ID
27314
Beschrijving
Original CRFs from: K.Afshar, J. Bleidorn, E. Hummers-Pradier, I. Gágyor. Further details on: http://www.allgemeinmedizin.med.uni-goettingen.de/en/content/research/510_520.html https://clinicaltrials.gov/ct2/show/NCT03151603 Questionnaire Day 28
Link
http://www.allgemeinmedizin.med.uni-goettingen.de/en/content/research/510_520.html
Trefwoorden
Versies (1)
- 07-11-17 07-11-17 -
Houder van rechten
K.Afshar, J. Bleidorn, E. Hummers-Pradier, I. Gágyor
Geüploaded op
7 november 2017
DOI
Voor een aanvraag inloggen.
Licentie
Creative Commons BY-NC-ND 3.0
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Questionnaire Day 28 REGATTA NCT03151603
Questionnaire Day 28 REGATTA NCT03151603
- StudyEvent: ODM
Beschrijving
1. Vorherige Harnwegsinfekte
Alias
- UMLS CUI-1
- C0205156
- UMLS CUI-2
- C0042029
Beschrijving
Previous Urinary Tract Infection
Datatype
boolean
Alias
- UMLS CUI [1,1]
- C0205156
- UMLS CUI [1,2]
- C0042029
Beschrijving
Numbers of Previous Urinary Tract Infection
Datatype
text
Alias
- UMLS CUI [1,1]
- C0449788
- UMLS CUI [1,2]
- C0205156
- UMLS CUI [1,3]
- C0042029
Beschrijving
Urinary Tract Infection: Sick Leave
Datatype
boolean
Alias
- UMLS CUI [1,1]
- C0242807
- UMLS CUI [1,2]
- C0042029
Beschrijving
Urinary Tract Infection: Sick Leave Specification
Datatype
float
Maateenheden
- Tage
Alias
- UMLS CUI [1,1]
- C0242807
- UMLS CUI [1,2]
- C0042029
- UMLS CUI [1,3]
- C2348235
Beschrijving
Urinary Tract Infection: Start Date
Datatype
date
Maateenheden
- tt.mm.jjjj
Alias
- UMLS CUI [1,1]
- C0042029
- UMLS CUI [1,2]
- C0808070
Beschrijving
Urinary Tract Infection: End Date
Datatype
date
Maateenheden
- tt.mm.jjjj
Alias
- UMLS CUI [1,1]
- C0042029
- UMLS CUI [1,2]
- C0806020
Beschrijving
Urinary Tract Infection: Office Visit
Datatype
boolean
Alias
- UMLS CUI [1,1]
- C0042029
- UMLS CUI [1,2]
- C0028900
Beschrijving
Urinary Tract Infection: Physicians
Datatype
text
Alias
- UMLS CUI [1,1]
- C0042029
- UMLS CUI [1,2]
- C0031831
Beschrijving
Urinary Tract Infection: Febrile Infection
Datatype
boolean
Alias
- UMLS CUI [1,1]
- C0042029
- UMLS CUI [1,2]
- C0948233
Beschrijving
Medikamentöse Behandlung - Wenn ja, bitte geben Sie alles an, was Sie noch nicht im Patientinnentagebuch notiert haben.
Alias
- UMLS CUI-1
- C0013216
Beschrijving
Pharmacotherapy
Datatype
boolean
Alias
- UMLS CUI [1]
- C0013216
Beschrijving
Antibiotics
Datatype
text
Alias
- UMLS CUI [1]
- C0003232
Beschrijving
Antibiotics: Dosage
Datatype
text
Alias
- UMLS CUI [1,1]
- C0003232
- UMLS CUI [1,2]
- C0178602
Beschrijving
Antibiotics: Medication Frequency
Datatype
text
Alias
- UMLS CUI [1,1]
- C0003232
- UMLS CUI [1,2]
- C3476109
Beschrijving
Antibiotics: Start Date
Datatype
date
Maateenheden
- tt.mm.jjjj
Alias
- UMLS CUI [1,1]
- C0003232
- UMLS CUI [1,2]
- C0808070
Beschrijving
Antibiotics: End Date
Datatype
date
Maateenheden
- tt.mm.jjjj
Alias
- UMLS CUI [1,1]
- C0003232
- UMLS CUI [1,2]
- C0806020
Beschrijving
Analgesics
Datatype
text
Alias
- UMLS CUI [1]
- C0002771
Beschrijving
Analgesics: Dosage
Datatype
text
Alias
- UMLS CUI [1,1]
- C0002771
- UMLS CUI [1,2]
- C0178602
Beschrijving
Analgesics: Medication Frequency
Datatype
text
Alias
- UMLS CUI [1,1]
- C0002771
- UMLS CUI [1,2]
- C3476109
Beschrijving
Analgesics: Start Date
Datatype
date
Maateenheden
- tt.mm.jjjj
Alias
- UMLS CUI [1,1]
- C0002771
- UMLS CUI [1,2]
- C0808070
Beschrijving
Anagesics: End Date
Datatype
date
Maateenheden
- tt.mm.jjjj
Alias
- UMLS CUI [1,1]
- C0002771
- UMLS CUI [1,2]
- C0806020
Beschrijving
Other Medication
Datatype
text
Alias
- UMLS CUI [1]
- C1115771
Beschrijving
Other Medication: Dosage
Datatype
text
Alias
- UMLS CUI [1,1]
- C1115771
- UMLS CUI [1,2]
- C0178602
Beschrijving
Other Medication: Medication Frequency
Datatype
text
Alias
- UMLS CUI [1,1]
- C1115771
- UMLS CUI [1,2]
- C3476109
Beschrijving
Other Medication: Start Date
Datatype
date
Maateenheden
- tt.mm.jjjj
Alias
- UMLS CUI [1,1]
- C1115771
- UMLS CUI [1,2]
- C0808070
Beschrijving
Other Medication: End Date
Datatype
date
Maateenheden
- tt.mm.jjjj
Alias
- UMLS CUI [1,1]
- C1115771
- UMLS CUI [1,2]
- C0806020
Beschrijving
Weiterer Harnwegsinfekt
Alias
- UMLS CUI-1
- C0042029
- UMLS CUI-2
- C1517331
Beschrijving
Further Urinary Tract Infection
Datatype
boolean
Alias
- UMLS CUI [1,1]
- C0042029
- UMLS CUI [1,2]
- C1517331
Beschrijving
Date of Further Urinary Tract Infection
Datatype
date
Maateenheden
- tt.mm.jjjj
Alias
- UMLS CUI [1,1]
- C0011008
- UMLS CUI [1,2]
- C0042029
- UMLS CUI [1,3]
- C1517331
Beschrijving
Further Urinary Tract Infection: Office Visit
Datatype
boolean
Alias
- UMLS CUI [1,1]
- C1517331
- UMLS CUI [1,2]
- C0042029
- UMLS CUI [1,3]
- C0028900
Beschrijving
Further Urinary Tract Infection: Physicians
Datatype
text
Alias
- UMLS CUI [1,1]
- C1517331
- UMLS CUI [1,2]
- C0042029
- UMLS CUI [1,3]
- C0031831
Beschrijving
Further Urinary Tract Infection: Febrile Infection
Datatype
boolean
Alias
- UMLS CUI [1,1]
- C1517331
- UMLS CUI [1,2]
- C0042029
- UMLS CUI [1,3]
- C0948233
Beschrijving
Medikamentöse Behandlung des weiteren Harnwegsinfektes - Wenn ja, bitte geben Sie alles an, was Sie noch nicht im Patientinnentagebuch notiert haben.
Alias
- UMLS CUI-1
- C0013216
- UMLS CUI-2
- C0042029
- UMLS CUI-3
- C1517331
Beschrijving
Further Pharmacotherapy
Datatype
boolean
Alias
- UMLS CUI [1,1]
- C0013216
- UMLS CUI [1,2]
- C1517331
Beschrijving
Further Antibiotics
Datatype
text
Alias
- UMLS CUI [1,1]
- C0003232
- UMLS CUI [1,2]
- C1517331
Beschrijving
Further Antibiotics: Dosage
Datatype
text
Alias
- UMLS CUI [1,1]
- C0003232
- UMLS CUI [1,2]
- C1517331
- UMLS CUI [1,3]
- C0178602
Beschrijving
Further Antibiotics: Medication Frequency
Datatype
text
Alias
- UMLS CUI [1,1]
- C0003232
- UMLS CUI [1,2]
- C1517331
- UMLS CUI [1,3]
- C3476109
Beschrijving
Further Antibiotics: Start Date
Datatype
date
Maateenheden
- tt.mm.jjjj
Alias
- UMLS CUI [1,1]
- C0003232
- UMLS CUI [1,2]
- C1517331
- UMLS CUI [1,3]
- C0808070
Beschrijving
Further Antibiotics: End Date
Datatype
date
Maateenheden
- tt.mm.jjjj
Alias
- UMLS CUI [1,1]
- C0003232
- UMLS CUI [1,2]
- C1517331
- UMLS CUI [1,3]
- C0806020
Beschrijving
Further Analgesics
Datatype
text
Alias
- UMLS CUI [1,1]
- C0002771
- UMLS CUI [1,2]
- C1517331
Beschrijving
Further Analgesics: Dosage
Datatype
text
Alias
- UMLS CUI [1,1]
- C0002771
- UMLS CUI [1,2]
- C1517331
- UMLS CUI [1,3]
- C0178602
Beschrijving
Further Analgesics: Medication Frequency
Datatype
text
Alias
- UMLS CUI [1,1]
- C0002771
- UMLS CUI [1,2]
- C1517331
- UMLS CUI [1,3]
- C3476109
Beschrijving
Further Analgesics: Start Date
Datatype
date
Maateenheden
- tt.mm.jjjj
Alias
- UMLS CUI [1,1]
- C0002771
- UMLS CUI [1,2]
- C1517331
- UMLS CUI [1,3]
- C0808070
Beschrijving
Further Anagesics: End Date
Datatype
date
Maateenheden
- tt.mm.jjjj
Alias
- UMLS CUI [1,1]
- C0002771
- UMLS CUI [1,2]
- C1517331
- UMLS CUI [1,3]
- C0806020
Beschrijving
Further Other Medication
Datatype
text
Alias
- UMLS CUI [1,1]
- C1115771
- UMLS CUI [1,2]
- C1517331
Beschrijving
Further Other Medication: Dosage
Datatype
text
Alias
- UMLS CUI [1,1]
- C1115771
- UMLS CUI [1,2]
- C1517331
- UMLS CUI [1,3]
- C0178602
Beschrijving
Further Other Medication: Medication Frequency
Datatype
text
Alias
- UMLS CUI [1,1]
- C1115771
- UMLS CUI [1,2]
- C1517331
- UMLS CUI [1,3]
- C3476109
Beschrijving
Further Other Medication: Start Date
Datatype
date
Maateenheden
- tt.mm.jjjj
Alias
- UMLS CUI [1,1]
- C1115771
- UMLS CUI [1,2]
- C1517331
- UMLS CUI [1,3]
- C0808070
Beschrijving
Further Other Medication: End Date
Datatype
date
Maateenheden
- tt.mm.jjjj
Alias
- UMLS CUI [1,1]
- C1115771
- UMLS CUI [1,2]
- C1517331
- UMLS CUI [1,3]
- C0806020
Beschrijving
Weitere gesundheitliche Beschwerden - Auf den folgenden Seiten bitten wir Sie um Angaben zu weiteren gesundheitlichen Beschwerden seit Aufnahme in die Studie. Bitte nutzen Sie für jeden Beschwerdekomplex eine neue Seite. Beschwerden, mit denen Sie Ihren Hausarzt aufgesucht haben, müsen hier nicht angegeben werden.
Alias
- UMLS CUI-1
- C1457887
Beschrijving
Further Symptoms
Datatype
boolean
Alias
- UMLS CUI [1]
- C1457887
Beschrijving
Further Symptoms: Specification
Datatype
text
Alias
- UMLS CUI [1,1]
- C1457887
- UMLS CUI [1,2]
- C2348235
Beschrijving
Further Symptoms: Start Date
Datatype
date
Maateenheden
- tt.mm.jjjj
Alias
- UMLS CUI [1,1]
- C1457887
- UMLS CUI [1,2]
- C0808070
Beschrijving
Further Symptoms: End Date
Datatype
date
Maateenheden
- tt.mm.jjjj
Alias
- UMLS CUI [1,1]
- C1457887
- UMLS CUI [1,2]
- C0806020
Beschrijving
Affected by Further Symptoms
Datatype
text
Alias
- UMLS CUI [1,1]
- C1457887
- UMLS CUI [1,2]
- C0392760
Beschrijving
Further Symptoms: Office Visit
Datatype
boolean
Alias
- UMLS CUI [1,1]
- C1457887
- UMLS CUI [1,2]
- C0028900
Beschrijving
Further Symptoms: Physicians
Datatype
text
Alias
- UMLS CUI [1,1]
- C1457887
- UMLS CUI [1,2]
- C0031831
Beschrijving
Further Symptoms: Treatment
Datatype
text
Alias
- UMLS CUI [1,1]
- C1457887
- UMLS CUI [1,2]
- C0087111
Beschrijving
Further Symptoms: Referral
Datatype
text
Alias
- UMLS CUI [1,1]
- C1457887
- UMLS CUI [1,2]
- C0034927
Beschrijving
Further Symptoms: Treatment Specification
Datatype
text
Alias
- UMLS CUI [1,1]
- C1457887
- UMLS CUI [1,2]
- C0087111
- UMLS CUI [1,3]
- C2348235
Beschrijving
Medikamentöse Behandlung dieser Beschwerden - Bitte tragen Sie die Medikamente ein, die Sie für diese Beschwerden eingenommen haben.
Alias
- UMLS CUI-1
- C0013216
- UMLS CUI-2
- C1457887
Beschrijving
Antibiotics
Datatype
text
Alias
- UMLS CUI [1]
- C0003232
Beschrijving
Antibiotics: Dosage
Datatype
text
Alias
- UMLS CUI [1,1]
- C0003232
- UMLS CUI [1,2]
- C0178602
Beschrijving
Antibiotics: Medication Frequency
Datatype
text
Alias
- UMLS CUI [1,1]
- C0003232
- UMLS CUI [1,2]
- C3476109
Beschrijving
Antibiotics: Start Date
Datatype
date
Maateenheden
- tt.mm.jjjj
Alias
- UMLS CUI [1,1]
- C0003232
- UMLS CUI [1,2]
- C0808070
Beschrijving
Antibiotics: End Date
Datatype
date
Maateenheden
- tt.mm.jjjj
Alias
- UMLS CUI [1,1]
- C0003232
- UMLS CUI [1,2]
- C0806020
Beschrijving
Analgesics
Datatype
text
Alias
- UMLS CUI [1]
- C0002771
Beschrijving
Analgesics: Dosage
Datatype
text
Alias
- UMLS CUI [1,1]
- C0002771
- UMLS CUI [1,2]
- C0178602
Beschrijving
Analgesics: Medication Frequency
Datatype
text
Alias
- UMLS CUI [1,1]
- C0002771
- UMLS CUI [1,2]
- C3476109
Beschrijving
Analgesics: Start Date
Datatype
date
Maateenheden
- tt.mm.jjjj
Alias
- UMLS CUI [1,1]
- C0002771
- UMLS CUI [1,2]
- C0808070
Beschrijving
Anagesics: End Date
Datatype
date
Maateenheden
- tt.mm.jjjj
Alias
- UMLS CUI [1,1]
- C0002771
- UMLS CUI [1,2]
- C0806020
Beschrijving
Other Medication
Datatype
text
Alias
- UMLS CUI [1]
- C1115771
Beschrijving
Other Medication: Dosage
Datatype
text
Alias
- UMLS CUI [1,1]
- C1115771
- UMLS CUI [1,2]
- C0178602
Beschrijving
Other Medication: Medication Frequency
Datatype
text
Alias
- UMLS CUI [1,1]
- C1115771
- UMLS CUI [1,2]
- C3476109
Beschrijving
Other Medication: Start Date
Datatype
date
Maateenheden
- tt.mm.jjjj
Alias
- UMLS CUI [1,1]
- C1115771
- UMLS CUI [1,2]
- C0808070
Beschrijving
Other Medication: End Date
Datatype
date
Maateenheden
- tt.mm.jjjj
Alias
- UMLS CUI [1,1]
- C1115771
- UMLS CUI [1,2]
- C0806020
Beschrijving
Studienmedikation
Alias
- UMLS CUI-1
- C0304229
Beschrijving
UE/SUE-Praxis (Dokumentation unerwünschter Ereignisse)
Alias
- UMLS CUI-1
- C0877248
Beschrijving
Adverse Event Symptom
Datatype
text
Alias
- UMLS CUI [1,1]
- C0877248
- UMLS CUI [1,2]
- C1457887
Beschrijving
Adverse Event Diagnosis
Datatype
text
Alias
- UMLS CUI [1,1]
- C0877248
- UMLS CUI [1,2]
- C0011900
Beschrijving
Adverse Event ICD-10-Code
Datatype
text
Alias
- UMLS CUI [1,1]
- C2598420
- UMLS CUI [1,2]
- C0877248
Beschrijving
Adverse Event: Start Date
Datatype
date
Maateenheden
- tt.mm.jjjj
Alias
- UMLS CUI [1]
- C2697888
Beschrijving
Adverse Event: End Date
Datatype
date
Maateenheden
- tt.mm.jjjj
Alias
- UMLS CUI [1]
- C2697886
Beschrijving
Adverse Event: Ongoing
Datatype
boolean
Alias
- UMLS CUI [1]
- C2826663
Beschrijving
Serious Adverse Event
Datatype
text
Alias
- UMLS CUI [1]
- C1519255
Beschrijving
Adverse Event Outcome
Datatype
text
Alias
- UMLS CUI [1]
- C1705586
Beschrijving
Severity of Adverse Event
Datatype
text
Alias
- UMLS CUI [1]
- C1710066
Beschrijving
Adverse Event Action Taken
Datatype
text
Alias
- UMLS CUI [1]
- C2826626
Beschrijving
Concomitant Medication: Pharmaceutical Preparations
Datatype
text
Alias
- UMLS CUI [1,1]
- C2347852
- UMLS CUI [1,2]
- C0013227
Beschrijving
Concomitant Medication: Daily Dosage
Datatype
text
Alias
- UMLS CUI [1,1]
- C0178602
- UMLS CUI [1,2]
- C2347852
Beschrijving
Relation to Fosfomycin
Datatype
text
Alias
- UMLS CUI [1,1]
- C0439849
- UMLS CUI [1,2]
- C0016610
Beschrijving
Relation to Bearberry preparation
Datatype
text
Alias
- UMLS CUI [1,1]
- C0439849
- UMLS CUI [1,2]
- C0885849
Beschrijving
Date of Adverse Event
Datatype
date
Maateenheden
- dd-mmm-yyyy
Alias
- UMLS CUI [1]
- C2985916
Beschrijving
Investigator's Signature
Datatype
text
Alias
- UMLS CUI [1]
- C2346576
Similar models
Questionnaire Day 28 REGATTA NCT03151603
- StudyEvent: ODM
C0042029 (UMLS CUI-2)
C0042029 (UMLS CUI [1,2])
C0205156 (UMLS CUI [1,2])
C0042029 (UMLS CUI [1,3])
C0042029 (UMLS CUI [1,2])
C0042029 (UMLS CUI [1,2])
C2348235 (UMLS CUI [1,3])
C0808070 (UMLS CUI [1,2])
C0806020 (UMLS CUI [1,2])
C0028900 (UMLS CUI [1,2])
C0031831 (UMLS CUI [1,2])
C0948233 (UMLS CUI [1,2])
C0178602 (UMLS CUI [1,2])
C3476109 (UMLS CUI [1,2])
C0808070 (UMLS CUI [1,2])
C0806020 (UMLS CUI [1,2])
C0178602 (UMLS CUI [1,2])
C3476109 (UMLS CUI [1,2])
C0808070 (UMLS CUI [1,2])
C0806020 (UMLS CUI [1,2])
C0178602 (UMLS CUI [1,2])
C3476109 (UMLS CUI [1,2])
C0808070 (UMLS CUI [1,2])
C0806020 (UMLS CUI [1,2])
C1517331 (UMLS CUI-2)
C1517331 (UMLS CUI [1,2])
C0042029 (UMLS CUI [1,2])
C1517331 (UMLS CUI [1,3])
C0042029 (UMLS CUI [1,2])
C0028900 (UMLS CUI [1,3])
C0042029 (UMLS CUI [1,2])
C0031831 (UMLS CUI [1,3])
C0042029 (UMLS CUI [1,2])
C0948233 (UMLS CUI [1,3])
C0042029 (UMLS CUI-2)
C1517331 (UMLS CUI-3)
C1517331 (UMLS CUI [1,2])
C1517331 (UMLS CUI [1,2])
C1517331 (UMLS CUI [1,2])
C0178602 (UMLS CUI [1,3])
C1517331 (UMLS CUI [1,2])
C3476109 (UMLS CUI [1,3])
C1517331 (UMLS CUI [1,2])
C0808070 (UMLS CUI [1,3])
C1517331 (UMLS CUI [1,2])
C0806020 (UMLS CUI [1,3])
C1517331 (UMLS CUI [1,2])
C1517331 (UMLS CUI [1,2])
C0178602 (UMLS CUI [1,3])
C1517331 (UMLS CUI [1,2])
C3476109 (UMLS CUI [1,3])
C1517331 (UMLS CUI [1,2])
C0808070 (UMLS CUI [1,3])
C1517331 (UMLS CUI [1,2])
C0806020 (UMLS CUI [1,3])
C1517331 (UMLS CUI [1,2])
C1517331 (UMLS CUI [1,2])
C0178602 (UMLS CUI [1,3])
C1517331 (UMLS CUI [1,2])
C3476109 (UMLS CUI [1,3])
C1517331 (UMLS CUI [1,2])
C0808070 (UMLS CUI [1,3])
C1517331 (UMLS CUI [1,2])
C0806020 (UMLS CUI [1,3])
C2348235 (UMLS CUI [1,2])
C0808070 (UMLS CUI [1,2])
C0806020 (UMLS CUI [1,2])
C0392760 (UMLS CUI [1,2])
C0028900 (UMLS CUI [1,2])
C0031831 (UMLS CUI [1,2])
C0087111 (UMLS CUI [1,2])
C0034927 (UMLS CUI [1,2])
C0087111 (UMLS CUI [1,2])
C2348235 (UMLS CUI [1,3])
C1457887 (UMLS CUI-2)
C0178602 (UMLS CUI [1,2])
C3476109 (UMLS CUI [1,2])
C0808070 (UMLS CUI [1,2])
C0806020 (UMLS CUI [1,2])
C0178602 (UMLS CUI [1,2])
C3476109 (UMLS CUI [1,2])
C0808070 (UMLS CUI [1,2])
C0806020 (UMLS CUI [1,2])
C0178602 (UMLS CUI [1,2])
C3476109 (UMLS CUI [1,2])
C0808070 (UMLS CUI [1,2])
C0806020 (UMLS CUI [1,2])
C1457887 (UMLS CUI [1,2])
C0011900 (UMLS CUI [1,2])
C0877248 (UMLS CUI [1,2])
C0013227 (UMLS CUI [1,2])
C2347852 (UMLS CUI [1,2])
C0016610 (UMLS CUI [1,2])
C0885849 (UMLS CUI [1,2])