ID

39326

Beskrivning

Gait and Alzheimer Interaction Tracking (GAIT) Study; ODM derived from: https://clinicaltrials.gov/show/NCT01315717

Länk

https://clinicaltrials.gov/show/NCT01315717

Nyckelord

Versioner (1)
  1. 2019-12-20 2019-12-20 -
Rättsinnehavare

See clinicaltrials.gov

Uppladdad den

20 december 2019

DOI

För en begäran logga in.

Licens

Creative Commons BY 4.0
Modellkommentarer :

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

Tillbaka till modellkommentarer
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.

Eligibility Gait Apraxia NCT01315717

Engelsk

Eligibility Gait Apraxia NCT01315717

1 Formulär  
Inclusion Criteria
Beskrivning

Inclusion Criteria

Alias
UMLS CUI
C1512693
age ≥ 60 years
Beskrivning

Age

Datatyp

boolean

Alias
UMLS CUI [1]
C0001779
able to walk without walking aid on 15 metres
Beskrivning

Able to walk Without Help Meter Quantity

Datatyp

boolean

Alias
UMLS CUI [1,1]
C2712089
UMLS CUI [1,2]
C3827452
UMLS CUI [1,3]
C0475209
UMLS CUI [1,4]
C1265611
score of mini-mental examination (mmse) > 10
Beskrivning

Mini-mental state examination

Datatyp

boolean

Alias
UMLS CUI [1]
C0451306
written informed consent to participate in the study (or trustworthy person)
Beskrivning

Informed Consent | Informed Consent Patient Representative

Datatyp

boolean

Alias
UMLS CUI [1]
C0021430
UMLS CUI [2,1]
C0021430
UMLS CUI [2,2]
C0030701
being affiliated to a social security regime
Beskrivning

Patient Affiliated Social Security Program

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0030705
UMLS CUI [1,2]
C1510826
UMLS CUI [1,3]
C0037435
near visual acuity ≥ 2/10
Beskrivning

Near visual acuity

Datatyp

boolean

Alias
UMLS CUI [1]
C0429541
absence of severe depression (score in the 15-item geriatric depression scale ≤ 10)
Beskrivning

Severe depression Absent Geriatric depression scale

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0588008
UMLS CUI [1,2]
C0332197
UMLS CUI [1,3]
C0451184
Exclusion Criteria
Beskrivning

Exclusion Criteria

Alias
UMLS CUI
C0680251
score of mini-mental examination (mmse) ≤ 10
Beskrivning

Mini-mental state examination

Datatyp

boolean

Alias
UMLS CUI [1]
C0451306
subject suffering from pre-existing impellent disturbances
Beskrivning

Psychomotor Disorders Pre-existing

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0033922
UMLS CUI [1,2]
C2347662
history of cerebrovascular accident or other cerebro-spinal pathology
Beskrivning

Cerebrovascular accident | CNS disorder

Datatyp

boolean

Alias
UMLS CUI [1]
C0038454
UMLS CUI [2]
C0007682
poor workmanship of the written or oral french language
Beskrivning

Lacking Able to write French language | Lacking Able to speak French language

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0332268
UMLS CUI [1,2]
C0584993
UMLS CUI [1,3]
C0376246
UMLS CUI [2,1]
C0332268
UMLS CUI [2,2]
C0564215
UMLS CUI [2,3]
C0376246
refusal of subject to be informed on possible hanging bare anomaly during study
Beskrivning

Patient Information Refused

Datatyp

boolean

Alias
UMLS CUI [1,1]
C1955348
UMLS CUI [1,2]
C1705116
use of walking aid
Beskrivning

Walking aid use

Datatyp

boolean

Alias
UMLS CUI [1]
C0429987
acute medical or surgical disease in the past 3 months
Beskrivning

Acute illness | Disease Surgical

Datatyp

boolean

Alias
UMLS CUI [1]
C4061114
UMLS CUI [2,1]
C0012634
UMLS CUI [2,2]
C0038895
refusal to participate (or trustworthy person)
Beskrivning

Participation Refused | Participation Refused Patient Representative

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0679823
UMLS CUI [1,2]
C1705116
UMLS CUI [2,1]
C0679823
UMLS CUI [2,2]
C1705116
UMLS CUI [2,3]
C0030701
contra-indication to the achievement of a magnetic resonance imaging
Beskrivning

Medical contraindication Magnetic Resonance Imaging

Datatyp

boolean

Alias
UMLS CUI [1,1]
C1301624
UMLS CUI [1,2]
C0024485
near visual acuity < 2/10
Beskrivning

Near visual acuity

Datatyp

boolean

Alias
UMLS CUI [1]
C0429541
presence of severe depression (score in the 15-item geriatric depression scale > 10)
Beskrivning

Severe depression Geriatric depression scale

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0588008
UMLS CUI [1,2]
C0451184
Tillbaka till toppen

Similar models

Eligibility Gait Apraxia NCT01315717

1 Formulär
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
C1512693 (UMLS CUI)
Age
Item
age ≥ 60 years
boolean
C0001779 (UMLS CUI [1])
Able to walk Without Help Meter Quantity
Item
able to walk without walking aid on 15 metres
boolean
C2712089 (UMLS CUI [1,1])
C3827452 (UMLS CUI [1,2])
C0475209 (UMLS CUI [1,3])
C1265611 (UMLS CUI [1,4])
Mini-mental state examination
Item
score of mini-mental examination (mmse) > 10
boolean
C0451306 (UMLS CUI [1])
Informed Consent | Informed Consent Patient Representative
Item
written informed consent to participate in the study (or trustworthy person)
boolean
C0021430 (UMLS CUI [1])
C0021430 (UMLS CUI [2,1])
C0030701 (UMLS CUI [2,2])
Patient Affiliated Social Security Program
Item
being affiliated to a social security regime
boolean
C0030705 (UMLS CUI [1,1])
C1510826 (UMLS CUI [1,2])
C0037435 (UMLS CUI [1,3])
Near visual acuity
Item
near visual acuity ≥ 2/10
boolean
C0429541 (UMLS CUI [1])
Severe depression Absent Geriatric depression scale
Item
absence of severe depression (score in the 15-item geriatric depression scale ≤ 10)
boolean
C0588008 (UMLS CUI [1,1])
C0332197 (UMLS CUI [1,2])
C0451184 (UMLS CUI [1,3])
Item Group
C0680251 (UMLS CUI)
Mini-mental state examination
Item
score of mini-mental examination (mmse) ≤ 10
boolean
C0451306 (UMLS CUI [1])
Psychomotor Disorders Pre-existing
Item
subject suffering from pre-existing impellent disturbances
boolean
C0033922 (UMLS CUI [1,1])
C2347662 (UMLS CUI [1,2])
Cerebrovascular accident | CNS disorder
Item
history of cerebrovascular accident or other cerebro-spinal pathology
boolean
C0038454 (UMLS CUI [1])
C0007682 (UMLS CUI [2])
Lacking Able to write French language | Lacking Able to speak French language
Item
poor workmanship of the written or oral french language
boolean
C0332268 (UMLS CUI [1,1])
C0584993 (UMLS CUI [1,2])
C0376246 (UMLS CUI [1,3])
C0332268 (UMLS CUI [2,1])
C0564215 (UMLS CUI [2,2])
C0376246 (UMLS CUI [2,3])
Patient Information Refused
Item
refusal of subject to be informed on possible hanging bare anomaly during study
boolean
C1955348 (UMLS CUI [1,1])
C1705116 (UMLS CUI [1,2])
Walking aid use
Item
use of walking aid
boolean
C0429987 (UMLS CUI [1])
Acute illness | Disease Surgical
Item
acute medical or surgical disease in the past 3 months
boolean
C4061114 (UMLS CUI [1])
C0012634 (UMLS CUI [2,1])
C0038895 (UMLS CUI [2,2])
Participation Refused | Participation Refused Patient Representative
Item
refusal to participate (or trustworthy person)
boolean
C0679823 (UMLS CUI [1,1])
C1705116 (UMLS CUI [1,2])
C0679823 (UMLS CUI [2,1])
C1705116 (UMLS CUI [2,2])
C0030701 (UMLS CUI [2,3])
Medical contraindication Magnetic Resonance Imaging
Item
contra-indication to the achievement of a magnetic resonance imaging
boolean
C1301624 (UMLS CUI [1,1])
C0024485 (UMLS CUI [1,2])
Near visual acuity
Item
near visual acuity < 2/10
boolean
C0429541 (UMLS CUI [1])
Severe depression Geriatric depression scale
Item
presence of severe depression (score in the 15-item geriatric depression scale > 10)
boolean
C0588008 (UMLS CUI [1,1])
C0451184 (UMLS CUI [1,2])
Tillbaka till toppen 

Kontakt

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

Fält markerade med * är obligatoriska.

Hjälp

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