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Medical History Taking ×
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Table of contents
  1. 1. Clinical Trial
  2. 2. Routine Documentation
  3. 3. Registry/Cohort Study
  4. 4. Quality Assurance
  5. 5. Data Standard
  6. 6. Patient-Reported Outcome
  7. 7. Medical Specialty
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590 Search results.

Telemedical Interventional Management in Heart Failure II (TIM-HF II) NCT01878630 - Baseline Visit

- 11/14/17 - 1 form, 10 itemgroups, 71 items, 2 languages
Itemgroups: Physical Examination / Medical History taking, Signs and Symptoms of heart failure, Cardiovascular Diseases, Comorbidities, Current medication, Cardiovascular interventions, Implantation of a cardiac device, Hematology, ECG, Baseline visit
Short title: TIM-HF II Permission to publish granted by: Prof. Dr. Friedrich Köhler, FESC Charité - Universitätsmedizin Berlin Further study details on: https://www.clinicaltrials.gov/ct2/show/NCT01878630 Baseline Visit (BV-Form)

26672_Common Data Elements Myeloid Leukemia (MDS AML CML) - Global Disease Course

- 4/21/18 - 13 forms, 3 itemgroups, 11 items, 1 language
Itemgroups: Global Disease Course, Red Cell Transfusion, Platelet Cell Transfusion
Common Data Elements Myeloid Leukemia (MDS, AML, CML) for use in clinical routine and clinical trial documentation. https://www.ncbi.nlm.nih.gov/pubmed/27577388

Physical Examination/Follow up

3 itemgroups, 14 items31

Administrative/Demographic Details

1 itemgroup, 11 items31

Apparatus-based Diagnostics

1 itemgroup, 4 items31

Medical History

3 itemgroups, 9 items31
8 more forms meeting the search are available in the detailed view.

Family history - HIS

- 6/4/17 - 1 form, 3 itemgroups, 33 items, 2 languages
Itemgroups: Maternal Family History, Paternal Family History, Siblings Family History
Form from HIS OpenVistA

CDASH Medical History

- 6/20/18 - 1 form, 4 itemgroups, 13 items, 3 languages
Itemgroups: General information, High Blood Pressure, Appendectomy, Other
modified from http://www.cdisc.org

EHR4CR Complete Data Inventory - EHR4CR Data Inventory

- 2/10/17 - 1 form, 13 itemgroups, 122 items, 1 language
Itemgroups: Demographics, Diagnoses and Procedures, Vital Signs, Laboratory, Generic Laboratory Data, Medication, Adverse Events, Medical History, Clinical Findings, ECG, Patient Reported Outcome, Substance Use, Study Participation Status
Compilation of Feasibility, Patient Identification & Recruitment and Clinical Trial Execution data inventories. https://www.ncbi.nlm.nih.gov/pubmed/24410735 https://www.ncbi.nlm.nih.gov/pubmed/25991199 https://www.ncbi.nlm.nih.gov/pubmed/27875988

Persönliches Interview SHIP-Trend-1 Herz-Kreislauf-Erkrankungen

- 11/2/17 - 1 form, 1 itemgroup, 5 items, 1 language
Itemgroup: Herz-Kreislauf-Erkrankungen
Herz-Kreislauf-Erkrankungen form of SHIP Study (Study of Health in Pomerania), conducted by the University of Greifswald. SHIP unique domain name TREND.TREND1.INT.KHK.KHK. ODM derived from https://www.fvcm.med.uni-greifswald.de/dd_service/data_use_explore.php. Further information: http://www2.medizin.uni-greifswald.de/cm/fv/ship.html.
 Publication granted by Prof. Völzke. Reference: Völzke H, et al. Cohort profile: the study of health in Pomerania. Int J Epidemiol. 2011;40(2):294-307. PMID: 20167617

HIS Review of Systems - HIS

- 5/21/14 - 1 form, 13 itemgroups, 111 items, 2 languages
Itemgroups: GENERAL, EYE, EAR, NOSE, MOUTH, RESPIRATORY, CARDIOVASCULAR, GASTROINTESTINAL, GENITOURINARY, MUSCULOSKELETAL, NEUROLOGIC, PAIN, GERIATRIC
Form from HIS OpenVistA

Efficacy and Safety of GSK163090 in Subjects with Major Depressive Disorder; NCT00896363 - Psychiatric History

- 11/17/19 - 1 form, 2 itemgroups, 92 items, 1 language
Itemgroups: Psychiatric History, Psychiatric History, Mental disorder, Other
Study ID: 109035 Clinical Study ID: 109035 Study Title: A Randomised, Double-Blind, Parallel-Group, Placebo-Controlled Study Evaluating the Efficacy and Safety of GSK163090 in Subjects With Major Depressive Disorder Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00896363 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 2 Study Recruitment Status: Completed Generic Name: GSK163090 1 mg, GSK163090 Placebo, GSK163090 3 mg Trade Name: Study Indication: Depressive Disorder

Polysomnographic Assessment of Vestipitant for the Treatment of Primary Insomnia NCT00992160 - Medical Conditions

- 11/10/19 - 1 form, 2 itemgroups, 7 items, 1 language
Itemgroups: Administrative Data, Medical Conditions
Study ID: 111364 Clinical Study ID: 111364 Study Title: A 28-Day, Polysomnographic and subjective assessment of Vestipitant (15mg/day) for the treatment of Primary Insomnia in adult Outpatients Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00992160 Clinicaltrials.gov Links: https://clinicaltrials.gov/ct2/show/NCT00992160 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 2 Study Recruitment Status: Completed Generic Name: Vestipitant, Placebo Trade Name: N/A Study Indication: Primary Insomnia, Sleep Disorders This phase II, placebo-controlled, double-blind trial studies the polysomnographic and subjective effect of the neurokinin (NK1) antagonist vestipitant (15mg/day at bedtime) for the treatment of primary insomnia in adult outpatients over a period of four weeks. The study consists of a clinical Screening Visit (Visit 1), up to 21 days before investigational product/placebo initiation, two screening polysomnographies (Visits 2 and 3), followed by a placebo run-in until Visit 4, at which the subject is randomized to vestipitant or placebo, taken every night for 28 days. On Day 1 and 2 (Visits 4 and 5), polysomnographies are performed. Visit 6 is a safety visit on Day 15. On Day 27 and 28, Visits 7 and 8 are performed, which again include polysomnography studies. Subjects then undergo a 7 to 10 day placebo run-out period and have Day 7 and Day 14 Follow-Up Visit (Visits 9 and 10). The purpose of this form is to record the subjects current medical conditions and should be filled out at Visit 1 (Screening) and Visit 2.

Kerndatensatz Herzinsuffizienz DZHI (Core data set heart failure CHFC) - Anamnese der Herzinsuffizienz (Anamnesis heart failure)

- 11/5/19 - 1 form, 8 itemgroups, 63 items, 1 language
Itemgroups: Logistics, Sociodemographic data, Cardiac Diagnosis, Former cardiac intervention, Cardiovascular risk factors / family history, Comorbidities, Medication, ESC-Guidelines
Core data set on heart failure, developed by the Comprehensive Heart Failure Center (CHFC). The CHFC researches and treats the complex disease heart failure and its comorbidities in a comprehensive approach. This form contains information about the anamnesis of a possible heart failure. Kerndatensatz zu Herzinsuffizienz, entwickelt vom Deutschen Zentrum für Herzinsuffizienz (DZHI). Das DZHI erforscht und therapiert in einem ganzheitlichen Ansatz die Systemerkrankung Herzinsuffizienz samt ihrer Begleit- und Folgeerkrankungen. Dieses Formular enthält Information zur Anamnese einer Herzinsuffizienz.

Kerndatensatz Herzinsuffizienz DZHI (Core data set heart failure CHFC) - Scores, Symptome und Zeichen von Herzinsuffizienz (Scores, Symptoms and signs heart failure)

- 11/4/19 - 1 form, 4 itemgroups, 15 items, 1 language
Itemgroups: Logistics, NYHA, LQ, Symptoms and signs of heart failure
Core data set on heart failure, developed by the Comprehensive Heart Failure Center (CHFC). The CHFC researches and treats the complex disease heart failure and its comorbidities in a comprehensive approach. This form contains information about scores, symptoms and signs of heart failure Kerndatensatz zu Herzinsuffizienz, entwickelt vom Deutschen Zentrum für Herzinsuffizienz (DZHI). Das DZHI erforscht und therapiert in einem ganzheitlichen Ansatz die Systemerkrankung Herzinsuffizienz samt ihrer Begleit- und Folgeerkrankungen. Dieses Formular enthält Informationen über Scores, Symptome und Zeichen einer Herzinsuffizienz.

clinic internal medicine B SHIP-3 Preparation Innere

- 10/30/19 - 1 form, 1 itemgroup, 34 items, 2 languages
Itemgroup: Preparation Innere
Preparation Innere form of SHIP Study (Study of Health in Pomerania), conducted by the University Medicine of Greifswald. SHIP unique domain name SHIP.SHIP3.IMB.OPDB.PRE. ODM derived from https://www.fvcm.med.uni-greifswald.de/dd_service/data_use_explore.php. Further information: http://www2.medizin.uni-greifswald.de/cm/fv/ship.html. Publication granted by Prof. Völzke. Reference: Völzke H, et al. Cohort profile: the study of health in Pomerania. Int J Epidemiol. 2011;40(2):294-307. PMID: 20167617 The English version of this form is under development.