Centre or investigator number
Item
Centre or investigator number
integer
C2826689 (UMLS CUI [1])
Subject Identifier
Item
Subject Identifier
integer
C2348585 (UMLS CUI [1])
Visit Date
Item
Visit Date
date
C1320303 (UMLS CUI [1])
Investigator Instructions
Item
Make a Withdrawal call to the IVRS system.
text
C1442085 (UMLS CUI [1])
Weight
Item
Patient weight
float
C0005910 (UMLS CUI [1])
Systolic Blood Pressure
Item
Systolic Blood Pressure
integer
C0871470 (UMLS CUI [1])
Diastolic blood pressure
Item
Diastolic blood pressure
integer
C0428883 (UMLS CUI [1])
Heart rate
Item
Heart rate
integer
C0018810 (UMLS CUI [1])
Central Laboratory (Non fasting samples)
Item
Central Laboratory (Non fasting samples)
text
C0022885 (UMLS CUI [1,1])
C2585491 (UMLS CUI [1,2])
Collection Date
Item
Date samples taken
date
C1317250 (UMLS CUI [1])
Pregnancy test
Item
Pregnancy test
text
C0032976 (UMLS CUI [1])
Concomitant Medications
Item
Record any changes to the subject's concomitant medications or any new medications taken since the last visit in the appropriate Concomitant Medications section.
text
C2347852 (UMLS CUI [1])
Adverse Events
Item
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.
text
C0877248 (UMLS CUI [1])
Physical Examination
Item
Perform a physical examination on the subject, including auscultation of heart and lungs.
text
C0031809 (UMLS CUI [1])
Item
Estimated Depth of Indentation
integer
C0574002 (UMLS CUI [1,1])
C0205125 (UMLS CUI [1,2])
Code List
Estimated Depth of Indentation
Item
Which ankle was assessed at this visit
integer
C0574002 (UMLS CUI [1])
Code List
Which ankle was assessed at this visit
Investigator instructions
Item
Schedule the subject for an Early Withdrawal Follow-Up visit 14 days(± 3 days) after this visit.
text
C1442085 (UMLS CUI [1])
Rating scale Instructions
Item
Complete the Early Withdrawal ADAS-cog and CIBIC+ from the Rating Scale CRF and record the results on the following pages.
boolean
C0681889 (UMLS CUI [1])
Alzheimer Disease Assessment Scale
Item
Alzheimer Disease Assessment Scale
text
C0450989 (UMLS CUI [1])
Clinician Interview-Based Impression of Change
Item
CIBIC+
boolean
C3641327 (UMLS CUI [1])
Investigator Instructions
Item
Telephone the IVRS system to register the visit.
text
C1442085 (UMLS CUI [1])
Subject Identifier
Item
Subject Identifier
integer
C2348585 (UMLS CUI [1])
Visit Date
Item
Visit Date
date
C1320303 (UMLS CUI [1])
Weight
Item
Patient weight
float
C0005910 (UMLS CUI [1])
Systolic Blood Pressure
Item
Systolic Blood Pressure
integer
C0871470 (UMLS CUI [1])
Diastolic blood pressure
Item
Diastolic blood pressure
integer
C0428883 (UMLS CUI [1])
Heart rate
Item
Heart rate
integer
C0018810 (UMLS CUI [1])
Central Laboratory (Non fasting samples)
Item
Central Laboratory (Non fasting samples)
text
C0022885 (UMLS CUI [1,1])
C2585491 (UMLS CUI [1,2])
Collection Date
Item
Date samples taken
date
C1317250 (UMLS CUI [1])
Concomitant Medications
Item
Record any changes to the subject's concomitant medications or any new medications taken since the last visit in the appropriate Concomitant Medications section.
text
C2347852 (UMLS CUI [1])
Adverse Events
Item
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.
text
C0877248 (UMLS CUI [1])
Physical Examination
Item
Perform a physical examination on the subject, including auscultation of heart and lungs.
text
C0031809 (UMLS CUI [1])
Item
Estimated Depth of Indentation
integer
C0574002 (UMLS CUI [1,1])
C0205125 (UMLS CUI [1,2])
Code List
Estimated Depth of Indentation
Item
Which ankle was assessed at this visit
integer
C0574002 (UMLS CUI [1])
Code List
Which ankle was assessed at this visit
End of Study Assessments
Item
Ensure the follwing sections are fully completed at this time: - Concomitant Medication - Non-serious Adverse Events - Pharmacogenetic and Pharmacogenomic Research - Study Conclusion
text
C0444496 (UMLS CUI [1,1])
C1516048 (UMLS CUI [1,2])