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12 Lead ECG

1 forms  
  1. StudyEvent: ODM
    1. 12 Lead ECG
Administrative Data
Description

Administrative Data

Alias
UMLS CUI-1
C1320722
Subject Number
Description

Subject Number

Data type

integer

Alias
UMLS CUI [1]
C2348585
Type of Visit
Description

Identical for all Parts/Cohorts/Subcohorts.

Data type

integer

Alias
UMLS CUI [1]
C3641100
Date of Visit
Description

Date of Visit

Data type

date

Alias
UMLS CUI [1]
C1320303
Dosing Date and Time
Description

Dosing Date and Time

Alias
UMLS CUI-1
C0178602
UMLS CUI-2
C1264639
Start Dosing date/time
Description

only applicable to Part A/B Day 1 Visits

Data type

datetime

Alias
UMLS CUI [1,1]
C3897500
UMLS CUI [1,2]
C3469597
UMLS CUI [1,3]
C0304229
ECG
Description

ECG

Alias
UMLS CUI-1
C1623258
Time relative to dosing
Description

On Day 1, record ECGs at the following times (identical for all Parts/Cohorts/Subcohorts). Fill in the entire repeating itemgroup once per ECG.

Data type

integer

Alias
UMLS CUI [1,1]
C0439564
UMLS CUI [1,2]
C3469597
UMLS CUI [1,3]
C0304229
Measurement Number
Description

At Screening, record three ECGs (Measurements 1 to 3). Fill in for repeat ECGs if necessary. Fill in the entire repeating itemgroup once per ECG.

Data type

integer

Alias
UMLS CUI [1,1]
C0430456
UMLS CUI [1,2]
C0449788
Date and Time of ECG
Description

ECG Date / Time

Data type

datetime

Alias
UMLS CUI [1]
C2826846
Heart Rate
Description

Heart Rate

Data type

integer

Measurement units
  • beats/min
Alias
UMLS CUI [1]
C0018810
beats/min
PR Interval
Description

PR Interval

Data type

float

Measurement units
  • msec
Alias
UMLS CUI [1]
C0429087
msec
QRS Duration
Description

QRS Duration

Data type

float

Measurement units
  • msec
Alias
UMLS CUI [1]
C0429025
msec
QT Interval
Description

QT Interval

Data type

float

Measurement units
  • msec
Alias
UMLS CUI [1]
C1287082
msec
Method of QTc Calculation: QTcF (Fridericia)?
Description

i.e. by machine. hidden

Data type

boolean

Alias
UMLS CUI [1,1]
C0855331
UMLS CUI [1,2]
C2911685
UMLS CUI [1,3]
C1882513
Method of QTc Calculation: RR interval available?
Description

i.e. manual hidden

Data type

text

Alias
UMLS CUI [1,1]
C0855331
UMLS CUI [1,2]
C2911685
UMLS CUI [1,3]
C0470187
UMLS CUI [1,4]
C0489636
QTcF Interval
Description

if applicable

Data type

float

Measurement units
  • msec
Alias
UMLS CUI [1,1]
C0855331
UMLS CUI [1,2]
C1882513
msec
record the RR interval that precedes the measured QT interval:
Description

if applicable

Data type

float

Measurement units
  • msec
Alias
UMLS CUI [1,1]
C0489636
UMLS CUI [1,2]
C0332152
UMLS CUI [1,3]
C0855331
msec
Result of the ECG
Description

if 3 = Abnormal - Clinically significant: complete the ECG abnormality form for all clinically significant abnormalities, and additionally complete the AE form if the abnormality meets the protocol definition for an AE

Data type

integer

Alias
UMLS CUI [1]
C0438154
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Similar models

12 Lead ECG

1 forms
  1. StudyEvent: ODM
    1. 12 Lead ECG
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Administrative Data
C1320722 (UMLS CUI-1)
Subject Number
Item
Subject Number
integer
C2348585 (UMLS CUI [1])
Item
Type of Visit
integer
C3641100 (UMLS CUI [1])
Type of Visit
Code List
Type of Visit
CL Item
Screening (1)
CL Item
Early Withdrawal (2)
CL Item
Part A/B Day 1 (3)
CL Item
Part A/B Day 3 (4)
CL Item
Part A/B Day 5 (5)
CL Item
Part A/B Day 7 (6)
CL Item
Part A/B Day 14 (7)
CL Item
Part A/B Day 28 (8)
CL Item
Repeat Assessment (9)
Date of Visit
Item
Date of Visit
date
C1320303 (UMLS CUI [1])
Item Group
Dosing Date and Time
C0178602 (UMLS CUI-1)
C1264639 (UMLS CUI-2)
Start Dosing date/time
Item
Start Dosing date/time
datetime
C3897500 (UMLS CUI [1,1])
C3469597 (UMLS CUI [1,2])
C0304229 (UMLS CUI [1,3])
Item Group
ECG
C1623258 (UMLS CUI-1)
Item
Time relative to dosing
integer
C0439564 (UMLS CUI [1,1])
C3469597 (UMLS CUI [1,2])
C0304229 (UMLS CUI [1,3])
Time relative to dosing
Code List
Time relative to dosing
CL Item
Predose 1 (1)
CL Item
Predose 2 (2)
CL Item
Predose 3 (3)
CL Item
2 Hours Post Start of Infusion (4)
CL Item
4 Hours Post Start of Infusion (5)
CL Item
8 Hours Post Start of Infusion (6)
CL Item
12 Hours Post Start of Infusion (7)
ECG Measurement Number
Item
Measurement Number
integer
C0430456 (UMLS CUI [1,1])
C0449788 (UMLS CUI [1,2])
ECG Date / Time
Item
Date and Time of ECG
datetime
C2826846 (UMLS CUI [1])
Heart Rate
Item
Heart Rate
integer
C0018810 (UMLS CUI [1])
PR Interval
Item
PR Interval
float
C0429087 (UMLS CUI [1])
QRS Duration
Item
QRS Duration
float
C0429025 (UMLS CUI [1])
QT Interval
Item
QT Interval
float
C1287082 (UMLS CUI [1])
Method of QTc Calculation: QTcF (Fridericia)?
Item
Method of QTc Calculation: QTcF (Fridericia)?
boolean
C0855331 (UMLS CUI [1,1])
C2911685 (UMLS CUI [1,2])
C1882513 (UMLS CUI [1,3])
Item
Method of QTc Calculation: RR interval available?
text
C0855331 (UMLS CUI [1,1])
C2911685 (UMLS CUI [1,2])
C0470187 (UMLS CUI [1,3])
C0489636 (UMLS CUI [1,4])
Method of QTC Calculation
Code List
Method of QTc Calculation: RR interval available?
CL Item
RR interval not available (NA)
CL Item
RR interval available (RR)
QTcF Interval
Item
QTcF Interval
float
C0855331 (UMLS CUI [1,1])
C1882513 (UMLS CUI [1,2])
Manual QTc: RR interval
Item
record the RR interval that precedes the measured QT interval:
float
C0489636 (UMLS CUI [1,1])
C0332152 (UMLS CUI [1,2])
C0855331 (UMLS CUI [1,3])
Item
Result of the ECG
integer
C0438154 (UMLS CUI [1])
ECG Result
Code List
Result of the ECG
CL Item
Normal (1)
CL Item
Abnormal - Not clinically significant (2)
CL Item
Abnormal - Clinically significant (3)
CL Item
No result (not available) (4)
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