Resultados da pesquisa - Portal para modelos de dados médicos (portal MDM)

Pediatric oncology (Kinderonkologie) - Medical history (Anamnese)

- 27/09/2021 - 1 Formulário, 8 Grupos de itens, 74 Elementos de dados, 2 Idiomas

Grupos de itens: Pregnancy, Childbirth, Postpartum development, Kindergarten / school, Puberty stage, Other information, Physical examination basic information, Physical examination (further information)

This form about medical history originates from the Department of Pediatric Oncology, Hematology and Clinical Immunology of the University Hospital Düsseldorf.

Swedish Heart Failure Registry (RiksSvikt) - SHFR Hospital

- 20/09/2021 - 1 Formulário, 9 Grupos de itens, 93 Elementos de dados, 2 Idiomas

Grupos de itens: Demography and Lifestyle, Patient self rated symptoms, Previous diseases, Performed procedures, Diagnostics, Biometrics and physical signs, Medication treatment, Patient and relative Information, Planned Follow-Up

Swedish Heart Failure Registry (RiksSvikt/SwedeHF) Sweden has a long tradition of measuring results and performance of the given health care. In order to stimulate to achieve better results, we try to find explanations for the discrepancies between different regions/hospitals/primary care units. In recent years, quality registries have become an increasingly important source of Swedish clinical research. SwedeHF (or RiksSvikt) was created in order to give the participating units knowledge, about how they diagnosed and treated their patients. The given information obtains indications where further efforts are needed in order to give patients with heart failure an optimal management. SwedeHF is an Internet-based registry, where participating units register their heart failure patient on-line, using transferred data from standardized forms or from computerized patients records. SHFR Hospital

ASIA Score

- 20/09/2021 - 1 Formulário, 1 Grupo de itens, 154 Elementos de dados, 2 Idiomas

Grupo de itens: ASIA Classification

Original Form name: ASIA Score. INTERNATIONAL STANDARDS FOR NEUROLOGICAL CLASSIFICATION OF SPINAL CORD INJURY (ISNCSCI) Owner: American Spinal Injury Association. Used as Hospital Routine Documentation Form at the University Hospital Muenster.

Patient Admision Pediatric Hematology and Oncology UK Muenster

- 20/09/2021 - 1 Formulário, 18 Grupos de itens, 195 Elementos de dados, 2 Idiomas

Grupos de itens: Patient, Father, Mother, Living arrangement, Sibling, Medical history, Nursing support, Support device, Personal aids, School, Kindergarten, workshop, Therapies in school, kindergarten, workshop, Medication, Medication history, Therapy, Nutrition, Continence, Catheters and drainages, Other

Freigabe zur Verarbeitung durch Frau Prof. Rössig, Quellenangabe: "Pädiatrische Hämatologie und Onkologie, UKM" Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Münster Released for adaption by Frau Prof. Rössig Source:Pediatric Hematology und Oncology, University hospital Münster

Persönliches Interview SHIP-Trend-1 Impfstatus

- 20/09/2021 - 1 Formulário, 1 Grupo de itens, 18 Elementos de dados, 1 Idioma

Grupo de itens: Impfstatus

Impfstatus form of SHIP Study (Study of Health in Pomerania), conducted by the University of Greifswald. SHIP unique domain name TREND.TREND1.INT.INFEKT.INFEKT. 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

Lifestyle Questionnaire GSK study Chronic Coronary Heart Disease NCT00799903

- 20/09/2021 - 1 Formulário, 11 Grupos de itens, 73 Elementos de dados, 1 Idioma

Grupos de itens: Diet, Alcoholic drinks, Weekly activity, Physical activity, Health-related limitations in physical activity, Symptoms limiting physical activity, Sleep, Stress assessment, Lifestyle comparison before and after heart problem, Lifestyle since first heart problem, Socio-economic

Study ID: 100601 Clinical Study ID: LPL100601 Study Title: LPL100601, A Clinical Outcomes Study of Darapladib versus Placebo in Subjects with Chronic Coronary Heart Disease to Compare the Incidence of Major Adverse Cardiovascular Events (MACE) Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00799903 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: phase 3 Study Recruitment Status: Completed Generic Name: darapladib Trade Name: darapladib Study Indication: Atherosclerosis Study part: Lifestyle Questionnaire.

Efficacy and Tolerability of TREXIMA™ (sumatriptan 85mg/naproxen sodium 500mg) ID 101999 - Headache Impact Test (HIT-6) Score, IHS Headache Classification, Migraine History, Previous Treatment for Migraine

- 20/09/2021 - 1 Formulário, 5 Grupos de itens, 33 Elementos de dados, 1 Idioma

Grupos de itens: Administrative Data, Head Impact Test (HIT-6) Score, IHS Headache Classification1, Migraine History, Previous Treatment for Migraine

This ODM-file contains the form to document the Head impact test (HIT-6) Score, the IHS Headache classification, the migraine history and the previous migraine treatment. To be assessed at screening. Study ID: 101999 Clinical Study ID: 101999 Study Title: A randomized, double-blind, parallel group, placebo-controlled, single-attack evaluation of the efficacy and tolerability of TREXIMA™ (sumatriptan 85mg/naproxen sodium 500mg)* tablets vs placebo when administered during the mild pain phase of a migraine Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 3 Study Recruitment Status: Completed Generic Name: sumatriptan Trade Name: Imitrex ,Imiject ,Imigran Study Indication: Migraine Disorders

Iodine 131 B1 Antibody for B-Cell Lymphomas NCT00950755 - History of Lymphoma

- 20/09/2021 - 1 Formulário, 5 Grupos de itens, 21 Elementos de dados, 1 Idioma

Grupos de itens: Administrative Data, Cell Type, Grade, Extranodal Involvement at Enrollment, CD20 Reactivity

Study ID: 104505 Clinical Study ID: BEX104505 Study Title: Phase II Study of Iodine 131 Anti B1 Antibody for 1st or 2nd Relapsed Indolent B-Cell Lymphomas or B-Cell Lymphomas That Have Transformed to a More Aggressive Histology Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00950755 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 2 Study Recruitment Status: Completed Generic Name: tositumomab Trade Name: Bexxar Study Indication: Lymphoma, Non-Hodgkin

Dutasteride Relative Bioavailability Soft Gelatine Capsules ID 103880 - Medical History, Physical Examination, Vital Signs and ECG (Screening)

- 20/09/2021 - 1 Formulário, 5 Grupos de itens, 39 Elementos de dados, 1 Idioma

Grupos de itens: Administrative Data, Medical Conditions, Physical Examination, Vital Signs, ECG

This ODM file contains the form to document the physical examination, ecg, vital signs and medical history. To be assessed at screening. Study ID: 103880 Clinical Study ID: ARI103880 Study Title: An open label, single dose, randomized, three period crossover study to investigate the relative bioavailability of 0.5 mg of dutasteride from soft gelatin capsules (reference) vs. soft gelatin capsules containing two investigational formulations in healthy male volunteers. Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier:N/A Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 1 Study Recruitment Status: Completed Generic Name: dutasteride Trade Name: Duagen,Zytefor,Avolve,Avodart,Avidart,Zyfetor; Zytefor,Zyfetor,Duagen,Avolve,Avodart,Avidart Study Indication: Prostatic Hyperplasia

Eligibility, Medical History, Vital Signs - Ropinirole and the effect of food in early stage Parkinson’s disease subjects 101468/164

- 20/09/2021 - 1 Formulário, 10 Grupos de itens, 61 Elementos de dados, 1 Idioma

Grupos de itens: Inclusion Criteria, Exclusion Criteria, Demographics, Medical history, Parkinson's disease Surgical history, Allergies, Parkinson's disease history, 12-lead electrocardiogram report, orthostatic blood pressure / Pulse, Pregnancy test

Eligibility, Medical History, Vital Signs - Ropinirole and the effect of food in early stage Parkinson’s disease subjects 101468/164 Study ID: 101468/164 Clinical Study ID: 101468/164 Study Title: An open-label, randomised, two part study to investigate the relative bioavailability of Ropinirole new and standard, marketed formulations and the effect of food on the pharmacokinetics of Ropinirole new formulation in early stage Parkinson’s disease subjects 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: ropinirole Trade Name: Modutab,ZIPEREVE,ZEPREVE,REPREVE,ADARTREL,REQUIP,Zygara; Zygara,ZIPEREVE,ZEPREVE,Requip Depot,REQUIP,REPREVE,Modutab,ADARTREL Study Indication: Restless Legs Syndrome

Immune Persistence of GSK Biologicals' Combined Hepatitis A / Hepatitis B Vaccine in Healthy Adult Volunteers NCT00289718 - Long-Term Follow Up (Year 12, Visit 1) - Informed Consent; Demographics; General medical history/ Physical examination; Laboratory Tests; Blood sample conclusion; Vaccine Administration; Unsolicited Adverse Events; Solicited Adverse Events - Local and General Symptoms

- 20/09/2021 - 1 Formulário, 12 Grupos de itens, 101 Elementos de dados, 1 Idioma

Grupos de itens: Administration, Demographics, General Medical History / Physical Examination, Medical Condition, Laboratory Tests, HCG Urine Pregnancy Test, Blood Sample Conclusion, Vaccine Administration, Vaccine Administration, Unsolicited Adverse Events, Solicited Adverse Events - Local Symptoms, Solicited Adverse Events - General Symptoms

Study ID: 100556 (Y11) Clinical Study ID: 100556 Study Title: Long-Term Persistence Follow-up Study to Evaluate the Immune Persistence of GSK Biologicals' Combined Hepatitis A / Hepatitis B Vaccine in Healthy Adult Volunteers Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00289718 Sponsor: GlaxoSmithKline Phase: phase 3 Study Recruitment Status: Completed Generic Name: Hepatitis A (Inactivated), Hepatitis B (Recombinant) Vaccine Trade Name: Twinrix Study Indication: Hepatitis A; Hepatitis B

Visit 1 Ponderosa CML ZKSJ0083 - Visit 1

- 20/09/2021 - 1 Formulário, 11 Grupos de itens, 191 Elementos de dados, 1 Idioma

Grupos de itens: Inclusion Criteria, Exclusion Criteria, Informed consent, Demographics, Myeloid Leukemia, Chronic, therapy CML, Patient medical history, medical history, Blood pressure, Laboratory parameters, Treatment

Study part: Visit 1.Observational study on CML patients in any phase treated with ponatinib (Iclusig®) at any dose. Principal Investigator Prof. Dr. A. Hochhaus.

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