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Tinnitus Protocol PhenX Toolkit

- 2016-12-18 - 1 Formulär, 1 Item-grupp, 25 Dataelement, 2 Språk
Item-grupp: PhenX - tinnitus protocol
The Tinnitus Handicap Inventory is a 25-item self-administered questionnaire that assesses the impact of tinnitus on the respondent’s general well-being. The Tinnitus Handicap Inventory includes a functional subscale (11 items) that measures limitations of mental, social, and physical functioning; an emotional subscale (9 items) that assesses affective responses such as anger and frustration; and a catastrophic subscale (5 items) that measures items such as desperation. The protocol also includes scoring instructions. ODM derived from: https://cde.nlm.nih.gov Primary source: https://www.phenxtoolkit.org/ Recent publication: Hendershot, T., Pan, H., Haines, J., Harlan, W.R., Marazita, M.L., McCarty, C.A., Ramos, E.M., and Hamilton, C.M. (2015) Using the PhenX toolkit to add standard measures to a study. Curr. Protoc. Hum. Genet. 86:1.21.1-1.21.17. doi: 10.1002/0471142905.hg0121s86 Permission to publish granted by Carol M. Hamilton.

Vertigo Protocol PhenX Toolkit

- 2017-02-19 - 1 Formulär, 1 Item-grupp, 25 Dataelement, 2 Språk
Item-grupp: PhenX - vertigo protocol
The Dizziness Handicap Inventory (DHI) assesses perceived disability due to dizziness (i.e., vertigo). This 25-item self-administered questionnaire contains three subscales which cover the areas of function, emotion, and physical aspects. Points from each subscale can be combined to assign a total score, or they can be combined by subscale. ODM derived from: https://cde.nlm.nih.gov Primary source: https://www.phenxtoolkit.org/ Recent publication: Hendershot, T., Pan, H., Haines, J., Harlan, W.R., Marazita, M.L., McCarty, C.A., Ramos, E.M., and Hamilton, C.M. (2015) Using the PhenX toolkit to add standard measures to a study. Curr. Protoc. Hum. Genet. 86:1.21.1-1.21.17. doi: 10.1002/0471142905.hg0121s86 German translation: Kurre A, van Gool CJ, Bastianen CH et al. Translation, cross-cultural adaptation and reliability of the German version of the Dizziness Handicap Inventory. Otol Neurotol 2009; 30: 359–367 Permission to publish granted by Carol M. Hamilton.

medical examination SHIP-Trend-0 swabs: nose, mouth, throat

- 2017-11-15 - 1 Formulär, 1 Item-grupp, 25 Dataelement, 2 Språk
Item-grupp: swabs: nose, mouth, throat
swabs: nose, mouth, throat form of SHIP Study (Study of Health in Pomerania), conducted by the University of Greifswald. SHIP unique domain name SHIP.SHIPTrend0.MEX.BIOMAT.ABSTRICHE. 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

Early Childhood Speech and Language Assessment - Speech and Language Assessment Scale PhenX Toolkit

- 2016-04-25 - 1 Formulär, 1 Item-grupp, 19 Dataelement, 1 Språk
Item-grupp: PhenX - early childhood speech and language assessment protocol - speech and language assessment scale
The Speech and Language Assessment Scale (SLAS) is a 19-item, parent-report questionnaire designed to identify children with delayed speech and language skills. The SLAS uses seven-point Likert-style questions to assess six subscales: assertiveness, responsiveness, semantics, syntax, articulation, and talkativeness. The protocol includes instructions to generate composite scale scores. ODM derived from: https://cde.nlm.nih.gov Primary source: https://www.phenxtoolkit.org/ Recent publication: Hendershot, T., Pan, H., Haines, J., Harlan, W.R., Marazita, M.L., McCarty, C.A., Ramos, E.M., and Hamilton, C.M. (2015) Using the PhenX toolkit to add standard measures to a study. Curr. Protoc. Hum. Genet. 86:1.21.1-1.21.17. doi: 10.1002/0471142905.hg0121s86 Permission to publish granted by Carol M. Hamilton.

Moxaverine 200mg p.o. in patients with central nervous vertigo - Case report form Visit 1

- 2016-01-25 - 1 Formulär, 10 Item-grupper, 65 Dataelement, 1 Språk
Item-grupper: Demographic Information, neurological preliminary assessment, otorhinolaryngologic preliminary assessment, Eligibility, Inclusion criteria, Exclusion criteria, otorhinolaryngologic examination, Posturography, Tasks of investigator during this visit, Comorbidities and concomitant Medication
Placebo controlled,double blind and randomized parallel group trial to verify effectivity and tolerability of moxaverine p.o. in patients with central nervous vertigo. Sponsor: URSAPHARM Industriestrasse 66129 Saarbrücken Phone 06805-9292-0 Fax 06805- 929288 Head of clinical trial: Univ.-Prof.Dr.med. Ralph Mösges Medical Faculty, University of Cologne Phone 0221-4783456 Fax 0221-4783465

Moxaverine 200mg p.o. in patients with central nervous vertigo 3 - Case report form Visit 3

- 2016-01-13 - 1 Formulär, 7 Item-grupper, 41 Dataelement, 1 Språk
Item-grupper: Demographic Information, otorhinolaryngologic examination, Posturography, Tasks of investigator during this visit, Comorbidities and concomitant Medication, General impression regarding the trial, Adverse reactions
Placebo controlled,double blind and randomized parallel group trial to verify effectivity and tolerability of moxaverine p.o. in patients with central nervous vertigo. Sponsor: URSAPHARM Industriestrasse 66129 Saarbrücken Phone 06805-9292-0 Fax 06805- 929288 Head of clinical trial: Univ.-Prof.Dr.med. Ralph Mösges Medical Faculty, University of Cologne Phone 0221-4783456 Fax 0221-4783465

Moxaverine 200mg p.o. in patients with central nervous vertigo 2 - Case report form Visit 2

- 2016-01-13 - 1 Formulär, 7 Item-grupper, 41 Dataelement, 1 Språk
Item-grupper: Patient Identification, otorhinolaryngologic examination, Posturography, Tasks of investigator during this visit, Comorbidities and concomitant Medication, General impression regarding the trial, Adverse reactions
Placebo controlled,double blind and randomized parallel group trial to verify effectivity and tolerability of moxaverine p.o. in patients with central nervous vertigo. Sponsor: URSAPHARM Industriestrasse 66129 Saarbrücken Phone 06805-9292-0 Fax 06805- 929288 Head of clinical trial: Univ.-Prof.Dr.med. Ralph Mösges Medical Faculty, University of Cologne Phone 0221-4783456 Fax 0221-4783465

Moxaverine 200mg p.o. in patients with central nervous vertigo Visit 4 - Case report form Visit 4

- 2016-01-12 - 1 Formulär, 8 Item-grupper, 49 Dataelement, 1 Språk
Item-grupper: Patient Identification, otorhinolaryngologic examination, Posturography, Tasks of investigator during this visit, Comorbidities and concomitant Medication, General impression regarding the trial, Adverse reactions, Final report
Placebo controlled,double blind and randomized parallel group trial to verify effectivity and tolerability of moxaverine p.o. in patients with central nervous vertigo. Sponsor: URSAPHARM Industriestrasse 66129 Saarbrücken Phone 06805-9292-0 Fax 06805- 929288 Head of clinical trial: Univ.-Prof.Dr.med. Ralph Mösges Medical Faculty, University of Cologne Phone 0221-4783456 Fax 0221-4783465

Moxaverine 200mg p.o. in patients with central nervous vertigo Pharmacovigilance - Case Report Form Pharmacovigilance

- 2016-01-13 - 1 Formulär, 3 Item-grupper, 32 Dataelement, 1 Språk
Item-grupper: Demographic Information, Pharmacovigilance 1, Pharmacovigilance 2
Placebo controlled,double blind and randomized parallel group trial to verify effectivity and tolerability of moxaverine p.o. in patients with central nervous vertigo. Sponsor: URSAPHARM Industriestrasse 66129 Saarbrücken Phone 06805-9292-0 Fax 06805- 929288 Head of clinical trial: Univ.-Prof.Dr.med. Ralph Mösges Medical Faculty, University of Cologne Phone 0221-4783456 Fax 0221-4783465

Audiogram Hearing Test Protocol PhenX Toolkit

- 2016-04-26 - 1 Formulär, 1 Item-grupp, 22 Dataelement, 1 Språk
Item-grupp: PhenX - audiogram hearing test protocol
The National Health and Nutrition Examination Survey (NHANES) 2008-2009 audiometry protocol tests the examinee’s hearing threshold (in decibels, dB) at 7 frequencies in a soundproof room. Examinees are asked a series of exclusionary questions, undergo an outer-ear examination (otoscopy), and then have the mobility of their eardrum tested (acoustic immittance). Pure tone signals are then presented to each ear through earphones and the intensity of the signals is varied until the level is identified at which the person is just able to hear the sound. ODM derived from: https://cde.nlm.nih.gov Primary source: https://www.phenxtoolkit.org/ Recent publication: Hendershot, T., Pan, H., Haines, J., Harlan, W.R., Marazita, M.L., McCarty, C.A., Ramos, E.M., and Hamilton, C.M. (2015) Using the PhenX toolkit to add standard measures to a study. Curr. Protoc. Hum. Genet. 86:1.21.1-1.21.17. doi: 10.1002/0471142905.hg0121s86 Permission to publish granted by Carol M. Hamilton.

Family History of Speech and Language Impairment Protocol PhenX Toolkit

- 2017-09-27 - 1 Formulär, 1 Item-grupp, 22 Dataelement, 1 Språk
Item-grupp: PhenX - family history of speech and language impairment protocol
The Family History Questionnaire is a 9-item proxy-administered questionnaire completed by a parent for their young child. It asks about the child’s personal and family history of speech and language impairment. ODM derived from: https://cde.nlm.nih.gov Primary source: https://www.phenxtoolkit.org/ Recent publication: Hendershot, T., Pan, H., Haines, J., Harlan, W.R., Marazita, M.L., McCarty, C.A., Ramos, E.M., and Hamilton, C.M. (2015) Using the PhenX toolkit to add standard measures to a study. Curr. Protoc. Hum. Genet. 86:1.21.1-1.21.17. doi: 10.1002/0471142905.hg0121s86 Permission to publish granted by Carol M. Hamilton.

Personal and Family History of Hearing Loss Protocol PhenX Toolkit

- 2021-09-20 - 1 Formulär, 7 Item-grupper, 118 Dataelement, 1 Språk
Item-grupper: PhenX - personal and family history of hearing loss protocol, List of operations, Grandparents Origin, Mother/Father History, Hearing difficulty: Siblings, List of other operations, Medication list
The Age-Related Hearing Impairment instrument is a self-administered questionnaire which asks about an individual’s hearing impairment history, history of ear diseases and operations, family history, and history of exposure to loud noises. ODM derived from: https://cde.nlm.nih.gov Primary source: https://www.phenxtoolkit.org/ Recent publication: Hendershot, T., Pan, H., Haines, J., Harlan, W.R., Marazita, M.L., McCarty, C.A., Ramos, E.M., and Hamilton, C.M. (2015) Using the PhenX toolkit to add standard measures to a study. Curr. Protoc. Hum. Genet. 86:1.21.1-1.21.17. doi: 10.1002/0471142905.hg0121s86 Permission to publish granted by Carol M. Hamilton.

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