ID

20230

Beschrijving

The purpose of the trial is to determine if extended-release dipyridamole + aspirin [Aggrenox, Asasa ntin] is superior to clopidogrel [Plavix], and if telmisartan [Micardis, Gliosartan, Kinzal, Kinzalm ono, Predxal, Pritor, Samertan, Telmisartan] is superior to placebo, in the presence of background antihypertensive therapy, in prevention of a second stroke in patients who have recently suffered a stroke and therefore are at high risk of suffering another one.

Trefwoorden

Versies (2)
  1. 15-02-17 15-02-17 -
  2. 20-02-17 20-02-17 -
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15 februari 2017

DOI

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Licentie

Creative Commons BY-NC 3.0
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TEST Inclusion Exclusion Randomization Trial Drug Administration PRoFESS - Prevention Regimen For Effectively Avoiding Second Strokes NCT00153062

Engels

TEST Inclusion Exclusion Randomization Trial Drug Administration PRoFESS - Prevention Regimen For Effectively Avoiding Second Strokes NCT00153062

1 Formulieren  
Inclusion / Exclusion Criteria
Beschrijving

Inclusion / Exclusion Criteria

1. Did the subject meet all the entry criteria at the time of enrollment (see opposite page)
Beschrijving

Entry criteria

Datatype

boolean

Alias
UMLS CUI [1]
C1516637
2. If no, please give line number(s) of the corresponding criteria not met
Beschrijving

Numbers of the corresponding criteria

Datatype

text

Randomisation
Beschrijving

Randomisation

Alias
UMLS CUI-1
C0034656
3. Date of randomisation using IVRS (dd mon yy)
Beschrijving

Date of randomisation

Datatype

date

Trial Drug Administration
Beschrijving

Trial Drug Administration

4. Will the trial medication kit be dispensed to the patient
Beschrijving

Trial medication kit

Datatype

boolean

5. If YES, provide patient with trial medication kit assigned by IVRS. Stick the label from trial medication kit below. If label is lost, please enter assigned medication number below:
Beschrijving

If yes

Datatype

text

6. If NO, primary reason for not dispensing trial drug (indicate one)
Beschrijving

If NO

Datatype

integer

Explain other:
Beschrijving

Other

Datatype

text

Preparation For Next Visit
Beschrijving

Preparation For Next Visit

7. Investigator´s Declaration By signing and dating this page, I declare that I have reviewed for accuracy all the case report form pages for this patient; the information contained on these pages accurately reflects the medical record including the results of tests and evaluations performed on the specified dates.
Beschrijving

Investigator´s Declaration

Datatype

text

Signature by investigator
Beschrijving

Signature

Datatype

text

Alias
UMLS CUI [1]
C1519316
Date (dd mon yy)
Beschrijving

Investigator Signature Date

Datatype

date

Alias
UMLS CUI [1,1]
C2346576
UMLS CUI [1,2]
C0011008
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Similar models

TEST Inclusion Exclusion Randomization Trial Drug Administration PRoFESS - Prevention Regimen For Effectively Avoiding Second Strokes NCT00153062

1 Formulieren
Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
Inclusion / Exclusion Criteria
Entry criteria
Item
1. Did the subject meet all the entry criteria at the time of enrollment (see opposite page)
boolean
C1516637 (UMLS CUI [1])
Numbers of the corresponding criteria
Item
2. If no, please give line number(s) of the corresponding criteria not met
text
Item Group
Randomisation
C0034656 (UMLS CUI-1)
Date of randomisation
Item
3. Date of randomisation using IVRS (dd mon yy)
date
Item Group
Trial Drug Administration
Trial medication kit
Item
4. Will the trial medication kit be dispensed to the patient
boolean
If yes
Item
5. If YES, provide patient with trial medication kit assigned by IVRS. Stick the label from trial medication kit below. If label is lost, please enter assigned medication number below:
text
Item
6. If NO, primary reason for not dispensing trial drug (indicate one)
integer
If NO
Code List
6. If NO, primary reason for not dispensing trial drug (indicate one)
CL Item
Adverse event (1)
CL Item
Inclusion / Exclusion criteria not met (2)
CL Item
Lost follow-up (3)
CL Item
Consent withdrawn (not due to adverse event) (4)
CL Item
Other (explain below) (5)
Other
Item
Explain other:
text
Item Group
Preparation For Next Visit
Investigator´s Declaration
Item
7. Investigator´s Declaration By signing and dating this page, I declare that I have reviewed for accuracy all the case report form pages for this patient; the information contained on these pages accurately reflects the medical record including the results of tests and evaluations performed on the specified dates.
text
Signature
Item
Signature by investigator
text
C1519316 (UMLS CUI [1])
Investigator Signature Date
Item
Date (dd mon yy)
date
C2346576 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Terug naar het begin van de pagina 

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