ID
21020
Beschrijving
Prospective Record Of the Use of Dabigatran in Patients With Acute Stroke or TIA (PRODAST) permission granted by Prof. Dr. Christian Weimar, University Hospital Essen The multi-center, prospective PRODAST study is investigating patients with non-valvular atrial fibrillation (AF) who experienced an ischemic stroke or a transient ischemic attack (TIA) recently (≤ 1 week) both with and without previous oral anticoagulation. This is the (serious) Adverse Events form. https://clinicaltrials.gov/ct2/show/NCT02507856
Link
https://clinicaltrials.gov/ct2/show/NCT02507856
Trefwoorden
Versies (1)
- 03-04-17 03-04-17 -
Geüploaded op
3 april 2017
DOI
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Licentie
Creative Commons BY 4.0
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Prodast Dabigatran NCT02507856 Serious Adverse Events
Prodast Dabigatran NCT02507856 Serious Adverse Events
- StudyEvent: ODM
Beschrijving
Patient Characteristics
Alias
- UMLS CUI-1
- C0815172
Beschrijving
Patient No.
Datatype
integer
Alias
- UMLS CUI [1]
- C2348585
Beschrijving
tblAE.SEX
Datatype
integer
Alias
- UMLS CUI [1]
- C0079399
Beschrijving
tblAE.BRTHYR
Datatype
integer
Alias
- UMLS CUI [1]
- C2826771
Beschrijving
tblAE.HEIGHT
Datatype
text
Maateenheden
- cm
Alias
- UMLS CUI [1]
- C0005890
Beschrijving
tblAE.WEIGHT
Datatype
integer
Maateenheden
- kg
Alias
- UMLS CUI [1]
- C0005910
Beschrijving
Site address
Alias
- UMLS CUI-1
- C0421449
Beschrijving
tblAE.location
Datatype
text
Alias
- UMLS CUI [1]
- C0450429
Beschrijving
tblAE.Site_Street
Datatype
text
Alias
- UMLS CUI [1]
- C1301826
Beschrijving
tblAE.city
Datatype
text
Alias
- UMLS CUI [1]
- C0008848
Beschrijving
tblAE.phone
Datatype
text
Alias
- UMLS CUI [1,1]
- C1550483
- UMLS CUI [1,2]
- C1515258
Beschrijving
tblAE.fax
Datatype
text
Alias
- UMLS CUI [1]
- C1549619
Beschrijving
Adverse Event
Alias
- UMLS CUI-1
- C0877248
Beschrijving
If not yet done, remember to document patient characteristics: Weight and Height. Sex and Year of Birth.
Datatype
integer
Alias
- UMLS CUI [1]
- C2826275
Beschrijving
tblAE.AGE
Datatype
integer
Maateenheden
- years
Alias
- UMLS CUI [1,1]
- C0150907
- UMLS CUI [1,2]
- C0877248
Beschrijving
tblAE.reporttype
Datatype
integer
Alias
- UMLS CUI [1,1]
- C0877248
- UMLS CUI [1,2]
- C3641180
Beschrijving
If possible, record diagnosis of the event and mention the symptoms in the "description of the event" below. If there is no diagnosis associated with the symptom, record the symptom as the adverse event.
Datatype
text
Alias
- UMLS CUI [1,1]
- C0877248
- UMLS CUI [1,2]
- C3641180
Beschrijving
tblAE.AESTDAT
Datatype
date
Alias
- UMLS CUI [1]
- C2697889
Beschrijving
tblAE.AESTTIM
Datatype
time
Alias
- UMLS CUI [1]
- C1301880
Beschrijving
undefined item
Datatype
integer
Alias
- UMLS CUI [1]
- C2826663
Beschrijving
tblAE.AEENDAT
Datatype
date
Alias
- UMLS CUI [1]
- C2697886
Beschrijving
tblAE.AEENTIM
Datatype
time
Alias
- UMLS CUI [1]
- C2826658
Beschrijving
If the answer is "yes", specify in the description below.
Datatype
text
Alias
- UMLS CUI [1]
- C2981656
Beschrijving
tblAE.AEOUT
Datatype
integer
Alias
- UMLS CUI [1]
- C1705586
Beschrijving
tblAE.aedescr
Datatype
text
Alias
- UMLS CUI [1,1]
- C0877248
- UMLS CUI [1,2]
- C2699044
Beschrijving
mild (leicht) = Leichte Beschwerden ohne Beeinträchtigung der normalen täglichen Aktivitäten moderate (mäßig) = Unannehmlichkeiten mit Behinderung bei normalen täglichen Aktivitäten severe (schwer) = Unfähigkeit zur Arbeit oder zur Ausübung der normalen täglichen Aktivitäten
Datatype
integer
Alias
- UMLS CUI [1]
- C1710066
Beschrijving
Hinweise zur Dokumentation: In diesem Abschnitt ist es möglich, 2 verschiedene antithrombotische Therapien innerhalb der letzten 7 Tage vor dem unerwünschten Ereignis zu erfassen. - Bei nicht schwerwiegenden AEs: - Erfassen Sie hier wenn vorhanden die beiden Therapien innerhalb von 7 Tagen, bei denen ein Kausalzusammenhang zum AE besteht oder die zum Zeitpunkt des AEs oder zeitlich am nächsten zum AE eingenommen wurden. - Bei SAEs: - Erfassen Sie hier wenn vorhanden die beiden Therapien innerhalb von 7 Tagen, bei denen ein Kausalzusammenhang zum SAE besteht oder die zum Zeitpunkt des SAEs oder zeitlich am nächsten zum SAE eingenommen wurden. - Fallen mehr als 2 Therapien in den 7-Tage-Zeitraum, dokumentieren Sie weitere Therapien bitte unter „Report Details“ und dort unter „Concomitant therapies“.
Datatype
integer
Alias
- UMLS CUI [1,1]
- C0877248
- UMLS CUI [1,2]
- C0003281
Beschrijving
tblAE.AEREL
Datatype
integer
Alias
- UMLS CUI [1]
- C0003281
Beschrijving
tblAE.AEACN2
Datatype
integer
Alias
- UMLS CUI [1]
- C0003281
Beschrijving
Study Outcomes are: - Stroke or TIA - Systemic embolism - Pulmonary (lung) embolism - Myocardial infarction - Major/Life threatening bleeding/gastrointestinal bleeding
Datatype
integer
Alias
- UMLS CUI [1]
- C1624730
Beschrijving
tblAE.AESER
Datatype
integer
Alias
- UMLS CUI [1,1]
- C1705586
- UMLS CUI [1,2]
- C1519255
Beschrijving
Include any further non-serious events that are associated with this serious event (occurence at the same time) and check for completeness
Datatype
integer
Alias
- UMLS CUI [1]
- C1519255
Beschrijving
tblAE.assocAE
Datatype
text
Alias
- UMLS CUI [1]
- C0877248
Beschrijving
Link this AE in the corresponding SAE report and report the SAE within 24 h the event was detected!
Datatype
integer
Alias
- UMLS CUI [1,1]
- C0877248
- UMLS CUI [1,2]
- C0439849
- UMLS CUI [1,3]
- C1519255
Beschrijving
Pregnancy
Alias
- UMLS CUI-1
- C0032961
Beschrijving
Details Antithrombotic Product
Alias
- UMLS CUI-1
- C0003280
Beschrijving
tblAE.drugterm
Datatype
text
Alias
- UMLS CUI [1,1]
- C0003280
- UMLS CUI [1,2]
- C0919189
Beschrijving
tblAE.drugform
Datatype
integer
Alias
- UMLS CUI [1]
- C1705957
Beschrijving
tblAE.drugformoth
Datatype
text
Alias
- UMLS CUI [1]
- C1705957
Beschrijving
tblAE.drugdose
Datatype
text
Alias
- UMLS CUI [1,1]
- C0003280
- UMLS CUI [1,2]
- C0178602
Beschrijving
tblAE.drugdose
Datatype
integer
Alias
- UMLS CUI [1,1]
- C0003280
- UMLS CUI [1,2]
- C0869039
Beschrijving
tblAE.drugunitoth
Datatype
text
Alias
- UMLS CUI [1,1]
- C0003280
- UMLS CUI [1,2]
- C0869039
Beschrijving
tblAE.drugroute
Datatype
integer
Alias
- UMLS CUI [1]
- C0013153
Beschrijving
tblAE.drugrouteoth
Datatype
text
Alias
- UMLS CUI [1]
- C0013153
Beschrijving
tblAE.drugstda
Datatype
date
Alias
- UMLS CUI [1,1]
- C0808070
- UMLS CUI [1,2]
- C0304229
Beschrijving
tblAE.drugongo
Datatype
integer
Alias
- UMLS CUI [1,1]
- C0549178
- UMLS CUI [1,2]
- C0013216
Beschrijving
tblAE.drugendat
Datatype
date
Alias
- UMLS CUI [1]
- C1531784
Beschrijving
tblAE.drugind
Datatype
text
Alias
- UMLS CUI [1,1]
- C1283828
- UMLS CUI [1,2]
- C1707479
- UMLS CUI [1,3]
- C0003281
Beschrijving
Details Further Antithrombotic Product
Alias
- UMLS CUI-1
- C0003281
Beschrijving
tblAE.drugterm2
Datatype
text
Alias
- UMLS CUI [1,1]
- C0003280
- UMLS CUI [1,2]
- C0919189
Beschrijving
tblAE.drugform2
Datatype
integer
Alias
- UMLS CUI [1]
- C1705957
Beschrijving
tblAE.drugformoth2
Datatype
text
Alias
- UMLS CUI [1]
- C1705957
Beschrijving
tblAE.drugdose2
Datatype
text
Alias
- UMLS CUI [1,1]
- C0003280
- UMLS CUI [1,2]
- C0178602
Beschrijving
tblAE.drugunitoth2
Datatype
integer
Alias
- UMLS CUI [1,1]
- C0003280
- UMLS CUI [1,2]
- C0869039
Beschrijving
tblAE.drugdose2
Datatype
text
Alias
- UMLS CUI [1,1]
- C0003280
- UMLS CUI [1,2]
- C0869039
Beschrijving
tblAE.drugroute2
Datatype
integer
Alias
- UMLS CUI [1]
- C0013153
Beschrijving
tblAE.drugrouteoth2
Datatype
text
Alias
- UMLS CUI [1]
- C0013153
Beschrijving
tblAE.drugstda2
Datatype
date
Alias
- UMLS CUI [1,1]
- C0808070
- UMLS CUI [1,2]
- C0304229
Beschrijving
tblAE.drugongo2
Datatype
integer
Alias
- UMLS CUI [1,1]
- C0549178
- UMLS CUI [1,2]
- C0013216
Beschrijving
tblAE.drugendat2
Datatype
date
Alias
- UMLS CUI [1]
- C1531784
Beschrijving
tblAE.drugind2
Datatype
text
Alias
- UMLS CUI [1,1]
- C1283828
- UMLS CUI [1,2]
- C1707479
- UMLS CUI [1,3]
- C0003281
Beschrijving
Concomitant Therapies
Alias
- UMLS CUI-1
- C1707479
Beschrijving
Concomitant diagnoses
Alias
- UMLS CUI-1
- C0243086
Beschrijving
tblSAE_CDiag.cdiagid
Datatype
integer
Alias
- UMLS CUI [1,1]
- C0243086
- UMLS CUI [1,2]
- C1300638
Beschrijving
tblSAE_CDiag.concdiag
Datatype
integer
Alias
- UMLS CUI [1,1]
- C0243086
- UMLS CUI [1,2]
- C0011900
Beschrijving
tblSAE_CDiag.cdiagid
Datatype
integer
Alias
- UMLS CUI [1,1]
- C0243086
- UMLS CUI [1,2]
- C1300638
Beschrijving
tblSAE_CDiag.concdiag
Datatype
integer
Alias
- UMLS CUI [1,1]
- C0243086
- UMLS CUI [1,2]
- C0011900
Beschrijving
tblSAE_CDiag.cdiagid
Datatype
integer
Alias
- UMLS CUI [1,1]
- C0243086
- UMLS CUI [1,2]
- C1300638
Beschrijving
tblSAE_CDiag.concdiag
Datatype
integer
Alias
- UMLS CUI [1,1]
- C0243086
- UMLS CUI [1,2]
- C0011900
Beschrijving
tblSAE_CDiag.cdiagid
Datatype
integer
Alias
- UMLS CUI [1,1]
- C0243086
- UMLS CUI [1,2]
- C1300638
Beschrijving
tblSAE_CDiag.concdiag
Datatype
integer
Alias
- UMLS CUI [1,1]
- C0243086
- UMLS CUI [1,2]
- C0011900
Beschrijving
tblSAE_CDiag.cdiagid
Datatype
integer
Alias
- UMLS CUI [1,1]
- C0243086
- UMLS CUI [1,2]
- C1300638
Beschrijving
tblSAE_CDiag.concdiag
Datatype
integer
Alias
- UMLS CUI [1,1]
- C0243086
- UMLS CUI [1,2]
- C0011900
Beschrijving
tblSAE_CDiag.cdiagid
Datatype
integer
Alias
- UMLS CUI [1,1]
- C0243086
- UMLS CUI [1,2]
- C1300638
Beschrijving
tblSAE_CDiag.concdiag
Datatype
integer
Alias
- UMLS CUI [1,1]
- C0243086
- UMLS CUI [1,2]
- C0011900
Beschrijving
tblSAE_CDiag.cdiagid
Datatype
integer
Alias
- UMLS CUI [1,1]
- C0243086
- UMLS CUI [1,2]
- C1300638
Beschrijving
ttblSAE_CDiag.concdiag
Datatype
integer
Alias
- UMLS CUI [1,1]
- C0243086
- UMLS CUI [1,2]
- C0011900
Beschrijving
tblSAE_CDiag.cdiagid
Datatype
integer
Alias
- UMLS CUI [1,1]
- C0243086
- UMLS CUI [1,2]
- C1300638
Beschrijving
tblSAE_CDiag.concdiag
Datatype
integer
Alias
- UMLS CUI [1,1]
- C0243086
- UMLS CUI [1,2]
- C0011900
Beschrijving
tblSAE_CDiag.cdiagid
Datatype
integer
Alias
- UMLS CUI [1,1]
- C0243086
- UMLS CUI [1,2]
- C1300638
Beschrijving
tblSAE_CDiag.concdiag
Datatype
integer
Alias
- UMLS CUI [1,1]
- C0243086
- UMLS CUI [1,2]
- C0011900
Beschrijving
tblSAE_CDiag.cdiagid
Datatype
integer
Alias
- UMLS CUI [1,1]
- C0243086
- UMLS CUI [1,2]
- C1300638
Beschrijving
tblSAE_CDiag.concdiag
Datatype
integer
Alias
- UMLS CUI [1,1]
- C0243086
- UMLS CUI [1,2]
- C0011900
Beschrijving
Comments
Alias
- UMLS CUI-1
- C0947611
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