Engelsk

Dose Level 1, Day 1

1 Formulär  
  1. StudyEvent: ODM
    1. Dose Level 1, Day 1
Regimen
Beskrivning

Regimen

Alias
UMLS CUI-1
C1276413
UMLS CUI-2
C0013227
Subject Identifier
Beskrivning

Subject Identifier

Datatyp

integer

Alias
UMLS CUI [1]
C2348585
Visit Date
Beskrivning

Visit Date

Datatyp

date

Alias
UMLS CUI [1]
C1320303
Regimen, check one:
Beskrivning

Regimen

Datatyp

integer

Alias
UMLS CUI [1,1]
C1276413
UMLS CUI [1,2]
C0013227
UMLS CUI [2]
C0244821
Drug Screen
Beskrivning

Drug Screen

Alias
UMLS CUI-1
C0373483
UMLS CUI-2
C0202274
UMLS CUI-3
C0022885
Date urine sample taken
Beskrivning

Date urine sample taken

Datatyp

date

Alias
UMLS CUI [1,1]
C0200354
UMLS CUI [1,2]
C0011008
Time sample taken
Beskrivning

Time sample taken

Datatyp

time

Alias
UMLS CUI [1,1]
C0200354
UMLS CUI [1,2]
C0040223
Cocaine
Beskrivning

Cocaine

Datatyp

text

Alias
UMLS CUI [1,1]
C0202274
UMLS CUI [1,2]
C0009170
Amphetamines
Beskrivning

Amphetamines

Datatyp

text

Alias
UMLS CUI [1,1]
C0202274
UMLS CUI [1,2]
C0002667
Benzodiazepines
Beskrivning

Benzodiazepines

Datatyp

text

Alias
UMLS CUI [1,1]
C0202274
UMLS CUI [1,2]
C0005064
Cannabis
Beskrivning

Cannabis

Datatyp

text

Alias
UMLS CUI [1,1]
C0202274
UMLS CUI [1,2]
C0936079
Opiates
Beskrivning

Opiates

Datatyp

text

Alias
UMLS CUI [1,1]
C0202274
UMLS CUI [1,2]
C0376196
Barbiturates
Beskrivning

Barbiturates

Datatyp

text

Alias
UMLS CUI [1,1]
C0202274
UMLS CUI [1,2]
C0004745
Tricyclic antidepressants
Beskrivning

Tricyclic antidepressants

Datatyp

text

Alias
UMLS CUI [1,1]
C0202274
UMLS CUI [1,2]
C0003290
Morphine
Beskrivning

Morphine

Datatyp

text

Alias
UMLS CUI [1,1]
C0202274
UMLS CUI [1,2]
C0026549
Morphine Derivatives
Beskrivning

Morphine Derivatives

Datatyp

text

Alias
UMLS CUI [1,1]
C0202274
UMLS CUI [1,2]
C0279996
Alcohol Breath Test
Beskrivning

Alcohol Breath Test

Alias
UMLS CUI-1
C0202306
UMLS CUI-2
C0022885
Date sample taken for alcohol breath test
Beskrivning

alcohol breath test date

Datatyp

date

Alias
UMLS CUI [1,1]
C0202306
UMLS CUI [1,2]
C0011008
Alcohol breath test Results
Beskrivning

Alcohol breath test Results

Datatyp

text

Alias
UMLS CUI [1,1]
C0202306
UMLS CUI [1,2]
C1274040
Pregnancy test
Beskrivning

Pregnancy test

Alias
UMLS CUI-1
C0032976
UMLS CUI-2
C0022885
Date sample taken for Pregnancy test
Beskrivning

Date sample taken

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0005834
UMLS CUI [1,2]
C0011008
Pregnancy test Result
Beskrivning

Pregnancy test Result

Datatyp

text

Alias
UMLS CUI [1,1]
C0032976
UMLS CUI [1,2]
C1274040
12-lead ECG
Beskrivning

12-lead ECG

Alias
UMLS CUI-1
C0430456
UMLS CUI-2
C1623258
UMLS CUI-3
C0031809
Timepoint of ECG
Beskrivning

Timepoint of ECG

Datatyp

integer

Alias
UMLS CUI [1,1]
C2348792
UMLS CUI [1,2]
C0430456
Start Date of ECG
Beskrivning

Start Date of ECG

Datatyp

date

Alias
UMLS CUI [1,1]
C0430456
UMLS CUI [1,2]
C0808070
Planned Relative Time ECG
Beskrivning

Planned Relative Time ECG

Datatyp

text

Alias
UMLS CUI [1,1]
C0430456
UMLS CUI [1,2]
C0439564
Start Time of ECG
Beskrivning

Start Time of ECG

Datatyp

time

Alias
UMLS CUI [1,1]
C0430456
UMLS CUI [1,2]
C1301880
Ventricular Rate
Beskrivning

Ventricular Rate

Datatyp

integer

Måttenheter
  • Beats/min
Alias
UMLS CUI [1,1]
C2189285
UMLS CUI [1,2]
C0430456
Beats/min
PR Interval
Beskrivning

PR Interval

Datatyp

float

Måttenheter
  • msec
Alias
UMLS CUI [1,1]
C0429087
UMLS CUI [1,2]
C0430456
msec
QRS Duration
Beskrivning

QRS Duration

Datatyp

float

Måttenheter
  • msec
Alias
UMLS CUI [1,1]
C0429025
UMLS CUI [1,2]
C0430456
msec
Uncorrected QT Interval
Beskrivning

Uncorrected QT Interval

Datatyp

float

Måttenheter
  • msec
Alias
UMLS CUI [1,1]
C1287082
UMLS CUI [1,2]
C0430456
msec
QTc Interval
Beskrivning

QTc Interval

Datatyp

float

Måttenheter
  • msec
Alias
UMLS CUI [1,1]
C0489625
UMLS CUI [1,2]
C0430456
msec
Result of the ECG
Beskrivning

Result of the ECG

Datatyp

integer

Alias
UMLS CUI [1,1]
C0438154
UMLS CUI [1,2]
C0430456
Vital signs
Beskrivning

Vital signs

Alias
UMLS CUI-1
C0518766
UMLS CUI-2
C0031809
Timepoint of Vital signs
Beskrivning

Timepoint of Vital signs

Datatyp

integer

Alias
UMLS CUI [1]
C0518766
Date
Beskrivning

Of Examination

Datatyp

date

Alias
UMLS CUI [1]
C0011008
Planned Relative Time
Beskrivning

Of Examination

Datatyp

text

Alias
UMLS CUI [1]
C0439564
Actual time
Beskrivning

of Examination

Datatyp

time

Alias
UMLS CUI [1,1]
C0518766
UMLS CUI [1,2]
C0040223
Systolic Blood pressure
Beskrivning

Systolic Blood pressure

Datatyp

integer

Måttenheter
  • mmHg
Alias
UMLS CUI [1]
C0871470
mmHg
Diastolic Blood pressure
Beskrivning

Diastolic Blood pressure

Datatyp

integer

Måttenheter
  • mmHg
Alias
UMLS CUI [1]
C0428883
mmHg
Subject Position
Beskrivning

Subject Position

Datatyp

integer

Alias
UMLS CUI [1,1]
C1262869
UMLS CUI [1,2]
C0518766
Heart rate
Beskrivning

Heart rate

Datatyp

integer

Måttenheter
  • beats/min
Alias
UMLS CUI [1]
C0018810
beats/min
Investigational Product
Beskrivning

Investigational Product

Alias
UMLS CUI-1
C0304229
UMLS CUI-2
C0244821
Investigational Product
Beskrivning

Investigational Product

Datatyp

integer

Alias
UMLS CUI [1]
C0304229
UMLS CUI [2]
C0244821
Date of Dose
Beskrivning

Date of Dose

Datatyp

date

Alias
UMLS CUI [1,1]
C0304229
UMLS CUI [1,2]
C0178602
UMLS CUI [1,3]
C0011008
Time of Dose
Beskrivning

Time of Dose

Datatyp

time

Alias
UMLS CUI [1,1]
C0304229
UMLS CUI [1,2]
C0178602
UMLS CUI [1,3]
C0040223
Dose
Beskrivning

Dose

Datatyp

float

Måttenheter
  • mg/Day
Alias
UMLS CUI [1,1]
C3174092
UMLS CUI [1,2]
C0304229
mg/Day
Units
Beskrivning

Units

Datatyp

text

Alias
UMLS CUI [1,1]
C1519795
UMLS CUI [1,2]
C0304229
Route
Beskrivning

Route

Datatyp

text

Alias
UMLS CUI [1,1]
C0013153
UMLS CUI [1,2]
C0304229
Did the subject receive the correct treatment (e.g., treatment which the subject was assigned to) during this dosing interval?
Beskrivning

Treatment confirmation

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0750484
UMLS CUI [1,2]
C0087111
If No, record reason(s)
Beskrivning

Did the subject receive the correct treatment (e.g., treatment which the subject was assigned to) during this dosing interval?

Datatyp

text

Alias
UMLS CUI [1,1]
C0750484
UMLS CUI [1,2]
C0087111
UMLS CUI [2]
C0392360
Tillbaka till toppen

Similar models

Dose Level 1, Day 1

1 Formulär
  1. StudyEvent: ODM
    1. Dose Level 1, Day 1
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Regimen
C1276413 (UMLS CUI-1)
C0013227 (UMLS CUI-2)
Subject Identifier
Item
Subject Identifier
integer
C2348585 (UMLS CUI [1])
Visit Date
Item
Visit Date
date
C1320303 (UMLS CUI [1])
Item
Regimen, check one:
integer
C1276413 (UMLS CUI [1,1])
C0013227 (UMLS CUI [1,2])
C0244821 (UMLS CUI [2])
Regimen
Code List
Regimen, check one:
CL Item
Ropinirole XR (1)
Item Group
Drug Screen
C0373483 (UMLS CUI-1)
C0202274 (UMLS CUI-2)
C0022885 (UMLS CUI-3)
Date urine sample taken
Item
Date urine sample taken
date
C0200354 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Time sample taken
Item
Time sample taken
time
C0200354 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Item
Cocaine
text
C0202274 (UMLS CUI [1,1])
C0009170 (UMLS CUI [1,2])
HIV antibodies
Code List
Cocaine
CL Item
Positive (P)
CL Item
Negative (N)
Item
Amphetamines
text
C0202274 (UMLS CUI [1,1])
C0002667 (UMLS CUI [1,2])
HIV antibodies
Code List
Amphetamines
CL Item
Positive (P)
CL Item
Negative (N)
Item
Benzodiazepines
text
C0202274 (UMLS CUI [1,1])
C0005064 (UMLS CUI [1,2])
HIV antibodies
Code List
Benzodiazepines
CL Item
Positive (P)
CL Item
Negative (N)
Item
Cannabis
text
C0202274 (UMLS CUI [1,1])
C0936079 (UMLS CUI [1,2])
HIV antibodies
Code List
Cannabis
CL Item
Positive (P)
CL Item
Negative (N)
Item
Opiates
text
C0202274 (UMLS CUI [1,1])
C0376196 (UMLS CUI [1,2])
HIV antibodies
Code List
Opiates
CL Item
Positive (P)
CL Item
Negative (N)
Item
Barbiturates
text
C0202274 (UMLS CUI [1,1])
C0004745 (UMLS CUI [1,2])
HIV antibodies
Code List
Barbiturates
CL Item
Positive (P)
CL Item
Negative (N)
Item
Tricyclic antidepressants
text
C0202274 (UMLS CUI [1,1])
C0003290 (UMLS CUI [1,2])
HIV antibodies
Code List
Tricyclic antidepressants
CL Item
Positive (P)
CL Item
Negative (N)
Item
Morphine
text
C0202274 (UMLS CUI [1,1])
C0026549 (UMLS CUI [1,2])
HIV antibodies
Code List
Morphine
CL Item
Positive (P)
CL Item
Negative (N)
Item
Morphine Derivatives
text
C0202274 (UMLS CUI [1,1])
C0279996 (UMLS CUI [1,2])
HIV antibodies
Code List
Morphine Derivatives
CL Item
Positive (P)
CL Item
Negative (N)
Item Group
Alcohol Breath Test
C0202306 (UMLS CUI-1)
C0022885 (UMLS CUI-2)
alcohol breath test date
Item
Date sample taken for alcohol breath test
date
C0202306 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Item
Alcohol breath test Results
text
C0202306 (UMLS CUI [1,1])
C1274040 (UMLS CUI [1,2])
HIV antibodies
Code List
Alcohol breath test Results
CL Item
Positive (P)
CL Item
Negative (N)
Item Group
Pregnancy test
C0032976 (UMLS CUI-1)
C0022885 (UMLS CUI-2)
Date sample taken
Item
Date sample taken for Pregnancy test
boolean
C0005834 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Item
Pregnancy test Result
text
C0032976 (UMLS CUI [1,1])
C1274040 (UMLS CUI [1,2])
Pregnancy test Result
Code List
Pregnancy test Result
CL Item
Positive (P)
CL Item
Negative (N)
CL Item
Not applicable (Not of childbearing potential) (NA)
Item Group
12-lead ECG
C0430456 (UMLS CUI-1)
C1623258 (UMLS CUI-2)
C0031809 (UMLS CUI-3)
Item
Timepoint of ECG
integer
C2348792 (UMLS CUI [1,1])
C0430456 (UMLS CUI [1,2])
Timepoint of ECG
Code List
Timepoint of ECG
CL Item
Pre-dose (1)
CL Item
+4 hrs (2)
CL Item
Unscheduled (3)
Start Date of ECG
Item
Start Date of ECG
date
C0430456 (UMLS CUI [1,1])
C0808070 (UMLS CUI [1,2])
Planned Relative Time ECG
Item
Planned Relative Time ECG
text
C0430456 (UMLS CUI [1,1])
C0439564 (UMLS CUI [1,2])
Start Time of ECG
Item
Start Time of ECG
time
C0430456 (UMLS CUI [1,1])
C1301880 (UMLS CUI [1,2])
Ventricular Rate
Item
Ventricular Rate
integer
C2189285 (UMLS CUI [1,1])
C0430456 (UMLS CUI [1,2])
PR Interval
Item
PR Interval
float
C0429087 (UMLS CUI [1,1])
C0430456 (UMLS CUI [1,2])
QRS Duration
Item
QRS Duration
float
C0429025 (UMLS CUI [1,1])
C0430456 (UMLS CUI [1,2])
Uncorrected QT Interval
Item
Uncorrected QT Interval
float
C1287082 (UMLS CUI [1,1])
C0430456 (UMLS CUI [1,2])
QTc Interval
Item
QTc Interval
float
C0489625 (UMLS CUI [1,1])
C0430456 (UMLS CUI [1,2])
Item
Result of the ECG
integer
C0438154 (UMLS CUI [1,1])
C0430456 (UMLS CUI [1,2])
Result of the ECG
Code List
Result of the ECG
CL Item
Normal (1)
CL Item
Abnormal - not clinically significant  (2)
CL Item
Abnormal- clinically significant (3)
CL Item
No result (not available) (4)
Item Group
Vital signs
C0518766 (UMLS CUI-1)
C0031809 (UMLS CUI-2)
Item
Timepoint of Vital signs
integer
C0518766 (UMLS CUI [1])
Timepoint of Vital signs
Code List
Timepoint of Vital signs
CL Item
Pre-dose 1 (1)
CL Item
Pre-dose 2 (2)
CL Item
Pre-dose 3 (3)
CL Item
+2 hrs (4)
CL Item
+4 hrs (5)
CL Item
+6 hrs (6)
CL Item
+12 hrs (7)
CL Item
+24 hrs (8)
CL Item
Unscheduled (9)
Date
Item
Date
date
C0011008 (UMLS CUI [1])
Planned Relative Time
Item
Planned Relative Time
text
C0439564 (UMLS CUI [1])
Actual time
Item
Actual time
time
C0518766 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Systolic Blood pressure
Item
Systolic Blood pressure
integer
C0871470 (UMLS CUI [1])
Diastolic Blood pressure
Item
Diastolic Blood pressure
integer
C0428883 (UMLS CUI [1])
Item
Subject Position
integer
C1262869 (UMLS CUI [1,1])
C0518766 (UMLS CUI [1,2])
Subject Position
Code List
Subject Position
CL Item
Supine (1)
CL Item
Standing (2)
Heart rate
Item
Heart rate
integer
C0018810 (UMLS CUI [1])
Item Group
Investigational Product
C0304229 (UMLS CUI-1)
C0244821 (UMLS CUI-2)
Item
Investigational Product
integer
C0304229 (UMLS CUI [1])
C0244821 (UMLS CUI [2])
Investigational Product
Code List
Investigational Product
CL Item
Ropinirole (1)
Date of Dose
Item
Date of Dose
date
C0304229 (UMLS CUI [1,1])
C0178602 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
Time of Dose
Item
Time of Dose
time
C0304229 (UMLS CUI [1,1])
C0178602 (UMLS CUI [1,2])
C0040223 (UMLS CUI [1,3])
Dose
Item
Dose
float
C3174092 (UMLS CUI [1,1])
C0304229 (UMLS CUI [1,2])
Units
Item
Units
text
C1519795 (UMLS CUI [1,1])
C0304229 (UMLS CUI [1,2])
Route
Item
Route
text
C0013153 (UMLS CUI [1,1])
C0304229 (UMLS CUI [1,2])
Treatment confirmation
Item
Did the subject receive the correct treatment (e.g., treatment which the subject was assigned to) during this dosing interval?
boolean
C0750484 (UMLS CUI [1,1])
C0087111 (UMLS CUI [1,2])
Treatment confirmation
Item
If No, record reason(s)
text
C0750484 (UMLS CUI [1,1])
C0087111 (UMLS CUI [1,2])
C0392360 (UMLS CUI [2])
Tillbaka till toppen