Inglés

Visit 9 GSK-AVA100468 NCT00381238

1 formularios  
formality
Descripción

formality

Alias
UMLS CUI-1
C0680133
Protocol Identifier: AVA100468
Descripción

Protocol Identifier

Tipo de datos

boolean

Alias
UMLS CUI [1]
C2826693
Subject Identifier
Descripción

Subject Identifier

Tipo de datos

integer

Alias
UMLS CUI [1]
C2348585
Visit Date
Descripción

Visit Date

Tipo de datos

date

Alias
UMLS CUI [1]
C1320303
Vital Signs
Descripción

Vital Signs

Alias
UMLS CUI-1
C0518766
Weight
Descripción

Weight

Tipo de datos

float

Unidades de medida
  • kg
Alias
UMLS CUI [1]
C0005910
kg
Systolic Blood pressure measurement
Descripción

Blood pressure and heart rate will be measured once, after the subject sits quietly for at least 5 minutes.

Tipo de datos

text

Unidades de medida
  • mmHg
Alias
UMLS CUI [1]
C0871470
mmHg
Diastolic Blood pressure measurement
Descripción

Blood pressure and heart rate will be measured once, after the subject sits quietly for at least 5 minutes.

Tipo de datos

text

Unidades de medida
  • mmHg
Alias
UMLS CUI [1]
C0428883
mmHg
Heart rate
Descripción

Blood pressure and heart rate will be measured once, after the subject sits quietly for at least 5 minutes.

Tipo de datos

integer

Unidades de medida
  • bpm
Alias
UMLS CUI [1]
C0018810
bpm
Neurological Examination
Descripción

Neurological Examination

Alias
UMLS CUI-1
C0027853
Neurological Examination
Descripción

Perform a Neurological examination on the subject, including assessment of gait, balance, coordination, cranial nerves and motor and sensory systems. If any abnormalities are found as a result of the physical examination, these most be recorded on the Non-erious Adverse Events page.

Tipo de datos

text

Alias
UMLS CUI [1]
C0027853
Central Laboratory (fasting samples)
Descripción

Central Laboratory (fasting samples)

Alias
UMLS CUI-1
C1880016
UMLS CUI-2
C0015663
Central Laboratory (fasting samples)
Descripción

Record any changes to the subject's concomitant medications or any new medications taken since the last visit in the appropriate Concomitant Medications section.

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1880016
UMLS CUI [1,2]
C0015663
Pregnancy Test
Descripción

Pregnancy Test

Alias
UMLS CUI-1
C0032976
Pregnancy Test
Descripción

If subject is female and of childbearing potential a serum pregnancy test must be performed.

Tipo de datos

text

Alias
UMLS CUI [1]
C0032976
12-Lead ECG
Descripción

12-Lead ECG

Alias
UMLS CUI-1
C0430456
Date of ECG
Descripción

Date of ECG

Tipo de datos

date

Alias
UMLS CUI [1]
C2826640
ECG result
Descripción

Complete an Adverse Event (AE) or Serious Adverse Event (SAE) page(s) if clinically significant abnormalities meet the protocol definition for an AE or SAE.

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C1623258
UMLS CUI [1,2]
C0456984
Concomitant medications
Descripción

Concomitant medications

Alias
UMLS CUI-1
C2347852
Concomitant Medications
Descripción

Record any changes to the subject's concomitant medications or any new medications taken since the last visit in the appropriate Concomitant Medications section.

Tipo de datos

text

Alias
UMLS CUI [1]
C2347852
Adverse Events
Descripción

Adverse Events

Alias
UMLS CUI-1
C0877248
Adverse events
Descripción

Record details of any new non-serious adverse events / serious adverse events observed or reported by the subject or any changes to ongoing non-serious adverse events in the appropriate Non-Serious Adverse Events / Serious Adverse Events section.

Tipo de datos

text

Alias
UMLS CUI [1]
C0877248
Physical Examination
Descripción

Physical Examination

Alias
UMLS CUI-1
C0031809
Physical Examination
Descripción

Perform a physical examination on the subject, including auscultation of heart and lungs. If any abnormalties are found as a result of the physical examination, these must be recorded on the Non-Serious Adverse Events page.

Tipo de datos

text

Alias
UMLS CUI [1]
C0031809
Pedal Oedema
Descripción

Pedal Oedema

Alias
UMLS CUI-1
C0574002
Pedal Oedema size
Descripción

Pedal Oedema size

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C0574002
UMLS CUI [1,2]
C0456389
Pedal Oedema side
Descripción

Pedal Oedema side

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C0574002
UMLS CUI [1,2]
C0441987
Rating Scale Instructions
Descripción

Rating Scale Instructions

Alias
UMLS CUI-1
C0681889
Rating Scale Instructions completed
Descripción

The following scales should be completed at this visit: ADAS-cog CIBIC+ NPI DAD

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0681889
Investigational Product
Descripción

Investigational Product

Alias
UMLS CUI-1
C0304229
Start Date
Descripción

Start Date

Tipo de datos

date

Alias
UMLS CUI [1,1]
C0808070
UMLS CUI [1,2]
C0304229
Stop Date
Descripción

Stop Date

Tipo de datos

date

Alias
UMLS CUI [1,1]
C0806020
UMLS CUI [1,2]
C0304229
Dose
Descripción

Dose

Tipo de datos

text

Unidades de medida
  • mg
Alias
UMLS CUI [1,1]
C3174092
UMLS CUI [1,2]
C0304229
mg
IP Container No
Descripción

IP Container No

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0180098
UMLS CUI [1,2]
C0304229
Compliance
Descripción

Compliance

Alias
UMLS CUI-1
C1321605
Total number of Tablets Dispensed
Descripción

Total number of Tablets Dispensed

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0805077
UMLS CUI [1,2]
C0039225
Total number of Tablets Returned
Descripción

Total number of Tablets Returned

Tipo de datos

text

Alias
UMLS CUI [1,1]
C2699071
UMLS CUI [1,2]
C0039225
Has the subject missed investigational product for >7 consecutive days?
Descripción

Compliance

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C1321605
UMLS CUI [1,2]
C0013227
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Similar models

Visit 9 GSK-AVA100468 NCT00381238

1 formularios
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
formality
C0680133 (UMLS CUI-1)
Protocol Identifier
Item
Protocol Identifier: AVA100468
boolean
C2826693 (UMLS CUI [1])
Subject Identifier
Item
Subject Identifier
integer
C2348585 (UMLS CUI [1])
Visit Date
Item
Visit Date
date
C1320303 (UMLS CUI [1])
Item Group
Vital Signs
C0518766 (UMLS CUI-1)
Weight
Item
Weight
float
C0005910 (UMLS CUI [1])
Systolic Blood pressure
Item
Systolic Blood pressure measurement
text
C0871470 (UMLS CUI [1])
Diastolic Blood pressure
Item
Diastolic Blood pressure measurement
text
C0428883 (UMLS CUI [1])
Heart rate
Item
Heart rate
integer
C0018810 (UMLS CUI [1])
Item Group
Neurological Examination
C0027853 (UMLS CUI-1)
Neurological Examination
Item
Neurological Examination
text
C0027853 (UMLS CUI [1])
Item Group
Central Laboratory (fasting samples)
C1880016 (UMLS CUI-1)
C0015663 (UMLS CUI-2)
Central Laboratory (fasting samples)
Item
Central Laboratory (fasting samples)
text
C1880016 (UMLS CUI [1,1])
C0015663 (UMLS CUI [1,2])
Item Group
Pregnancy Test
C0032976 (UMLS CUI-1)
Pregnancy Test
Item
Pregnancy Test
text
C0032976 (UMLS CUI [1])
Item Group
12-Lead ECG
C0430456 (UMLS CUI-1)
Date of ECG
Item
Date of ECG
date
C2826640 (UMLS CUI [1])
Item
ECG result
integer
C1623258 (UMLS CUI [1,1])
C0456984 (UMLS CUI [1,2])
ECG result
Code List
ECG result
CL Item
Normal (1)
CL Item
Abnormal, not clinically significant (2)
CL Item
Abnormal, clinically significant (3)
Item Group
Concomitant medications
C2347852 (UMLS CUI-1)
Concomitant Medications
Item
Concomitant Medications
text
C2347852 (UMLS CUI [1])
Item Group
Adverse Events
C0877248 (UMLS CUI-1)
Adverse events
Item
Adverse events
text
C0877248 (UMLS CUI [1])
Item Group
Physical Examination
C0031809 (UMLS CUI-1)
Physical Examination
Item
Physical Examination
text
C0031809 (UMLS CUI [1])
Item Group
Pedal Oedema
C0574002 (UMLS CUI-1)
Item
Pedal Oedema size
integer
C0574002 (UMLS CUI [1,1])
C0456389 (UMLS CUI [1,2])
Pedal Oedema size
Code List
Pedal Oedema size
CL Item
<1mm (1)
CL Item
1-2mm (2)
CL Item
3-5mm (3)
CL Item
6-10mm (4)
CL Item
>10mm (5)
Item
Pedal Oedema side
integer
C0574002 (UMLS CUI [1,1])
C0441987 (UMLS CUI [1,2])
Pedal Oedema side
Code List
Pedal Oedema side
CL Item
Right Ankle (1)
CL Item
Left Ankle (2)
Item Group
Rating Scale Instructions
C0681889 (UMLS CUI-1)
Rating Scale Instructions
Item
Rating Scale Instructions completed
boolean
C0681889 (UMLS CUI [1])
Item Group
Investigational Product
C0304229 (UMLS CUI-1)
Start Date
Item
Start Date
date
C0808070 (UMLS CUI [1,1])
C0304229 (UMLS CUI [1,2])
Stop Date
Item
Stop Date
date
C0806020 (UMLS CUI [1,1])
C0304229 (UMLS CUI [1,2])
Dose
Item
Dose
text
C3174092 (UMLS CUI [1,1])
C0304229 (UMLS CUI [1,2])
IP Container No
Item
IP Container No
text
C0180098 (UMLS CUI [1,1])
C0304229 (UMLS CUI [1,2])
Item Group
Compliance
C1321605 (UMLS CUI-1)
Total number of Tablets Dispensed
Item
Total number of Tablets Dispensed
text
C0805077 (UMLS CUI [1,1])
C0039225 (UMLS CUI [1,2])
Total number of Tablets Returned
Item
Total number of Tablets Returned
text
C2699071 (UMLS CUI [1,1])
C0039225 (UMLS CUI [1,2])
Compliance
Item
Has the subject missed investigational product for >7 consecutive days?
boolean
C1321605 (UMLS CUI [1,1])
C0013227 (UMLS CUI [1,2])
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