ID

31490

Descripción

Study ID: 104619 Clinical Study ID: 63129 Study Title:A multinational, randomized, double-blind comparison of once daily subcutaneous fondaparinux sodium with placebo for the prevention of venous thromboembolic events in acutely ill medical patients (ARTEMIS). Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 3 Study Recruitment Status: Completed Generic Name: fondaparinux sodium Trade Name: Arixtra Study Indication: Thrombosis, Venous

Palabras clave

  1. 28/8/18 28/8/18 -
Titular de derechos de autor

GlaxoSmithKline

Subido en

28 de agosto de 2018

DOI

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Licencia

Creative Commons BY-NC 3.0

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Subcutaneous fondaparinux sodium for prevention of venous thromboembolic events; Study ID: 104619

SAE Complementary Information Form

Serious Adverse Event
Descripción

Serious Adverse Event

Alias
UMLS CUI-1
C1519255
Date of Birth
Descripción

Patient Date of Birth

Tipo de datos

date

Alias
UMLS CUI [1]
C0421451
Age
Descripción

Age

Tipo de datos

integer

Alias
UMLS CUI [1]
C0001779
Sex
Descripción

Gender

Tipo de datos

text

Alias
UMLS CUI [1]
C0079399
Race
Descripción

Racial group

Tipo de datos

text

Alias
UMLS CUI [1]
C0034510
Height
Descripción

Body Height

Tipo de datos

integer

Unidades de medida
  • cm
Alias
UMLS CUI [1]
C0005890
cm
Weight
Descripción

Body Weight

Tipo de datos

float

Unidades de medida
  • kg
Alias
UMLS CUI [1]
C0005910
kg
Detailed Description
Descripción

Serious Adverse Event; description

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0678257
Study Drug - Treatment Number
Descripción

Study Drug, Identifier

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C0304229
UMLS CUI [1,2]
C0600091
Date and of the FIRST administration of Study Drug
Descripción

Study Drug, Date and Time of First Study Treatment

Tipo de datos

datetime

Alias
UMLS CUI [1,1]
C0304229
UMLS CUI [1,2]
C3899436
Date and of the LAST administration of Study Drug
Descripción

Study Drug, Date and Time of last Study Treatment

Tipo de datos

datetime

Alias
UMLS CUI [1,1]
C0304229
UMLS CUI [1,2]
C3469597
UMLS CUI [1,3]
C1517741
UMLS CUI [1,4]
C0011008
UMLS CUI [1,5]
C0040223
Study drug ongoing (at the time of report)
Descripción

Experimental drug; Administration of medication; Continuous

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0304229
UMLS CUI [1,2]
C3469597
UMLS CUI [1,3]
C0549178
In case of Hospitalization: Date of admission
Descripción

serious adverse event; hospitalization; admission date

Tipo de datos

date

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C1708385
UMLS CUI [1,3]
C1302393
Previous and concomitant Medications
Descripción

Serious Adverse Event, Pharmaceutical Preparations, Previous; Serious Adverse Event, Concomitant Agent

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0013227
UMLS CUI [1,3]
C0205156
UMLS CUI [2,1]
C1519255
UMLS CUI [2,2]
C2347852
Medical History and Concomitant Diseases
Descripción

Serious Adverse Event; Medical History; Concomitant Diseases

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0262926
UMLS CUI [1,3]
C0243087
SAE Follow-Up Information
Descripción

SAE Follow-Up Information

Alias
UMLS CUI-1
C1519255
UMLS CUI-2
C1522577
Adverse Event
Descripción

Serious Adverse Event

Tipo de datos

text

Alias
UMLS CUI [1]
C1519255
Date of Evaluation
Descripción

Serious Adverse Event; Date of Evaluation

Tipo de datos

date

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0220825
UMLS CUI [1,3]
C0011008
Additional Information and Comments
Descripción

Serious Adverse Event; Additional Information, Comments

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C1546922
UMLS CUI [1,3]
C0947611

Similar models

SAE Complementary Information Form

Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
Serious Adverse Event
C1519255 (UMLS CUI-1)
Patient Date of Birth
Item
Date of Birth
date
C0421451 (UMLS CUI [1])
Age
Item
Age
integer
C0001779 (UMLS CUI [1])
Item
Sex
text
C0079399 (UMLS CUI [1])
Code List
Sex
CL Item
Male (Male)
CL Item
Female (Female)
Item
Race
text
C0034510 (UMLS CUI [1])
Code List
Race
CL Item
Caucasian (Caucasian)
CL Item
Black (Black)
CL Item
Asian, Oriental (Asian, Oriental)
CL Item
Other (Other)
Body Height
Item
Height
integer
C0005890 (UMLS CUI [1])
Body Weight
Item
Weight
float
C0005910 (UMLS CUI [1])
Serious Adverse Event; description
Item
Detailed Description
text
C1519255 (UMLS CUI [1,1])
C0678257 (UMLS CUI [1,2])
Study Drug, Identifier
Item
Study Drug - Treatment Number
integer
C0304229 (UMLS CUI [1,1])
C0600091 (UMLS CUI [1,2])
Study Drug, Date and Time of First Study Treatment
Item
Date and of the FIRST administration of Study Drug
datetime
C0304229 (UMLS CUI [1,1])
C3899436 (UMLS CUI [1,2])
Study Drug, Date and Time of last Study Treatment
Item
Date and of the LAST administration of Study Drug
datetime
C0304229 (UMLS CUI [1,1])
C3469597 (UMLS CUI [1,2])
C1517741 (UMLS CUI [1,3])
C0011008 (UMLS CUI [1,4])
C0040223 (UMLS CUI [1,5])
Experimental drug; Administration of medication; Continuous
Item
Study drug ongoing (at the time of report)
boolean
C0304229 (UMLS CUI [1,1])
C3469597 (UMLS CUI [1,2])
C0549178 (UMLS CUI [1,3])
serious adverse event; hospitalization; admission date
Item
In case of Hospitalization: Date of admission
date
C1519255 (UMLS CUI [1,1])
C1708385 (UMLS CUI [1,2])
C1302393 (UMLS CUI [1,3])
Serious Adverse Event, Pharmaceutical Preparations, Previous; Serious Adverse Event, Concomitant Agent
Item
Previous and concomitant Medications
boolean
C1519255 (UMLS CUI [1,1])
C0013227 (UMLS CUI [1,2])
C0205156 (UMLS CUI [1,3])
C1519255 (UMLS CUI [2,1])
C2347852 (UMLS CUI [2,2])
Serious Adverse Event; Medical History; Concomitant Diseases
Item
Medical History and Concomitant Diseases
boolean
C1519255 (UMLS CUI [1,1])
C0262926 (UMLS CUI [1,2])
C0243087 (UMLS CUI [1,3])
Item Group
SAE Follow-Up Information
C1519255 (UMLS CUI-1)
C1522577 (UMLS CUI-2)
Serious Adverse Event
Item
Adverse Event
text
C1519255 (UMLS CUI [1])
Serious Adverse Event; Date of Evaluation
Item
Date of Evaluation
date
C1519255 (UMLS CUI [1,1])
C0220825 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
Serious Adverse Event; Additional Information, Comments
Item
Additional Information and Comments
text
C1519255 (UMLS CUI [1,1])
C1546922 (UMLS CUI [1,2])
C0947611 (UMLS CUI [1,3])

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