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Screening Part 4 - ECG and Pulmonary function (exhaled nitric oxide and AMP Challenge)

1 forms  
12-Lead ECG
Description

12-Lead ECG

Alias
UMLS CUI-1
C0430456
ECG number
Description

Three ECG strips more than 1 minute apart will be recorded (scheduled). Unscheduled ECGs are possible, too.

Data type

text

Alias
UMLS CUI [1,1]
C1623258
UMLS CUI [1,2]
C0237753
Start Date of ECG
Description

Start Date of ECG

Data type

date

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

Planned Relative Time

Data type

text

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

Start Time of ECG

Data type

time

Alias
UMLS CUI [1,1]
C0430456
UMLS CUI [1,2]
C1301880
Ventricular rate
Description

Ventricular rate

Data type

integer

Measurement units
  • beats/min
Alias
UMLS CUI [1]
C2189285
beats/min
PR interval
Description

PR interval

Data type

float

Measurement units
  • msec
Alias
UMLS CUI [1]
C0429087
msec
QRS duration
Description

QRS duration

Data type

float

Measurement units
  • msec
Alias
UMLS CUI [1,1]
C0429025
UMLS CUI [1,2]
C0430456
msec
Uncorrected QT interval
Description

Uncorrected QT interval

Data type

float

Measurement units
  • msec
Alias
UMLS CUI [1,1]
C0430456
UMLS CUI [1,2]
C1287082
UMLS CUI [1,3]
C4072785
msec
QTc interval
Description

QTc interval

Data type

float

Measurement units
  • msec
Alias
UMLS CUI [1]
C0855331
msec
Result of ECG
Description

Complete the additional ECG Abnormalities page if clinically significant abnormalities are present.

Data type

integer

Alias
UMLS CUI [1,1]
C1623258
UMLS CUI [1,2]
C0456984
Exhaled nitric oxide
Description

Exhaled nitric oxide

Alias
UMLS CUI-1
C3700245
Exhaled nitric oxide - Date
Description

Exhaled nitric oxide - Date

Data type

date

Alias
UMLS CUI [1,1]
C3700245
UMLS CUI [1,2]
C0011008
Planned relative time
Description

Planned relative time

Data type

text

Alias
UMLS CUI [1,1]
C0439564
UMLS CUI [1,2]
C3700245
Actual Time of First Reading
Description

Actual Time of First Reading

Data type

time

Alias
UMLS CUI [1,1]
C3700245
UMLS CUI [1,2]
C0040223
Reading 1
Description

Reading 1

Data type

float

Measurement units
  • ppb
Alias
UMLS CUI [1,1]
C3700245
UMLS CUI [1,2]
C0456984
ppb
Reading 2
Description

Reading 2

Data type

float

Measurement units
  • ppb
Alias
UMLS CUI [1,1]
C3700245
UMLS CUI [1,2]
C0456984
ppb
Reading 3
Description

Reading 3

Data type

float

Measurement units
  • ppb
Alias
UMLS CUI [1,1]
C3700245
UMLS CUI [1,2]
C0456984
ppb
Pulmonary function tests / FEV 1
Description

Pulmonary function tests / FEV 1

Alias
UMLS CUI-1
C0024119
UMLS CUI-2
C0429706
Date of FEV1
Description

Date of FEV1

Data type

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C0429706
Planned Relative Time
Description

Time relative to dosing

Data type

text

Alias
UMLS CUI [1,1]
C0439564
UMLS CUI [1,2]
C0748133
Pulmonary Function Time
Description

Pulmonary Function Time

Data type

time

Alias
UMLS CUI [1,1]
C0040223
UMLS CUI [1,2]
C0024119
FEV1 Reading 1
Description

FEV1 Reading 1

Data type

float

Measurement units
  • L
Alias
UMLS CUI [1,1]
C0456984
UMLS CUI [1,2]
C0429706
L
FEV1 Reading 2
Description

FEV1 Reading 2

Data type

float

Measurement units
  • L
Alias
UMLS CUI [1,1]
C0456984
UMLS CUI [1,2]
C0429706
L
FEV1 Reading 3
Description

FEV1 Reading 3

Data type

float

Measurement units
  • L
Alias
UMLS CUI [1,1]
C0456984
UMLS CUI [1,2]
C0429706
L
FEV1 Reading 1
Description

Value A in investigator Calculation

Data type

float

Measurement units
  • L
Alias
UMLS CUI [1,1]
C0456984
UMLS CUI [1,2]
C0429706
L
FEV1 predicted normal
Description

Value B in Investigator Calculation

Data type

float

Measurement units
  • L
Alias
UMLS CUI [1,1]
C0748133
UMLS CUI [1,2]
C0086715
L
FEV1 percent predicted normal
Description

Investigator Calculation: A / B x 100 FEV1 must be > 70% of predicted at Screening.

Data type

float

Measurement units
  • %
Alias
UMLS CUI [1]
C0730561
%
Pulmonary function tests: Pre-AMP Challenge
Description

Pulmonary function tests: Pre-AMP Challenge

Alias
UMLS CUI-1
C0024119
UMLS CUI-2
C1096479
UMLS CUI-3
C3812758
pre-AMP pulmonary function test date
Description

pre-AMP pulmonary function test date

Data type

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C0024119
UMLS CUI [1,3]
C1096479
UMLS CUI [1,4]
C3812758
Planned relative Time
Description

Time relative to start of challenge. 3 pre-saline measurements are required.

Data type

text

Alias
UMLS CUI [1,1]
C0439564
UMLS CUI [1,2]
C0748133
Time of FEV1
Description

Time of FEV1

Data type

time

Alias
UMLS CUI [1,1]
C0040223
UMLS CUI [1,2]
C0429706
FEV1 Reading
Description

FEV1 Reading

Data type

float

Measurement units
  • L
Alias
UMLS CUI [1,1]
C0456984
UMLS CUI [1,2]
C0429706
L
Pulmonary function tests: AMP Challenge
Description

Pulmonary function tests: AMP Challenge

Alias
UMLS CUI-1
C0024119
UMLS CUI-2
C1096479
AMP-Challenge Date
Description

AMP-Challenge Date

Data type

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C1096479
Inhaled Substance
Description

Inhaled Substance

Data type

text

Alias
UMLS CUI [1,1]
C0205535
UMLS CUI [1,2]
C0001465
UMLS CUI [2,1]
C0205535
UMLS CUI [2,2]
C0036082
Challenge Concentration (New subjects)
Description

Following the baseline assessment in which FEV1 is measured after inhalation of saline, subjects are to inhale doubling increments of AMP until a ≥20percent fall in FEV1 from the baseline saline value is achieved. 0.000 is the concentration value for saline.

Data type

text

Measurement units
  • mg/mL
Alias
UMLS CUI [1,1]
C1446561
UMLS CUI [1,2]
C0001465
Challenge Concentration (Historical concentration)
Description

Use this item, if historical concentrations instead of the concentrations given in the item "challenge concentration (New Subjects)" are used. Following the baseline assessment in which FEV1 is measured after inhalation of saline, subjects are to inhale doubling increments of AMP until a ≥20percent fall in FEV1 from the baseline saline value is achieved. Use 0.000 for saline inhaltation.

Data type

float

Measurement units
  • mg/mL
Alias
UMLS CUI [1,1]
C1446561
UMLS CUI [1,2]
C0001465
mg/mL
Start Time of Inhalation
Description

Fill in only for saline inhalation.

Data type

time

Alias
UMLS CUI [1,1]
C1301880
UMLS CUI [1,2]
C0001559
Stop Time of Inhalation
Description

Stop Time of Inhalation

Data type

time

Alias
UMLS CUI [1,1]
C1522314
UMLS CUI [1,2]
C0001559
Planned relative Time of FEV1
Description

Both timepoints must be filled after each inhalation. Time relative to stop time of inhalation.

Data type

text

Alias
UMLS CUI [1,1]
C0439564
UMLS CUI [1,2]
C0205535
UMLS CUI [1,3]
C0748133
Pulmonary function time
Description

Pulmonary function time

Data type

time

Alias
UMLS CUI [1,1]
C0040223
UMLS CUI [1,2]
C0429706
FEV1 Result
Description

FEV1 Result

Data type

float

Measurement units
  • L
Alias
UMLS CUI [1,1]
C0429706
UMLS CUI [1,2]
C1096479
L
Pulmonary function tests: Post-AMP Challenge
Description

Pulmonary function tests: Post-AMP Challenge

Alias
UMLS CUI-1
C0231921
UMLS CUI-2
C1096479
UMLS CUI-3
C0439568
Date of post-challenge FEV1
Description

Date of post-challenge FEV1

Data type

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C0429706
UMLS CUI [1,3]
C0439568
Time of post-challenge FEV1
Description

Time relative to end of challenge: Post-challenge 6 measurements are required.

Data type

time

Alias
UMLS CUI [1,1]
C0040223
UMLS CUI [1,2]
C0429706
UMLS CUI [1,3]
C0439568
Result of post-challenge FEV1
Description

Record use of rescue Salbutamol on the Concomitant Medications page.

Data type

float

Measurement units
  • L
Alias
UMLS CUI [1,1]
C0429706
UMLS CUI [1,2]
C1274040
UMLS CUI [1,3]
C0439568
L
PC20 (AMP Challenge)
Description

PC20 (AMP Challenge)

Alias
UMLS CUI-1
C1446561
UMLS CUI-2
C0001465
UMLS CUI-3
C0429706
UMLS CUI-4
C0547047
Date of challenge
Description

Date of challenge

Data type

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C1096479
PC20
Description

Provocative concentration resulting in a 20% reduction in FEV1.

Data type

float

Measurement units
  • mg/mL
Alias
UMLS CUI [1,1]
C1446561
UMLS CUI [1,2]
C0001465
UMLS CUI [2,1]
C0429706
UMLS CUI [2,2]
C0547047
mg/mL
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Similar models

Screening Part 4 - ECG and Pulmonary function (exhaled nitric oxide and AMP Challenge)

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
12-Lead ECG
C0430456 (UMLS CUI-1)
Item
ECG number
text
C1623258 (UMLS CUI [1,1])
C0237753 (UMLS CUI [1,2])
ECG number
Code List
ECG number
CL Item
ECG1 (ECG1)
CL Item
ECG2 (ECG2)
CL Item
ECG3 (ECG3)
CL Item
ECG4 (ECG4)
CL Item
ECG5 (ECG5)
CL Item
ECG6 (ECG6)
Start Date of ECG
Item
Start Date of ECG
date
C0430456 (UMLS CUI [1,1])
C0808070 (UMLS CUI [1,2])
Item
Planned Relative Time
text
C0430456 (UMLS CUI [1,1])
C0439564 (UMLS CUI [1,2])
Planned Relative Time
Code List
Planned Relative Time
CL Item
screening (screening)
CL Item
unscheduled (unscheduled)
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])
PR interval
Item
PR interval
float
C0429087 (UMLS CUI [1])
QRS duration
Item
QRS duration
float
C0429025 (UMLS CUI [1,1])
C0430456 (UMLS CUI [1,2])
Uncorrected QT interval
Item
Uncorrected QT interval
float
C0430456 (UMLS CUI [1,1])
C1287082 (UMLS CUI [1,2])
C4072785 (UMLS CUI [1,3])
QTc interval
Item
QTc interval
float
C0855331 (UMLS CUI [1])
Item
Result of ECG
integer
C1623258 (UMLS CUI [1,1])
C0456984 (UMLS CUI [1,2])
Result of ECG
Code List
Result of 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
Exhaled nitric oxide
C3700245 (UMLS CUI-1)
Exhaled nitric oxide - Date
Item
Exhaled nitric oxide - Date
date
C3700245 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Item
Planned relative time
text
C0439564 (UMLS CUI [1,1])
C3700245 (UMLS CUI [1,2])
Planned relative time
Code List
Planned relative time
CL Item
screening (screening)
CL Item
unscheduled (unscheduled)
Actual Time of First Reading
Item
Actual Time of First Reading
time
C3700245 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Reading 1
Item
Reading 1
float
C3700245 (UMLS CUI [1,1])
C0456984 (UMLS CUI [1,2])
Reading 2
Item
Reading 2
float
C3700245 (UMLS CUI [1,1])
C0456984 (UMLS CUI [1,2])
Reading 3
Item
Reading 3
float
C3700245 (UMLS CUI [1,1])
C0456984 (UMLS CUI [1,2])
Item Group
Pulmonary function tests / FEV 1
C0024119 (UMLS CUI-1)
C0429706 (UMLS CUI-2)
Date of FEV1
Item
Date of FEV1
date
C0011008 (UMLS CUI [1,1])
C0429706 (UMLS CUI [1,2])
Item
Planned Relative Time
text
C0439564 (UMLS CUI [1,1])
C0748133 (UMLS CUI [1,2])
Planned Relative Time
Code List
Planned Relative Time
CL Item
Screening (Screening)
CL Item
Unscheduled (Unscheduled)
Pulmonary Function Time
Item
Pulmonary Function Time
time
C0040223 (UMLS CUI [1,1])
C0024119 (UMLS CUI [1,2])
FEV1 Reading 1
Item
FEV1 Reading 1
float
C0456984 (UMLS CUI [1,1])
C0429706 (UMLS CUI [1,2])
FEV1 Reading 2
Item
FEV1 Reading 2
float
C0456984 (UMLS CUI [1,1])
C0429706 (UMLS CUI [1,2])
FEV1 Reading 3
Item
FEV1 Reading 3
float
C0456984 (UMLS CUI [1,1])
C0429706 (UMLS CUI [1,2])
FEV1 Highest Reading
Item
FEV1 Reading 1
float
C0456984 (UMLS CUI [1,1])
C0429706 (UMLS CUI [1,2])
FEV1 Predicted normal
Item
FEV1 predicted normal
float
C0748133 (UMLS CUI [1,1])
C0086715 (UMLS CUI [1,2])
FEV1 percent predicted normal
Item
FEV1 percent predicted normal
float
C0730561 (UMLS CUI [1])
Item Group
Pulmonary function tests: Pre-AMP Challenge
C0024119 (UMLS CUI-1)
C1096479 (UMLS CUI-2)
C3812758 (UMLS CUI-3)
pre-AMP pulmonary function test date
Item
pre-AMP pulmonary function test date
date
C0011008 (UMLS CUI [1,1])
C0024119 (UMLS CUI [1,2])
C1096479 (UMLS CUI [1,3])
C3812758 (UMLS CUI [1,4])
Item
Planned relative Time
text
C0439564 (UMLS CUI [1,1])
C0748133 (UMLS CUI [1,2])
Planned relative time
Code List
Planned relative Time
CL Item
pre-saline (pre-saline)
CL Item
unscheduled (unscheduled)
Time of FEV1
Item
Time of FEV1
time
C0040223 (UMLS CUI [1,1])
C0429706 (UMLS CUI [1,2])
FEV1 Reading
Item
FEV1 Reading
float
C0456984 (UMLS CUI [1,1])
C0429706 (UMLS CUI [1,2])
Item Group
Pulmonary function tests: AMP Challenge
C0024119 (UMLS CUI-1)
C1096479 (UMLS CUI-2)
AMP-Challenge Date
Item
AMP-Challenge Date
date
C0011008 (UMLS CUI [1,1])
C1096479 (UMLS CUI [1,2])
Item
Inhaled Substance
text
C0205535 (UMLS CUI [1,1])
C0001465 (UMLS CUI [1,2])
C0205535 (UMLS CUI [2,1])
C0036082 (UMLS CUI [2,2])
Inhaled Substance
Code List
Inhaled Substance
CL Item
Saline (Saline)
CL Item
Saline, unscheduled (Saline, unscheduled)
CL Item
AMP (AMP)
Item
Challenge Concentration (New subjects)
text
C1446561 (UMLS CUI [1,1])
C0001465 (UMLS CUI [1,2])
Challenge Concentration (New Subjects)
Code List
Challenge Concentration (New subjects)
CL Item
0.000 (0.000)
CL Item
0.039 (0.039)
CL Item
0.078 (0.078)
CL Item
0.156 (0.156)
CL Item
0.3125 (0.3125)
CL Item
0.625 (0.625)
CL Item
1.25 (1.25)
CL Item
2.5 (2.5)
CL Item
5 (5)
CL Item
10 (10)
CL Item
20 (20)
CL Item
40 (40)
CL Item
80 (80)
CL Item
160 (160)
CL Item
320 (320)
Challenge Concentration (Historical Concentration)
Item
Challenge Concentration (Historical concentration)
float
C1446561 (UMLS CUI [1,1])
C0001465 (UMLS CUI [1,2])
Start Time of Inhalation
Item
Start Time of Inhalation
time
C1301880 (UMLS CUI [1,1])
C0001559 (UMLS CUI [1,2])
Stop Time of Inhalation
Item
Stop Time of Inhalation
time
C1522314 (UMLS CUI [1,1])
C0001559 (UMLS CUI [1,2])
Item
Planned relative Time of FEV1
text
C0439564 (UMLS CUI [1,1])
C0205535 (UMLS CUI [1,2])
C0748133 (UMLS CUI [1,3])
Planned relative Time of FEV1
Code List
Planned relative Time of FEV1
CL Item
60 secs post-inhalation (60 secs post-inhalation)
CL Item
180 secs post-inhalation (180 secs post-inhalation)
Pulmonary function time
Item
Pulmonary function time
time
C0040223 (UMLS CUI [1,1])
C0429706 (UMLS CUI [1,2])
FEV1 Result
Item
FEV1 Result
float
C0429706 (UMLS CUI [1,1])
C1096479 (UMLS CUI [1,2])
Item Group
Pulmonary function tests: Post-AMP Challenge
C0231921 (UMLS CUI-1)
C1096479 (UMLS CUI-2)
C0439568 (UMLS CUI-3)
Date of post-challenge FEV1
Item
Date of post-challenge FEV1
date
C0011008 (UMLS CUI [1,1])
C0429706 (UMLS CUI [1,2])
C0439568 (UMLS CUI [1,3])
Time of post-challenge FEV1
Item
Time of post-challenge FEV1
time
C0040223 (UMLS CUI [1,1])
C0429706 (UMLS CUI [1,2])
C0439568 (UMLS CUI [1,3])
Result of post-challenge FEV1
Item
Result of post-challenge FEV1
float
C0429706 (UMLS CUI [1,1])
C1274040 (UMLS CUI [1,2])
C0439568 (UMLS CUI [1,3])
Item Group
PC20 (AMP Challenge)
C1446561 (UMLS CUI-1)
C0001465 (UMLS CUI-2)
C0429706 (UMLS CUI-3)
C0547047 (UMLS CUI-4)
Date of challenge
Item
Date of challenge
date
C0011008 (UMLS CUI [1,1])
C1096479 (UMLS CUI [1,2])
PC20
Item
PC20
float
C1446561 (UMLS CUI [1,1])
C0001465 (UMLS CUI [1,2])
C0429706 (UMLS CUI [2,1])
C0547047 (UMLS CUI [2,2])
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