ID
27421
Beschreibung
Short title: TIM-HF II Permission to publish granted by: Prof. Dr. Friedrich Köhler, FESC Charité - Universitätsmedizin Berlin Further study details on: https://www.clinicaltrials.gov/ct2/show/NCT01878630 Screening-Visit (S-Form)
Link
https://www.clinicaltrials.gov/ct2/show/NCT01878630
Stichworte
Versionen (1)
- 14.11.17 14.11.17 -
Rechteinhaber
Prof. Dr. Friedrich Köhler, FESC Charité - Universitätsmedizin Berlin
Hochgeladen am
14. November 2017
DOI
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Lizenz
Creative Commons BY-NC 3.0
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Study Title: Telemedical Interventional Management in Heart Failure II (TIM-HF II) NCT01878630
Screening-Visit
- StudyEvent: ODM
Beschreibung
Einschlusskriterien
Alias
- UMLS CUI-1
- C1512693
- UMLS CUI-2
- C0008976
- UMLS CUI-3
- C0018801
Beschreibung
(alle Kriterien müssen erfüllt sein)
Datentyp
boolean
Alias
- UMLS CUI [1,1]
- C0264716
- UMLS CUI [1,2]
- C1275491
Beschreibung
chronic heart failure NYHA class
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C0264716
- UMLS CUI [1,2]
- C1275491
Beschreibung
chronic heart failure criteria
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0264716
- UMLS CUI [2]
- C0428772
- UMLS CUI [3]
- C0012798
Beschreibung
LVEF
Datentyp
integer
Maßeinheiten
- %
Alias
- UMLS CUI [1]
- C0428772
Beschreibung
hospitalization because of cardiac decompensation
Datentyp
boolean
Alias
- UMLS CUI [1,1]
- C1961112
- UMLS CUI [1,2]
- C0019993
Beschreibung
date of discharge
Datentyp
date
Alias
- UMLS CUI [1,1]
- C1961112
- UMLS CUI [1,2]
- C0019993
- UMLS CUI [1,3]
- C2361123
Beschreibung
depression
Datentyp
boolean
Alias
- UMLS CUI [1,1]
- C0011581
- UMLS CUI [1,2]
- C0009488
Beschreibung
Ausschlusskriterien
Alias
- UMLS CUI-1
- C0680251
- UMLS CUI-2
- C0008976
- UMLS CUI-3
- C0018801
Beschreibung
(kein Kriterium darf erfüllt sein)
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0019993
Beschreibung
Implantation of Cardiac Assist System
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0189879
Beschreibung
acute coronary syndrome
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0948089
Beschreibung
high urgent heart transplantation listing
Datentyp
boolean
Alias
- UMLS CUI [1,1]
- C0018823
- UMLS CUI [1,2]
- C0422768
- UMLS CUI [1,3]
- C3272275
Beschreibung
planned cardiac procedure
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0018821
Beschreibung
planned cardiac procedure
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0018821
Beschreibung
drug and or alcohol abuse
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0038586
Beschreibung
renal failure with dialysis
Datentyp
boolean
Alias
- UMLS CUI [1,1]
- C0035078
- UMLS CUI [1,2]
- C0011946
Beschreibung
Telemonitoring compliance or inability
Datentyp
boolean
Alias
- UMLS CUI [1,1]
- C3898905
- UMLS CUI [1,2]
- C1299582
- UMLS CUI [2]
- C1321605
Beschreibung
comorbidity with low life expectancy
Datentyp
boolean
Alias
- UMLS CUI [1,1]
- C0023671
- UMLS CUI [1,2]
- C0009488
Beschreibung
patient age
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0001779
Beschreibung
pregnancy
Datentyp
integer
Alias
- UMLS CUI [1]
- C0032961
Beschreibung
participation in other trial
Datentyp
boolean
Alias
- UMLS CUI [1,1]
- C2348568
- UMLS CUI [1,2]
- C0008976
Beschreibung
Screeningvisite Information
Alias
- UMLS CUI-1
- C1710477
- UMLS CUI-2
- C0587453
- UMLS CUI-3
- C0018801
- UMLS CUI-4
- C0183863
- UMLS CUI-5
- C1508263
Beschreibung
date of screening
Datentyp
date
Alias
- UMLS CUI [1,1]
- C1710477
- UMLS CUI [1,2]
- C0011008
Beschreibung
name of screening investigator
Datentyp
text
Alias
- UMLS CUI [1,1]
- C2826892
- UMLS CUI [1,2]
- C1710477
Beschreibung
investigator signature
Datentyp
text
Alias
- UMLS CUI [1,1]
- C2346576
- UMLS CUI [1,2]
- C1710477
Beschreibung
telephone number or fax number investigator
Datentyp
text
Alias
- UMLS CUI [1]
- C1549619
- UMLS CUI [2]
- C1515258
- UMLS CUI [3,1]
- C2826892
- UMLS CUI [3,2]
- C1710477
Beschreibung
appointment date for baseline visit
Datentyp
date
Alias
- UMLS CUI [1,1]
- C1512346
- UMLS CUI [1,2]
- C1442488
- UMLS CUI [1,3]
- C0585085
Beschreibung
appointment time for baseline visit
Datentyp
time
Alias
- UMLS CUI [1,1]
- C1512346
- UMLS CUI [1,2]
- C1442488
- UMLS CUI [1,3]
- C0040223
- UMLS CUI [1,4]
- C0585085
Beschreibung
Vom Kardiologen nach der Basisvisite auszufüllen
Alias
- UMLS CUI-1
- C1710477
- UMLS CUI-2
- C0587453
- UMLS CUI-3
- C0018801
- UMLS CUI-4
- C0183863
- UMLS CUI-5
- C1508263
Beschreibung
patient inclusion in clinical trial
Datentyp
boolean
Alias
- UMLS CUI [1,1]
- C2348568
- UMLS CUI [1,2]
- C0018801
- UMLS CUI [1,3]
- C0183863
Beschreibung
patient ID
Datentyp
integer
Alias
- UMLS CUI [1]
- C2348585
Beschreibung
reason patient was not included in clinical trial
Datentyp
text
Alias
- UMLS CUI [1,1]
- C3242266
- UMLS CUI [1,2]
- C0008976
- UMLS CUI [1,3]
- C0392360
Beschreibung
date of cardiologist visit
Datentyp
date
Alias
- UMLS CUI [1,1]
- C0175906
- UMLS CUI [1,2]
- C1320303
Beschreibung
name of cardiologist
Datentyp
text
Alias
- UMLS CUI [1,1]
- C0175906
- UMLS CUI [1,2]
- C0027365
Beschreibung
signature cardiologist
Datentyp
text
Alias
- UMLS CUI [1,1]
- C0175906
- UMLS CUI [1,2]
- C1519316
Beschreibung
telephone number or fax number cardiologist
Datentyp
text
Alias
- UMLS CUI [1]
- C1549619
- UMLS CUI [2]
- C1515258
- UMLS CUI [3]
- C0175906
Beschreibung
Screeningergebnis
Alias
- UMLS CUI-1
- C1710477
- UMLS CUI-2
- C2348568
- UMLS CUI-3
- C0018801
- UMLS CUI-4
- C0183863
- UMLS CUI-5
- C0587453
Beschreibung
patient inclusion in TIM-HF II clinical trial
Datentyp
boolean
Alias
- UMLS CUI [1,1]
- C2348568
- UMLS CUI [1,2]
- C0018801
- UMLS CUI [1,3]
- C0183863
Beschreibung
patient ID
Datentyp
text
Alias
- UMLS CUI [1]
- C2348585
Beschreibung
appointment date baseline visit
Datentyp
date
Alias
- UMLS CUI [1,1]
- C1512346
- UMLS CUI [1,2]
- C1442488
- UMLS CUI [1,3]
- C0585085
Beschreibung
appointment date of next clinical trial patient visit
Datentyp
date
Alias
- UMLS CUI [1,1]
- C1512346
- UMLS CUI [1,2]
- C0008976
- UMLS CUI [1,3]
- C0585085
Beschreibung
reason patient was not included in clinical trial
Datentyp
text
Alias
- UMLS CUI [1,1]
- C3242266
- UMLS CUI [1,2]
- C0008976
- UMLS CUI [1,3]
- C0392360
Beschreibung
reason patient was not included in clinical trial
Datentyp
text
Alias
- UMLS CUI [1,1]
- C3242266
- UMLS CUI [1,2]
- C0008976
- UMLS CUI [1,3]
- C0392360
Beschreibung
Comment Screening
Datentyp
text
Alias
- UMLS CUI [1,1]
- C1710477
- UMLS CUI [1,2]
- C1512346
- UMLS CUI [1,3]
- C0947611
Ähnliche Modelle
Screening-Visit
- StudyEvent: ODM
C0587453 (UMLS CUI-2)
C0018801 (UMLS CUI-3)
C0183863 (UMLS CUI-4)
C0600091 (UMLS CUI [1,2])
C0008976 (UMLS CUI-2)
C0018801 (UMLS CUI-3)
C1275491 (UMLS CUI [1,2])
C1275491 (UMLS CUI [1,2])
C0428772 (UMLS CUI [2])
C0012798 (UMLS CUI [3])
C0019993 (UMLS CUI [1,2])
C0019993 (UMLS CUI [1,2])
C2361123 (UMLS CUI [1,3])
C0009488 (UMLS CUI [1,2])
C0008976 (UMLS CUI-2)
C0018801 (UMLS CUI-3)
C0422768 (UMLS CUI [1,2])
C3272275 (UMLS CUI [1,3])
C0011946 (UMLS CUI [1,2])
C1299582 (UMLS CUI [1,2])
C1321605 (UMLS CUI [2])
C0009488 (UMLS CUI [1,2])
C0008976 (UMLS CUI [1,2])
C0587453 (UMLS CUI-2)
C0018801 (UMLS CUI-3)
C0183863 (UMLS CUI-4)
C1508263 (UMLS CUI-5)
C0011008 (UMLS CUI [1,2])
C1710477 (UMLS CUI [1,2])
C1710477 (UMLS CUI [1,2])
C1515258 (UMLS CUI [2])
C2826892 (UMLS CUI [3,1])
C1710477 (UMLS CUI [3,2])
C1442488 (UMLS CUI [1,2])
C0585085 (UMLS CUI [1,3])
C1442488 (UMLS CUI [1,2])
C0040223 (UMLS CUI [1,3])
C0585085 (UMLS CUI [1,4])
C0587453 (UMLS CUI-2)
C0018801 (UMLS CUI-3)
C0183863 (UMLS CUI-4)
C1508263 (UMLS CUI-5)
C0018801 (UMLS CUI [1,2])
C0183863 (UMLS CUI [1,3])
C0008976 (UMLS CUI [1,2])
C0392360 (UMLS CUI [1,3])
C1320303 (UMLS CUI [1,2])
C0027365 (UMLS CUI [1,2])
C1519316 (UMLS CUI [1,2])
C1515258 (UMLS CUI [2])
C0175906 (UMLS CUI [3])
C2348568 (UMLS CUI-2)
C0018801 (UMLS CUI-3)
C0183863 (UMLS CUI-4)
C0587453 (UMLS CUI-5)
C0018801 (UMLS CUI [1,2])
C0183863 (UMLS CUI [1,3])
C1442488 (UMLS CUI [1,2])
C0585085 (UMLS CUI [1,3])
C0008976 (UMLS CUI [1,2])
C0585085 (UMLS CUI [1,3])
C0008976 (UMLS CUI [1,2])
C0392360 (UMLS CUI [1,3])
C0008976 (UMLS CUI [1,2])
C0392360 (UMLS CUI [1,3])
C1512346 (UMLS CUI [1,2])
C0947611 (UMLS CUI [1,3])