Information:
Fel:
ID
15354
Beskrivning
Alemtuzumab in Autoimmune Inflammatory Neurodegeneration: Mechanisms of Action and Neuroprotective Potential (ALAIN01) https://clinicaltrials.gov/ct2/show/NCT02419378 Principal Investigator Prof. Dr. Dr. Sven Meuth, University Hospital Muenster, Germany
Länk
https://clinicaltrials.gov/ct2/show/NCT02419378
Nyckelord
Versioner (3)
- 2015-08-13 2015-08-13 - Martin Dugas
- 2016-05-23 2016-05-23 -
- 2016-05-28 2016-05-28 -
Uppladdad den
28 maj 2016
DOI
För en begäran logga in.
Licens
Creative Commons BY 4.0
Modellkommentarer :
Här kan du kommentera modellen. Med hjälp av pratbubblor i Item-grupperna och Item kan du lägga in specifika kommentarer.
Itemgroup-kommentar för :
Item-kommentar för :
Du måste vara inloggad för att kunna ladda ner formulär. Var vänlig logga in eller registrera dig utan kostnad.
Discontinue Trial Medication Multiple Sclerosis ALAIN01 NCT02419378
Discontinue Trial Medication Multiple Sclerosis ALAIN01 NCT02419378
Similar models
Discontinue Trial Medication Multiple Sclerosis ALAIN01 NCT02419378
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Discontinue Trial Medication
C0013227 (UMLS CUI-1)
C0457454 (UMLS CUI-2)
C0457454 (UMLS CUI-2)
Patient ID (derived)
Item
Patient ID (derived)
text
C2348585 (UMLS CUI [1])
Trial medication end date
Item
Discont. of Trial Medication: Date
date
C1521826 (UMLS CUI [1,1])
C0806020 (UMLS CUI [1,2])
C0806020 (UMLS CUI [1,2])
Other reason
Item
If other reason was selected, please specify
text
C3840932 (UMLS CUI [1])
Item
Reason for discontinuation
integer
C0566251 (UMLS CUI [1,1])
C0457454 (UMLS CUI [1,2])
C0457454 (UMLS CUI [1,2])
CL Item
Investigator considers it would be in the best interests of the patient (1)
CL Item
Unacceptable toxicity of the study drug (2)
CL Item
HIV infection (3)
CL Item
Patient requests discontinuation (4)
CL Item
Patient is unable or unwilling to comply with planned study safety monitoring (5)
CL Item
Other reason: ____________ (6)
Discontinuation reason
Item
Discont. of Trial Medication: Reason Text
text
C0457454 (UMLS CUI [1,1])
C0566251 (UMLS CUI [1,2])
C0566251 (UMLS CUI [1,2])
Date of Signature
Item
Discont. of Trial Medication: Date of Signature
date
C1519316 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,2])