ID

41304

Beskrivning

Study ID: 109275 Clinical Study ID: 109275 Study Title: An Open-Label, Single Sequence Study to Examine the Effects of Esomeprazole on the Pharmacokinetics of Orally Administered Lapatinib in Subjects with Metastatic ErbB2 Positive Breast Cancer 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: Lapatinib, Esomeprazole Trade Name: lapatinib plus esomeprazole Study Indication: Neoplasms, Breast

Nyckelord

Versioner (1)
  1. 2020-08-13 2020-08-13 -
Rättsinnehavare

GlaxoSmithKline

Uppladdad den

13 augusti 2020

DOI

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Licens

Creative Commons BY 4.0
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Effects of Esomeprazole on Lapatinib in Subjects with Breast Cancer; 109275

Engelsk

Logs/Repeats

1 Formulär  
  1. StudyEvent: ODM
    1. Logs/Repeats
Logs and Repeats
Beskrivning

Logs and Repeats

Alias
UMLS CUI-1
C1708728
UMLS CUI-2
C0205341
Date of visit/assessment
Beskrivning

Event Log, Repeat, Date of visit, Assessment Date

Datatyp

date

Alias
UMLS CUI [1,1]
C1708728
UMLS CUI [1,2]
C0205341
UMLS CUI [1,3]
C1320303
UMLS CUI [1,4]
C2985720
Were there any concomitant medications taken by the subject during the study?
Beskrivning

Concomitant Agent

Datatyp

boolean

Alias
UMLS CUI [1]
C2347852
Did the subject experience any adverse events during the study?
Beskrivning

Adverse event

Datatyp

boolean

Alias
UMLS CUI [1]
C0877248
Did the subject experience any serious adverse events during the study?
Beskrivning

Serious Adverse Event

Datatyp

boolean

Alias
UMLS CUI [1]
C1519255
Were any repeat or unscheduled vital signs recorded?
Beskrivning

Vital signs, Repeat; Vital signs, Unscheduled

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0518766
UMLS CUI [1,2]
C0205341
UMLS CUI [2,1]
C0518766
UMLS CUI [2,2]
C3854240
Was any unscheduled study medication taken?
Beskrivning

Experimental drug, Unscheduled

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0304229
UMLS CUI [1,2]
C3854240
Were any repeat or unscheduled PK blood samples taken?
Beskrivning

Pharmacokinetic aspects, Collection of blood specimen for laboratory procedure, Repeat; Pharmacokinetic aspects, Collection of blood specimen for laboratory procedure, Unscheduled

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0031328
UMLS CUI [1,2]
C0005834
UMLS CUI [1,3]
C0205341
UMLS CUI [2,1]
C0031328
UMLS CUI [2,2]
C0005834
UMLS CUI [2,3]
C3854240
Were there an unscheduled or repeat ECHO/MUGA examinations performed?
Beskrivning

Echocardiography, Multiple gated acquisition scanning, Repeat; Echocardiography, Multiple gated acquisition scanning, Unscheduled

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0013516
UMLS CUI [1,2]
C0521317
UMLS CUI [1,3]
C0205341
UMLS CUI [2,1]
C0013516
UMLS CUI [2,2]
C0521317
UMLS CUI [2,3]
C3854240
Were any unscheduled or repeat ECGs performed?
Beskrivning

Electrocardiography, Repeat; Electrocardiography, Unscheduled

Datatyp

boolean

Alias
UMLS CUI [1,1]
C1623258
UMLS CUI [1,2]
C0205341
UMLS CUI [2,1]
C1623258
UMLS CUI [2,2]
C3854240
Were the liver event criteria met for this subject as defined by the protocol?
Beskrivning

Liver, Adverse Event

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0023884
UMLS CUI [1,2]
C0877248
ECHO/MUGA
Beskrivning

ECHO/MUGA

Alias
UMLS CUI-1
C0013516
UMLS CUI-2
C0521317
Ejection fraction range lower limit
Beskrivning

Echocardiography, Multiple gated acquisition scanning, Ejection fraction (finding), Lower Limit of Normal

Datatyp

integer

Måttenheter
  • %
Alias
UMLS CUI [1,1]
C0013516
UMLS CUI [1,2]
C0521317
UMLS CUI [1,3]
C2700378
UMLS CUI [1,4]
C1518030
%
Scan Type
Beskrivning

Echocardiography, Multiple gated acquisition scanning

Datatyp

text

Alias
UMLS CUI [1,1]
C0013516
UMLS CUI [1,2]
C0521317
Date and Time of Scan
Beskrivning

Echocardiography, Multiple gated acquisition scanning, Date in time, Time

Datatyp

datetime

Alias
UMLS CUI [1,1]
C0013516
UMLS CUI [1,2]
C0521317
UMLS CUI [1,3]
C0011008
UMLS CUI [1,4]
C0040223
Left ventricular ejection fraction (LVEF)
Beskrivning

Echocardiography, Multiple gated acquisition scanning, Left ventricular ejection fraction

Datatyp

integer

Måttenheter
  • %
Alias
UMLS CUI [1,1]
C0013516
UMLS CUI [1,2]
C0521317
UMLS CUI [1,3]
C0428772
%
Left ventricular ejection fraction (LVEF)
Beskrivning

Echocardiography, Multiple gated acquisition scanning, Left ventricular ejection fraction

Datatyp

integer

Måttenheter
  • %
Alias
UMLS CUI [1,1]
C0013516
UMLS CUI [1,2]
C0521317
UMLS CUI [1,3]
C0428772
%
Scan results
Beskrivning

Echocardiography, Multiple gated acquisition scanning, Result

Datatyp

text

Alias
UMLS CUI [1,1]
C0013516
UMLS CUI [1,2]
C0521317
UMLS CUI [1,3]
C1274040
Describe abnormality
Beskrivning

Echocardiography, Multiple gated acquisition scanning, Abnormality

Datatyp

text

Alias
UMLS CUI [1,1]
C0013516
UMLS CUI [1,2]
C0521317
UMLS CUI [1,3]
C1704258
Vital Signs - Repeating Form
Beskrivning

Vital Signs - Repeating Form

Alias
UMLS CUI-1
C0518766
UMLS CUI-2
C0205341
Actual date/time
Beskrivning

Vital signs, Date in time, Time

Datatyp

datetime

Alias
UMLS CUI [1,1]
C0518766
UMLS CUI [1,2]
C0011008
UMLS CUI [1,3]
C0040223
Weight
Beskrivning

Body Weight

Datatyp

float

Måttenheter
  • kg
Alias
UMLS CUI [1]
C0005910
kg
Sitting heart rate
Beskrivning

Heart rate while sitting

Datatyp

integer

Måttenheter
  • bpm
Alias
UMLS CUI [1]
C2029904
Sitting blood pressure measurement - Systolic
Beskrivning

Systolic Pressure, Sitting position

Datatyp

integer

Måttenheter
  • mmHg
Alias
UMLS CUI [1,1]
C0871470
UMLS CUI [1,2]
C0277814
mmHg
Sitting blood pressure measurement - Diastolic
Beskrivning

Diastolic blood pressure, Sitting position

Datatyp

integer

Måttenheter
  • mmHg
Alias
UMLS CUI [1,1]
C0428883
UMLS CUI [1,2]
C0277814
mmHg
Unscheduled 12-Lead ECG - Repeating Form
Beskrivning

Unscheduled 12-Lead ECG - Repeating Form

Alias
UMLS CUI-1
C0430456
UMLS CUI-2
C3854240
UMLS CUI-3
C0205341
Date and Time of ECG
Beskrivning

12 lead ECG, Date in time, Time

Datatyp

datetime

Alias
UMLS CUI [1,1]
C0430456
UMLS CUI [1,2]
C0011008
UMLS CUI [1,3]
C0040223
Heart rate
Beskrivning

12 lead ECG, Heart rate

Datatyp

integer

Måttenheter
  • bpm
Alias
UMLS CUI [1,1]
C0430456
UMLS CUI [1,2]
C0018810
bpm
PR Interval
Beskrivning

12 lead ECG, Electrocardiogram: P-R interval

Datatyp

integer

Måttenheter
  • msec
Alias
UMLS CUI [1,1]
C0430456
UMLS CUI [1,2]
C0429087
msec
QRS Duration
Beskrivning

12 lead ECG, QRS complex duration

Datatyp

integer

Måttenheter
  • msec
Alias
UMLS CUI [1,1]
C0430456
UMLS CUI [1,2]
C0429025
msec
Uncorrected QT Interval
Beskrivning

12 lead ECG, QT interval - finding

Datatyp

integer

Måttenheter
  • msec
Alias
UMLS CUI [1,1]
C0430456
UMLS CUI [1,2]
C1287082
msec
QTc Interval
Beskrivning

12 lead ECG, Electrocardiogram QT corrected interval

Datatyp

integer

Måttenheter
  • msec
Alias
UMLS CUI [1,1]
C0430456
UMLS CUI [1,2]
C0855331
Result of the ECG
Beskrivning

12 lead ECG, Result

Datatyp

text

Alias
UMLS CUI [1,1]
C0430456
UMLS CUI [1,2]
C1274040
12-Lead ECG Abnormalities
Beskrivning

12-Lead ECG Abnormalities

Alias
UMLS CUI-1
C0430456
UMLS CUI-2
C1704258
Date and Time of ECG
Beskrivning

12 lead ECG, Abnormality, Date in time, Time

Datatyp

datetime

Alias
UMLS CUI [1,1]
C0430456
UMLS CUI [1,2]
C1704258
UMLS CUI [1,3]
C0011008
UMLS CUI [1,4]
C0040223
Record clinically significant abnormalities
Beskrivning

12 lead ECG, Abnormality

Datatyp

text

Alias
UMLS CUI [1,1]
C0430456
UMLS CUI [1,2]
C1704258
Unscheduled Pharmacokinetics Samples (PK) - Repeating Form
Beskrivning

Unscheduled Pharmacokinetics Samples (PK) - Repeating Form

Alias
UMLS CUI-1
C0031328
UMLS CUI-2
C3854240
UMLS CUI-3
C0205341
PK Sample ID
Beskrivning

Pharmacokinetic aspects, Sample identification number

Datatyp

integer

Alias
UMLS CUI [1,1]
C0031328
UMLS CUI [1,2]
C1299222
Actual date/time
Beskrivning

Pharmacokinetic aspects, Date in time, Time

Datatyp

datetime

Alias
UMLS CUI [1,1]
C0031328
UMLS CUI [1,2]
C0011008
UMLS CUI [1,3]
C0040223
Investigational Product - GSK1120212 Unscheduled (Study Drug) - Repeating Form
Beskrivning

Investigational Product - GSK1120212 Unscheduled (Study Drug) - Repeating Form

Alias
UMLS CUI-1
C0304229
UMLS CUI-2
C3854240
UMLS CUI-3
C0205341
Unscheduled Dose - Date/Time
Beskrivning

Experimental drug, Unscheduled, Date in time, Time

Datatyp

datetime

Alias
UMLS CUI [1,1]
C0304229
UMLS CUI [1,2]
C3854240
UMLS CUI [1,3]
C0011008
UMLS CUI [1,4]
C0040223
Adverse Event (AE) - Repeating Form
Beskrivning

Adverse Event (AE) - Repeating Form

Alias
UMLS CUI-1
C0877248
UMLS CUI-2
C0205341
Sequence number
Beskrivning

Adverse event, Sequence Number

Datatyp

integer

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C2348184
Was the event serious?
Beskrivning

Serious Adverse Event

Datatyp

boolean

Alias
UMLS CUI [1]
C1519255
Yes, Seriousness Reason(s)
Beskrivning

Serious Adverse Event, Reason and justification

Datatyp

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0566251
Event
Beskrivning

Adverse event

Datatyp

text

Alias
UMLS CUI [1]
C0877248
Modified term
Beskrivning

Adverse Event Modified Reported Term

Datatyp

text

Alias
UMLS CUI [1]
C2826798
MedDRA synonym
Beskrivning

Adverse event, Medical Dictionary for Regulatory Activities Terminology (MedDRA)

Datatyp

text

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C1140263
MedDRA lower level term code
Beskrivning

Adverse event, MedDRA Low Level Term Code

Datatyp

text

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C3898442
Failed coding
Beskrivning

Adverse event, Code, Failed

Datatyp

text

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C0805701
UMLS CUI [1,3]
C0231175
Start date
Beskrivning

Adverse Event Start Date

Datatyp

date

Alias
UMLS CUI [1]
C2697888
Did the event occur prior to rollover?
Beskrivning

Adverse event, Before

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C0332152
Outcome/End date
Beskrivning

Adverse Event Outcome, Adverse Event End Date

Datatyp

text

Alias
UMLS CUI [1,1]
C1705586
UMLS CUI [1,2]
C2697886
End Date and Time
Beskrivning

Adverse Event End Date Time

Datatyp

datetime

Alias
UMLS CUI [1]
C2826793
Date and Time of Death
Beskrivning

Adverse event, Date of death, Time of death

Datatyp

datetime

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C1148348
UMLS CUI [1,3]
C1301931
Frequency
Beskrivning

Adverse event, Frequencies

Datatyp

text

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C0439603
Intensity at onset of event
Beskrivning

Adverse event, Symptom intensity, Onset

Datatyp

text

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C0518690
UMLS CUI [1,3]
C0332162
Maximum intensity
Beskrivning

Adverse event, Symptom intensity, Maximum

Datatyp

text

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C0518690
UMLS CUI [1,3]
C0806909
Grade at onset of event
Beskrivning

Adverse event, Grade, Onset

Datatyp

text

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C0441800
UMLS CUI [1,3]
C0332162
Maximum grade
Beskrivning

Adverse event, Grade, Maximum

Datatyp

text

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C0441800
UMLS CUI [1,3]
C0806909
Grade or intensity at onset of event
Beskrivning

Adverse event, Grade, Symptom intensity, Onset

Datatyp

text

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C0441800
UMLS CUI [1,3]
C0518690
UMLS CUI [1,4]
C0332162
Maximum Grade or intensity
Beskrivning

Adverse event, Grade, Symptom intensity, Maximum

Datatyp

text

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C0441800
UMLS CUI [1,3]
C0518690
UMLS CUI [1,4]
C0806909
Were any actions taken with investigational product(s) as a result of the AE?
Beskrivning

Adverse event, Action Taken with Study Treatment

Datatyp

text

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C1704758
Yes, tick all that apply
Beskrivning

Adverse event, Action Taken with Study Treatment

Datatyp

text

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C1704758
Most clinically significant action taken with investigational product(s) as a Result of the AE
Beskrivning

Adverse Event, Action Taken with Study Treatment, Clinical Significance

Datatyp

text

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C1704758
UMLS CUI [1,3]
C2826293
Did the subject withdraw from study as a result of this AE?
Beskrivning

Adverse event, Withdraw

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C2349954
Is there a reasonable possibility that the AE may have been caused by the investigational product?
Beskrivning

Adverse event, Causations, Experimental drug

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C0085978
UMLS CUI [1,3]
C0304229
Yes, Check all that apply
Beskrivning

Adverse event, Causations, Experimental drug

Datatyp

text

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C0085978
UMLS CUI [1,3]
C0304229
Duration of AE if < 24 hours
Beskrivning

Adverse event, Duration

Datatyp

time

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C2926735
Time to onset since last dose
Beskrivning

Adverse event, Time of onset, Date last dose

Datatyp

time

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C0449244
UMLS CUI [1,3]
C1762893
Is this adverse event a dose-limiting toxicity during the determinative period?
Beskrivning

Adverse event, dose-limiting, Drug toxicity

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C1512043
UMLS CUI [1,3]
C0013221
Were concomitant medications taken to treat this adverse event?
Beskrivning

Adverse event, Therapeutic procedure, Concomitant Agent

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C0087111
UMLS CUI [1,3]
C2347852
Start Date of Event Segment
Beskrivning

Adverse event, Part, Start Date

Datatyp

date

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C0449719
UMLS CUI [1,3]
C0808070
Intensity of event segment
Beskrivning

Adverse event, Part, Symptom intensity

Datatyp

text

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C0449719
UMLS CUI [1,3]
C0518690
Grade of event segment
Beskrivning

Adverse event, Part, Grade

Datatyp

text

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C0449719
UMLS CUI [1,3]
C0441800
Grade or Intensity of event segment
Beskrivning

Adverse event, Part, Grade, Symptom intensity

Datatyp

text

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C0449719
UMLS CUI [1,3]
C0441800
UMLS CUI [1,4]
C0518690
Start Date of Action(s)
Beskrivning

Adverse event, Therapeutic procedure, Start Date

Datatyp

date

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C0087111
UMLS CUI [1,3]
C0808070
Action taken with investigational product
Beskrivning

Adverse event, Action Taken with Study Treatment

Datatyp

text

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C1704758
Investigational product action is taken with
Beskrivning

Adverse event, Action Taken with Study Treatment

Datatyp

text

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C1704758
Date event became serious (Date event met serious criteria)
Beskrivning

Serious Adverse Event, Start Date

Datatyp

date

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0808070
Date event ceased to be serious
Beskrivning

Serious Adverse Event, End date

Datatyp

date

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0806020
Serious Adverse Events (SAE)
Beskrivning

Serious Adverse Events (SAE)

Alias
UMLS CUI-1
C1519255
SAE Sequence Number
Beskrivning

Serious Adverse Event, Sequence Number

Datatyp

integer

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C2348184
Report
Beskrivning

Serious Adverse Event Report

Datatyp

text

Alias
UMLS CUI [1]
C3897642
SAE form started
Beskrivning

Serious Adverse Event, Report, Start Date, Start time

Datatyp

datetime

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0684224
UMLS CUI [1,3]
C0808070
UMLS CUI [1,4]
C1301880
Seriousness Reason(s)
Beskrivning

Serious Adverse Event, Reason and justification

Datatyp

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0566251
Was SAE caused by activities related to study participation (e.g. procedures)?
Beskrivning

Serious Adverse Event, Causations, Activities, Study Subject Participation Status

Datatyp

boolean

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0085978
UMLS CUI [1,3]
C0441655
UMLS CUI [1,4]
C2348568
Serious Adverse Event
Beskrivning

Serious Adverse Event

Datatyp

text

Modified term copied from adverse event form
Beskrivning

Serious Adverse Event, Adverse Event Modified Reported Term

Datatyp

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C2826798
Start date
Beskrivning

Serious Adverse Event, Start Date

Datatyp

date

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0808070
Outcome / End date
Beskrivning

Serious Adverse Event, Adverse Event Outcome

Datatyp

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C1705586
End Date and Time
Beskrivning

Serious Adverse Event, End date, End Time

Datatyp

datetime

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0806020
UMLS CUI [1,3]
C1522314
Date and Time of Death
Beskrivning

Serious Adverse Event, Date of death, Time of death

Datatyp

datetime

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C1302234
UMLS CUI [1,3]
C1148348
UMLS CUI [1,4]
C1301931
Frequency
Beskrivning

Serious Adverse Event, Frequencies

Datatyp

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0439603
Maximum Intensity
Beskrivning

Serious Adverse Event, Symptom intensity, Maximum

Datatyp

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0518690
UMLS CUI [1,3]
C0806909
Maximum grade
Beskrivning

Serious Adverse Event, Grade, Maximum

Datatyp

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0441800
UMLS CUI [1,3]
C0806909
Maximum Grade or Intensity
Beskrivning

Serious Adverse Event, Grade, Symptom intensity, Maximum

Datatyp

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0441800
UMLS CUI [1,3]
C0518690
UMLS CUI [1,4]
C0806909
Toxicity/Intensity History
Beskrivning

Serious Adverse Event, Toxicity aspects, Patient History

Datatyp

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0040539
UMLS CUI [1,3]
C0679831
Most clinically significant action taken with investigational product(s) as a Result of the AE
Beskrivning

Serious Adverse Event, Action Taken with Study Treatment, Clinical Significance

Datatyp

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C1704758
UMLS CUI [1,3]
C2826293
Action(s) taken with Investigational Product
Beskrivning

Serious Adverse Event, Action Taken with Study Treatment

Datatyp

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C1704758
Did the subject withdraw from study as a result of this AE?
Beskrivning

Serious Adverse Event, Withdraw

Datatyp

boolean

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C2349954
Is there a reasonable possibility that the AE may have been caused by the investigational product?
Beskrivning

Serious Adverse Event, Investigational New Drugs, Relationships

Datatyp

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0013230
UMLS CUI [1,3]
C0439849
Duration of AE if < 24 hours
Beskrivning

Serious Adverse Event, Duration

Datatyp

time

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C2926735
Time to onset since last dose
Beskrivning

Serious Adverse Event, Time of onset, Time last dose

Datatyp

time

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0449244
UMLS CUI [1,3]
C0946444
Is this adverse event a dose-limiting toxicity during the determinative period?
Beskrivning

Serious Adverse Event, Dose-limiting, Drug toxicity

Datatyp

boolean

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C1512043
UMLS CUI [1,3]
C0013221
Date segments adverse event was serious
Beskrivning

Serious Adverse Event, Part

Datatyp

date

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0449719
Are there any relevant concomitant medications associated with this serious adverse event?
Beskrivning

Serious Adverse Event, Concomitant Agent

Datatyp

boolean

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C2347852
Concomitant Medication - Sequence Number
Beskrivning

Serious Adverse Event, Concomitant Agent, Sequence Number

Datatyp

integer

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C2347852
UMLS CUI [1,3]
C2348184
Concomitant Medication - Drug Name
Beskrivning

Serious Adverse Event, Concomitant Agent, Medication name

Datatyp

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C2347852
UMLS CUI [1,3]
C2360065
Concomitant Medication - Modified reported term
Beskrivning

Serious Adverse Event, Concomitant Agent, Concomitant Medication Modified Reported Term

Datatyp

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C2347852
UMLS CUI [1,3]
C2826819
Concomitant Medication - Drug Name
Beskrivning

Serious Adverse Event, Concomitant Agent, Medication name

Datatyp

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C2347852
UMLS CUI [1,3]
C2360065
Concomitant Medication - Unit Dose
Beskrivning

Serious Adverse Event, Concomitant Agent, Dosage

Datatyp

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C2347852
UMLS CUI [1,3]
C0178602
Concomitant Medication - Units
Beskrivning

Serious Adverse Event, Concomitant Agent, Unit of Measure

Datatyp

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C2347852
UMLS CUI [1,3]
C1519795
Concomitant Medication - Frequency
Beskrivning

Serious Adverse Event, Concomitant Agent, Frequencies

Datatyp

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C2347852
UMLS CUI [1,3]
C0439603
Concomitant Medication - Route
Beskrivning

Serious Adverse Event, Concomitant Agent, Drug Administration Routes

Datatyp

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C2347852
UMLS CUI [1,3]
C0013153
Concomitant Medication - Reason for Medication
Beskrivning

Serious Adverse Event, Concomitant Agent, Reason and justification

Datatyp

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C2347852
UMLS CUI [1,3]
C0566251
Concomitant Medication - Reason for Medication Modified Report Term
Beskrivning

Serious Adverse Event, Concomitant Agent, Concomitant Medication Modified Reported Term, Reason and justification

Datatyp

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C2347852
UMLS CUI [1,3]
C2826819
UMLS CUI [1,4]
C0566251
Concomitant Medication - Start Date
Beskrivning

Serious Adverse Event, Concomitant Agent, Start Date

Datatyp

date

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C2347852
UMLS CUI [1,3]
C0808070
Concomitant Medication - Ongoing?
Beskrivning

Serious Adverse Event, Concomitant Agent, Concomitant Medication Ongoing

Datatyp

boolean

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C2347852
UMLS CUI [1,3]
C2826666
Concomitant Medication - No, End Date
Beskrivning

Serious Adverse Event, Concomitant Agent, End Date

Datatyp

date

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C2347852
UMLS CUI [1,3]
C0806020
Concomitant Medication - Total Duration
Beskrivning

Serious Adverse Event, Concomitant Agent, Duration

Datatyp

time

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C2347852
UMLS CUI [1,3]
C0449238
Concomitant Medication - Duration Unit
Beskrivning

Serious Adverse Event, Concomitant Agent, Duration, Unit of Measure

Datatyp

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C2347852
UMLS CUI [1,3]
C0449238
UMLS CUI [1,4]
C1519795
Did SAE occur after initiation of study medication?
Beskrivning

Serious Adverse Event, Experimental drug, Initiation

Datatyp

boolean

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0304229
UMLS CUI [1,3]
C1704686
Randomization Number
Beskrivning

Serious Adverse Event, Randomization, Numbers

Datatyp

integer

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0034656
UMLS CUI [1,3]
C0237753
Relevant Medical Conditions - MHx Sequence Number
Beskrivning

Serious Adverse Event, Disease, Sequence Number

Datatyp

integer

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0012634
UMLS CUI [1,3]
C2348184
Relevant Medical Conditions - Specific Condition Name
Beskrivning

Serious Adverse Event, Disease

Datatyp

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0012634
UMLS CUI [1,3]
C2348184
Relevant Medical Conditions - Modified reported term
Beskrivning

Serious Adverse Event, Disease, Adverse Event Modified Reported Term

Datatyp

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0012634
UMLS CUI [1,3]
C2826798
Relevant Medical Conditions - Date of onset
Beskrivning

Serious Adverse Event, Disease, Date of onset

Datatyp

date

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0012634
UMLS CUI [1,3]
C0574845
Relevant Medical Conditions - Continuing?
Beskrivning

Serious Adverse Event, Disease, Continuous

Datatyp

boolean

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0012634
UMLS CUI [1,3]
C0549178
Relevant Medical Conditions - No, specify date of last occurrence
Beskrivning

Serious Adverse Event, Disease, End date

Datatyp

date

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0012634
UMLS CUI [1,3]
C0806020
Relevant Diagnostic Results - Lab Sequence Number
Beskrivning

Serious Adverse Event, diagnostic procedure, Sequence Number

Datatyp

integer

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0430022
UMLS CUI [1,3]
C2348184
Relevant Diagnostic Results - Test Name
Beskrivning

Serious Adverse Event, diagnostic procedure, Test Name

Datatyp

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0430022
UMLS CUI [1,3]
C2826273
Relevant Diagnostic Results - Test Date
Beskrivning

Serious Adverse Event, diagnostic procedure, Date in time

Datatyp

date

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0430022
UMLS CUI [1,3]
C0011008
Relevant Diagnostic Results - Test Result
Beskrivning

Serious Adverse Event, diagnostic procedure, Result

Datatyp

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0430022
UMLS CUI [1,3]
C1274040
Relevant Diagnostic Results - Test Units
Beskrivning

Serious Adverse Event, diagnostic procedure, Unit of Measure

Datatyp

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0430022
UMLS CUI [1,3]
C1519795
Relevant Diagnostic Results - Normal Low Range
Beskrivning

Serious Adverse Event, diagnostic procedure, Normal Range, Low

Datatyp

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0430022
UMLS CUI [1,3]
C0086715
UMLS CUI [1,4]
C0205251
Relevant Diagnostic Results - Normal High Range
Beskrivning

Serious Adverse Event, diagnostic procedure, Normal Range, High

Datatyp

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0430022
UMLS CUI [1,3]
C0086715
UMLS CUI [1,4]
C0205250
Relevant Diagnostic Results - Relevant diagnostic results not noted above
Beskrivning

Serious Adverse Event, diagnostic procedure, Result, Other

Datatyp

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0430022
UMLS CUI [1,3]
C1274040
UMLS CUI [1,4]
C0205394
Rechallenge - If investigational product(s) were stopped temporarily, did the reported event(s) recur after investigational products were restarted?
Beskrivning

Serious Adverse Event, Relationships, Experimental drug

Datatyp

text

Alias
UMLS CUI [1,1]
C1518404
UMLS CUI [1,2]
C0439849
UMLS CUI [1,3]
C0304229
Investigational Product - Study Drug
Beskrivning

Serious Adverse Event, Experimental drug

Datatyp

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0304229
UMLS CUI [1,3]
C0808070
Investigational Product - Start Date
Beskrivning

Serious Adverse Event, Experimental drug, Start Date

Datatyp

date

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0304229
UMLS CUI [1,3]
C0808070
Investigational Product - Stop Date
Beskrivning

Serious Adverse Event, Experimental drug, End Date

Datatyp

date

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0304229
UMLS CUI [1,3]
C0806020
Investigational Product - Dose
Beskrivning

Serious Adverse Event, Experimental drug, Dosage

Datatyp

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0304229
UMLS CUI [1,3]
C0178602
Investigational Product - Cumulative Dose
Beskrivning

Serious Adverse Event, Experimental drug, Cumulative Dose

Datatyp

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0304229
UMLS CUI [1,3]
C2986497
General Narrative Comments
Beskrivning

Serious Adverse Event, Comment

Datatyp

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0947611
Concomitant Medications - Repeating Form
Beskrivning

Concomitant Medications - Repeating Form

Alias
UMLS CUI-1
C2347852
Sequence Number
Beskrivning

Concomitant Agent, Sequence Number

Datatyp

integer

Alias
UMLS CUI [1,1]
C2347852
UMLS CUI [1,2]
C2348184
Drug Name
Beskrivning

Concomitant Agent, Medication name

Datatyp

text

Alias
UMLS CUI [1,1]
C2347852
UMLS CUI [1,2]
C2360065
Modified reported term
Beskrivning

Concomitant Agent, Concomitant Medication Modified Reported Term

Datatyp

text

Alias
UMLS CUI [1,1]
C2347852
UMLS CUI [1,2]
C2826819
Failed coding
Beskrivning

Concomitant Agent, Code, Failed

Datatyp

text

Alias
UMLS CUI [1,1]
C2347852
UMLS CUI [1,2]
C0805701
UMLS CUI [1,3]
C0231175
Unit Dose
Beskrivning

Concomitant Agent, Dosage

Datatyp

text

Alias
UMLS CUI [1,1]
C2347852
UMLS CUI [1,2]
C0178602
Units
Beskrivning

Concomitant Agent, Unit of Measure

Datatyp

text

Alias
UMLS CUI [1,1]
C2347852
UMLS CUI [1,2]
C1519795
Frequency
Beskrivning

Concomitant Agent, Frequencies

Datatyp

text

Alias
UMLS CUI [1,1]
C2347852
UMLS CUI [1,2]
C0439603
Route
Beskrivning

Concomitant Agent, Drug Administration Routes

Datatyp

text

Alias
UMLS CUI [1,1]
C2347852
UMLS CUI [1,2]
C0013153
Reason for Medication
Beskrivning

Concomitant Agent, Reason and justification

Datatyp

text

Alias
UMLS CUI [1,1]
C2347852
UMLS CUI [1,2]
C0566251
Start Date
Beskrivning

Concomitant Medication Start Date

Datatyp

date

Alias
UMLS CUI [1]
C2826734
Taken Prior to Study?
Beskrivning

Concomitant Medication Previous Occurrence

Datatyp

boolean

Alias
UMLS CUI [1]
C2826667
Ongoing?
Beskrivning

Concomitant Medication Ongoing

Datatyp

boolean

Alias
UMLS CUI [1]
C2826666
No, specify End Date
Beskrivning

Concomitant Medication End Date

Datatyp

date

Alias
UMLS CUI [1]
C2826744
Device Used to Administer Medication
Beskrivning

Concomitant Agent, Devices, Medication administered

Datatyp

text

Alias
UMLS CUI [1,1]
C2347852
UMLS CUI [1,2]
C0699733
UMLS CUI [1,3]
C0806914
Total Daily Dose
Beskrivning

Concomitant Agent, Daily Dose, Total

Datatyp

text

Alias
UMLS CUI [1,1]
C2347852
UMLS CUI [1,2]
C2348070
UMLS CUI [1,3]
C0439810
Was drug administered for an exacerbation?
Beskrivning

Concomitant Agent, Disease Exacerbation

Datatyp

boolean

Alias
UMLS CUI [1,1]
C2347852
UMLS CUI [1,2]
C0235874
Was drug administered as a rescue medication?
Beskrivning

Concomitant Agent, Rescue remedy

Datatyp

boolean

Alias
UMLS CUI [1,1]
C2347852
UMLS CUI [1,2]
C0884980
Cumulative Dose Used?
Beskrivning

Concomitant Agent, Cumulative Dose

Datatyp

boolean

Alias
UMLS CUI [1,1]
C2347852
UMLS CUI [1,2]
C2986497
Was drug ever used?
Beskrivning

Concomitant Agent

Datatyp

boolean

Alias
UMLS CUI [1]
C2347852
Total Duration
Beskrivning

Concomitant Agent, Duration, Total

Datatyp

text

Alias
UMLS CUI [1,1]
C2347852
UMLS CUI [1,2]
C0449238
UMLS CUI [1,3]
C0439810
Duration Unit
Beskrivning

Concomitant Agent, Duration, Unit of Measure

Datatyp

text

Alias
UMLS CUI [1,1]
C2347852
UMLS CUI [1,2]
C0449238
UMLS CUI [1,3]
C1519795
Tillbaka till toppen

Similar models

Logs/Repeats

1 Formulär
  1. StudyEvent: ODM
    1. Logs/Repeats
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Logs and Repeats
C1708728 (UMLS CUI-1)
C0205341 (UMLS CUI-2)
Event Log, Repeat, Date of visit, Assessment Date
Item
Date of visit/assessment
date
C1708728 (UMLS CUI [1,1])
C0205341 (UMLS CUI [1,2])
C1320303 (UMLS CUI [1,3])
C2985720 (UMLS CUI [1,4])
Concomitant Agent
Item
Were there any concomitant medications taken by the subject during the study?
boolean
C2347852 (UMLS CUI [1])
Adverse event
Item
Did the subject experience any adverse events during the study?
boolean
C0877248 (UMLS CUI [1])
Serious Adverse Event
Item
Did the subject experience any serious adverse events during the study?
boolean
C1519255 (UMLS CUI [1])
Vital signs, Repeat; Vital signs, Unscheduled
Item
Were any repeat or unscheduled vital signs recorded?
boolean
C0518766 (UMLS CUI [1,1])
C0205341 (UMLS CUI [1,2])
C0518766 (UMLS CUI [2,1])
C3854240 (UMLS CUI [2,2])
Experimental drug, Unscheduled
Item
Was any unscheduled study medication taken?
boolean
C0304229 (UMLS CUI [1,1])
C3854240 (UMLS CUI [1,2])
Pharmacokinetic aspects, Collection of blood specimen for laboratory procedure, Repeat; Pharmacokinetic aspects, Collection of blood specimen for laboratory procedure, Unscheduled
Item
Were any repeat or unscheduled PK blood samples taken?
boolean
C0031328 (UMLS CUI [1,1])
C0005834 (UMLS CUI [1,2])
C0205341 (UMLS CUI [1,3])
C0031328 (UMLS CUI [2,1])
C0005834 (UMLS CUI [2,2])
C3854240 (UMLS CUI [2,3])
Echocardiography, Multiple gated acquisition scanning, Repeat; Echocardiography, Multiple gated acquisition scanning, Unscheduled
Item
Were there an unscheduled or repeat ECHO/MUGA examinations performed?
boolean
C0013516 (UMLS CUI [1,1])
C0521317 (UMLS CUI [1,2])
C0205341 (UMLS CUI [1,3])
C0013516 (UMLS CUI [2,1])
C0521317 (UMLS CUI [2,2])
C3854240 (UMLS CUI [2,3])
Electrocardiography, Repeat; Electrocardiography, Unscheduled
Item
Were any unscheduled or repeat ECGs performed?
boolean
C1623258 (UMLS CUI [1,1])
C0205341 (UMLS CUI [1,2])
C1623258 (UMLS CUI [2,1])
C3854240 (UMLS CUI [2,2])
Liver, Adverse Event
Item
Were the liver event criteria met for this subject as defined by the protocol?
boolean
C0023884 (UMLS CUI [1,1])
C0877248 (UMLS CUI [1,2])
Item Group
ECHO/MUGA
C0013516 (UMLS CUI-1)
C0521317 (UMLS CUI-2)
Echocardiography, Multiple gated acquisition scanning, Ejection fraction (finding), Lower Limit of Normal
Item
Ejection fraction range lower limit
integer
C0013516 (UMLS CUI [1,1])
C0521317 (UMLS CUI [1,2])
C2700378 (UMLS CUI [1,3])
C1518030 (UMLS CUI [1,4])
Item
Scan Type
text
C0013516 (UMLS CUI [1,1])
C0521317 (UMLS CUI [1,2])
Echocardiography, Multiple gated acquisition scanning
Code List
Scan Type
CL Item
ECHO (1)
CL Item
MUGA (2)
Echocardiography, Multiple gated acquisition scanning, Date in time, Time
Item
Date and Time of Scan
datetime
C0013516 (UMLS CUI [1,1])
C0521317 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
C0040223 (UMLS CUI [1,4])
Echocardiography, Multiple gated acquisition scanning, Left ventricular ejection fraction
Item
Left ventricular ejection fraction (LVEF)
integer
C0013516 (UMLS CUI [1,1])
C0521317 (UMLS CUI [1,2])
C0428772 (UMLS CUI [1,3])
Echocardiography, Multiple gated acquisition scanning, Left ventricular ejection fraction
Item
Left ventricular ejection fraction (LVEF)
integer
C0013516 (UMLS CUI [1,1])
C0521317 (UMLS CUI [1,2])
C0428772 (UMLS CUI [1,3])
Item
Scan results
text
C0013516 (UMLS CUI [1,1])
C0521317 (UMLS CUI [1,2])
C1274040 (UMLS CUI [1,3])
Echocardiography, Multiple gated acquisition scanning, Result
Code List
Scan results
CL Item
Normal (1)
CL Item
Abnormal, describe abnormality (2)
Echocardiography, Multiple gated acquisition scanning, Abnormality
Item
Describe abnormality
text
C0013516 (UMLS CUI [1,1])
C0521317 (UMLS CUI [1,2])
C1704258 (UMLS CUI [1,3])
Item Group
Vital Signs - Repeating Form
C0518766 (UMLS CUI-1)
C0205341 (UMLS CUI-2)
Vital signs, Date in time, Time
Item
Actual date/time
datetime
C0518766 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C0040223 (UMLS CUI [1,3])
Body Weight
Item
Weight
float
C0005910 (UMLS CUI [1])
Item
Sitting heart rate
integer
C2029904 (UMLS CUI [1])
Gender
Code List
Sitting heart rate
Systolic Pressure, Sitting position
Item
Sitting blood pressure measurement - Systolic
integer
C0871470 (UMLS CUI [1,1])
C0277814 (UMLS CUI [1,2])
Diastolic blood pressure, Sitting position
Item
Sitting blood pressure measurement - Diastolic
integer
C0428883 (UMLS CUI [1,1])
C0277814 (UMLS CUI [1,2])
Item Group
Unscheduled 12-Lead ECG - Repeating Form
C0430456 (UMLS CUI-1)
C3854240 (UMLS CUI-2)
C0205341 (UMLS CUI-3)
12 lead ECG, Date in time, Time
Item
Date and Time of ECG
datetime
C0430456 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C0040223 (UMLS CUI [1,3])
12 lead ECG, Heart rate
Item
Heart rate
integer
C0430456 (UMLS CUI [1,1])
C0018810 (UMLS CUI [1,2])
12 lead ECG, Electrocardiogram: P-R interval
Item
PR Interval
integer
C0430456 (UMLS CUI [1,1])
C0429087 (UMLS CUI [1,2])
12 lead ECG, QRS complex duration
Item
QRS Duration
integer
C0430456 (UMLS CUI [1,1])
C0429025 (UMLS CUI [1,2])
12 lead ECG, QT interval - finding
Item
Uncorrected QT Interval
integer
C0430456 (UMLS CUI [1,1])
C1287082 (UMLS CUI [1,2])
Item
QTc Interval
integer
C0430456 (UMLS CUI [1,1])
C0855331 (UMLS CUI [1,2])
12 lead ECG, Electrocardiogram QT corrected interval, Evaluation Method
Code List
QTc Interval
Item
Result of the ECG
text
C0430456 (UMLS CUI [1,1])
C1274040 (UMLS CUI [1,2])
12 lead ECG, Electrocardiogram QT corrected interval, Evaluation Method
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)
Item Group
12-Lead ECG Abnormalities
C0430456 (UMLS CUI-1)
C1704258 (UMLS CUI-2)
12 lead ECG, Abnormality, Date in time, Time
Item
Date and Time of ECG
datetime
C0430456 (UMLS CUI [1,1])
C1704258 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
C0040223 (UMLS CUI [1,4])
Item
Record clinically significant abnormalities
text
C0430456 (UMLS CUI [1,1])
C1704258 (UMLS CUI [1,2])
12 lead ECG, Abnormality
Code List
Record clinically significant abnormalities
CL Item
No abnormalities (1)
CL Item
Sinus bradycardia (50-59 beats/min) (2)
CL Item
Sinus bradycardia (40-49 beats/min) (3)
CL Item
Sinus bradycardia (30-39 beats/min) (4)
CL Item
Sinus bradycardia (<30 beats/min) (5)
CL Item
Sinus pause (6)
CL Item
Sinus tachycardia (>100 beats/min) (7)
CL Item
Ectopic supraventricular beats (8)
CL Item
Ectopic supraventricular rhythm (9)
CL Item
Wandering atrial pacemaker (10)
CL Item
Multifocal atrial tachycardia (wandering atrial pacemaker w/rate >100 beats/min) (11)
CL Item
Non-sustained supraventricular tachycardia (>100 beats/min, 3-30 beats) (12)
CL Item
Sustained supraventricular tachycardia (>100 beats/min, >30 beats) (13)
CL Item
Atrial flutter (14)
CL Item
Atrial fibrillation (15)
CL Item
Junctional rhythm (<=100 beats/min, defined by narrow QRS complex) (16)
CL Item
Junctional tachycardia (>100 beats/min) (17)
CL Item
Ventricular premature deplorisation (18)
CL Item
Ventricular couplets (19)
CL Item
Bigeminy (20)
CL Item
Trigeminy (21)
CL Item
Electrical alternans (22)
CL Item
R on T phenomenon (23)
CL Item
Ventricular fibrillation (24)
CL Item
Idioventricular rhythm (<=100 beats/min, defined by wide QRS complex) (25)
CL Item
Non-sustained ventricular tachycardia (>100 beats/min, 3-30 beats) (26)
CL Item
Sustained ventricular tachycardia (>100 beats/min, >30 beats) (27)
CL Item
Wide QRS tachycardia (diagnosis unknown (28)
CL Item
Monomorphic non-sustained ventricular tachycardia (>100 beats/min, 3-30 beats) (29)
CL Item
Monomorphic sustained ventricular tachycardia (>100 beats/min, >30 beats) (30)
CL Item
Polymorphic non-sustained ventricular tachycardia (>100 beats/min, 3-30 beats) (31)
CL Item
Polymorphic sustained ventricular tachycardia (>100 beats/min, >30 beats) (32)
CL Item
Torsades de Pointes (TdP) (33)
CL Item
Pacemaker (34)
CL Item
First degree AV block (PR interval >200msec) (35)
CL Item
Short PR Intervak (36)
CL Item
Second degree AV block (Mobitz type 1) (37)
CL Item
Second degree AV block (Mobitz type 2) (38)
CL Item
2:1 AV block (39)
CL Item
Third degree AV block (40)
CL Item
Left axis deviation (QRS axis more negative than -30 degrees) (41)
CL Item
Right axis deviation (QRS axis more positive than +100 degrees) (42)
CL Item
Incomplete left bundle branch block (43)
CL Item
Incomplete left bundle branch block (44)
CL Item
Right bundle branch block (45)
CL Item
Left anterior hemiblock (46)
CL Item
Left posterior hemiblock (47)
CL Item
Left bundle branch block (48)
CL Item
Bifascicular block (49)
CL Item
Non-specific intraventricular conduction delay (QRS >=120 msec) (50)
CL Item
Accessory pathway (Wolff-Parkinson-White, Lown-Ganong-Levine (51)
CL Item
QTc prolongation >=500 msec (52)
CL Item
AV dissociation (53)
CL Item
Myocardial infarction, old (54)
CL Item
Myocardial infarction, non Q-wave (55)
CL Item
Non-specific ST-T changes (56)
CL Item
J point elevation (57)
CL Item
ST elevation (58)
CL Item
ST depression (59)
CL Item
ST segment abnormality (60)
CL Item
U waves (61)
CL Item
T wave inversion (62)
CL Item
T wave peaked (63)
CL Item
T waves biphasic (64)
CL Item
T waves flat (65)
CL Item
66)Notched T-waves (66)Notched T-waves)
CL Item
Low QRS voltage (67)
CL Item
T wave abnormality (68)
CL Item
Other abnormal rhythm (69)
CL Item
Other morphology (70)
CL Item
Other conduction (71)
CL Item
Other myocardial infarction (72)
CL Item
Other depolarization/repolarisation (73)
CL Item
Other abnormality/Cardiologist comments (74)
Item Group
Unscheduled Pharmacokinetics Samples (PK) - Repeating Form
C0031328 (UMLS CUI-1)
C3854240 (UMLS CUI-2)
C0205341 (UMLS CUI-3)
Pharmacokinetic aspects, Sample identification number
Item
PK Sample ID
integer
C0031328 (UMLS CUI [1,1])
C1299222 (UMLS CUI [1,2])
Pharmacokinetic aspects, Date in time, Time
Item
Actual date/time
datetime
C0031328 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C0040223 (UMLS CUI [1,3])
Item Group
Investigational Product - GSK1120212 Unscheduled (Study Drug) - Repeating Form
C0304229 (UMLS CUI-1)
C3854240 (UMLS CUI-2)
C0205341 (UMLS CUI-3)
Experimental drug, Unscheduled, Date in time, Time
Item
Unscheduled Dose - Date/Time
datetime
C0304229 (UMLS CUI [1,1])
C3854240 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
C0040223 (UMLS CUI [1,4])
Item Group
Adverse Event (AE) - Repeating Form
C0877248 (UMLS CUI-1)
C0205341 (UMLS CUI-2)
Adverse event, Sequence Number
Item
Sequence number
integer
C0877248 (UMLS CUI [1,1])
C2348184 (UMLS CUI [1,2])
Serious Adverse Event
Item
Was the event serious?
boolean
C1519255 (UMLS CUI [1])
Item
Yes, Seriousness Reason(s)
text
C1519255 (UMLS CUI [1,1])
C0566251 (UMLS CUI [1,2])
Serious Adverse Event, Reason and justification
Code List
Yes, Seriousness Reason(s)
CL Item
Results in death (1)
CL Item
Is life-threatening (2)
CL Item
Requires hospitalization or prolongation of existing hospitalization (3)
CL Item
Results in disability/incapacity (4)
CL Item
Congenital anomaly/birth defect (5)
CL Item
Other, specify within general narrative comment (6)
CL Item
Serious Protocol Defined Liver Chemistry Stopping/Interruption Criteria Met (7)
Adverse event
Item
Event
text
C0877248 (UMLS CUI [1])
Adverse Event Modified Reported Term
Item
Modified term
text
C2826798 (UMLS CUI [1])
Adverse event, Medical Dictionary for Regulatory Activities Terminology (MedDRA)
Item
MedDRA synonym
text
C0877248 (UMLS CUI [1,1])
C1140263 (UMLS CUI [1,2])
Adverse event, MedDRA Low Level Term Code
Item
MedDRA lower level term code
text
C0877248 (UMLS CUI [1,1])
C3898442 (UMLS CUI [1,2])
Adverse event, Code, Failed
Item
Failed coding
text
C0877248 (UMLS CUI [1,1])
C0805701 (UMLS CUI [1,2])
C0231175 (UMLS CUI [1,3])
Adverse Event Start Date
Item
Start date
date
C2697888 (UMLS CUI [1])
Adverse event, Before
Item
Did the event occur prior to rollover?
boolean
C0877248 (UMLS CUI [1,1])
C0332152 (UMLS CUI [1,2])
Item
Outcome/End date
text
C1705586 (UMLS CUI [1,1])
C2697886 (UMLS CUI [1,2])
Adverse Event Outcome, Adverse Event End Date
Code List
Outcome/End date
CL Item
Recovered/Resolved, prove End Date and Time (1)
CL Item
Recovering/Resolving (2)
CL Item
Not recovered/Not resolved (3)
CL Item
Recovered/Recovered with sequelae, prove End Date and Time (4)
CL Item
Fatal, record Date and Time of Death (5)
Adverse Event End Date Time
Item
End Date and Time
datetime
C2826793 (UMLS CUI [1])
Adverse event, Date of death, Time of death
Item
Date and Time of Death
datetime
C0877248 (UMLS CUI [1,1])
C1148348 (UMLS CUI [1,2])
C1301931 (UMLS CUI [1,3])
Item
Frequency
text
C0877248 (UMLS CUI [1,1])
C0439603 (UMLS CUI [1,2])
Adverse event, Frequencies
Code List
Frequency
CL Item
Single Episode (1)
CL Item
Intermittent (2)
Item
Intensity at onset of event
text
C0877248 (UMLS CUI [1,1])
C0518690 (UMLS CUI [1,2])
C0332162 (UMLS CUI [1,3])
Adverse event, Symptom intensity, Onset
Code List
Intensity at onset of event
CL Item
Mild (1)
CL Item
Moderate (2)
CL Item
Severe (3)
CL Item
Not applicable (4)
Item
Maximum intensity
text
C0877248 (UMLS CUI [1,1])
C0518690 (UMLS CUI [1,2])
C0806909 (UMLS CUI [1,3])
Adverse event, Symptom intensity, Onset
Code List
Maximum intensity
CL Item
Mild (1)
CL Item
Moderate (2)
CL Item
Severe (3)
CL Item
Not applicable (4)
Item
Grade at onset of event
text
C0877248 (UMLS CUI [1,1])
C0441800 (UMLS CUI [1,2])
C0332162 (UMLS CUI [1,3])
Adverse event, Grade, Onset
Code List
Grade at onset of event
CL Item
Grade 1 (1)
CL Item
Grade 2 (2)
CL Item
Grade 3 (3)
CL Item
Grade 4 (4)
CL Item
Grade 5 (5)
Item
Maximum grade
text
C0877248 (UMLS CUI [1,1])
C0441800 (UMLS CUI [1,2])
C0806909 (UMLS CUI [1,3])
Adverse event, Grade, Onset
Code List
Maximum grade
CL Item
Grade 1 (1)
CL Item
Grade 2 (2)
CL Item
Grade 3 (3)
CL Item
Grade 4 (4)
CL Item
Grade 5 (5)
Item
Grade or intensity at onset of event
text
C0877248 (UMLS CUI [1,1])
C0441800 (UMLS CUI [1,2])
C0518690 (UMLS CUI [1,3])
C0332162 (UMLS CUI [1,4])
Adverse event, Grade, Symptom intensity, Onset
Code List
Grade or intensity at onset of event
CL Item
Mild or Grade 1 (1)
CL Item
Moderate or Grade 2 (2)
CL Item
Severe or Grade 3 (3)
CL Item
Grade 4 (4)
CL Item
Grade 5 (5)
CL Item
Not applicable (6)
Item
Maximum Grade or intensity
text
C0877248 (UMLS CUI [1,1])
C0441800 (UMLS CUI [1,2])
C0518690 (UMLS CUI [1,3])
C0806909 (UMLS CUI [1,4])
Adverse event, Grade, Symptom intensity, Onset
Code List
Maximum Grade or intensity
CL Item
Mild or Grade 1 (1)
CL Item
Moderate or Grade 2 (2)
CL Item
Severe or Grade 3 (3)
CL Item
Grade 4 (4)
CL Item
Grade 5 (5)
CL Item
Not applicable (6)
Item
Were any actions taken with investigational product(s) as a result of the AE?
text
C0877248 (UMLS CUI [1,1])
C1704758 (UMLS CUI [1,2])
Adverse event, Action Taken with Study Treatment
Code List
Were any actions taken with investigational product(s) as a result of the AE?
CL Item
No action taken with investigational product(s) (1)
CL Item
Yes, actions were taken with investigational product(s) (2)
CL Item
Not applicable, AE occurred when not receiving investigational product(s) (3)
Item
Yes, tick all that apply
text
C0877248 (UMLS CUI [1,1])
C1704758 (UMLS CUI [1,2])
Adverse event, Action Taken with Study Treatment
Code List
Yes, tick all that apply
CL Item
Investigational product(s) withdrawn (1)
CL Item
Dose reduced (2)
CL Item
Dose interrupted (3)
CL Item
Dose delayed (4)
CL Item
Cycle interrupted (5)
CL Item
Cycle delayed (6)
CL Item
Infusion interrupted (7)
CL Item
Infusion delayed (8)
Item
Most clinically significant action taken with investigational product(s) as a Result of the AE
text
C0877248 (UMLS CUI [1,1])
C1704758 (UMLS CUI [1,2])
C2826293 (UMLS CUI [1,3])
Adverse Event, Action Taken with Study Treatment, Clinical Significance
Code List
Most clinically significant action taken with investigational product(s) as a Result of the AE
CL Item
Investigational product(s) withdrawn (1)
CL Item
Dose reduced (2)
CL Item
Dose increased (3)
CL Item
Dose not changed (4)
CL Item
Dose interrupted (5)
CL Item
Not applicable (6)
Adverse event, Withdraw
Item
Did the subject withdraw from study as a result of this AE?
boolean
C0877248 (UMLS CUI [1,1])
C2349954 (UMLS CUI [1,2])
Adverse event, Causations, Experimental drug
Item
Is there a reasonable possibility that the AE may have been caused by the investigational product?
boolean
C0877248 (UMLS CUI [1,1])
C0085978 (UMLS CUI [1,2])
C0304229 (UMLS CUI [1,3])
Item
Yes, Check all that apply
text
C0877248 (UMLS CUI [1,1])
C0085978 (UMLS CUI [1,2])
C0304229 (UMLS CUI [1,3])
Adverse event, Causations, Experimental drug
Code List
Yes, Check all that apply
CL Item
Lapatinib (1)
CL Item
Esomeprazole (2)
Adverse event, Duration
Item
Duration of AE if < 24 hours
time
C0877248 (UMLS CUI [1,1])
C2926735 (UMLS CUI [1,2])
Adverse event, Time of onset, Date last dose
Item
Time to onset since last dose
time
C0877248 (UMLS CUI [1,1])
C0449244 (UMLS CUI [1,2])
C1762893 (UMLS CUI [1,3])
Adverse event, dose-limiting, Drug toxicity
Item
Is this adverse event a dose-limiting toxicity during the determinative period?
boolean
C0877248 (UMLS CUI [1,1])
C1512043 (UMLS CUI [1,2])
C0013221 (UMLS CUI [1,3])
Adverse event, Therapeutic procedure, Concomitant Agent
Item
Were concomitant medications taken to treat this adverse event?
boolean
C0877248 (UMLS CUI [1,1])
C0087111 (UMLS CUI [1,2])
C2347852 (UMLS CUI [1,3])
Adverse event, Part, Start Date
Item
Start Date of Event Segment
date
C0877248 (UMLS CUI [1,1])
C0449719 (UMLS CUI [1,2])
C0808070 (UMLS CUI [1,3])
Item
Intensity of event segment
text
C0877248 (UMLS CUI [1,1])
C0449719 (UMLS CUI [1,2])
C0518690 (UMLS CUI [1,3])
Adverse event, Part, Symptom intensity
Code List
Intensity of event segment
CL Item
Mild (1)
CL Item
Moderate (2)
CL Item
Severe (3)
Item
Grade of event segment
text
C0877248 (UMLS CUI [1,1])
C0449719 (UMLS CUI [1,2])
C0441800 (UMLS CUI [1,3])
Adverse event, Part, Symptom intensity
Code List
Grade of event segment
CL Item
Grade 1 (1)
CL Item
Grade 2 (2)
CL Item
Grade 3 (3)
CL Item
Grade 4 (4)
CL Item
Grade 5 (5)
Item
Grade or Intensity of event segment
text
C0877248 (UMLS CUI [1,1])
C0449719 (UMLS CUI [1,2])
C0441800 (UMLS CUI [1,3])
C0518690 (UMLS CUI [1,4])
Adverse event, Part, Symptom intensity
Code List
Grade or Intensity of event segment
CL Item
Mild or Grade 1 (1)
CL Item
Moderate or Grade 2 (2)
CL Item
Severe or Grade 3 (3)
CL Item
Grade 4 (4)
CL Item
Grade 5 (5)
Adverse event, Therapeutic procedure, Start Date
Item
Start Date of Action(s)
date
C0877248 (UMLS CUI [1,1])
C0087111 (UMLS CUI [1,2])
C0808070 (UMLS CUI [1,3])
Item
Action taken with investigational product
text
C0877248 (UMLS CUI [1,1])
C1704758 (UMLS CUI [1,2])
Adverse event, Action Taken with Study Treatment
Code List
Action taken with investigational product
CL Item
Investigational product(s) withdrawn (1)
CL Item
Dose reduced (2)
CL Item
Dose interrupted (3)
CL Item
Dose delayed (4)
Item
Investigational product action is taken with
text
C0877248 (UMLS CUI [1,1])
C1704758 (UMLS CUI [1,2])
Adverse event, Action Taken with Study Treatment
Code List
Investigational product action is taken with
CL Item
Lapatinib (1)
CL Item
Esomeprazole (2)
Serious Adverse Event, Start Date
Item
Date event became serious (Date event met serious criteria)
date
C1519255 (UMLS CUI [1,1])
C0808070 (UMLS CUI [1,2])
Serious Adverse Event, End date
Item
Date event ceased to be serious
date
C1519255 (UMLS CUI [1,1])
C0806020 (UMLS CUI [1,2])
Item Group
Serious Adverse Events (SAE)
C1519255 (UMLS CUI-1)
Serious Adverse Event, Sequence Number
Item
SAE Sequence Number
integer
C1519255 (UMLS CUI [1,1])
C2348184 (UMLS CUI [1,2])
Item
Report
text
C3897642 (UMLS CUI [1])
Serious Adverse Event Report
Code List
Report
CL Item
Initial (1)
CL Item
Follow-Up (2)
Serious Adverse Event, Report, Start Date, Start time
Item
SAE form started
datetime
C1519255 (UMLS CUI [1,1])
C0684224 (UMLS CUI [1,2])
C0808070 (UMLS CUI [1,3])
C1301880 (UMLS CUI [1,4])
Item
Seriousness Reason(s)
text
C1519255 (UMLS CUI [1,1])
C0566251 (UMLS CUI [1,2])
undefined item
Code List
Seriousness Reason(s)
CL Item
Results in death  (1)
CL Item
Is life-threatening (2)
CL Item
Requires hospitalization or prolongation of existing hospitalization (3)
CL Item
Results in disability/incapacity (4)
CL Item
Congenital anomaly/birth defect  (5)
CL Item
Other, specify with general narrative comment (6)
Serious Adverse Event, Causations, Activities, Study Subject Participation Status
Item
Was SAE caused by activities related to study participation (e.g. procedures)?
boolean
C1519255 (UMLS CUI [1,1])
C0085978 (UMLS CUI [1,2])
C0441655 (UMLS CUI [1,3])
C2348568 (UMLS CUI [1,4])
Serious Adverse Event
Item
Serious Adverse Event
text
Serious Adverse Event, Adverse Event Modified Reported Term
Item
Modified term copied from adverse event form
text
C1519255 (UMLS CUI [1,1])
C2826798 (UMLS CUI [1,2])
Serious Adverse Event, Start Date
Item
Start date
date
C1519255 (UMLS CUI [1,1])
C0808070 (UMLS CUI [1,2])
Item
Outcome / End date
text
C1519255 (UMLS CUI [1,1])
C1705586 (UMLS CUI [1,2])
Serious Adverse Event, Adverse Event Outcome
Code List
Outcome / End date
CL Item
Recovered/Resolved, provide End Date and Time (1)
CL Item
Recovering/Resolving (2)
CL Item
Not recovered/Not resolved (3)
CL Item
Recovered/Resolved with sequelae, provide End Date and Time  (4)
CL Item
Fatal, record Date and Time of Death (5)
Serious Adverse Event, End date, End Time
Item
End Date and Time
datetime
C1519255 (UMLS CUI [1,1])
C0806020 (UMLS CUI [1,2])
C1522314 (UMLS CUI [1,3])
Serious Adverse Event, Date of death, Time of death
Item
Date and Time of Death
datetime
C1519255 (UMLS CUI [1,1])
C1302234 (UMLS CUI [1,2])
C1148348 (UMLS CUI [1,3])
C1301931 (UMLS CUI [1,4])
Item
Frequency
text
C1519255 (UMLS CUI [1,1])
C0439603 (UMLS CUI [1,2])
Serious Adverse Event, Frequencies
Code List
Frequency
CL Item
Single Episode (1)
CL Item
Intermittent (2)
Item
Maximum Intensity
text
C1519255 (UMLS CUI [1,1])
C0518690 (UMLS CUI [1,2])
C0806909 (UMLS CUI [1,3])
Serious Adverse Event, Symptom intensity, Maximum
Code List
Maximum Intensity
CL Item
Mild (1)
CL Item
Moderate (2)
CL Item
Severe  (3)
CL Item
Not applicable (4)
Item
Maximum grade
text
C1519255 (UMLS CUI [1,1])
C0441800 (UMLS CUI [1,2])
C0806909 (UMLS CUI [1,3])
Serious Adverse Event, Grade, Maximum
Code List
Maximum grade
CL Item
Grade 1 (1)
CL Item
Grade 2 (2)
CL Item
Grade 3 (3)
CL Item
Grade 4 (4)
CL Item
Grade 5 (5)
Item
Maximum Grade or Intensity
text
C1519255 (UMLS CUI [1,1])
C0441800 (UMLS CUI [1,2])
C0518690 (UMLS CUI [1,3])
C0806909 (UMLS CUI [1,4])
Serious Adverse Event, Grade, Symptom intensity, Maximum
Code List
Maximum Grade or Intensity
CL Item
Mild or Grade 1 (1)
CL Item
Moderate or Grade 2 (2)
CL Item
Severe or Grade 3 (3)
CL Item
Grade 4 (4)
CL Item
Grade 5 (5)
CL Item
Not applicable (6)
Serious Adverse Event, Toxicity aspects, Patient History
Item
Toxicity/Intensity History
text
C1519255 (UMLS CUI [1,1])
C0040539 (UMLS CUI [1,2])
C0679831 (UMLS CUI [1,3])
Item
Most clinically significant action taken with investigational product(s) as a Result of the AE
text
C1519255 (UMLS CUI [1,1])
C1704758 (UMLS CUI [1,2])
C2826293 (UMLS CUI [1,3])
Serious Adverse Event, Action Taken with Study Treatment, Clinical Significance
Code List
Most clinically significant action taken with investigational product(s) as a Result of the AE
CL Item
Investigational product(s) withdrawn (1)
CL Item
Dose reduced (2)
CL Item
Dose increased (3)
CL Item
Dose not changed (4)
CL Item
Dose interrupted (5)
CL Item
Not applicable (6)
Serious Adverse Event, Action Taken with Study Treatment
Item
Action(s) taken with Investigational Product
text
C1519255 (UMLS CUI [1,1])
C1704758 (UMLS CUI [1,2])
Serious Adverse Event, Withdraw
Item
Did the subject withdraw from study as a result of this AE?
boolean
C1519255 (UMLS CUI [1,1])
C2349954 (UMLS CUI [1,2])
Serious Adverse Event, Investigational New Drugs, Relationships
Item
Is there a reasonable possibility that the AE may have been caused by the investigational product?
text
C1519255 (UMLS CUI [1,1])
C0013230 (UMLS CUI [1,2])
C0439849 (UMLS CUI [1,3])
Serious Adverse Event, Duration
Item
Duration of AE if < 24 hours
time
C1519255 (UMLS CUI [1,1])
C2926735 (UMLS CUI [1,2])
Serious Adverse Event, Time of onset, Time last dose
Item
Time to onset since last dose
time
C1519255 (UMLS CUI [1,1])
C0449244 (UMLS CUI [1,2])
C0946444 (UMLS CUI [1,3])
Serious Adverse Event, Dose-limiting, Drug toxicity
Item
Is this adverse event a dose-limiting toxicity during the determinative period?
boolean
C1519255 (UMLS CUI [1,1])
C1512043 (UMLS CUI [1,2])
C0013221 (UMLS CUI [1,3])
Serious Adverse Event, Part
Item
Date segments adverse event was serious
date
C1519255 (UMLS CUI [1,1])
C0449719 (UMLS CUI [1,2])
Serious Adverse Event, Concomitant Agent
Item
Are there any relevant concomitant medications associated with this serious adverse event?
boolean
C1519255 (UMLS CUI [1,1])
C2347852 (UMLS CUI [1,2])
Serious Adverse Event, Concomitant Agent, Sequence Number
Item
Concomitant Medication - Sequence Number
integer
C1519255 (UMLS CUI [1,1])
C2347852 (UMLS CUI [1,2])
C2348184 (UMLS CUI [1,3])
Serious Adverse Event, Concomitant Agent, Medication name
Item
Concomitant Medication - Drug Name
text
C1519255 (UMLS CUI [1,1])
C2347852 (UMLS CUI [1,2])
C2360065 (UMLS CUI [1,3])
Serious Adverse Event, Concomitant Agent, Concomitant Medication Modified Reported Term
Item
Concomitant Medication - Modified reported term
text
C1519255 (UMLS CUI [1,1])
C2347852 (UMLS CUI [1,2])
C2826819 (UMLS CUI [1,3])
Serious Adverse Event, Concomitant Agent, Medication name
Item
Concomitant Medication - Drug Name
text
C1519255 (UMLS CUI [1,1])
C2347852 (UMLS CUI [1,2])
C2360065 (UMLS CUI [1,3])
Serious Adverse Event, Concomitant Agent, Dosage
Item
Concomitant Medication - Unit Dose
text
C1519255 (UMLS CUI [1,1])
C2347852 (UMLS CUI [1,2])
C0178602 (UMLS CUI [1,3])
Serious Adverse Event, Concomitant Agent, Unit of Measure
Item
Concomitant Medication - Units
text
C1519255 (UMLS CUI [1,1])
C2347852 (UMLS CUI [1,2])
C1519795 (UMLS CUI [1,3])
Serious Adverse Event, Concomitant Agent, Frequencies
Item
Concomitant Medication - Frequency
text
C1519255 (UMLS CUI [1,1])
C2347852 (UMLS CUI [1,2])
C0439603 (UMLS CUI [1,3])
Serious Adverse Event, Concomitant Agent, Drug Administration Routes
Item
Concomitant Medication - Route
text
C1519255 (UMLS CUI [1,1])
C2347852 (UMLS CUI [1,2])
C0013153 (UMLS CUI [1,3])
Serious Adverse Event, Concomitant Agent, Reason and justification
Item
Concomitant Medication - Reason for Medication
text
C1519255 (UMLS CUI [1,1])
C2347852 (UMLS CUI [1,2])
C0566251 (UMLS CUI [1,3])
Serious Adverse Event, Concomitant Agent, Concomitant Medication Modified Reported Term, Reason and justification
Item
Concomitant Medication - Reason for Medication Modified Report Term
text
C1519255 (UMLS CUI [1,1])
C2347852 (UMLS CUI [1,2])
C2826819 (UMLS CUI [1,3])
C0566251 (UMLS CUI [1,4])
Serious Adverse Event, Concomitant Agent, Start Date
Item
Concomitant Medication - Start Date
date
C1519255 (UMLS CUI [1,1])
C2347852 (UMLS CUI [1,2])
C0808070 (UMLS CUI [1,3])
Serious Adverse Event, Concomitant Agent, Concomitant Medication Ongoing
Item
Concomitant Medication - Ongoing?
boolean
C1519255 (UMLS CUI [1,1])
C2347852 (UMLS CUI [1,2])
C2826666 (UMLS CUI [1,3])
Serious Adverse Event, Concomitant Agent, End Date
Item
Concomitant Medication - No, End Date
date
C1519255 (UMLS CUI [1,1])
C2347852 (UMLS CUI [1,2])
C0806020 (UMLS CUI [1,3])
Serious Adverse Event, Concomitant Agent, Duration
Item
Concomitant Medication - Total Duration
time
C1519255 (UMLS CUI [1,1])
C2347852 (UMLS CUI [1,2])
C0449238 (UMLS CUI [1,3])
Serious Adverse Event, Concomitant Agent, Duration, Unit of Measure
Item
Concomitant Medication - Duration Unit
text
C1519255 (UMLS CUI [1,1])
C2347852 (UMLS CUI [1,2])
C0449238 (UMLS CUI [1,3])
C1519795 (UMLS CUI [1,4])
Serious Adverse Event, Experimental drug, Initiation
Item
Did SAE occur after initiation of study medication?
boolean
C1519255 (UMLS CUI [1,1])
C0304229 (UMLS CUI [1,2])
C1704686 (UMLS CUI [1,3])
Serious Adverse Event, Randomization, Numbers
Item
Randomization Number
integer
C1519255 (UMLS CUI [1,1])
C0034656 (UMLS CUI [1,2])
C0237753 (UMLS CUI [1,3])
Serious Adverse Event, Disease, Sequence Number
Item
Relevant Medical Conditions - MHx Sequence Number
integer
C1519255 (UMLS CUI [1,1])
C0012634 (UMLS CUI [1,2])
C2348184 (UMLS CUI [1,3])
Serious Adverse Event, Disease
Item
Relevant Medical Conditions - Specific Condition Name
text
C1519255 (UMLS CUI [1,1])
C0012634 (UMLS CUI [1,2])
C2348184 (UMLS CUI [1,3])
Serious Adverse Event, Disease, Adverse Event Modified Reported Term
Item
Relevant Medical Conditions - Modified reported term
text
C1519255 (UMLS CUI [1,1])
C0012634 (UMLS CUI [1,2])
C2826798 (UMLS CUI [1,3])
Serious Adverse Event, Disease, Date of onset
Item
Relevant Medical Conditions - Date of onset
date
C1519255 (UMLS CUI [1,1])
C0012634 (UMLS CUI [1,2])
C0574845 (UMLS CUI [1,3])
Serious Adverse Event, Disease, Continuous
Item
Relevant Medical Conditions - Continuing?
boolean
C1519255 (UMLS CUI [1,1])
C0012634 (UMLS CUI [1,2])
C0549178 (UMLS CUI [1,3])
Serious Adverse Event, Disease, End date
Item
Relevant Medical Conditions - No, specify date of last occurrence
date
C1519255 (UMLS CUI [1,1])
C0012634 (UMLS CUI [1,2])
C0806020 (UMLS CUI [1,3])
Serious Adverse Event, diagnostic procedure, Sequence Number
Item
Relevant Diagnostic Results - Lab Sequence Number
integer
C1519255 (UMLS CUI [1,1])
C0430022 (UMLS CUI [1,2])
C2348184 (UMLS CUI [1,3])
Serious Adverse Event, diagnostic procedure, Test Name
Item
Relevant Diagnostic Results - Test Name
text
C1519255 (UMLS CUI [1,1])
C0430022 (UMLS CUI [1,2])
C2826273 (UMLS CUI [1,3])
Serious Adverse Event, diagnostic procedure, Date in time
Item
Relevant Diagnostic Results - Test Date
date
C1519255 (UMLS CUI [1,1])
C0430022 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
Serious Adverse Event, diagnostic procedure, Result
Item
Relevant Diagnostic Results - Test Result
text
C1519255 (UMLS CUI [1,1])
C0430022 (UMLS CUI [1,2])
C1274040 (UMLS CUI [1,3])
Serious Adverse Event, diagnostic procedure, Unit of Measure
Item
Relevant Diagnostic Results - Test Units
text
C1519255 (UMLS CUI [1,1])
C0430022 (UMLS CUI [1,2])
C1519795 (UMLS CUI [1,3])
Serious Adverse Event, diagnostic procedure, Normal Range, Low
Item
Relevant Diagnostic Results - Normal Low Range
text
C1519255 (UMLS CUI [1,1])
C0430022 (UMLS CUI [1,2])
C0086715 (UMLS CUI [1,3])
C0205251 (UMLS CUI [1,4])
Serious Adverse Event, diagnostic procedure, Normal Range, High
Item
Relevant Diagnostic Results - Normal High Range
text
C1519255 (UMLS CUI [1,1])
C0430022 (UMLS CUI [1,2])
C0086715 (UMLS CUI [1,3])
C0205250 (UMLS CUI [1,4])
Serious Adverse Event, diagnostic procedure, Result, Other
Item
Relevant Diagnostic Results - Relevant diagnostic results not noted above
text
C1519255 (UMLS CUI [1,1])
C0430022 (UMLS CUI [1,2])
C1274040 (UMLS CUI [1,3])
C0205394 (UMLS CUI [1,4])
Serious Adverse Event, Relationships, Experimental drug
Item
Rechallenge - If investigational product(s) were stopped temporarily, did the reported event(s) recur after investigational products were restarted?
text
C1518404 (UMLS CUI [1,1])
C0439849 (UMLS CUI [1,2])
C0304229 (UMLS CUI [1,3])
Serious Adverse Event, Experimental drug
Item
Investigational Product - Study Drug
text
C1519255 (UMLS CUI [1,1])
C0304229 (UMLS CUI [1,2])
C0808070 (UMLS CUI [1,3])
Serious Adverse Event, Experimental drug, Start Date
Item
Investigational Product - Start Date
date
C1519255 (UMLS CUI [1,1])
C0304229 (UMLS CUI [1,2])
C0808070 (UMLS CUI [1,3])
Serious Adverse Event, Experimental drug, End Date
Item
Investigational Product - Stop Date
date
C1519255 (UMLS CUI [1,1])
C0304229 (UMLS CUI [1,2])
C0806020 (UMLS CUI [1,3])
Serious Adverse Event, Experimental drug, Dosage
Item
Investigational Product - Dose
text
C1519255 (UMLS CUI [1,1])
C0304229 (UMLS CUI [1,2])
C0178602 (UMLS CUI [1,3])
Serious Adverse Event, Experimental drug, Cumulative Dose
Item
Investigational Product - Cumulative Dose
text
C1519255 (UMLS CUI [1,1])
C0304229 (UMLS CUI [1,2])
C2986497 (UMLS CUI [1,3])
Serious Adverse Event, Comment
Item
General Narrative Comments
text
C1519255 (UMLS CUI [1,1])
C0947611 (UMLS CUI [1,2])
Item Group
Concomitant Medications - Repeating Form
C2347852 (UMLS CUI-1)
Concomitant Agent, Sequence Number
Item
Sequence Number
integer
C2347852 (UMLS CUI [1,1])
C2348184 (UMLS CUI [1,2])
Concomitant Agent, Medication name
Item
Drug Name
text
C2347852 (UMLS CUI [1,1])
C2360065 (UMLS CUI [1,2])
Concomitant Agent, Concomitant Medication Modified Reported Term
Item
Modified reported term
text
C2347852 (UMLS CUI [1,1])
C2826819 (UMLS CUI [1,2])
Concomitant Agent, Code, Failed
Item
Failed coding
text
C2347852 (UMLS CUI [1,1])
C0805701 (UMLS CUI [1,2])
C0231175 (UMLS CUI [1,3])
Concomitant Agent, Dosage
Item
Unit Dose
text
C2347852 (UMLS CUI [1,1])
C0178602 (UMLS CUI [1,2])
Concomitant Agent, Unit of Measure
Item
Units
text
C2347852 (UMLS CUI [1,1])
C1519795 (UMLS CUI [1,2])
Concomitant Agent, Frequencies
Item
Frequency
text
C2347852 (UMLS CUI [1,1])
C0439603 (UMLS CUI [1,2])
Concomitant Agent, Drug Administration Routes
Item
Route
text
C2347852 (UMLS CUI [1,1])
C0013153 (UMLS CUI [1,2])
Concomitant Agent, Reason and justification
Item
Reason for Medication
text
C2347852 (UMLS CUI [1,1])
C0566251 (UMLS CUI [1,2])
Concomitant Medication Start Date
Item
Start Date
date
C2826734 (UMLS CUI [1])
Concomitant Medication Previous Occurrence
Item
Taken Prior to Study?
boolean
C2826667 (UMLS CUI [1])
Concomitant Medication Ongoing
Item
Ongoing?
boolean
C2826666 (UMLS CUI [1])
Concomitant Medication End Date
Item
No, specify End Date
date
C2826744 (UMLS CUI [1])
Concomitant Agent, Devices, Medication administered
Item
Device Used to Administer Medication
text
C2347852 (UMLS CUI [1,1])
C0699733 (UMLS CUI [1,2])
C0806914 (UMLS CUI [1,3])
Concomitant Agent, Daily Dose, Total
Item
Total Daily Dose
text
C2347852 (UMLS CUI [1,1])
C2348070 (UMLS CUI [1,2])
C0439810 (UMLS CUI [1,3])
Concomitant Agent, Disease Exacerbation
Item
Was drug administered for an exacerbation?
boolean
C2347852 (UMLS CUI [1,1])
C0235874 (UMLS CUI [1,2])
Concomitant Agent, Rescue remedy
Item
Was drug administered as a rescue medication?
boolean
C2347852 (UMLS CUI [1,1])
C0884980 (UMLS CUI [1,2])
Concomitant Agent, Cumulative Dose
Item
Cumulative Dose Used?
boolean
C2347852 (UMLS CUI [1,1])
C2986497 (UMLS CUI [1,2])
Concomitant Agent
Item
Was drug ever used?
boolean
C2347852 (UMLS CUI [1])
Concomitant Agent, Duration, Total
Item
Total Duration
text
C2347852 (UMLS CUI [1,1])
C0449238 (UMLS CUI [1,2])
C0439810 (UMLS CUI [1,3])
Concomitant Agent, Duration, Unit of Measure
Item
Duration Unit
text
C2347852 (UMLS CUI [1,1])
C0449238 (UMLS CUI [1,2])
C1519795 (UMLS CUI [1,3])
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