please specify withdrawn IC, kind of comorbidity,death and other reasons for premature end of study
    Descrizione

    Specification

    Tipo di dati

    text

    Alias
    UMLS CUI [1]
    C2348235 (Specification)
    Date of completion of this form
    Descrizione

    Date of completion

    Tipo di dati

    date

    Alias
    UMLS CUI [1]
    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)

    Similar models

    CABACS Case Report Form [follow up completion form]

    Name
    genere
    Description | Question | Decode (Coded Value)
    Tipo di dati
    Alias
    Item Group
    Follow up completion
    Patient Study ID
    Item
    Patient ID
    text
    C2348585 (UMLS CUI [1])
    Study end date
    Item
    Study end date
    date
    C2983670 (UMLS CUI [1])
    Item
    Type of trial completion
    integer
    C2732579 (UMLS CUI [1])
    Code List
    Type of trial completion
    CL Item
    no follow-up, see completion clinical trial section (0)
    CL Item
    normal end of study (1)
    CL Item
    premature end of study (specify) (2)
    Item
    If premature end of study, specify reason
    integer
    C2732579 (UMLS CUI [1])
    Code List
    If premature end of study, specify reason
    CL Item
    informed consent withdrawn (1)
    CL Item
    Patient unable to participate any more due to comorbidity, no legal representative  (2)
    CL Item
    lost to follow up (3)
    CL Item
    Death (Investigate further,fill in outcome event form) (4)
    CL Item
    other reason (5)
    Specification
    Item
    Please specify withdrawn IC, kind of comorbidity,death and other reasons for premature end of study
    text
    C2348235 (UMLS CUI [1])
    Date of completion
    Item
    Date of completion of this form
    date
    C0011008 (UMLS CUI [1])
    Signature
    Item
    Signature by investigator
    text
    C1519316 (UMLS CUI [1])
    Name of Investigator
    Item
    Name of Investigator
    text
    C0008961 (UMLS CUI [1])

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