ID

25151

Beschreibung

DEMOGRAPHY Ropinirole Case Report Form GSK Study ID: 100013 Clinical Study ID: RRL100013 A 12-Week, Double-Blind, Placebo-Controlled, Twice-Daily Dosing Study to Assess the Efficacy and Safety of Ropinirole in Patients Suffering from Restless Legs Syndrome (RLS) Requiring Extended Treatment Coverage

Stichworte

Versionen (1)
  1. 27.08.17 27.08.17 -
Rechteinhaber

gsk

Hochgeladen am

27. August 2017

DOI

Für eine Beantragung loggen Sie sich ein.

Lizenz

Creative Commons BY-NC 3.0
Modell Kommentare :

Hier können Sie das Modell kommentieren. Über die Sprechblasen an den Itemgruppen und Items können Sie diese spezifisch kommentieren.

Zurück zu Modell Kommentaren
Itemgroup Kommentare für :

Item Kommentare für :

Um Formulare herunterzuladen müssen Sie angemeldet sein. Bitte loggen Sie sich ein oder registrieren Sie sich kostenlos.

DEMOGRAPHY Ropinirole Case Report Form GSK RRL100013

Deutsch Englisch

DEMOGRAPHY Ropinirole Case Report Form GSK

1 Formulare  
DEMOGRAPHY
Beschreibung

DEMOGRAPHY

Date of birth
Beschreibung

Date of birth

Datentyp

date

Alias
UMLS CUI [1]
C0421451
Gender
Beschreibung

Gender

Datentyp

integer

Alias
UMLS CUI [1]
C0079399
Ethnicity
Beschreibung

Ethnicity

Datentyp

integer

Alias
UMLS CUI [1]
C0015031
Race
Beschreibung

Race

Datentyp

integer

Alias
UMLS CUI [1]
C0034510
VITAL SIGNS
Beschreibung

VITAL SIGNS

Height
Beschreibung

Height

Datentyp

integer

Maßeinheiten
  • cm
Alias
UMLS CUI [1]
C0005890
cm
Weight
Beschreibung

Weight

Datentyp

integer

Maßeinheiten
  • kg
Alias
UMLS CUI [1]
C0005910
kg
Blood pressure Semi-Supine
Beschreibung

Blood pressure Semi-Supine

Datentyp

integer

Maßeinheiten
  • mmHg
Alias
UMLS CUI [1,1]
C0005823
UMLS CUI [1,2]
C0038846
Blood pressure Standing position
Beschreibung

Blood pressure Standing position

Datentyp

integer

Maßeinheiten
  • mmHg
Alias
UMLS CUI [1,1]
C0005823
UMLS CUI [1,2]
C0231472
Heart rate standing position
Beschreibung

Heart rate standing position

Datentyp

integer

Maßeinheiten
  • beats/minute
Alias
UMLS CUI [1,1]
C0018810
UMLS CUI [1,2]
C0231472
beats/minute
Heart rate Semi-Supine
Beschreibung

Heart rate Semi-Supine

Datentyp

integer

Maßeinheiten
  • beats/minute
Alias
UMLS CUI [1,1]
C0018810
UMLS CUI [1,2]
C0038846
beats/minute
RLS DIAGNOSTIC CLINICAL INTERVIEW - WORKSHEET
Beschreibung

RLS DIAGNOSTIC CLINICAL INTERVIEW - WORKSHEET

Final diagnosis
Beschreibung

Final diagnosis

Datentyp

integer

Alias
UMLS CUI [1]
C0011900
Does subject report growing pains:
Beschreibung

Does subject report growing pains:

Datentyp

boolean

Alias
UMLS CUI [1]
C0423693
Have you ever had unpleasant or uncomfortable feelings in your legs that occurred mainly while you were either sitting or lying down?
Beschreibung

If no, go to #3

Datentyp

boolean

Alias
UMLS CUI [1]
C2112857
Are these feelings painful rather than just uncomfortable?
Beschreibung

Are these feelings painful rather than just uncomfortable?

Datentyp

boolean

Alias
UMLS CUI [1]
C0030193
UMLS CUI [2]
C2051418
How would you describe these feelings or sensations?
Beschreibung

How would you describe these feelings or sensations?

Datentyp

text

Alias
UMLS CUI [1,1]
C0036659
UMLS CUI [1,2]
C0678257
Have you ever felt the need or urge to move your legs that occurred mainly while you were either sitting or lying down?
Beschreibung

If yes, go to #3a. If no, go to #4.

Datentyp

boolean

Alias
UMLS CUI [1]
C4289280
Do these feelings in your legs ever become overwhelming to the point that you cannot resist moving your legs?
Beschreibung

Do these feelings in your legs ever become overwhelming to the point that you cannot resist moving your legs?

Datentyp

boolean

Alias
UMLS CUI [1]
C0030193
If you developed these feelings in your legs and you could not move your legs, or if someone were to hold your legs down, how would this effect the feelings in your legs?:
Beschreibung

If you developed these feelings in your legs and you could not move your legs, or if someone were to hold your legs down, how would this effect the feelings in your legs?:

Datentyp

boolean

Alias
UMLS CUI [1]
C0560841
ALCOHOL INTAKE
Beschreibung

ALCOHOL INTAKE

ALCOHOL INTAKE
Beschreibung

ALCOHOL CONVERTER 1 unit of alcohol in US = 1.5oz hard liquor, 1 beer, 4oz wine Round up/down to the nearest integer.

Datentyp

integer

Alias
UMLS CUI [1]
C0001948
CAFFEINE INTAKE INVEST/GA TOR INSTRUCTIONS
Beschreibung

CAFFEINE INTAKE INVEST/GA TOR INSTRUCTIONS

CAFFEINE INTAKE
Beschreibung

8 fluid ounces coffee = 3 units (approximately 136mg caffeine) 8 fluid ounces tea = 2 units (approximately 64mg caffeine) 8 fluid ounces caffeinated soda = 1 unit (approximately 46mg caffeine) Round up/down to the nearest integer.

Datentyp

integer

RLS SCREEN HISTORY
Beschreibung

RLS SCREEN HISTORY

What was the subject's age at the onset of RLS?
Beschreibung

What was the subject's age at the onset of RLS?

Datentyp

integer

Alias
UMLS CUI [1,1]
C0206132
UMLS CUI [1,2]
C0035258
Did the subject start any new medication near the time of their first onset of RLS symptoms that may have caused RLS?
Beschreibung

If 'Yes' specify medication(s)

Datentyp

boolean

Alias
UMLS CUI [1,1]
C0035258
UMLS CUI [1,2]
C0420250
If female, did RLS symptoms develop during pregnancy?
Beschreibung

If female, did RLS symptoms develop during pregnancy?

Datentyp

integer

Alias
UMLS CUI [1,1]
C0035258
UMLS CUI [1,2]
C0032961
Has any first degree relative (mother/father, brother/sister, son/daughter) of the subject ever been diagnosed with or had symptoms of RLS?
Beschreibung

Has any first degree relative (mother/father, brother/sister, son/daughter) of the subject ever been diagnosed with or had symptoms of RLS?

Datentyp

boolean

Alias
UMLS CUI [1,1]
C0035258
UMLS CUI [1,2]
C0080103
Has the subject ever had PLMS (Periodic Limb Movements during Sleep)?
Beschreibung

If 'YES', what was the subject's age at the onset of PLMS?

Datentyp

boolean

Alias
UMLS CUI [1]
C1970020
Has any first degree relative (mother/father, brother/sister, son/daughter) of the subject ever been diagnosed with or had symptoms of PLMS?
Beschreibung

Has any first degree relative (mother/father, brother/sister, son/daughter) of the subject ever been diagnosed with or had symptoms of PLMS?

Datentyp

boolean

Alias
UMLS CUI [1,1]
C1970020
UMLS CUI [1,2]
C0080103
Does the subject have any sleep disorder as defined by DSM IV other than qualifying disease state for this study?
Beschreibung

If 'Yes' record on the Medical Conditions page.

Datentyp

boolean

Alias
UMLS CUI [1]
C0851578
When are the subject's current RLS symptoms mainly present?
Beschreibung

When are the subject's current RLS symptoms mainly present?

Datentyp

integer

Alias
UMLS CUI [1,1]
C0035258
UMLS CUI [1,2]
C1457887
Have any of the following parts of the subject's body ever been affected by RLS symptoms?
Beschreibung

Have any of the following parts of the subject's body ever been affected by RLS symptoms?

Datentyp

integer

Alias
UMLS CUI [1,1]
C0035258
UMLS CUI [1,2]
C0035258
Does the subject consume alcohol?
Beschreibung

Does the subject consume alcohol?

Datentyp

boolean

Alias
UMLS CUI [1]
C0001948
If Yes, record the average number of units of alcohol' consumed per week
Beschreibung

If Yes, record the average number of units of alcohol' consumed per week

Datentyp

text

Alias
UMLS CUI [1,1]
C0001948
UMLS CUI [1,2]
C0556331
Does the subject consume caffeine (coffee, tea, other caffeinated substances)?
Beschreibung

Does the subject consume caffeine (coffee, tea, other caffeinated substances)?

Datentyp

boolean

Alias
UMLS CUI [1]
C0948365
INTERNATIONAL RESTLESS LEG SYNDROME STUDY GROUP (IRLSSG) DIAGNOSTIC CRITERIA
Beschreibung

INTERNATIONAL RESTLESS LEG SYNDROME STUDY GROUP (IRLSSG) DIAGNOSTIC CRITERIA

An urge to move the legs, usually accompanied or caused by uncomfortable and unpleasant sensations in the legs.
Beschreibung

An urge to move the legs, usually accompanied or caused by uncomfortable and unpleasant sensations in the legs.

Datentyp

boolean

Alias
UMLS CUI [1,1]
C0518561
UMLS CUI [1,2]
C0035258
The urge to move or unpleasant sensations begin or worsen during periods of rest or inactivity such as lying or sitting.
Beschreibung

The urge to move or unpleasant sensations begin or worsen during periods of rest or inactivity such as lying or sitting.

Datentyp

boolean

Alias
UMLS CUI [1,1]
C0035258
UMLS CUI [1,2]
C3890554
The urge to move or unpleasant sensations are partially or totally relieved by movement, such as walking or stretching, at least as long as the activity continues.
Beschreibung

The urge to move or unpleasant sensations are partially or totally relieved by movement, such as walking or stretching, at least as long as the activity continues.

Datentyp

integer

Alias
UMLS CUI [1,1]
C0080331
UMLS CUI [1,2]
C0600080
The urge to move or unpleasant sensations are worse in the evening or night than during the day or only occur in the evening or night.
Beschreibung

The urge to move or unpleasant sensations are worse in the evening or night than during the day or only occur in the evening or night.

Datentyp

boolean

Alias
UMLS CUI [1,1]
C1457887
UMLS CUI [1,2]
C3845371
CARDIOVASCULAR MEDICAL HISTORY
Beschreibung

CARDIOVASCULAR MEDICAL HISTORY

Myocardial infarction
Beschreibung

Myocardial infarction

Datentyp

integer

Alias
UMLS CUI [1]
C0027051
Atherosclerosis
Beschreibung

Atherosclerosis

Datentyp

integer

Alias
UMLS CUI [1]
C0004153
Cardiac valve disease
Beschreibung

Cardiac valve disease

Datentyp

integer

Alias
UMLS CUI [1]
C0018824
Peripheral vascular disease
Beschreibung

Peripheral vascular disease

Datentyp

integer

Alias
UMLS CUI [1]
C0085096
Unspecified cerebrovascular disease
Beschreibung

Unspecified cerebrovascular disease

Datentyp

integer

Alias
UMLS CUI [1]
C0007820
Transient ischaemic attack
Beschreibung

Transient ischaemic attack

Datentyp

integer

Alias
UMLS CUI [1]
C0007787
Stroke
Beschreibung

Stroke

Datentyp

integer

Alias
UMLS CUI [1]
C0038454
Cardiac arrest
Beschreibung

Cardiac arrest

Datentyp

integer

Alias
UMLS CUI [1]
C0018790
Coronary artery disease
Beschreibung

Coronary artery disease

Datentyp

integer

Alias
UMLS CUI [1]
C1956346
ischaemic heart disease
Beschreibung

ischaemic heart disease

Datentyp

integer

Alias
UMLS CUI [1]
C0151744
ischaemic heart disease with cardiomyopathy
Beschreibung

ischaemic heart disease with cardiomyopathy

Datentyp

integer

Alias
UMLS CUI [1,1]
C0151744
UMLS CUI [1,2]
C0878544
Stable angina pectoris
Beschreibung

Stable angina pectoris

Datentyp

integer

Alias
UMLS CUI [1]
C0340288
Unstable angina
Beschreibung

Unstable angina

Datentyp

integer

Alias
UMLS CUI [1]
C0002965
Heart failure
Beschreibung

Heart failure

Datentyp

integer

Alias
UMLS CUI [1]
C0018801
Arrhythmia
Beschreibung

Arrhythmia

Datentyp

integer

Alias
UMLS CUI [1]
C0003811
Left ventricular dysfunction
Beschreibung

Left ventricular dysfunction

Datentyp

integer

Alias
UMLS CUI [1]
C0242698
Pulmonary oedema
Beschreibung

Pulmonary oedema

Datentyp

integer

Alias
UMLS CUI [1]
C0034063
Hypertension
Beschreibung

Hypertension

Datentyp

integer

Alias
UMLS CUI [1]
C0020538
Oedema
Beschreibung

Oedema

Datentyp

text

Alias
UMLS CUI [1]
C0013604
Left ventricular hypertrophy
Beschreibung

Left ventricular hypertrophy

Datentyp

integer

Alias
UMLS CUI [1]
C0149721
Cardiomegaly
Beschreibung

Cardiomegaly

Datentyp

integer

Alias
UMLS CUI [1]
C0018800
Cardiomyopathy
Beschreibung

Cardiomyopathy

Datentyp

integer

Alias
UMLS CUI [1]
C0878544
Diastolic dysfunction
Beschreibung

Diastolic dysfunction

Datentyp

integer

Alias
UMLS CUI [1]
C0520863
Coronary artery by-pass
Beschreibung

Coronary artery by-pass

Datentyp

integer

Alias
UMLS CUI [1]
C0010055
Angioplasty
Beschreibung

Angioplasty

Datentyp

integer

Alias
UMLS CUI [1]
C0162577
STENT insertion
Beschreibung

STENT insertion

Datentyp

integer

Alias
UMLS CUI [1]
C0398087
Cardiac transplantation
Beschreibung

Cardiac transplantation

Datentyp

integer

Alias
UMLS CUI [1]
C3275052
Amputation
Beschreibung

Amputation

Datentyp

integer

Alias
UMLS CUI [1]
C0002688
Pacemaker insertion
Beschreibung

Pacemaker insertion

Datentyp

integer

Alias
UMLS CUI [1]
C0189843
Carotid endarterectomy
Beschreibung

Carotid endarterectomy

Datentyp

integer

Alias
UMLS CUI [1]
C3275052
Vascular bypass graft (other than coronary)
Beschreibung

Vascular bypass graft (other than coronary)

Datentyp

integer

Alias
UMLS CUI [1]
C0863745
Zum Seitenanfang zurückkehren

Ähnliche Modelle

DEMOGRAPHY Ropinirole Case Report Form GSK

1 Formulare
Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
Alias
Item Group
DEMOGRAPHY
Date of birth
Item
Date of birth
date
C0421451 (UMLS CUI [1])
Item
Gender
integer
C0079399 (UMLS CUI [1])
Gender
Code List
Gender
CL Item
m (1)
CL Item
f (2)
Item
Ethnicity
integer
C0015031 (UMLS CUI [1])
Ethnicity
Code List
Ethnicity
CL Item
Hispanic or Latino (1)
CL Item
Not Hispanic or Latino (2)
Item
Race
integer
C0034510 (UMLS CUI [1])
Race
Code List
Race
CL Item
White - White/Caucasian/European Heritage (1)
CL Item
White - Arabic/North African Heritage (2)
CL Item
Native Hawaiian or Other Pacific Islander (3)
CL Item
Asian - South East Asian Heritage (4)
CL Item
Asian - Japanese Heritage (5)
CL Item
Asian - East Asian Heritage (6)
CL Item
Asian - Central/South Asian Heritage (7)
CL Item
American Indian or Alaskan Native (8)
CL Item
African American/African Heritage (9)
Item Group
VITAL SIGNS
Height
Item
Height
integer
C0005890 (UMLS CUI [1])
Weight
Item
Weight
integer
C0005910 (UMLS CUI [1])
Item
Blood pressure Semi-Supine
integer
C0005823 (UMLS CUI [1,1])
C0038846 (UMLS CUI [1,2])
Blood pressure
Code List
Blood pressure Semi-Supine
CL Item
systolic (1)
C0871470 (UMLS CUI-1)
(Comment:en)
CL Item
diastolic (2)
C0428883 (UMLS CUI-1)
(Comment:en)
Item
Blood pressure Standing position
integer
C0005823 (UMLS CUI [1,1])
C0231472 (UMLS CUI [1,2])
Blood pressure
Code List
Blood pressure Standing position
CL Item
systolic (1)
C0871470 (UMLS CUI-1)
(Comment:en)
CL Item
diastolic (2)
C0428883 (UMLS CUI-1)
(Comment:en)
Heart rate standing position
Item
Heart rate standing position
integer
C0018810 (UMLS CUI [1,1])
C0231472 (UMLS CUI [1,2])
Heart rate Semi-Supine
Item
Heart rate Semi-Supine
integer
C0018810 (UMLS CUI [1,1])
C0038846 (UMLS CUI [1,2])
Item Group
RLS DIAGNOSTIC CLINICAL INTERVIEW - WORKSHEET
Item
Final diagnosis
integer
C0011900 (UMLS CUI [1])
Final diagnosis
Code List
Final diagnosis
CL Item
Definite RLS (1)
C0035258 (UMLS CUI-1)
C0439544 (UMLS CUI-2)
(Comment:en)
CL Item
Probable RLS (2)
C0035258 (UMLS CUI-1)
C0332148 (UMLS CUI-2)
(Comment:en)
CL Item
Possible RLS (3)
C0035258 (UMLS CUI-1)
C2362652 (UMLS CUI-2)
(Comment:en)
CL Item
Not-RLS (4)
C0035258 (UMLS CUI-1)
C0497153 (UMLS CUI-2)
(Comment:en)
CL Item
Secondary Definite (5)
C0035258 (UMLS CUI-1)
C0439544 (UMLS CUI-2)
C0332138 (UMLS CUI-3)
(Comment:en)
CL Item
Secondary Possible (6)
C0035258 (UMLS CUI-1)
C2362652 (UMLS CUI-2)
C0332138 (UMLS CUI-3)
(Comment:en)
CL Item
Diagnosis Unknown (7)
C0011900 (UMLS CUI-1)
C0439673 (UMLS CUI-2)
(Comment:en)
Does subject report growing pains:
Item
Does subject report growing pains:
boolean
C0423693 (UMLS CUI [1])
Have you ever had unpleasant or uncomfortable feelings in your legs that occurred mainly while you were either sitting or lying down?
Item
Have you ever had unpleasant or uncomfortable feelings in your legs that occurred mainly while you were either sitting or lying down?
boolean
C2112857 (UMLS CUI [1])
Are these feelings painful rather than just uncomfortable?
Item
Are these feelings painful rather than just uncomfortable?
boolean
C0030193 (UMLS CUI [1])
C2051418 (UMLS CUI [2])
How would you describe these feelings or sensations?
Item
How would you describe these feelings or sensations?
text
C0036659 (UMLS CUI [1,1])
C0678257 (UMLS CUI [1,2])
Have you ever felt the need or urge to move your legs that occurred mainly while you were either sitting or lying down?
Item
Have you ever felt the need or urge to move your legs that occurred mainly while you were either sitting or lying down?
boolean
C4289280 (UMLS CUI [1])
Do these feelings in your legs ever become overwhelming to the point that you cannot resist moving your legs?
Item
Do these feelings in your legs ever become overwhelming to the point that you cannot resist moving your legs?
boolean
C0030193 (UMLS CUI [1])
If you developed these feelings in your legs and you could not move your legs, or if someone were to hold your legs down, how would this effect the feelings in your legs?:
Item
If you developed these feelings in your legs and you could not move your legs, or if someone were to hold your legs down, how would this effect the feelings in your legs?:
boolean
C0560841 (UMLS CUI [1])
Item Group
ALCOHOL INTAKE
ALCOHOL INTAKE
Item
ALCOHOL INTAKE
integer
C0001948 (UMLS CUI [1])
Item Group
CAFFEINE INTAKE INVEST/GA TOR INSTRUCTIONS
CAFFEINE INTAKE
Item
CAFFEINE INTAKE
integer
Item Group
RLS SCREEN HISTORY
What was the subject's age at the onset of RLS?
Item
What was the subject's age at the onset of RLS?
integer
C0206132 (UMLS CUI [1,1])
C0035258 (UMLS CUI [1,2])
Did the subject start any new medication near the time of their first onset of RLS symptoms that may have caused RLS?
Item
Did the subject start any new medication near the time of their first onset of RLS symptoms that may have caused RLS?
boolean
C0035258 (UMLS CUI [1,1])
C0420250 (UMLS CUI [1,2])
Item
If female, did RLS symptoms develop during pregnancy?
integer
C0035258 (UMLS CUI [1,1])
C0032961 (UMLS CUI [1,2])
If female, did RLS symptoms develop during pregnancy?
Code List
If female, did RLS symptoms develop during pregnancy?
CL Item
no (1)
C1298908 (UMLS CUI-1)
(Comment:en)
CL Item
yes (2)
C0035258 (UMLS CUI-1)
(Comment:en)
CL Item
Not applicable (3)
C1272460 (UMLS CUI-1)
(Comment:en)
Has any first degree relative (mother/father, brother/sister, son/daughter) of the subject ever been diagnosed with or had symptoms of RLS?
Item
Has any first degree relative (mother/father, brother/sister, son/daughter) of the subject ever been diagnosed with or had symptoms of RLS?
boolean
C0035258 (UMLS CUI [1,1])
C0080103 (UMLS CUI [1,2])
Has the subject ever had PLMS (Periodic Limb Movements during Sleep)?
Item
Has the subject ever had PLMS (Periodic Limb Movements during Sleep)?
boolean
C1970020 (UMLS CUI [1])
Has any first degree relative (mother/father, brother/sister, son/daughter) of the subject ever been diagnosed with or had symptoms of PLMS?
Item
Has any first degree relative (mother/father, brother/sister, son/daughter) of the subject ever been diagnosed with or had symptoms of PLMS?
boolean
C1970020 (UMLS CUI [1,1])
C0080103 (UMLS CUI [1,2])
Does the subject have any sleep disorder as defined by DSM IV other than qualifying disease state for this study?
Item
Does the subject have any sleep disorder as defined by DSM IV other than qualifying disease state for this study?
boolean
C0851578 (UMLS CUI [1])
Item
When are the subject's current RLS symptoms mainly present?
integer
C0035258 (UMLS CUI [1,1])
C1457887 (UMLS CUI [1,2])
When are the subject's current RLS symptoms mainly present?
Code List
When are the subject's current RLS symptoms mainly present?
CL Item
At nighttime only (1)
C2608290 (UMLS CUI-1)
(Comment:en)
CL Item
In evening and nighttime (2)
C0587117 (UMLS CUI-1)
C0587117 (UMLS CUI-2)
(Comment:en)
CL Item
Daytime, evening and nighttime (3)
C0587117 (UMLS CUI-1)
C0587117 (UMLS CUI-2)
C0332169 (UMLS CUI-3)
(Comment:en)
Item
Have any of the following parts of the subject's body ever been affected by RLS symptoms?
integer
C0035258 (UMLS CUI [1,1])
C0035258 (UMLS CUI [1,2])
Have any of the following parts of the subject's body ever been affected by RLS symptoms?
Code List
Have any of the following parts of the subject's body ever been affected by RLS symptoms?
CL Item
Right leg (1)
C0230442 (UMLS CUI-1)
(Comment:en)
CL Item
Left leg (2)
C0230443 (UMLS CUI-1)
(Comment:en)
CL Item
Right arm (3)
C0230346 (UMLS CUI-1)
(Comment:en)
CL Item
Left arm (4)
C0230347 (UMLS CUI-1)
(Comment:en)
CL Item
Trunk (5)
C0460005 (UMLS CUI-1)
(Comment:en)
CL Item
Face or neck (6)
C0015450 (UMLS CUI-1)
C0027530 (UMLS CUI-3)
(Comment:en)
Does the subject consume alcohol?
Item
Does the subject consume alcohol?
boolean
C0001948 (UMLS CUI [1])
If Yes, record the average number of units of alcohol' consumed per week
Item
If Yes, record the average number of units of alcohol' consumed per week
text
C0001948 (UMLS CUI [1,1])
C0556331 (UMLS CUI [1,2])
Does the subject consume caffeine (coffee, tea, other caffeinated substances)?
Item
Does the subject consume caffeine (coffee, tea, other caffeinated substances)?
boolean
C0948365 (UMLS CUI [1])
Item Group
INTERNATIONAL RESTLESS LEG SYNDROME STUDY GROUP (IRLSSG) DIAGNOSTIC CRITERIA
An urge to move the legs, usually accompanied or caused by uncomfortable and unpleasant sensations in the legs.
Item
An urge to move the legs, usually accompanied or caused by uncomfortable and unpleasant sensations in the legs.
boolean
C0518561 (UMLS CUI [1,1])
C0035258 (UMLS CUI [1,2])
The urge to move or unpleasant sensations begin or worsen during periods of rest or inactivity such as lying or sitting.
Item
The urge to move or unpleasant sensations begin or worsen during periods of rest or inactivity such as lying or sitting.
boolean
C0035258 (UMLS CUI [1,1])
C3890554 (UMLS CUI [1,2])
The urge to move or unpleasant sensations are partially or totally relieved by movement, such as walking or stretching, at least as long as the activity continues.
Item
The urge to move or unpleasant sensations are partially or totally relieved by movement, such as walking or stretching, at least as long as the activity continues.
integer
C0080331 (UMLS CUI [1,1])
C0600080 (UMLS CUI [1,2])
The urge to move or unpleasant sensations are worse in the evening or night than during the day or only occur in the evening or night.
Item
The urge to move or unpleasant sensations are worse in the evening or night than during the day or only occur in the evening or night.
boolean
C1457887 (UMLS CUI [1,1])
C3845371 (UMLS CUI [1,2])
Item Group
CARDIOVASCULAR MEDICAL HISTORY
Item
Myocardial infarction
integer
C0027051 (UMLS CUI [1])
Myocardial infarction
Code List
Myocardial infarction
CL Item
past (1)
C1444637 (UMLS CUI-1)
(Comment:en)
CL Item
current (2)
C0521116 (UMLS CUI-1)
(Comment:en)
CL Item
no medical history (3)
C0262926 (UMLS CUI-1)
(Comment:en)
Item
Atherosclerosis
integer
C0004153 (UMLS CUI [1])
Myocardial infarction
Code List
Atherosclerosis
CL Item
past (1)
C1444637 (UMLS CUI-1)
(Comment:en)
CL Item
current (2)
C0521116 (UMLS CUI-1)
(Comment:en)
CL Item
no medical history (3)
C0262926 (UMLS CUI-1)
(Comment:en)
Item
Cardiac valve disease
integer
C0018824 (UMLS CUI [1])
Myocardial infarction
Code List
Cardiac valve disease
CL Item
past (1)
C1444637 (UMLS CUI-1)
(Comment:en)
CL Item
current (2)
C0521116 (UMLS CUI-1)
(Comment:en)
CL Item
no medical history (3)
C0262926 (UMLS CUI-1)
(Comment:en)
Item
Peripheral vascular disease
integer
C0085096 (UMLS CUI [1])
Myocardial infarction
Code List
Peripheral vascular disease
CL Item
past (1)
C1444637 (UMLS CUI-1)
(Comment:en)
CL Item
current (2)
C0521116 (UMLS CUI-1)
(Comment:en)
CL Item
no medical history (3)
C0262926 (UMLS CUI-1)
(Comment:en)
Item
Unspecified cerebrovascular disease
integer
C0007820 (UMLS CUI [1])
Myocardial infarction
Code List
Unspecified cerebrovascular disease
CL Item
past (1)
C1444637 (UMLS CUI-1)
(Comment:en)
CL Item
current (2)
C0521116 (UMLS CUI-1)
(Comment:en)
CL Item
no medical history (3)
C0262926 (UMLS CUI-1)
(Comment:en)
Item
Transient ischaemic attack
integer
C0007787 (UMLS CUI [1])
Myocardial infarction
Code List
Transient ischaemic attack
CL Item
past (1)
C1444637 (UMLS CUI-1)
(Comment:en)
CL Item
current (2)
C0521116 (UMLS CUI-1)
(Comment:en)
CL Item
no medical history (3)
C0262926 (UMLS CUI-1)
(Comment:en)
Item
Stroke
integer
C0038454 (UMLS CUI [1])
Myocardial infarction
Code List
Stroke
CL Item
past (1)
C1444637 (UMLS CUI-1)
(Comment:en)
CL Item
current (2)
C0521116 (UMLS CUI-1)
(Comment:en)
CL Item
no medical history (3)
C0262926 (UMLS CUI-1)
(Comment:en)
Item
Cardiac arrest
integer
C0018790 (UMLS CUI [1])
Myocardial infarction
Code List
Cardiac arrest
CL Item
past (1)
C1444637 (UMLS CUI-1)
(Comment:en)
CL Item
current (2)
C0521116 (UMLS CUI-1)
(Comment:en)
CL Item
no medical history (3)
C0262926 (UMLS CUI-1)
(Comment:en)
Item
Coronary artery disease
integer
C1956346 (UMLS CUI [1])
Myocardial infarction
Code List
Coronary artery disease
CL Item
past (1)
C1444637 (UMLS CUI-1)
(Comment:en)
CL Item
current (2)
C0521116 (UMLS CUI-1)
(Comment:en)
CL Item
no medical history (3)
C0262926 (UMLS CUI-1)
(Comment:en)
Item
ischaemic heart disease
integer
C0151744 (UMLS CUI [1])
Myocardial infarction
Code List
ischaemic heart disease
CL Item
past (1)
C1444637 (UMLS CUI-1)
(Comment:en)
CL Item
current (2)
C0521116 (UMLS CUI-1)
(Comment:en)
CL Item
no medical history (3)
C0262926 (UMLS CUI-1)
(Comment:en)
Item
ischaemic heart disease with cardiomyopathy
integer
C0151744 (UMLS CUI [1,1])
C0878544 (UMLS CUI [1,2])
Myocardial infarction
Code List
ischaemic heart disease with cardiomyopathy
CL Item
past (1)
C1444637 (UMLS CUI-1)
(Comment:en)
CL Item
current (2)
C0521116 (UMLS CUI-1)
(Comment:en)
CL Item
no medical history (3)
C0262926 (UMLS CUI-1)
(Comment:en)
Item
Stable angina pectoris
integer
C0340288 (UMLS CUI [1])
Myocardial infarction
Code List
Stable angina pectoris
CL Item
past (1)
C1444637 (UMLS CUI-1)
(Comment:en)
CL Item
current (2)
C0521116 (UMLS CUI-1)
(Comment:en)
CL Item
no medical history (3)
C0262926 (UMLS CUI-1)
(Comment:en)
Item
Unstable angina
integer
C0002965 (UMLS CUI [1])
Myocardial infarction
Code List
Unstable angina
CL Item
past (1)
C1444637 (UMLS CUI-1)
(Comment:en)
CL Item
current (2)
C0521116 (UMLS CUI-1)
(Comment:en)
CL Item
no medical history (3)
C0262926 (UMLS CUI-1)
(Comment:en)
Item
Heart failure
integer
C0018801 (UMLS CUI [1])
Myocardial infarction
Code List
Heart failure
CL Item
past (1)
C1444637 (UMLS CUI-1)
(Comment:en)
CL Item
current (2)
C0521116 (UMLS CUI-1)
(Comment:en)
CL Item
no medical history (3)
C0262926 (UMLS CUI-1)
(Comment:en)
Item
Arrhythmia
integer
C0003811 (UMLS CUI [1])
Myocardial infarction
Code List
Arrhythmia
CL Item
past (1)
C1444637 (UMLS CUI-1)
(Comment:en)
CL Item
current (2)
C0521116 (UMLS CUI-1)
(Comment:en)
CL Item
no medical history (3)
C0262926 (UMLS CUI-1)
(Comment:en)
Item
Left ventricular dysfunction
integer
C0242698 (UMLS CUI [1])
Myocardial infarction
Code List
Left ventricular dysfunction
CL Item
past (1)
C1444637 (UMLS CUI-1)
(Comment:en)
CL Item
current (2)
C0521116 (UMLS CUI-1)
(Comment:en)
CL Item
no medical history (3)
C0262926 (UMLS CUI-1)
(Comment:en)
Item
Pulmonary oedema
integer
C0034063 (UMLS CUI [1])
Myocardial infarction
Code List
Pulmonary oedema
CL Item
past (1)
C1444637 (UMLS CUI-1)
(Comment:en)
CL Item
current (2)
C0521116 (UMLS CUI-1)
(Comment:en)
CL Item
no medical history (3)
C0262926 (UMLS CUI-1)
(Comment:en)
Item
Hypertension
integer
C0020538 (UMLS CUI [1])
Myocardial infarction
Code List
Hypertension
CL Item
past (1)
C1444637 (UMLS CUI-1)
(Comment:en)
CL Item
current (2)
C0521116 (UMLS CUI-1)
(Comment:en)
CL Item
no medical history (3)
C0262926 (UMLS CUI-1)
(Comment:en)
Item
Oedema
text
C0013604 (UMLS CUI [1])
Oedema
Code List
Oedema
CL Item
Past (Past)
CL Item
Current (Current)
CL Item
No Medical History (No Medical History)
Item
Left ventricular hypertrophy
integer
C0149721 (UMLS CUI [1])
Left ventricular hypertrophy
Code List
Left ventricular hypertrophy
CL Item
past (1)
C1444637 (UMLS CUI-1)
C0012634 (UMLS CUI-2)
(Comment:en)
CL Item
current (2)
C0521116 (UMLS CUI-1)
C0012634 (UMLS CUI-2)
(Comment:en)
CL Item
no medical history (3)
C0262926 (UMLS CUI-1)
(Comment:en)
Item
Cardiomegaly
integer
C0018800 (UMLS CUI [1])
Left ventricular hypertrophy
Code List
Cardiomegaly
CL Item
past (1)
C1444637 (UMLS CUI-1)
C0012634 (UMLS CUI-2)
(Comment:en)
CL Item
current (2)
C0521116 (UMLS CUI-1)
C0012634 (UMLS CUI-2)
(Comment:en)
CL Item
no medical history (3)
C0262926 (UMLS CUI-1)
(Comment:en)
Item
Cardiomyopathy
integer
C0878544 (UMLS CUI [1])
Left ventricular hypertrophy
Code List
Cardiomyopathy
CL Item
past (1)
C1444637 (UMLS CUI-1)
C0012634 (UMLS CUI-2)
(Comment:en)
CL Item
current (2)
C0521116 (UMLS CUI-1)
C0012634 (UMLS CUI-2)
(Comment:en)
CL Item
no medical history (3)
C0262926 (UMLS CUI-1)
(Comment:en)
Item
Diastolic dysfunction
integer
C0520863 (UMLS CUI [1])
Left ventricular hypertrophy
Code List
Diastolic dysfunction
CL Item
past (1)
C1444637 (UMLS CUI-1)
C0012634 (UMLS CUI-2)
(Comment:en)
CL Item
current (2)
C0521116 (UMLS CUI-1)
C0012634 (UMLS CUI-2)
(Comment:en)
CL Item
no medical history (3)
C0262926 (UMLS CUI-1)
(Comment:en)
Item
Coronary artery by-pass
integer
C0010055 (UMLS CUI [1])
Left ventricular hypertrophy
Code List
Coronary artery by-pass
CL Item
past (1)
C1444637 (UMLS CUI-1)
C0012634 (UMLS CUI-2)
(Comment:en)
CL Item
current (2)
C0521116 (UMLS CUI-1)
C0012634 (UMLS CUI-2)
(Comment:en)
CL Item
no medical history (3)
C0262926 (UMLS CUI-1)
(Comment:en)
Item
Angioplasty
integer
C0162577 (UMLS CUI [1])
Left ventricular hypertrophy
Code List
Angioplasty
CL Item
past (1)
C1444637 (UMLS CUI-1)
C0012634 (UMLS CUI-2)
(Comment:en)
CL Item
current (2)
C0521116 (UMLS CUI-1)
C0012634 (UMLS CUI-2)
(Comment:en)
CL Item
no medical history (3)
C0262926 (UMLS CUI-1)
(Comment:en)
Item
STENT insertion
integer
C0398087 (UMLS CUI [1])
Left ventricular hypertrophy
Code List
STENT insertion
CL Item
past (1)
C1444637 (UMLS CUI-1)
C0012634 (UMLS CUI-2)
(Comment:en)
CL Item
current (2)
C0521116 (UMLS CUI-1)
C0012634 (UMLS CUI-2)
(Comment:en)
CL Item
no medical history (3)
C0262926 (UMLS CUI-1)
(Comment:en)
Item
Cardiac transplantation
integer
C3275052 (UMLS CUI [1])
Left ventricular hypertrophy
Code List
Cardiac transplantation
CL Item
past (1)
C1444637 (UMLS CUI-1)
C0012634 (UMLS CUI-2)
(Comment:en)
CL Item
current (2)
C0521116 (UMLS CUI-1)
C0012634 (UMLS CUI-2)
(Comment:en)
CL Item
no medical history (3)
C0262926 (UMLS CUI-1)
(Comment:en)
Item
Amputation
integer
C0002688 (UMLS CUI [1])
Left ventricular hypertrophy
Code List
Amputation
CL Item
past (1)
C1444637 (UMLS CUI-1)
C0012634 (UMLS CUI-2)
(Comment:en)
CL Item
current (2)
C0521116 (UMLS CUI-1)
C0012634 (UMLS CUI-2)
(Comment:en)
CL Item
no medical history (3)
C0262926 (UMLS CUI-1)
(Comment:en)
Item
Pacemaker insertion
integer
C0189843 (UMLS CUI [1])
Left ventricular hypertrophy
Code List
Pacemaker insertion
CL Item
past (1)
C1444637 (UMLS CUI-1)
C0012634 (UMLS CUI-2)
(Comment:en)
CL Item
current (2)
C0521116 (UMLS CUI-1)
C0012634 (UMLS CUI-2)
(Comment:en)
CL Item
no medical history (3)
C0262926 (UMLS CUI-1)
(Comment:en)
Item
Carotid endarterectomy
integer
C3275052 (UMLS CUI [1])
Left ventricular hypertrophy
Code List
Carotid endarterectomy
CL Item
past (1)
C1444637 (UMLS CUI-1)
C0012634 (UMLS CUI-2)
(Comment:en)
CL Item
current (2)
C0521116 (UMLS CUI-1)
C0012634 (UMLS CUI-2)
(Comment:en)
CL Item
no medical history (3)
C0262926 (UMLS CUI-1)
(Comment:en)
Item
Vascular bypass graft (other than coronary)
integer
C0863745 (UMLS CUI [1])
Left ventricular hypertrophy
Code List
Vascular bypass graft (other than coronary)
CL Item
past (1)
C1444637 (UMLS CUI-1)
C0012634 (UMLS CUI-2)
(Comment:en)
CL Item
current (2)
C0521116 (UMLS CUI-1)
C0012634 (UMLS CUI-2)
(Comment:en)
CL Item
no medical history (3)
C0262926 (UMLS CUI-1)
(Comment:en)
Zum Seitenanfang zurückkehren 

Kontakt

Benutzen Sie dieses Formular für Rückmeldungen, Fragen und Verbesserungsvorschläge.

Mit * gekennzeichnete Felder sind notwendig.

Hilfe

Benötigen Sie Hilfe bei der Suche? Um mehr Details zu erfahren und die Suche effektiver nutzen zu können schauen Sie sich doch das entsprechende Video auf unserer Tutorial Seite an.

Zum Video