ID

20232

Descrição

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.

Palavras-chave

  1. 15/02/2017 15/02/2017 -
  2. 20/02/2017 20/02/2017 -
Transferido a

15 de fevereiro de 2017

DOI

Para um pedido faça login.

Licença

Creative Commons BY-NC 3.0

Comentários do modelo :

Aqui pode comentar o modelo. Pode comentá-lo especificamente através dos balões de texto nos grupos de itens e itens.

Comentários do grupo de itens para :

Comentários do item para :

Para descarregar formulários, precisa de ter uma sessão iniciada. Por favor faça login ou registe-se gratuitamente.

Visit 1A Events PRoFESS - Prevention Regimen For Effectively Avoiding Second Strokes NCT00153062

Visit 1A Events PRoFESS - Prevention Regimen For Effectively Avoiding Second Strokes NCT00153062

Events
Descrição

Events

Alias
UMLS CUI-1
C0877248
1. Has the patient experienced any of the following since randomization:
Descrição

Patient experience

Tipo de dados

text

Dizziness or Lightheadedness
Descrição

Dizziness or Lightheadedness

Tipo de dados

boolean

Fainting
Descrição

Fainting

Tipo de dados

boolean

Alias
UMLS CUI [1]
C0039070
Headache during first week of study drug administration
Descrição

Headache

Tipo de dados

boolean

If headache occurred please indicate how it was treated (indicate all that apply):
Descrição

If headache

Tipo de dados

integer

2. Have any Outcome Events or Serious Adverse Events been experienced? (See instructions on facing page)
Descrição

Outcome Events or Serious Adverse Events

Tipo de dados

boolean

if "Yes" please indicate all that apply
Descrição

If Yes

Tipo de dados

integer

Please complete the respective forms
Descrição

Please complete the respective forms

4. Signature of Investigator or Sub-Investigator
Descrição

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

Tipo de dados

text

Date of Signature (dd mon yy)
Descrição

Date of Signature

Tipo de dados

date

Similar models

Visit 1A Events PRoFESS - Prevention Regimen For Effectively Avoiding Second Strokes NCT00153062

Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de dados
Alias
Item Group
Events
C0877248 (UMLS CUI-1)
Patient experience
Item
1. Has the patient experienced any of the following since randomization:
text
Dizziness or Lightheadedness
Item
Dizziness or Lightheadedness
boolean
Fainting
Item
Fainting
boolean
C0039070 (UMLS CUI [1])
Headache
Item
Headache during first week of study drug administration
boolean
Item
If headache occurred please indicate how it was treated (indicate all that apply):
integer
Code List
If headache occurred please indicate how it was treated (indicate all that apply):
CL Item
Analgestic (1)
CL Item
Down titration of study medication A (2)
CL Item
No treatment (3)
Outcome Events or Serious Adverse Events
Item
2. Have any Outcome Events or Serious Adverse Events been experienced? (See instructions on facing page)
boolean
Item
if "Yes" please indicate all that apply
integer
Code List
if "Yes" please indicate all that apply
CL Item
Stroke (1)
CL Item
Myocardial Infarction (2)
CL Item
Death (3)
CL Item
New or worsening congestive heart failure (CHF) (4)
CL Item
Other designated vascular event (5)
CL Item
Hemorrhagic Event (6)
CL Item
Thrombotic Thrombocytopenia purpura (7)
CL Item
Neutropenia (8)
CL Item
Newly diagnosed diabetes (9)
Item Group
Please complete the respective forms
Signature of Investigator or Sub-Investigator
Item
4. Signature of Investigator or Sub-Investigator
text
Date of Signature
Item
Date of Signature (dd mon yy)
date

Use este formulário para feedback, perguntas e sugestões de aperfeiçoamento.

Campos marcados com * são obrigatórios.

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