ID

32116

Beschreibung

Study ID: 106218 Clinical Study ID: TDC106218 Study Title: Study On Bioavailability And Pharmacokinetics Of Various Doses Of Testosterone Administered With And Without Dutasteride  Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier:  Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 1 Study Recruitment Status: Completed Generic Name: testosterone Trade Name: Andropatch,Androderm Study Indication: Hypogonadism, Male

Stichworte

  1. 18.10.18 18.10.18 -
  2. 27.12.18 27.12.18 -
  3. 04.03.19 04.03.19 -
Rechteinhaber

GSK group of companies

Hochgeladen am

18. Oktober 2018

DOI

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Creative Commons BY-NC 3.0

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Bioavailability and Pharmacokinetics of Testosterone with/without Dutasteride - 106218

12-lead ECG Abnormalities Form

Administrative data
Beschreibung

Administrative data

Subject Identifier
Beschreibung

Subject Identifier

Datentyp

integer

List of Abnormalities
Beschreibung

List of Abnormalities

Date of ECG
Beschreibung

Date of ECG

Datentyp

date

Time of ECG
Beschreibung

Time of ECG

Datentyp

time

Record clinically significant abnormalities below. Mark all that apply:
Beschreibung

Record clinically significant abnormalities below. Mark all that apply:

A. Rhythm
Beschreibung

A. Rhythm

Datentyp

text

Comment
Beschreibung

Comment

Datentyp

text

B. P-Wave and QRS Morphology
Beschreibung

B. P-Wave and QRS Morphology

Datentyp

text

Comment
Beschreibung

Comment

Datentyp

text

C. Conduction
Beschreibung

C. Conduction

Datentyp

text

Comment
Beschreibung

Comment

Datentyp

text

D. Myocardial Infraction
Beschreibung

D. Myocardial Infraction

Datentyp

text

Comment
Beschreibung

Comment

Datentyp

text

E. Depolarisation/Repolarisation (QRS-T)
Beschreibung

E. Depolarisation/Repolarisation (QRS-T)

Datentyp

text

Comment
Beschreibung

Comment

Datentyp

text

Other abnormalities
Beschreibung

Other abnormalities

Datentyp

text

Comment
Beschreibung

Comment

Datentyp

text

Ähnliche Modelle

12-lead ECG Abnormalities Form

Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
Alias
Item Group
Administrative data
Subject Identifier
Item
Subject Identifier
integer
Item Group
List of Abnormalities
Date of ECG
Item
Date of ECG
date
Time of ECG
Item
Time of ECG
time
Item Group
Record clinically significant abnormalities below. Mark all that apply:
Item
A. Rhythm
text
Code List
A. Rhythm
CL Item
[A1] Sinus bradycardia (1)
CL Item
[A21] Sinus bradycardia (heart rate 40-50 bpm) (2)
CL Item
[A22] Sinus bradycardia (heart rate 30-39 bpm) (3)
CL Item
[A23] Sinus bradycardia (heart rate <30 bpm) (4)
CL Item
[A3] Sinus pause (5)
CL Item
[A2] Sinus tachycardia (heart rate >100 bpm) (6)
CL Item
[A4] Ectopic supraventricular beats (7)
CL Item
[A20] Ectopic supraventricular rhythm (8)
CL Item
[A17] Wandering atrial pacemaker (9)
CL Item
[A26] Multifocal atrial tachycardia (Wandering atrial pacemaker with heart rate >100 bpm) (10)
CL Item
[A6] Supraventricular tachycardia (heart rate >100 bpm) (11)
CL Item
[A7] Atrial flutter (12)
CL Item
[A8] Atrial fibrillation (13)
CL Item
[A5] Junctional rhythm (heart rate <=100 bpm) (14)
CL Item
[A25] Junctional rhythm (15)
CL Item
[A24] Junctional tachycardia (heart rate > 100 bpm) (16)
CL Item
[A9] Ectopic ventricular beats (17)
CL Item
[A12] Ventricular couplets (18)
CL Item
[A13] Bigeminy (19)
CL Item
[A28] Trigeminy (20)
CL Item
[A14] Electrical alternans (21)
CL Item
[A29] R on T phenomenon (22)
CL Item
[A18] Ventricular fibrillation (23)
CL Item
[A19] Idioventricular rhythm (heart rate < 100 bpm) (24)
CL Item
[A10] Sustained ventricular tachycardia (25)
CL Item
[A11] Non-sustained ventricular tachycardia (26)
CL Item
[A32] Wide QRS Tachycardia (diagnosis unknown) (27)
CL Item
[A27] Ventricular tachycardia (28)
CL Item
[A30] Monomorphic ventricular tachycardia (29)
CL Item
[A15] Torsades de Pointes (Polymosphic ventricular tachycardia with prolonged QT) (30)
CL Item
[A31] Polymorphic (sustained and non-sustained) ventricular tachycardia (31)
CL Item
[A16] Artificial pacemaker (32)
CL Item
[A99] Other abnormal rhythm (33)
Comment
Item
Comment
text
Item
B. P-Wave and QRS Morphology
text
Code List
B. P-Wave and QRS Morphology
CL Item
[B1] Left atrial abnormality (P mitrale) (1)
CL Item
[B2] Rightatrial abnormality (P pulmonale) (2)
CL Item
[B3] Right ventricular hypertrophy (3)
CL Item
[B5] Intraatrial conduction delay (4)
CL Item
[B14] Increased voltage consistent with left ventricular hypertrophy (5)
CL Item
[B99] Other morphology (6)
Comment
Item
Comment
text
Item
C. Conduction
text
Code List
C. Conduction
CL Item
[C1] First degree AV block (PR interval > 200 msec) (1)
CL Item
[C20] Short PR interval (2)
CL Item
[C2] Second degree AV block (Mobitz type 1) (3)
CL Item
[C3] Second degree AV block (Mobitz type 2) (4)
CL Item
[C16] 2:1 AV block (5)
CL Item
[C4] Third degree AV block (6)
CL Item
[C5] Left axis deviation (QRS axis more negative than -30°) (7)
CL Item
[C6] Right axis deviation (QRS axis more positive than +110°) (8)
CL Item
[C7] Incomplete right bundle branch block (9)
CL Item
[C13] Incomplete left bundle branch block (10)
CL Item
[C8] Right bundle branch block (11)
CL Item
[C14] Left anterior hemiblock (synonymous to left anterior fascicular block) (12)
CL Item
[C15] Left posterior hemiblock (synonymous to left posterior fascicular block) (13)
CL Item
[C9] Left bundle branch block (14)
CL Item
[C17] Bifascicular block (15)
CL Item
[C10] Non-specific intraventricular conduction delay (QRS >=120msec) (16)
CL Item
[C11] Accessory pathway (Wolff-Parkinson White, Lown-Ganong-Levine) (17)
CL Item
[C19] Prolonged QT interval (18)
CL Item
[C12] QT/QTc prolongation >=500 msec (19)
CL Item
[C18] AV dissociation (20)
CL Item
[C99] Other conduction  (21)
Comment
Item
Comment
text
Item
D. Myocardial Infraction
text
Code List
D. Myocardial Infraction
CL Item
[D1] Myocardial infraction, old (1)
CL Item
[D2] Myocardial infraction, anterior (2)
CL Item
[D3] Myocardial infraction, lateral (3)
CL Item
[D4] Myocardial infraction, posterior (4)
CL Item
[D5] Myocardial infraction, inferior (5)
CL Item
[D6] Myocardial infraction, septal (6)
CL Item
[D20] Myocardial infraction, Non-Q wave (7)
CL Item
[D98] Other myocardial infraction  (8)
Comment
Item
Comment
text
Item
E. Depolarisation/Repolarisation (QRS-T)
text
Code List
E. Depolarisation/Repolarisation (QRS-T)
CL Item
[D7] Non-specific ST-T changes (1)
CL Item
[D19] J point elevation (2)
CL Item
[D8] ST elevation (3)
CL Item
[D21] ST elevation-pericarditis (4)
CL Item
[D9] ST depression (5)
CL Item
[D10] U waves abnormal (6)
CL Item
[D11] T wave inversion (7)
CL Item
[D12] T wave peaked (8)
CL Item
[D15] T waves flat (9)
CL Item
[D16] T waves biphasic (10)
CL Item
[D18] Notched T-waves (11)
CL Item
[D13] Low QRS voltage (12)
CL Item
[D17] T-wave flattening/inversion (13)
CL Item
[D99] Other depolarisation/repolarisation  (14)
Comment
Item
Comment
text
Item
Other abnormalities
text
Code List
Other abnormalities
CL Item
[E99] Other abnormalities (1)
Comment
Item
Comment
text

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