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Informações:
Falhas:
ID
28107
Descrição
NCT02695940 A Phase 2a, Proof of Concept Trial, Testing Twice Daily Application of LEO 124249 Ointment 30 mg/g in the Treatment of Mild to Moderate Inverse Psoriasis. Quelle: Prof. Dr. Dr. h.c. Thomas Luger University Hospital of Muenster Department of Dermatology
Palavras-chave
Versões (2)
- 18/12/2017 18/12/2017 -
- 22/01/2018 22/01/2018 -
Titular dos direitos
Prof. Dr. Dr. h.c. Thomas Luger
Transferido a
18 de dezembro de 2017
DOI
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Licença
Creative Commons BY-NC 3.0
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Visit 6 Psoriasis NCT02695940
Visit 6 Psoriasis NCT02695940
- StudyEvent: ODM
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Visit 6 Psoriasis NCT02695940
- StudyEvent: ODM
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de dados
Alias
Date
Item
Date
date
Patient ID
Item
Pat. #
integer
C2348585 (UMLS CUI [1])
questionnaires staff member
Item
Die Fragenbögen an den Patienten ausgehändigt durch:
text
return patient diary
Item
Patiententagebuch zurückgenommen
boolean
patient diary return staff member
Item
Patiententagebuch zurückgenommen durch:
text
return study medication
Item
Rücknahme der Studienmedikation
boolean
usage care products
Item
Patient hat 12 Stunden vor der Visite Pflegeprodukte benutzt?
boolean
Physical Examination
Item
a) Physical Examination ausgefüllt
boolean
Concomitant Medication
Item
b) Concomitant Medikation ausgefüllt
boolean
Physician Global Assessment score completed
Item
c) PGA Score ausgefüllt
boolean
Total Sign score completed
Item
d) TSS Sign Score ausgefüllt
boolean
treated body regions
Item
e) Überprüfung der Behandlungsareale (Körperregion u. Größe in cm²) ausgefüllt
boolean
blood values
Item
Blutwerte kontrolliert und abgezeichnet
boolean
CL Item
Ja, siehe AE-Bogen (Ja, siehe AE-Bogen)
CL Item
Nein (Nein)
CL Item
Ja, siehe Concom. Medi.-Bogen (Ja, siehe Concom. Medi.-Bogen)
CL Item
Nein (Nein)
Physical examination skin mucosal status
Item
Körperliche Untersuchung ausfüllen/Haut Schleimhaut Status
boolean
Total Sign Score
Item
TSS
boolean
Physician Global Assessment
Item
PGA
boolean
Plaque Psoriasis
Item
Hat Patient auch Plaque Psoriasis?
boolean
Plaque Psoriasis localisation
Item
Falls ja, wo?
text
Examiner vital signs
Item
Vitalzeichen durch:
text
Time vital signs
Item
Uhrzeit (nach 5 Minuten Ruhezeit)
time
vital signs first measurement time
Item
1. Messung um:
time
Blood Pressure first measurement
Item
1. Messung: Blutdruck
text
C0005823 (UMLS CUI [1])
Pulse first measurement
Item
1. Messung: Puls
integer
C0232117 (UMLS CUI [1])
Temperature first measurement
Item
1. Messung: Temp (Ohr)
float
time vital signs second measurement
Item
2. Messung um:
time
Blood Pressure second measurement
Item
2. Messung: Blutdruck
text
C0005823 (UMLS CUI [1])
Pulse second measurement
Item
2. Messung: Puls
integer
C0232117 (UMLS CUI [1])
Temperature second measurement
Item
2. Messung: Temp (Ohr)
float
vital signs third measurement time
Item
3. Messung um:
time
Blood Pressure third measurement
Item
3. Messung: Blutdruck
text
C0005823 (UMLS CUI [1])
Pulse third measurement
Item
3. Messung: Puls
integer
C0232117 (UMLS CUI [1])
Temperature third measurement
Item
3. Messung: Temp (Ohr)
float
Weight
Item
Gewicht
float
C0005910 (UMLS CUI [1])
ECG examiner
Item
Geschrieben durch:
text
ECG time
Item
Uhrzeit:
time
ECG physician
Item
EKG eingesehen durch Arzt:
text
ECG analysis staff member
Item
Zur Analyse zu ERT geschickt durch:
text
blood sample staff member
Item
Blutentnahme durch:
text
blood sample time
Item
Uhrzeit:
time
Urine sample staff member
Item
Urin Dip-Stick durch:
text
urine sample time
Item
Uhrzeit:
time
pregnancy test staff member
Item
SST durch:
text
CL Item
Positiv (exclusion) (Positiv (exclusion))
CL Item
Negativ (Negativ)
CL Item
N/A (N/A)
small pictures
Item
2x Kärtchen
text
picture of body area
Item
2x Arealaufnahme (mit Umgebung)
text
close-up picture
Item
2x Arealaufnahme (Nahaufnahme)
text
Date
Item
Datum
date
signature physician
Item
Unterschrift Prüfarzt
text