ID

33916

Beskrivning

Study ID: 107032 Clinical Study ID: GLP107032 Study Title: An open-label study to evaluate the pharmacokinetics of an oral contraceptive containing Norethindrone and Ethinyl Estradiol when co-administered with GSK716155 in healthy adult female subjects Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT01077505 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 1 Study Recruitment Status: Completed Generic Name: albiglutide Trade Name: Tanzeum,Eperzan Study Indication: Diabetes Mellitus, Type 2

Nyckelord

  1. 2019-01-07 2019-01-07 -
Rättsinnehavare

GSK group of companies

Uppladdad den

7 januari 2019

DOI

För en begäran logga in.

Licens

Creative Commons BY-NC 3.0

Modellkommentarer :

Här kan du kommentera modellen. Med hjälp av pratbubblor i Item-grupperna och Item kan du lägga in specifika kommentarer.

Itemgroup-kommentar för :

Item-kommentar för :

Du måste vara inloggad för att kunna ladda ner formulär. Var vänlig logga in eller registrera dig utan kostnad.

Pharmacokinetics of an oral contraceptive co-administered with Albiglutide in women - 107032

Adjudication Events - Acute Myocardial Infraction/Hospitalized Angina or Chest Pain

Administrative data
Beskrivning

Administrative data

Site
Beskrivning

Site

Datatyp

text

Subject
Beskrivning

Subject

Datatyp

text

Visit Name
Beskrivning

Visit Name

Datatyp

text

Status
Beskrivning

Status

Datatyp

text

Document Number
Beskrivning

Document Number

Datatyp

text

Acute Myocardial Infraction/Hospitalized Angina or Chest Pain
Beskrivning

Acute Myocardial Infraction/Hospitalized Angina or Chest Pain

AE / SAE Number
Beskrivning

AE / SAE Number

Datatyp

integer

Date of event
Beskrivning

Date of event

Datatyp

date

Estimated time of event
Beskrivning

Estimated time of event

Datatyp

time

Was the subject hospitalized because of this event?
Beskrivning

Was the subject hospitalized because of this event?

Datatyp

boolean

Date of hospitalization
Beskrivning

Date of Hospitalization

Datatyp

date

Time of Hospitalization
Beskrivning

Time of Hospitalization

Datatyp

time

If Yes, was this event the primary reason for hospitalization?
Beskrivning

If Yes, was this event the primary reason for hospitalization?

Datatyp

boolean

If No, please specify primary reason for hospitalization:
Beskrivning

If No, please specify primary reason for hospitalization:

Datatyp

text

AE/SAE Number
Beskrivning

AE/SAE Number

Datatyp

integer

Did the event occur during an ongoing hospitalization?
Beskrivning

Did the event occur during an ongoing hospitalization?

Datatyp

boolean

If Yes, please specify primary reason for hospitalization
Beskrivning

If Yes, please specify primary reason for hospitalization

Datatyp

text

AE/SAE Number
Beskrivning

AE/SAE Number

Datatyp

integer

Did the subject die because of this event?
Beskrivning

if Yes, please complete the Death form

Datatyp

boolean

Do you consider that this event occurred as a direct consequence of any procedure/operation?
Beskrivning

Do you consider that this event occurred as a direct consequence of any procedure/operation?

Datatyp

boolean

If Yes, please record AE/SAE Number
Beskrivning

If Yes, please record AE/SAE Number

Datatyp

integer

Date of procedure/operation
Beskrivning

Date of procedure/operation

Datatyp

date

Specify the procedure/operation
Beskrivning

Specify the procedure/operation

Datatyp

text

Did this even occur after a coronary revascularization procedure?
Beskrivning

If Yes, please complete a Coronary Revascularization form

Datatyp

boolean

Clinical Presentation
Beskrivning

Clinical Presentation

Exercise related cardiac ischaemic-type chest pain/discomfort of new onset and duration of at least 10 minutes.
Beskrivning

Exercise related cardiac ischaemic-type chest pain/discomfort of new onset and duration of at least 10 minutes.

Datatyp

boolean

Exercise related cardiac ischaemic-type chest pain/discomfort increasing in frequency and/or severity and duration of at least 10 minutes.
Beskrivning

Exercise related cardiac ischaemic-type chest pain/discomfort increasing in frequency and/or severity and duration of at least 10 minutes.

Datatyp

boolean

Decreasing threshold for onset of exercise related cardiac ishaemic-type chest pain/discomfort.
Beskrivning

Decreasing threshold for onset of exercise related cardiac ishaemic-type chest pain/discomfort.

Datatyp

boolean

Cardiac ischaemic-type chest pain/discomfort at rest
Beskrivning

Cardiac ischaemic-type chest pain/discomfort at rest

Datatyp

boolean

Severe, prolonged cardiac ischaemic-type chest pain or discomfort.
Beskrivning

Severe, prolonged cardiac ischaemic-type chest pain or discomfort.

Datatyp

boolean

Other chest pain
Beskrivning

e.g., non-cardiac-type chest pain or discomfort

Datatyp

text

Other possible manifestation of myocardial ischaemia.
Beskrivning

e.g., arm, throat or jaw pain/discomfort

Datatyp

text

Electrocardiographic Details
Beskrivning

Electrocardiographic Details

Were ECGs recorded in view of this event?
Beskrivning

Were ECGs recorded in view of this event?

Datatyp

boolean

a. Are ECGs relating to this event (i.e during and/or after event) available?
Beskrivning

a. Are ECGs relating to this event (i.e during and/or after event) available?

Datatyp

text

Dates of ECG
Beskrivning

record all dates here

Datatyp

integer

Times of ECG
Beskrivning

record all times here

Datatyp

time

b. Did the subject develop new ECG changes?
Beskrivning

if Yes, please ensure that you have provided copies of any ECG tracings that show these new changes.

Datatyp

boolean

New pathologic Q waves (or new R waves in V1 and V2) in 2 or more contiguous leads
Beskrivning

New pathologic Q waves (or new R waves in V1 and V2) in 2 or more contiguous leads

Datatyp

boolean

If Yes, mark all that apply
Beskrivning

If Yes, mark all that apply

Datatyp

text

If Other, specify
Beskrivning

If Other, specify

Datatyp

text

New ST segment elevation in 2 or more contiguous leads
Beskrivning

New ST segment elevation in 2 or more contiguous leads

Datatyp

boolean

If Yes, mark all that apply
Beskrivning

If Yes, mark all that apply

Datatyp

text

Other, specify
Beskrivning

Other, specify

Datatyp

text

New ST segment depression
Beskrivning

New ST segment depression

Datatyp

boolean

If Yes, mark all that apply
Beskrivning

If Yes, mark all that apply

Datatyp

text

Other, specify
Beskrivning

Other, specify

Datatyp

text

New T wave changes
Beskrivning

New T wave changes

Datatyp

text

Other, specify
Beskrivning

Other, specify

Datatyp

text

New left bundle branch block
Beskrivning

New left bundle branch block

Datatyp

boolean

Other new ECG changes
Beskrivning

Other new ECG changes

Datatyp

boolean

Other, specify
Beskrivning

Other, specify

Datatyp

text

Cardiac Enzymes/Markers
Beskrivning

Cardiac Enzymes/Markers

Were cardiac enzymes/markers measured in view of this event?
Beskrivning

PLease submit a copy of the cardiac enzymes/markers report, if available

Datatyp

boolean

CK-MB
Beskrivning

CK-MB

Were the values taken?
Beskrivning

Were the values taken?

Datatyp

boolean

Peak Value
Beskrivning

Peak Value

Datatyp

text

Date sample taken
Beskrivning

Date sample taken

Datatyp

date

Time
Beskrivning

Time

Datatyp

time

Upper Limit of Normal
Beskrivning

Upper Limit of Normal

Datatyp

text

Enzyme Unit
Beskrivning

Enzyme Unit

Datatyp

text

Troponin I
Beskrivning

Troponin I

Were the values taken?
Beskrivning

Were the values taken?

Datatyp

boolean

Peak Value
Beskrivning

Peak Value

Datatyp

text

Date sample taken
Beskrivning

Date sample taken

Datatyp

date

Time
Beskrivning

Time

Datatyp

time

Upper Limit of Normal
Beskrivning

Upper Limit of Normal

Datatyp

text

Enzyme Unit
Beskrivning

Enzyme Unit

Datatyp

text

Troponin T
Beskrivning

Troponin T

Were the values taken?
Beskrivning

Were the values taken?

Datatyp

text

Peak Value
Beskrivning

Peak Value

Datatyp

text

Date sample taken
Beskrivning

Date sample taken

Datatyp

date

Time
Beskrivning

Time

Datatyp

time

Upper Limit of Normal
Beskrivning

Upper Limit of Normal

Datatyp

text

Enzyme Unit
Beskrivning

Enzyme Unit

Datatyp

text

Treatment Given for Acute MI/Hospitalized Angina/Chest Pain Event
Beskrivning

Treatment Given for Acute MI/Hospitalized Angina/Chest Pain Event

What treatment was prescribed?
Beskrivning

check all that apply

Datatyp

text

If Primary or rescue percutaneous coronary intervention was prescribed, record the AE/SAE number:
Beskrivning

If Primary or rescue percutaneous coronary intervention was prescribed, record the AE/SAE number:

Datatyp

integer

If Percutaneous coronary intervention for unstable angina was prescribed, record the AE/SAE number:
Beskrivning

If Percutaneous coronary intervention for unstable angina was prescribed, record the AE/SAE number:

Datatyp

integer

For Other percutaneous coronary intervention record AE/SAE number
Beskrivning

For Other percutaneous coronary intervention record AE/SAE number

Datatyp

integer

Date
Beskrivning

Date

Datatyp

date

For Coronary bypass surgery record AE/SAE number
Beskrivning

For Coronary bypass surgery record AE/SAE number

Datatyp

integer

For Other revascularisation procedure/operation/mechanical intervention specify the treatment type:
Beskrivning

For Other revascularisation procedure/operation/mechanical intervention specify the treatment type:

Datatyp

text

AE/SAE number
Beskrivning

AE/SAE number

Datatyp

integer

Specify any additional therapies:
Beskrivning

Specify any additional therapies:

Datatyp

text

Other Investigations Undertaken in View of this Event
Beskrivning

Other Investigations Undertaken in View of this Event

1. Was coronary angiography performed in view of this event?
Beskrivning

1. Was coronary angiography performed in view of this event?

Datatyp

boolean

Date of coronary angiography performed
Beskrivning

Date of coronary angiography performed

Datatyp

date

Was invasive coronary angiography (i.e involving cardiac catheterization) performed?
Beskrivning

Was invasive coronary angiography (i.e involving cardiac catheterization) performed?

Datatyp

boolean

Date of invasive coronary angiography performed
Beskrivning

Date of invasive coronary angiography performed

Datatyp

date

Was this reported to demonstrate angiographycally significant coronary artery disease thought to be responsible for the subject's presentation?
Beskrivning

Was this reported to demonstrate angiographycally significant coronary artery disease thought to be responsible for the subject's presentation?

Datatyp

boolean

Was a stent previously placed prior to this hospitalization?
Beskrivning

Was a stent previously placed prior to this hospitalization?

Datatyp

boolean

Was there evidence of stent thrombosis?
Beskrivning

Was there evidence of stent thrombosis?

Datatyp

boolean

CT coronary angiography
Beskrivning

CT coronary angiography

Datatyp

boolean

If Yes, date of angiography performed
Beskrivning

Please submit a copy of the report, if available

Datatyp

date

Was this reported to demonstrate angiographically significant coronary artery disease thought to be responsible for the subject's presentation?
Beskrivning

Was this reported to demonstrate angiographically significant coronary artery disease thought to be responsible for the subject's presentation?

Datatyp

boolean

2. Was echocardiography performed in view of this event?
Beskrivning

2. Was echocardiography performed in view of this event?

Datatyp

boolean

Date of echocardiography
Beskrivning

Date of echocardiography

Datatyp

date

Did this show evidence of a new regional wall motion abnormality?
Beskrivning

Did this show evidence of a new regional wall motion abnormality?

Datatyp

boolean

If Yes, mark all that apply
Beskrivning

If Yes, mark all that apply

Datatyp

text

If Other, specify
Beskrivning

If Other, specify

Datatyp

text

3. Was an exercise ECG test undertaken?
Beskrivning

3. Was an exercise ECG test undertaken?

Datatyp

boolean

Date of ECG test
Beskrivning

please submit a copy of the echocardiogram report, if available

Datatyp

date

Was the test positive for reversible myocardial ischaemia?
Beskrivning

Was the test positive for reversible myocardial ischaemia?

Datatyp

boolean

4. Was a stress myocardial perfusion scan undertaken?
Beskrivning

4. Was a stress myocardial perfusion scan undertaken?

Datatyp

boolean

If Yes, record the date
Beskrivning

please submit a copy of the stress myocardial perfusion scan report, if available

Datatyp

date

Test type
Beskrivning

Test type

Datatyp

text

Was this test positive for reversible myocardial ischaemia?
Beskrivning

Was this test positive for reversible myocardial ischaemia?

Datatyp

boolean

5. Was any other investigation to test for the presence of reversible myocardial ischaemia undertaken (e.g. stress echocardiogram)?
Beskrivning

5. Was any other investigation to test for the presence of reversible myocardial ischaemia undertaken (e.g. stress echocardiogram)?

Datatyp

boolean

Specify type of test
Beskrivning

Specify type of test

Datatyp

text

Date of test
Beskrivning

Please submit a copy of the other investigation report, if available

Datatyp

date

Was the test positive for reversible myocardial ischaemia?
Beskrivning

Was the test positive for reversible myocardial ischaemia?

Datatyp

boolean

Final Clinical Diagnosis
Beskrivning

Final Clinical Diagnosis

Was the final clinical diagnosis in relation to this event?
Beskrivning

Was the final clinical diagnosis in relation to this event?

Datatyp

integer

In case of acute myocardial infraction, choose the type of myocardial infraction
Beskrivning

mark one only

Datatyp

text

In case of other chest pain, specify
Beskrivning

In case of other chest pain, specify

Datatyp

text

In case of other clinical diagnosis, specify
Beskrivning

In case of other clinical diagnosis, specify

Datatyp

text

Narrative
Beskrivning

Narrative

Briefly describe the event
Beskrivning

include clinical presentation, treatment (including procedures or operations), results of investigations (e.g., ECGs and whether cardiac enzymes/biomarkers were elevated), and outcome, including autopsy if appropriate. Please provide sufficient information to allow the Endpoint Committee to accurately classify this event. A copy of the hospital discharge summary should be submitted.

Datatyp

text

Similar models

Adjudication Events - Acute Myocardial Infraction/Hospitalized Angina or Chest Pain

Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Administrative data
Site
Item
Site
text
Subject
Item
Subject
text
Item
Visit Name
text
Code List
Visit Name
CL Item
Adjudication (1)
Status
Item
Status
text
Document Number
Item
Document Number
text
Item Group
Acute Myocardial Infraction/Hospitalized Angina or Chest Pain
AE / SAE Number
Item
AE / SAE Number
integer
Date of event
Item
Date of event
date
Estimated time of event
Item
Estimated time of event
time
Was the subject hospitalized because of this event?
Item
Was the subject hospitalized because of this event?
boolean
Date of Hospitalization
Item
Date of hospitalization
date
Time of Hospitalization
Item
Time of Hospitalization
time
If Yes, was this event the primary reason for hospitalization?
Item
If Yes, was this event the primary reason for hospitalization?
boolean
If No, please specify primary reason for hospitalization:
Item
If No, please specify primary reason for hospitalization:
text
AE/SAE Number
Item
AE/SAE Number
integer
Did the event occur during an ongoing hospitalization?
Item
Did the event occur during an ongoing hospitalization?
boolean
If Yes, please specify primary reason for hospitalization
Item
If Yes, please specify primary reason for hospitalization
text
AE/SAE Number
Item
AE/SAE Number
integer
Did the subject die because of this event?
Item
Did the subject die because of this event?
boolean
Do you consider that this event occurred as a direct consequence of any procedure/operation?
Item
Do you consider that this event occurred as a direct consequence of any procedure/operation?
boolean
If Yes, please record AE/SAE Number
Item
If Yes, please record AE/SAE Number
integer
Date of procedure/operation
Item
Date of procedure/operation
date
Specify the procedure/operation
Item
Specify the procedure/operation
text
Did this even occur after a coronary revascularization procedure?
Item
Did this even occur after a coronary revascularization procedure?
boolean
Item Group
Clinical Presentation
Exercise related cardiac ischaemic-type chest pain/discomfort of new onset and duration of at least 10 minutes.
Item
Exercise related cardiac ischaemic-type chest pain/discomfort of new onset and duration of at least 10 minutes.
boolean
Exercise related cardiac ischaemic-type chest pain/discomfort increasing in frequency and/or severity and duration of at least 10 minutes.
Item
Exercise related cardiac ischaemic-type chest pain/discomfort increasing in frequency and/or severity and duration of at least 10 minutes.
boolean
Decreasing threshold for onset of exercise related cardiac ishaemic-type chest pain/discomfort.
Item
Decreasing threshold for onset of exercise related cardiac ishaemic-type chest pain/discomfort.
boolean
Cardiac ischaemic-type chest pain/discomfort at rest
Item
Cardiac ischaemic-type chest pain/discomfort at rest
boolean
Severe, prolonged cardiac ischaemic-type chest pain or discomfort.
Item
Severe, prolonged cardiac ischaemic-type chest pain or discomfort.
boolean
Other chest pain
Item
Other chest pain
text
Other possible manifestation of myocardial ischaemia.
Item
Other possible manifestation of myocardial ischaemia.
text
Item Group
Electrocardiographic Details
Were ECGs recorded in view of this event?
Item
Were ECGs recorded in view of this event?
boolean
Item
a. Are ECGs relating to this event (i.e during and/or after event) available?
text
Code List
a. Are ECGs relating to this event (i.e during and/or after event) available?
CL Item
Yes (please submit copies of these ECGs and ensure that the date and time of recording is clearly marked on each tracing) (1)
CL Item
No (2)
Dates of ECG
Item
Dates of ECG
integer
Times of ECG
Item
Times of ECG
time
b. Did the subject develop new ECG changes?
Item
b. Did the subject develop new ECG changes?
boolean
New pathologic Q waves (or new R waves in V1 and V2) in 2 or more contiguous leads
Item
New pathologic Q waves (or new R waves in V1 and V2) in 2 or more contiguous leads
boolean
Item
If Yes, mark all that apply
text
Code List
If Yes, mark all that apply
CL Item
Anterior (1)
CL Item
Septal (2)
CL Item
Lateral (3)
CL Item
Inferior (4)
CL Item
Other (5)
If Other, specify
Item
If Other, specify
text
New ST segment elevation in 2 or more contiguous leads
Item
New ST segment elevation in 2 or more contiguous leads
boolean
Item
If Yes, mark all that apply
text
Code List
If Yes, mark all that apply
CL Item
Anterior (1)
CL Item
Septal (2)
CL Item
Lateral (3)
CL Item
Inferior (4)
CL Item
Other (5)
Other, specify
Item
Other, specify
text
New ST segment depression
Item
New ST segment depression
boolean
Item
If Yes, mark all that apply
text
Code List
If Yes, mark all that apply
CL Item
Anterior (1)
CL Item
Septal (2)
CL Item
Lateral (3)
CL Item
Inferior (4)
CL Item
Other (5)
Other, specify
Item
Other, specify
text
Item
New T wave changes
text
Code List
New T wave changes
CL Item
Anterior (1)
CL Item
Septal (2)
CL Item
Lateral (3)
CL Item
Inferior (4)
CL Item
Other (5)
Other, specify
Item
Other, specify
text
New left bundle branch block
Item
New left bundle branch block
boolean
Other new ECG changes
Item
Other new ECG changes
boolean
Other, specify
Item
Other, specify
text
Item Group
Cardiac Enzymes/Markers
Were cardiac enzymes/markers measured in view of this event?
Item
Were cardiac enzymes/markers measured in view of this event?
boolean
Item Group
CK-MB
Were the values taken?
Item
Were the values taken?
boolean
Peak Value
Item
Peak Value
text
Date sample taken
Item
Date sample taken
date
Time
Item
Time
time
Upper Limit of Normal
Item
Upper Limit of Normal
text
Enzyme Unit
Item
Enzyme Unit
text
Item Group
Troponin I
Were the values taken?
Item
Were the values taken?
boolean
Peak Value
Item
Peak Value
text
Date sample taken
Item
Date sample taken
date
Time
Item
Time
time
Upper Limit of Normal
Item
Upper Limit of Normal
text
Enzyme Unit
Item
Enzyme Unit
text
Item Group
Troponin T
Were the values taken?
Item
Were the values taken?
text
Peak Value
Item
Peak Value
text
Date sample taken
Item
Date sample taken
date
Time
Item
Time
time
Upper Limit of Normal
Item
Upper Limit of Normal
text
Enzyme Unit
Item
Enzyme Unit
text
Item Group
Treatment Given for Acute MI/Hospitalized Angina/Chest Pain Event
Item
What treatment was prescribed?
text
Code List
What treatment was prescribed?
CL Item
Thrombolytic therapy (e.g., tenecteplase, reteplase, alteplase, streptokinase) (1)
CL Item
Primary or rescue percutaneous coronary intervention (PCI) for suspected acute myocardial infraction (e.g., primary angioplasty or rescue angioplasty) (2)
CL Item
Percutaneous coronary intervention for unstable angina (3)
CL Item
Other percutaneous coronary intervention (4)
CL Item
Coronary bypass surgery (5)
CL Item
Other revascularisation procedure/operation/mechanical intervention  (6)
CL Item
Other therapy for this event (7)
If Primary or rescue percutaneous coronary intervention was prescribed, record the AE/SAE number:
Item
If Primary or rescue percutaneous coronary intervention was prescribed, record the AE/SAE number:
integer
If Percutaneous coronary intervention for unstable angina was prescribed, record the AE/SAE number:
Item
If Percutaneous coronary intervention for unstable angina was prescribed, record the AE/SAE number:
integer
For Other percutaneous coronary intervention record AE/SAE number
Item
For Other percutaneous coronary intervention record AE/SAE number
integer
Date
Item
Date
date
For Coronary bypass surgery record AE/SAE number
Item
For Coronary bypass surgery record AE/SAE number
integer
For Other revascularisation procedure/operation/mechanical intervention specify the treatment type:
Item
For Other revascularisation procedure/operation/mechanical intervention specify the treatment type:
text
AE/SAE number
Item
AE/SAE number
integer
Specify any additional therapies:
Item
Specify any additional therapies:
text
Item Group
Other Investigations Undertaken in View of this Event
1. Was coronary angiography performed in view of this event?
Item
1. Was coronary angiography performed in view of this event?
boolean
Date of coronary angiography performed
Item
Date of coronary angiography performed
date
Was invasive coronary angiography (i.e involving cardiac catheterization) performed?
Item
Was invasive coronary angiography (i.e involving cardiac catheterization) performed?
boolean
Date of invasive coronary angiography performed
Item
Date of invasive coronary angiography performed
date
Was this reported to demonstrate angiographycally significant coronary artery disease thought to be responsible for the subject's presentation?
Item
Was this reported to demonstrate angiographycally significant coronary artery disease thought to be responsible for the subject's presentation?
boolean
Was a stent previously placed prior to this hospitalization?
Item
Was a stent previously placed prior to this hospitalization?
boolean
Was there evidence of stent thrombosis?
Item
Was there evidence of stent thrombosis?
boolean
CT coronary angiography
Item
CT coronary angiography
boolean
If Yes, date of angiography performed
Item
If Yes, date of angiography performed
date
Was this reported to demonstrate angiographically significant coronary artery disease thought to be responsible for the subject's presentation?
Item
Was this reported to demonstrate angiographically significant coronary artery disease thought to be responsible for the subject's presentation?
boolean
2. Was echocardiography performed in view of this event?
Item
2. Was echocardiography performed in view of this event?
boolean
Date of echocardiography
Item
Date of echocardiography
date
Did this show evidence of a new regional wall motion abnormality?
Item
Did this show evidence of a new regional wall motion abnormality?
boolean
Item
If Yes, mark all that apply
text
Code List
If Yes, mark all that apply
CL Item
Anterior (1)
CL Item
Septal (2)
CL Item
Lateral (3)
CL Item
Inferior (4)
CL Item
Other (5)
If Other, specify
Item
If Other, specify
text
3. Was an exercise ECG test undertaken?
Item
3. Was an exercise ECG test undertaken?
boolean
Date of ECG test
Item
Date of ECG test
date
Was the test positive for reversible myocardial ischaemia?
Item
Was the test positive for reversible myocardial ischaemia?
boolean
4. Was a stress myocardial perfusion scan undertaken?
Item
4. Was a stress myocardial perfusion scan undertaken?
boolean
If Yes, record the date
Item
If Yes, record the date
date
Item
Test type
text
Code List
Test type
CL Item
Stress cardiac MRI (1)
CL Item
Stress nuclear perfusion imaging (2)
Was this test positive for reversible myocardial ischaemia?
Item
Was this test positive for reversible myocardial ischaemia?
boolean
5. Was any other investigation to test for the presence of reversible myocardial ischaemia undertaken (e.g. stress echocardiogram)?
Item
5. Was any other investigation to test for the presence of reversible myocardial ischaemia undertaken (e.g. stress echocardiogram)?
boolean
Specify type of test
Item
Specify type of test
text
Date of test
Item
Date of test
date
Was the test positive for reversible myocardial ischaemia?
Item
Was the test positive for reversible myocardial ischaemia?
boolean
Item Group
Final Clinical Diagnosis
Item
Was the final clinical diagnosis in relation to this event?
integer
Code List
Was the final clinical diagnosis in relation to this event?
CL Item
Acute myocardial infraction (1)
CL Item
Unstable angina (2)
CL Item
Other angina (3)
CL Item
Other chest pain (4)
CL Item
Other final clinical diagnosis (5)
Item
In case of acute myocardial infraction, choose the type of myocardial infraction
text
Code List
In case of acute myocardial infraction, choose the type of myocardial infraction
CL Item
ST segment elevation myocardial infraction (STEMI) (1)
CL Item
Non-ST segment elevation myocardial infraction (NSTEMI) (2)
CL Item
Acute myocardial infraction, type (i.e STEMI or NSTEMI) not specified (3)
In case of other chest pain, specify
Item
In case of other chest pain, specify
text
In case of other clinical diagnosis, specify
Item
In case of other clinical diagnosis, specify
text
Item Group
Narrative
Description of Event
Item
Briefly describe the event
text

Använd detta formulär för feedback, frågor och förslag på förbättringar.

Fält markerade med * är obligatoriska.

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial