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Induction Period - Visit 1 Observation Period UK Essen Therapy of Chronic Cold Agglutinin Disease With Eculizumab NCT01303952

1 formularios  
Datum der Visite
Descripción

Datum der Visite

Alias
UMLS CUI-1
C1320303
Datum der Visite
Descripción

Date of Visit

Tipo de datos

text

Unidades de medida
  • YYYY-MM-DD
Alias
UMLS CUI [1]
C1320303
YYYY-MM-DD
Patient ist für die Studie geeignet
Descripción

eligibility

Tipo de datos

integer

Alias
UMLS CUI [1]
C1302261
Wurde die Studie vorzeitig beendet?
Descripción

early termination

Tipo de datos

integer

Alias
UMLS CUI [1]
C2718058
LDH
Descripción

LDH

Alias
UMLS CUI-1
C0202113
LDH
Descripción

LDH

Tipo de datos

float

Unidades de medida
  • U/l
Alias
UMLS CUI [1]
C0202113
U/l
Vital signs
Descripción

Vital signs

Alias
UMLS CUI-1
C0518766
1. Systolischer Blutdruck
Descripción

1. Systolic blood pressure

Tipo de datos

integer

Unidades de medida
  • mmHg
Alias
UMLS CUI [1]
C0871470
mmHg
1. Diastolischer Blutdruck
Descripción

1. Diastolic blood pressure

Tipo de datos

integer

Unidades de medida
  • mmHg
Alias
UMLS CUI [1]
C0428883
mmHg
2. Systolischer Blutdruck
Descripción

2. Systolic blood pressure

Tipo de datos

integer

Unidades de medida
  • mmHg
Alias
UMLS CUI [1]
C0871470
mmHg
2. Diastolischer Blutdruck
Descripción

2. Diastolic blood pressure

Tipo de datos

integer

Unidades de medida
  • mmHg
Alias
UMLS CUI [1]
C0428883
mmHg
3. Systolischer Blutdruck
Descripción

3. Systolic blood pressure

Tipo de datos

integer

Unidades de medida
  • mmHg
Alias
UMLS CUI [1]
C0871470
mmHg
3. Diastolischer Blutdruck
Descripción

3. Diastolic blood pressure

Tipo de datos

integer

Unidades de medida
  • mmHg
Alias
UMLS CUI [1]
C0428883
mmHg
Herzfrequenz, sitzend
Descripción

Sitting heart rate

Tipo de datos

integer

Unidades de medida
  • beats per minute
Alias
UMLS CUI [1]
C2029904
beats per minute
Körpertemperatur
Descripción

Body temperature

Tipo de datos

float

Unidades de medida
  • °C
Alias
UMLS CUI [1]
C0005903
°C
Sechs Minuten Gehtest
Descripción

Sechs Minuten Gehtest

Alias
UMLS CUI-1
C0430515
Gehdistanz
Descripción

Walk distance

Tipo de datos

integer

Unidades de medida
  • Meter
Alias
UMLS CUI [1]
C3854161
Meter
Zeigt der Patient Zeichen von Dyspnoe?
Descripción

dyspnea

Tipo de datos

integer

Alias
UMLS CUI [1]
C0013404
Kardiovaskuläre Symptome
Descripción

Kardiovaskuläre Symptome

Alias
UMLS CUI-1
C0476270
Thrombophlebitis/Tiefe Beinvenenthrombose
Descripción

Thrombophlebitis/Deep Vein Thrombosis

Tipo de datos

integer

Alias
UMLS CUI [1]
C0040046
UMLS CUI [2]
C0149871
Lungenembolie
Descripción

Pulmonary Embolus

Tipo de datos

integer

Alias
UMLS CUI [1]
C0034065
Zerebrovaskuläres Ereignis
Descripción

Cerebrovascular Accident

Tipo de datos

integer

Alias
UMLS CUI [1]
C0038454
Amputation
Descripción

Amputation

Tipo de datos

integer

Alias
UMLS CUI [1]
C0002688
Myocardial Infarction
Descripción

Myocardial Infarction

Tipo de datos

integer

Alias
UMLS CUI [1]
C0027051
Transient Ischemic Attack
Descripción

Transient Ischemic Attack

Tipo de datos

integer

Alias
UMLS CUI [1]
C0007787
Unstable Angina
Descripción

Unstable Angina

Tipo de datos

integer

Alias
UMLS CUI [1]
C0002965
Renal Vein Thrombosis
Descripción

Renal Vein Thrombosis

Tipo de datos

integer

Alias
UMLS CUI [1]
C0238457
Mesenteric Vein Thrombosis
Descripción

Mesenteric Vein Thrombosis

Tipo de datos

integer

Alias
UMLS CUI [1]
C0267412
Portal Vein Thrombosis (Budd-Chiari)
Descripción

Portal Vein Thrombosis (Budd-Chiari)

Tipo de datos

integer

Alias
UMLS CUI [1]
C0155773
Gangrene
Descripción

Gangrene

Tipo de datos

integer

Alias
UMLS CUI [1]
C0017086
Acute Peripheral Vascular Occlusion
Descripción

Acute Peripheral Vascular Occlusion

Tipo de datos

integer

Alias
UMLS CUI [1]
C0240728
Sudden Death
Descripción

Sudden Death

Tipo de datos

integer

Alias
UMLS CUI [1]
C0011071
Patient suffers from other accompanying illnesses?
Descripción

Patient suffers from other accompanying illnesses?

Tipo de datos

integer

Alias
UMLS CUI [1]
C0009488
Only for Woman (under 50): Is the pregnancy test negativ?
Descripción

Only for Woman (under 50): Is the pregnancy test negativ?

Tipo de datos

integer

Alias
UMLS CUI [1]
C0032976
Comments
Descripción

Comments

Tipo de datos

text

Alias
UMLS CUI [1]
C0947611
Signature date
Descripción

Signature date

Tipo de datos

date

Alias
UMLS CUI [1]
C0807937
Investigators signature
Descripción

Investigators signature

Tipo de datos

integer

Alias
UMLS CUI [1]
C2346576
Signature principal investigator
Descripción

Signature principal investigator

Alias
UMLS CUI-1
C1519316
UMLS CUI-2
C1521895
Signature date
Descripción

Signature date

Tipo de datos

text

Unidades de medida
  • YYYY-MM-DD
Alias
UMLS CUI [1]
C0807937
YYYY-MM-DD
Signature investigator
Descripción

Signature investigator

Tipo de datos

integer

Alias
UMLS CUI [1]
C2346576
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Similar models

Induction Period - Visit 1 Observation Period UK Essen Therapy of Chronic Cold Agglutinin Disease With Eculizumab NCT01303952

1 formularios
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
Datum der Visite
C1320303 (UMLS CUI-1)
Date of Visit
Item
Datum der Visite
text
C1320303 (UMLS CUI [1])
Item
Patient ist für die Studie geeignet
integer
C1302261 (UMLS CUI [1])
eligibility
Code List
Patient ist für die Studie geeignet
CL Item
Nein (0)
CL Item
Ja (1)
Item
Wurde die Studie vorzeitig beendet?
integer
C2718058 (UMLS CUI [1])
dyspnea
Code List
Wurde die Studie vorzeitig beendet?
CL Item
Nein (0)
CL Item
Ja (1)
Item Group
LDH
C0202113 (UMLS CUI-1)
LDH
Item
LDH
float
C0202113 (UMLS CUI [1])
Item Group
C0518766 (UMLS CUI-1)
1. Systolic blood pressure
Item
1. Systolischer Blutdruck
integer
C0871470 (UMLS CUI [1])
1. Diastolic blood pressure
Item
1. Diastolischer Blutdruck
integer
C0428883 (UMLS CUI [1])
2. Systolic blood pressure
Item
2. Systolischer Blutdruck
integer
C0871470 (UMLS CUI [1])
2. Diastolic blood pressure
Item
2. Diastolischer Blutdruck
integer
C0428883 (UMLS CUI [1])
3. Systolic blood pressure
Item
3. Systolischer Blutdruck
integer
C0871470 (UMLS CUI [1])
3. Diastolic blood pressure
Item
3. Diastolischer Blutdruck
integer
C0428883 (UMLS CUI [1])
Sitting heart rate
Item
Herzfrequenz, sitzend
integer
C2029904 (UMLS CUI [1])
Body temperature
Item
Körpertemperatur
float
C0005903 (UMLS CUI [1])
Item Group
Sechs Minuten Gehtest
C0430515 (UMLS CUI-1)
Walk distance
Item
Gehdistanz
integer
C3854161 (UMLS CUI [1])
Item
Zeigt der Patient Zeichen von Dyspnoe?
integer
C0013404 (UMLS CUI [1])
dyspnea
Code List
Zeigt der Patient Zeichen von Dyspnoe?
CL Item
Nein (0)
CL Item
Ja (1)
Item Group
Kardiovaskuläre Symptome
C0476270 (UMLS CUI-1)
Item
Thrombophlebitis/Tiefe Beinvenenthrombose
integer
C0040046 (UMLS CUI [1])
C0149871 (UMLS CUI [2])
Thrombophlebitis/Deep Vein Thrombosis
Code List
Thrombophlebitis/Tiefe Beinvenenthrombose
CL Item
Nein (0)
CL Item
Ja (1)
Item
Lungenembolie
integer
C0034065 (UMLS CUI [1])
Pulmonary Embolus
Code List
Lungenembolie
CL Item
Nein (0)
CL Item
Ja (1)
Item
Zerebrovaskuläres Ereignis
integer
C0038454 (UMLS CUI [1])
Cerebrovascular Accident
Code List
Zerebrovaskuläres Ereignis
CL Item
Nein (0)
CL Item
Ja (1)
Item
Amputation
integer
C0002688 (UMLS CUI [1])
Amputation
Code List
Amputation
CL Item
Nein (0)
CL Item
Ja (1)
Item
integer
C0027051 (UMLS CUI [1])
Thrombophlebitis/Deep Vein Thrombosis
Code List
Myocardial Infarction
CL Item
 (0)
CL Item
 (1)
Item
integer
C0007787 (UMLS CUI [1])
Thrombophlebitis/Deep Vein Thrombosis
Code List
Transient Ischemic Attack
CL Item
Nein (0)
CL Item
Ja (1)
Item
integer
C0002965 (UMLS CUI [1])
Thrombophlebitis/Deep Vein Thrombosis
Code List
Unstable Angina
CL Item
Nein (0)
CL Item
Ja (1)
Item
integer
C0238457 (UMLS CUI [1])
Pulmonary Embolus
Code List
Renal Vein Thrombosis
CL Item
 (0)
CL Item
 (1)
Item
integer
C0267412 (UMLS CUI [1])
Thrombophlebitis/Deep Vein Thrombosis
Code List
Mesenteric Vein Thrombosis
CL Item
Nein (0)
CL Item
Ja (1)
Item
integer
C0155773 (UMLS CUI [1])
Thrombophlebitis/Deep Vein Thrombosis
Code List
Portal Vein Thrombosis (Budd-Chiari)
CL Item
Nein (0)
CL Item
Ja (1)
Item
integer
C0017086 (UMLS CUI [1])
Thrombophlebitis/Deep Vein Thrombosis
Code List
Gangrene
CL Item
Nein (0)
CL Item
Ja (1)
Item
integer
C0240728 (UMLS CUI [1])
Thrombophlebitis/Deep Vein Thrombosis
Code List
Acute Peripheral Vascular Occlusion
CL Item
Nein (0)
CL Item
Ja (1)
Item
integer
C0011071 (UMLS CUI [1])
Thrombophlebitis/Deep Vein Thrombosis
Code List
Sudden Death
CL Item
Nein (0)
CL Item
Ja (1)
Item
integer
C0009488 (UMLS CUI [1])
Thrombophlebitis/Deep Vein Thrombosis
Code List
Patient suffers from other accompanying illnesses?
CL Item
Nein (0)
CL Item
Ja (1)
Thrombophlebitis/Deep Vein Thrombosis
Code List
Only for Woman (under 50): Is the pregnancy test negativ?
CL Item
Nein (0)
CL Item
Ja (1)
Comments
Item
text
C0947611 (UMLS CUI [1])
Signature date
Item
date
C0807937 (UMLS CUI [1])
Item
integer
C2346576 (UMLS CUI [1])
Are all inclusion criteria fulfilled?
Code List
Investigators signature
CL Item
 (0)
CL Item
 (1)
Item Group
C1519316 (UMLS CUI-1)
C1521895 (UMLS CUI-2)
Signature date
Item
text
C0807937 (UMLS CUI [1])
Item
integer
C2346576 (UMLS CUI [1])
Thrombophlebitis/Deep Vein Thrombosis
Code List
Signature investigator
CL Item
Nein (0)
CL Item
Ja (1)
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