Information: This is an outdated version of the data model. You can find a Versions overview via Versions on the left. You can find the newest Version by clicking here.
Information:
Error:
ID
31791
Description
Study ID: 105-040 Clinical Study ID: 105-040 Study Title: A Multicenter, Double-Blind, Placebo-Controlled, Parallel-Design Evaluation of LAMICTAL for Add-on Treatment of Partial Seizures in Pediatric Patients Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 3 Study Recruitment Status: Completed Generic Name: lamotrigine Trade Name: lamictal Study Indication: Epilepsy, Partial
Keywords
Versions (4)
- 9/16/18 9/16/18 -
- 9/27/18 9/27/18 -
- 10/8/18 10/8/18 -
- 10/8/18 10/8/18 -
Copyright Holder
GlaxoSmithKline
Uploaded on
September 27, 2018
DOI
To request one please log in.
License
Creative Commons BY-NC 3.0
Model comments :
You can comment on the data model here. Via the speech bubbles at the itemgroups and items you can add comments to those specificially.
Itemgroup comments for :
Item comments for :
In order to download data models you must be logged in. Please log in or register for free.
Evaluation of LAMICTAL for Add-on Treatment of Partial Seizures in Pediatric Patients (Clinical Study ID: 105-040)
Seizure history and information/ Epilepsy information - Screen
- StudyEvent: ODM
Similar models
Seizure history and information/ Epilepsy information - Screen
- StudyEvent: ODM
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Study Site; Numbers
Item
Site number
text
C2825164 (UMLS CUI [1,1])
C0237753 (UMLS CUI [1,2])
C0237753 (UMLS CUI [1,2])
Person Initials
Item
Patient's initials
text
C2986440 (UMLS CUI [1])
Clinical Trial Subject Unique Identifier
Item
Patient's trial number
text
C2348585 (UMLS CUI [1])
Assessment Date
Item
Date of assessment
date
C2985720 (UMLS CUI [1])
CL Item
Idiopathic (1)
CL Item
Symptomatic (2)
Etiology; Symptomatic
Item
If etiology is symptomatic, specify.
text
C1314792 (UMLS CUI [1,1])
C0231220 (UMLS CUI [1,2])
C0231220 (UMLS CUI [1,2])
Age; Seizures; First (number) | Febrile Convulsions
Item
Age at first seizure (excluding febrile seizures)
float
C0001779 (UMLS CUI [1,1])
C0036572 (UMLS CUI [1,2])
C0205435 (UMLS CUI [1,3])
C0009952 (UMLS CUI [2])
C0036572 (UMLS CUI [1,2])
C0205435 (UMLS CUI [1,3])
C0009952 (UMLS CUI [2])
CL Item
Simple partial seizures (Consciousness not impaired)- With motor signs - focal motor without march (A1a)
CL Item
Simple partial seizures (Consciousness not impaired)- With motor signs - focal motor with march (Jacksonian) (A1b)
CL Item
Simple partial seizures (Consciousness not impaired)- With motor signs - Versive (A1c)
CL Item
Simple partial seizures (Consciousness not impaired)- With motor signs - Postural (A1d)
CL Item
With somatosensory or special- sensory symptoms - Somatosensory (A2a)
CL Item
With somatosensory or special- sensory symptoms - Visual (A2b)
CL Item
With somatosensory or special- sensory symptoms - Auditory (A2c)
CL Item
With somatosensory or special- sensory symptoms - Olfactory (A2d)
CL Item
With somatosensory or special- sensory symptoms - Gustatory (A2e)
CL Item
With somatosensory or special- sensory symptoms - Vertiginous (A2f)
CL Item
With autonomic symptoms or signs (including epigastric sensation, pallor, sweating, flushing, piloerection, and pupillary dilatation) (A3)
CL Item
With psychic symptoms - Dysphasic (A4a)
CL Item
With psychic symptoms - Dysmnesic (e. g. deja- vu) (A4b)
CL Item
With psychic symptoms - Cognitive (e. g. dreamy states and distortions of time sense) (A4c)
CL Item
With psychic symptoms - Affective (fear, anger, etc.) (A4d)
CL Item
With psychic symptoms - Illusions (e. g. macropsia) (A4e)
CL Item
With psychic symptoms - Structured hallucinations (e. g. music, scenes) (A4f)
CL Item
Simple partial onset followed by impairment of consciousness - With simple partial features (A1- A4) followed by impaired consciousness (B1a)
CL Item
Simple partial onset followed by impairment of consciousness - With automatisms (B1b)
CL Item
With impairment of consciousness at onset - With impairment of consciousness only (B2a)
CL Item
With impairment of consciousness at onset - With automatism (B2b)
CL Item
Partial seizures evolving to secondarily generalized seizures (GS) - Simple partial seizures (A) evolving to GS (C1)
CL Item
Partial seizures evolving to secondarily generalized seizures (GS) - Complex partial (B) evolving to GS (C2)
CL Item
Partial seizures evolving to secondarily generalized seizures (GS) - Simple partial seizures (A) evolving to complex partial seizures (B) evolving to GS (C3)
CL Item
Generalized seizures (Convulsive or Non- convulsive) - Typical Abscence (D1a)
CL Item
Generalized seizures (Convulsive or Non- convulsive) - Impairment of consciousness only (D1ai)
CL Item
Generalized seizures (Convulsive or Non- convulsive) - With mild clonic component (D1aii)
CL Item
Generalized seizures (Convulsive or Non- convulsive) - With atonic component (D1aiii)
CL Item
Generalized seizures (Convulsive or Non- convulsive) - With tonic component (D1aiv)
CL Item
Generalized seizures (Convulsive or Non- convulsive) - With automatisms (D1av)
CL Item
Generalized seizures (Convulsive or Non- convulsive) - With autonomic components (Mixed forms of D1ai- D1avi may occur and should be dosumented by using all applicable code numbers) (D1avi)
CL Item
Atypical Absence (D1b)
CL Item
Changes in tone that are more pronounced than D1a (D1bi)
CL Item
Onset and/ or cessation that is not abrupt (D1bii)
CL Item
Myoclonic seizures (myoclonic jerks- single or multiple) (D2)
CL Item
Clonic seizures (D3)
CL Item
Tonic seizures (D4)
CL Item
Tonic- clonic seizures (D5)
CL Item
Atonic seizures (astatic) (D6)
CL Item
Combination of any of the above generalized seizured may occur and should be documented by using all applicable codde numbers. (Combination of any of the above generalized seizured may occur and should be documented by using all applicable codde numbers.)
CL Item
Unclassified Seizures (E)
Occurrence; Last; Date in time
Item
Date of last occurence
date
C2745955 (UMLS CUI [1,1])
C1517741 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
C1517741 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
Seizures; Count
Item
Number of seizures
float
C0036572 (UMLS CUI [1,1])
C0750480 (UMLS CUI [1,2])
C0750480 (UMLS CUI [1,2])
Unit | day | week | month | year
Item
Unit (specify unit as: day, week, month [4 weeks] or year)
text
C0439148 (UMLS CUI [1])
C0439228 (UMLS CUI [2])
C0439230 (UMLS CUI [3])
C0439231 (UMLS CUI [4])
C0439234 (UMLS CUI [5])
C0439228 (UMLS CUI [2])
C0439230 (UMLS CUI [3])
C0439231 (UMLS CUI [4])
C0439234 (UMLS CUI [5])
Item
Seizure Classification (Use ICE CODES)
text
C0036572 (UMLS CUI [1,1])
C0008902 (UMLS CUI [1,2])
C0008902 (UMLS CUI [1,2])
CL Item
Simple partial seizures (Consciousness not impaired)- With motor signs - focal motor without march (A1a)
CL Item
Simple partial seizures (Consciousness not impaired)- With motor signs - focal motor with march (Jacksonian) (A1b)
CL Item
Simple partial seizures (Consciousness not impaired)- With motor signs - Versive (A1c)
CL Item
Simple partial seizures (Consciousness not impaired)- With motor signs - Postural (A1d)
CL Item
With somatosensory or special- sensory symptoms - Somatosensory (A2a)
CL Item
With somatosensory or special- sensory symptoms - Visual (A2b)
CL Item
With somatosensory or special- sensory symptoms - Auditory (A2c)
CL Item
With somatosensory or special- sensory symptoms - Olfactory (A2d)
CL Item
With somatosensory or special- sensory symptoms - Gustatory (A2e)
CL Item
With somatosensory or special- sensory symptoms - Vertiginous (A2f)
CL Item
With autonomic symptoms or signs (including epigastric sensation, pallor, sweating, flushing, piloerection, and pupillary dilatation) (A3)
CL Item
With psychic symptoms - Dysphasic (A4a)
CL Item
With psychic symptoms - Dysmnesic (e. g. deja- vu) (A4b)
CL Item
With psychic symptoms - Cognitive (e. g. dreamy states and distortions of time sense) (A4c)
CL Item
With psychic symptoms - Affective (fear, anger, etc.) (A4d)
CL Item
With psychic symptoms - Illusions (e. g. macropsia) (A4e)
CL Item
With psychic symptoms - Structured hallucinations (e. g. music, scenes) (A4f)
CL Item
Simple partial onset followed by impairment of consciousness - With simple partial features (A1- A4) followed by impaired consciousness (B1a)
CL Item
Simple partial onset followed by impairment of consciousness - With automatisms (B1b)
CL Item
With impairment of consciousness at onset - With impairment of consciousness only (B2a)
CL Item
With impairment of consciousness at onset - With automatism (B2b)
CL Item
Partial seizures evolving to secondarily generalized seizures (GS) - Simple partial seizures (A) evolving to GS (C1)
CL Item
Partial seizures evolving to secondarily generalized seizures (GS) - Complex partial (B) evolving to GS (C2)
CL Item
Partial seizures evolving to secondarily generalized seizures (GS) - Simple partial seizures (A) evolving to complex partial seizures (B) evolving to GS (C3)
CL Item
Generalized seizures (Convulsive or Non- convulsive) - Typical Abscence (D1a)
CL Item
Generalized seizures (Convulsive or Non- convulsive) - Impairment of consciousness only (D1ai)
CL Item
Generalized seizures (Convulsive or Non- convulsive) - With mild clonic component (D1aii)
CL Item
Generalized seizures (Convulsive or Non- convulsive) - With atonic component (D1aiii)
CL Item
Generalized seizures (Convulsive or Non- convulsive) - With tonic component (D1aiv)
CL Item
Generalized seizures (Convulsive or Non- convulsive) - With automatisms (D1av)
CL Item
Generalized seizures (Convulsive or Non- convulsive) - With autonomic components (Mixed forms of D1ai- D1avi may occur and should be dosumented by using all applicable code numbers) (D1avi)
CL Item
Atypical Absence (D1b)
CL Item
Changes in tone that are more pronounced than D1a (D1bi)
CL Item
Onset and/ or cessation that is not abrupt (D1bii)
CL Item
Myoclonic seizures (myoclonic jerks- single or multiple) (D2)
CL Item
Clonic seizures (D3)
CL Item
Tonic seizures (D4)
CL Item
Tonic- clonic seizures (D5)
CL Item
Atonic seizures (astatic) (D6)
CL Item
Combination of any of the above generalized seizured may occur and should be documented by using all applicable codde numbers. (Combination of any of the above generalized seizured may occur and should be documented by using all applicable codde numbers.)
CL Item
Unclassified Seizures (E)