English

Concomitant Medications - Study Week 1 Through Taper and Follow- up, AED Prescription and Compliance - Week 2 through Taper and Follow- Up, Study Medication Prescription and Compliance Record - Study Week 9 Through Taper and Follow- Up

1 forms  
Administrative
Description

Administrative

Alias
UMLS CUI-1
C1320722
Site number
Description

Study Site; Numbers

Data type

text

Alias
UMLS CUI [1,1]
C2825164
UMLS CUI [1,2]
C0237753
Patient's initials
Description

Person Initials

Data type

text

Alias
UMLS CUI [1]
C2986440
Patient's trial number
Description

Clinical Trial Subject Unique Identifier

Data type

text

Alias
UMLS CUI [1]
C2348585
Additional medications
Description

Additional medications

Alias
UMLS CUI-1
C0013227
UMLS CUI-2
C1706712
Were any additional medications other than antiepileptic drugs taken during the study? (If yes, record below.)
Description

Pharmaceutical Preparations; Additional Therapy; Taken; Clinical Trials; During

Data type

boolean

Alias
UMLS CUI [1,1]
C0013227
UMLS CUI [1,2]
C1706712
UMLS CUI [1,3]
C1883727
UMLS CUI [1,4]
C0008976
UMLS CUI [1,5]
C0347984
Record Additional medications
Description

Record Additional medications

Alias
UMLS CUI-1
C0013227
UMLS CUI-2
C1706712
UMLS CUI-3
C0034869
Date medication first taken during study
Description

Date in time; Pharmaceutical Preparations; Taken

Data type

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C0013227
UMLS CUI [1,3]
C1883727
Name of drug/ Generic
Description

Medication name | Generic drug name

Data type

text

Alias
UMLS CUI [1]
C2360065
UMLS CUI [2]
C0592502
AED Prescription Record
Description

AED Prescription Record

Alias
UMLS CUI-1
C0003299
UMLS CUI-2
C1521941
Name of antiepileptic drug
Description

Antiepileptic Agents; Medication name

Data type

text

Alias
UMLS CUI [1,1]
C0003299
UMLS CUI [1,2]
C2360065
Start date antiepileptic drug
Description

Antiepileptic Agents; Start Date

Data type

date

Alias
UMLS CUI [1,1]
C0003299
UMLS CUI [1,2]
C0808070
Stop date antiepileptic drug
Description

Antiepileptic Agents; End date

Data type

text

Alias
UMLS CUI [1,1]
C0003299
UMLS CUI [1,2]
C0806020
Time of dose 1
Description

Dosage; Time

Data type

time

Alias
UMLS CUI [1,1]
C0178602
UMLS CUI [1,2]
C0040223
Amount of dose 1
Description

Dosage

Data type

float

Measurement units
  • mg
Alias
UMLS CUI [1]
C0178602
mg
Time of dose 2
Description

Dosage; Time

Data type

time

Alias
UMLS CUI [1,1]
C0178602
UMLS CUI [1,2]
C0040223
Amount of dose 2
Description

Dosage

Data type

float

Measurement units
  • mg
Alias
UMLS CUI [1]
C0178602
mg
Time of dose 3
Description

Dosage; Time

Data type

time

Alias
UMLS CUI [1,1]
C0178602
UMLS CUI [1,2]
C0040223
Amount of dose 3
Description

Dosage

Data type

float

Measurement units
  • mg
Alias
UMLS CUI [1]
C0178602
mg
Time of dose 4
Description

Dosage; Time

Data type

time

Alias
UMLS CUI [1,1]
C0178602
UMLS CUI [1,2]
C0040223
Amount of dose 4
Description

Dosage

Data type

float

Measurement units
  • mg
Alias
UMLS CUI [1]
C0178602
mg
Time of dose 5
Description

Dosage; Time

Data type

time

Alias
UMLS CUI [1,1]
C0178602
UMLS CUI [1,2]
C0040223
Amount of dose 5
Description

Dosage

Data type

float

Measurement units
  • mg
Alias
UMLS CUI [1]
C0178602
mg
Antiepileptic drugs Compliance Record
Description

Antiepileptic drugs Compliance Record

Alias
UMLS CUI-1
C0003299
UMLS CUI-2
C0525058
Name of antiepileptic drug
Description

Antiepileptic Agents; Medication name

Data type

text

Alias
UMLS CUI [1,1]
C0003299
UMLS CUI [1,2]
C2360065
Start date antiepileptic drug
Description

Antiepileptic Agents; Start Date

Data type

date

Alias
UMLS CUI [1,1]
C0003299
UMLS CUI [1,2]
C0808070
Stop date antiepileptic drug
Description

Antiepileptic Agents; End date

Data type

date

Alias
UMLS CUI [1,1]
C0003299
UMLS CUI [1,2]
C0806020
Time of dose 1
Description

Dosage; Time

Data type

time

Alias
UMLS CUI [1,1]
C0178602
UMLS CUI [1,2]
C0040223
Amount of dose 1
Description

Dosage

Data type

float

Measurement units
  • mg
Alias
UMLS CUI [1]
C0178602
mg
Time of dose 2
Description

Dosage; Time

Data type

time

Alias
UMLS CUI [1,1]
C0178602
UMLS CUI [1,2]
C0040223
Amount of dose 2
Description

Dosage

Data type

float

Measurement units
  • mg
Alias
UMLS CUI [1]
C0178602
mg
Time of dose 3
Description

Dosage; Time

Data type

time

Alias
UMLS CUI [1,1]
C0178602
UMLS CUI [1,2]
C0040223
Amount of dose 3
Description

Dosage

Data type

float

Measurement units
  • mg
Alias
UMLS CUI [1]
C0178602
mg
Time of dose 4
Description

Dosage; Time

Data type

time

Alias
UMLS CUI [1,1]
C0178602
UMLS CUI [1,2]
C0040223
Amount of dose 4
Description

Dosage

Data type

float

Measurement units
  • mg
Alias
UMLS CUI [1]
C0178602
mg
Time of dose 5
Description

Dosage; Time

Data type

time

Alias
UMLS CUI [1,1]
C0178602
UMLS CUI [1,2]
C0040223
Amount of dose 5
Description

Dosage

Data type

float

Measurement units
  • mg
Alias
UMLS CUI [1]
C0178602
mg
AED entire day's dosing information
Description

AED entire day's dosing information

Alias
UMLS CUI-1
C0003299
UMLS CUI-2
C0678766
UMLS CUI-3
C1533716
UMLS CUI-4
C0439228
UMLS CUI-5
C0439751
Name of antiepileptic drug
Description

Antiepileptic Agents; Medication name

Data type

text

Alias
UMLS CUI [1,1]
C0003299
UMLS CUI [1,2]
C2360065
Start date antiepileptic drug
Description

Antiepileptic Agents; Start Date

Data type

date

Alias
UMLS CUI [1,1]
C0003299
UMLS CUI [1,2]
C0808070
Stop date antiepileptic drug
Description

Antiepileptic Agents; End date

Data type

date

Alias
UMLS CUI [1,1]
C0003299
UMLS CUI [1,2]
C0806020
Time of dose 1
Description

Dosage; Time

Data type

time

Alias
UMLS CUI [1,1]
C0178602
UMLS CUI [1,2]
C0040223
Amount of dose 1
Description

Dosage

Data type

float

Measurement units
  • mg
Alias
UMLS CUI [1]
C0178602
mg
Time of dose 2
Description

Dosage; Time

Data type

time

Alias
UMLS CUI [1,1]
C0178602
UMLS CUI [1,2]
C0040223
Amount of dose 2
Description

Dosage

Data type

float

Measurement units
  • mg
Alias
UMLS CUI [1]
C0178602
mg
Time of dose 3
Description

Dosage; Time

Data type

time

Alias
UMLS CUI [1,1]
C0178602
UMLS CUI [1,2]
C0040223
Amount of dose 3
Description

Dosage

Data type

float

Measurement units
  • mg
Alias
UMLS CUI [1]
C0178602
mg
Time of dose 4
Description

Dosage; Time

Data type

time

Alias
UMLS CUI [1,1]
C0178602
UMLS CUI [1,2]
C0040223
Amount of dose 4
Description

Dosage

Data type

float

Measurement units
  • mg
Alias
UMLS CUI [1]
C0178602
mg
Time of dose 5
Description

Dosage; Time

Data type

time

Alias
UMLS CUI [1,1]
C0178602
UMLS CUI [1,2]
C0040223
Amount of dose 5
Description

Dosage

Data type

float

Measurement units
  • mg
Alias
UMLS CUI [1]
C0178602
mg
Study Medication Prescription Record
Description

Study Medication Prescription Record

Alias
UMLS CUI-1
C0304229
UMLS CUI-2
C1521941
Study Medication Start date
Description

Experimental drug; Start Date

Data type

date

Alias
UMLS CUI [1,1]
C0304229
UMLS CUI [1,2]
C0808070
Study Medication Stop Date
Description

Experimental drug; End Date

Data type

date

Alias
UMLS CUI [1,1]
C0304229
UMLS CUI [1,2]
C0806020
Protocol required scheduled dose
Description

Dosage; Schedule (document type); Study Protocol; Requirement

Data type

float

Measurement units
  • mg/kg/day
Alias
UMLS CUI [1,1]
C0178602
UMLS CUI [1,2]
C0086960
UMLS CUI [1,3]
C2348563
UMLS CUI [1,4]
C1514873
mg/kg/day
Weight
Description

Body Weight

Data type

float

Measurement units
  • kg
Alias
UMLS CUI [1]
C0005910
kg
Calculated dose
Description

Medication dose; Calculated

Data type

text

Measurement units
  • mg/day
Alias
UMLS CUI [1,1]
C3174092
UMLS CUI [1,2]
C0444686
mg/day
Investigator actual prescribed dose - A.M. dose - Time
Description

Drug dose; prescribed; Clinical Investigators; |Experimental drug; Time; a.m.

Data type

time

Alias
UMLS CUI [1,1]
C0678766
UMLS CUI [1,2]
C0278329
UMLS CUI [1,3]
C0008961
UMLS CUI [2,1]
C0304229
UMLS CUI [2,2]
C0040223
UMLS CUI [2,3]
C4331833
Investigator actual prescribed dose - A.M. dose - Amount
Description

Drug dose; prescribed; Clinical Investigators; |Experimental drug; Dosage; a.m.

Data type

float

Measurement units
  • mg
Alias
UMLS CUI [1,1]
C0678766
UMLS CUI [1,2]
C0278329
UMLS CUI [1,3]
C0008961
UMLS CUI [2,1]
C0304229
UMLS CUI [2,2]
C0178602
UMLS CUI [2,3]
C4331833
mg
Investigator actual prescribed dose - P.M. dose - Time
Description

Drug dose; prescribed; Clinical Investigators; |Experimental drug; Time; post meridiem

Data type

time

Alias
UMLS CUI [1,1]
C0678766
UMLS CUI [1,2]
C0278329
UMLS CUI [1,3]
C0008961
UMLS CUI [2,1]
C0304229
UMLS CUI [2,2]
C0040223
UMLS CUI [2,3]
C1509133
Investigator actual prescribed dose - P.M. dose - Amount
Description

Drug dose; prescribed; Clinical Investigators; |Experimental drug; Dosage; post meridiem

Data type

float

Measurement units
  • mg
Alias
UMLS CUI [1,1]
C0678766
UMLS CUI [1,2]
C0278329
UMLS CUI [1,3]
C0008961
UMLS CUI [2,1]
C0304229
UMLS CUI [2,2]
C0178602
UMLS CUI [2,3]
C1509133
mg
Study Medication Compliance Record
Description

Study Medication Compliance Record

Alias
UMLS CUI-1
C0304229
UMLS CUI-2
C3714738
UMLS CUI-3
C0034869
Study Medication Start date
Description

Experimental drug; Start Date

Data type

date

Alias
UMLS CUI [1,1]
C0304229
UMLS CUI [1,2]
C0808070
Study Medication Stop Date
Description

Experimental drug; End Date

Data type

date

Alias
UMLS CUI [1,1]
C0304229
UMLS CUI [1,2]
C0806020
A.M. dose - Amount of dose
Description

Experimental drug; Dosage; a.m.

Data type

float

Measurement units
  • mg
Alias
UMLS CUI [1,1]
C0304229
UMLS CUI [1,2]
C0178602
UMLS CUI [1,3]
C4331833
mg
A.M. dose - Time
Description

Experimental drug; Time; a.m.

Data type

time

Alias
UMLS CUI [1,1]
C0304229
UMLS CUI [1,2]
C0040223
UMLS CUI [1,3]
C4331833
P.M. dose - Amount of dose
Description

Experimental drug; Dosage; post meridiem

Data type

float

Measurement units
  • mg
Alias
UMLS CUI [1,1]
C0304229
UMLS CUI [1,2]
C0178602
UMLS CUI [1,3]
C1509133
mg
P.M. dose - Time
Description

Experimental drug; Time; post meridiem

Data type

time

Alias
UMLS CUI [1,1]
C0304229
UMLS CUI [1,2]
C0040223
UMLS CUI [1,3]
C1509133
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Similar models

Concomitant Medications - Study Week 1 Through Taper and Follow- up, AED Prescription and Compliance - Week 2 through Taper and Follow- Up, Study Medication Prescription and Compliance Record - Study Week 9 Through Taper and Follow- Up

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Administrative
C1320722 (UMLS CUI-1)
Study Site; Numbers
Item
Site number
text
C2825164 (UMLS CUI [1,1])
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])
Item Group
Additional medications
C0013227 (UMLS CUI-1)
C1706712 (UMLS CUI-2)
Pharmaceutical Preparations; Additional Therapy; Taken; Clinical Trials; During
Item
Were any additional medications other than antiepileptic drugs taken during the study? (If yes, record below.)
boolean
C0013227 (UMLS CUI [1,1])
C1706712 (UMLS CUI [1,2])
C1883727 (UMLS CUI [1,3])
C0008976 (UMLS CUI [1,4])
C0347984 (UMLS CUI [1,5])
Item Group
Record Additional medications
C0013227 (UMLS CUI-1)
C1706712 (UMLS CUI-2)
C0034869 (UMLS CUI-3)
Date in time; Pharmaceutical Preparations; Taken
Item
Date medication first taken during study
date
C0011008 (UMLS CUI [1,1])
C0013227 (UMLS CUI [1,2])
C1883727 (UMLS CUI [1,3])
Medication name | Generic drug name
Item
Name of drug/ Generic
text
C2360065 (UMLS CUI [1])
C0592502 (UMLS CUI [2])
Item Group
AED Prescription Record
C0003299 (UMLS CUI-1)
C1521941 (UMLS CUI-2)
Antiepileptic Agents; Medication name
Item
Name of antiepileptic drug
text
C0003299 (UMLS CUI [1,1])
C2360065 (UMLS CUI [1,2])
Antiepileptic Agents; Start Date
Item
Start date antiepileptic drug
date
C0003299 (UMLS CUI [1,1])
C0808070 (UMLS CUI [1,2])
Antiepileptic Agents; End date
Item
Stop date antiepileptic drug
text
C0003299 (UMLS CUI [1,1])
C0806020 (UMLS CUI [1,2])
Dosage; Time
Item
Time of dose 1
time
C0178602 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Dosage
Item
Amount of dose 1
float
C0178602 (UMLS CUI [1])
Dosage; Time
Item
Time of dose 2
time
C0178602 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Dosage
Item
Amount of dose 2
float
C0178602 (UMLS CUI [1])
Dosage; Time
Item
Time of dose 3
time
C0178602 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Dosage
Item
Amount of dose 3
float
C0178602 (UMLS CUI [1])
Dosage; Time
Item
Time of dose 4
time
C0178602 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Dosage
Item
Amount of dose 4
float
C0178602 (UMLS CUI [1])
Dosage; Time
Item
Time of dose 5
time
C0178602 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Dosage
Item
Amount of dose 5
float
C0178602 (UMLS CUI [1])
Item Group
Antiepileptic drugs Compliance Record
C0003299 (UMLS CUI-1)
C0525058 (UMLS CUI-2)
Antiepileptic Agents; Medication name
Item
Name of antiepileptic drug
text
C0003299 (UMLS CUI [1,1])
C2360065 (UMLS CUI [1,2])
Antiepileptic Agents; Start Date
Item
Start date antiepileptic drug
date
C0003299 (UMLS CUI [1,1])
C0808070 (UMLS CUI [1,2])
Antiepileptic Agents; End date
Item
Stop date antiepileptic drug
date
C0003299 (UMLS CUI [1,1])
C0806020 (UMLS CUI [1,2])
Dosage; Time
Item
Time of dose 1
time
C0178602 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Dosage
Item
Amount of dose 1
float
C0178602 (UMLS CUI [1])
Dosage; Time
Item
Time of dose 2
time
C0178602 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Dosage
Item
Amount of dose 2
float
C0178602 (UMLS CUI [1])
Dosage; Time
Item
Time of dose 3
time
C0178602 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Dosage
Item
Amount of dose 3
float
C0178602 (UMLS CUI [1])
Dosage; Time
Item
Time of dose 4
time
C0178602 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Dosage
Item
Amount of dose 4
float
C0178602 (UMLS CUI [1])
Dosage; Time
Item
Time of dose 5
time
C0178602 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Dosage
Item
Amount of dose 5
float
C0178602 (UMLS CUI [1])
Item Group
AED entire day's dosing information
C0003299 (UMLS CUI-1)
C0678766 (UMLS CUI-2)
C1533716 (UMLS CUI-3)
C0439228 (UMLS CUI-4)
C0439751 (UMLS CUI-5)
Antiepileptic Agents; Medication name
Item
Name of antiepileptic drug
text
C0003299 (UMLS CUI [1,1])
C2360065 (UMLS CUI [1,2])
Antiepileptic Agents; Start Date
Item
Start date antiepileptic drug
date
C0003299 (UMLS CUI [1,1])
C0808070 (UMLS CUI [1,2])
Antiepileptic Agents; End date
Item
Stop date antiepileptic drug
date
C0003299 (UMLS CUI [1,1])
C0806020 (UMLS CUI [1,2])
Dosage; Time
Item
Time of dose 1
time
C0178602 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Dosage
Item
Amount of dose 1
float
C0178602 (UMLS CUI [1])
Dosage; Time
Item
Time of dose 2
time
C0178602 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Dosage
Item
Amount of dose 2
float
C0178602 (UMLS CUI [1])
Dosage; Time
Item
Time of dose 3
time
C0178602 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Dosage
Item
Amount of dose 3
float
C0178602 (UMLS CUI [1])
Dosage; Time
Item
Time of dose 4
time
C0178602 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Dosage
Item
Amount of dose 4
float
C0178602 (UMLS CUI [1])
Dosage; Time
Item
Time of dose 5
time
C0178602 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Dosage
Item
Amount of dose 5
float
C0178602 (UMLS CUI [1])
Item Group
Study Medication Prescription Record
C0304229 (UMLS CUI-1)
C1521941 (UMLS CUI-2)
Experimental drug; Start Date
Item
Study Medication Start date
date
C0304229 (UMLS CUI [1,1])
C0808070 (UMLS CUI [1,2])
Experimental drug; End Date
Item
Study Medication Stop Date
date
C0304229 (UMLS CUI [1,1])
C0806020 (UMLS CUI [1,2])
Dosage; Schedule (document type); Study Protocol; Requirement
Item
Protocol required scheduled dose
float
C0178602 (UMLS CUI [1,1])
C0086960 (UMLS CUI [1,2])
C2348563 (UMLS CUI [1,3])
C1514873 (UMLS CUI [1,4])
Body Weight
Item
Weight
float
C0005910 (UMLS CUI [1])
Medication dose; Calculated
Item
Calculated dose
text
C3174092 (UMLS CUI [1,1])
C0444686 (UMLS CUI [1,2])
Drug dose; prescribed; Clinical Investigators; |Experimental drug; Time; a.m.
Item
Investigator actual prescribed dose - A.M. dose - Time
time
C0678766 (UMLS CUI [1,1])
C0278329 (UMLS CUI [1,2])
C0008961 (UMLS CUI [1,3])
C0304229 (UMLS CUI [2,1])
C0040223 (UMLS CUI [2,2])
C4331833 (UMLS CUI [2,3])
Drug dose; prescribed; Clinical Investigators; |Experimental drug; Dosage; a.m.
Item
Investigator actual prescribed dose - A.M. dose - Amount
float
C0678766 (UMLS CUI [1,1])
C0278329 (UMLS CUI [1,2])
C0008961 (UMLS CUI [1,3])
C0304229 (UMLS CUI [2,1])
C0178602 (UMLS CUI [2,2])
C4331833 (UMLS CUI [2,3])
Drug dose; prescribed; Clinical Investigators; |Experimental drug; Time; post meridiem
Item
Investigator actual prescribed dose - P.M. dose - Time
time
C0678766 (UMLS CUI [1,1])
C0278329 (UMLS CUI [1,2])
C0008961 (UMLS CUI [1,3])
C0304229 (UMLS CUI [2,1])
C0040223 (UMLS CUI [2,2])
C1509133 (UMLS CUI [2,3])
Drug dose; prescribed; Clinical Investigators; |Experimental drug; Dosage; post meridiem
Item
Investigator actual prescribed dose - P.M. dose - Amount
float
C0678766 (UMLS CUI [1,1])
C0278329 (UMLS CUI [1,2])
C0008961 (UMLS CUI [1,3])
C0304229 (UMLS CUI [2,1])
C0178602 (UMLS CUI [2,2])
C1509133 (UMLS CUI [2,3])
Item Group
Study Medication Compliance Record
C0304229 (UMLS CUI-1)
C3714738 (UMLS CUI-2)
C0034869 (UMLS CUI-3)
Experimental drug; Start Date
Item
Study Medication Start date
date
C0304229 (UMLS CUI [1,1])
C0808070 (UMLS CUI [1,2])
Experimental drug; End Date
Item
Study Medication Stop Date
date
C0304229 (UMLS CUI [1,1])
C0806020 (UMLS CUI [1,2])
Experimental drug; Dosage; a.m.
Item
A.M. dose - Amount of dose
float
C0304229 (UMLS CUI [1,1])
C0178602 (UMLS CUI [1,2])
C4331833 (UMLS CUI [1,3])
Experimental drug; Time; a.m.
Item
A.M. dose - Time
time
C0304229 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
C4331833 (UMLS CUI [1,3])
Experimental drug; Dosage; post meridiem
Item
P.M. dose - Amount of dose
float
C0304229 (UMLS CUI [1,1])
C0178602 (UMLS CUI [1,2])
C1509133 (UMLS CUI [1,3])
Experimental drug; Time; post meridiem
Item
P.M. dose - Time
time
C0304229 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
C1509133 (UMLS CUI [1,3])
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