ID

16059

Beskrivning

Documentation part: Subject/Guardian Activity Diary & Concomitant Medication A Randomised, Observer-blind, Multicentre, Non-inferiority, Comparative, Phase III Study of the Safety and Efficacy of Topical 1% SB-275833 Ointment, Applied Twice Daily for 5 Days, versus Topical 2% Sodium Fusidate Ointment Applied Three Times Daily for 7 Days in the Treatment of Adult and Paediatric Subjects with Impetigo. ClinicalTrials.gov Identifier: NCT00133874 Other Study ID Numbers: TOC100224 Responsible Party: GlaxoSmithKline

Nyckelord

Versioner (1)
  1. 2016-06-27 2016-06-27 -
Uppladdad den

27 juni 2016

DOI

För en begäran logga in.

Licens

Creative Commons BY-NC 3.0
Modellkommentarer :

Här kan du kommentera modellen. Med hjälp av pratbubblor i Item-grupperna och Item kan du lägga in specifika kommentarer.

Tillbaka till modellkommentarer
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.

Subject/Guardian Activity Diary & Concomitant Medication Topical SB-275833 Ointment 1% For The Treatment Of Impetigo NCT00133874

Engelsk

Subject/Guardian Activity Diary & Concomitant Medication Topical SB-275833 Ointment 1% For The Treatment Of Impetigo NCT00133874

1 Formulär  
Subject/Guardian Activity Diary (DIARY)
Beskrivning

Subject/Guardian Activity Diary (DIARY)

How much effort has your child having had impetigo had on your daily activities (attendance at work, household chores, etc.) today?
Beskrivning

How much effort has your child having had impetigo had on your daily activities (attendance at work, household chores, etc.) today?

Datatyp

text

Alias
UMLS CUI [1,1]
C0871707
UMLS CUI [1,2]
C0162468
Has your child having impetigo had any effect on his or her normal daily activities (Attendance at school, day care, play dates, recreational activity, etc) today?
Beskrivning

Has your child having impetigo had any effect on his or her normal daily activities (Attendance at school, day care, play dates, recreational activity, etc) today?

Datatyp

text

Alias
UMLS CUI [1,1]
C0871707
UMLS CUI [1,2]
C0162468
Concomitant Medications (CONMEDS)
Beskrivning

Concomitant Medications (CONMEDS)

Drug name (Trade Name preferred)
Beskrivning

Drug name

Datatyp

text

Alias
UMLS CUI [1]
C0013227
Modified reported term
Beskrivning

Modified reported term

Datatyp

text

Total Daily Dose
Beskrivning

total daily dose

Datatyp

text

Alias
UMLS CUI [1]
C2348070
Route
Beskrivning

Route

Datatyp

text

Alias
UMLS CUI [1]
C0013153
Reason for Medication
Beskrivning

Reason for medication

Datatyp

text

Alias
UMLS CUI [1,1]
C0392360
UMLS CUI [1,2]
C0013227
Start date
Beskrivning

Start date

Datatyp

date

Måttenheter
  • DDMONYYYY
Alias
UMLS CUI [1]
C0808070
DDMONYYYY
Ongoing?
Beskrivning

Ongoing?

Datatyp

text

Alias
UMLS CUI [1]
C0549178
If "No", specify End date
Beskrivning

End date

Datatyp

date

Måttenheter
  • DDMONYYYY
Alias
UMLS CUI [1]
C0806020
DDMONYYYY
Tillbaka till toppen

Similar models

Subject/Guardian Activity Diary & Concomitant Medication Topical SB-275833 Ointment 1% For The Treatment Of Impetigo NCT00133874

1 Formulär
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Subject/Guardian Activity Diary (DIARY)
Item
How much effort has your child having had impetigo had on your daily activities (attendance at work, household chores, etc.) today?
text
C0871707 (UMLS CUI [1,1])
C0162468 (UMLS CUI [1,2])
How much effort has your child having had impetigo had on your daily activities (attendance at work, household chores, etc.) today?
Code List
How much effort has your child having had impetigo had on your daily activities (attendance at work, household chores, etc.) today?
CL Item
0 - Not at All (0)
CL Item
1 (1)
CL Item
2 (2)
CL Item
3 (3)
CL Item
4 - Very Much (4)
Item
Has your child having impetigo had any effect on his or her normal daily activities (Attendance at school, day care, play dates, recreational activity, etc) today?
text
C0871707 (UMLS CUI [1,1])
C0162468 (UMLS CUI [1,2])
Has your child having impetigo had any effect on his or her normal daily activities (Attendance at school, day care, play dates, recreational activity, etc) today?
Code List
Has your child having impetigo had any effect on his or her normal daily activities (Attendance at school, day care, play dates, recreational activity, etc) today?
CL Item
Yes (Y)
CL Item
No (N)
Item Group
Concomitant Medications (CONMEDS)
Drug name
Item
Drug name (Trade Name preferred)
text
C0013227 (UMLS CUI [1])
Modified reported term
Item
Modified reported term
text
total daily dose
Item
Total Daily Dose
text
C2348070 (UMLS CUI [1])
Item
Route
text
C0013153 (UMLS CUI [1])
Route
Code List
Route
CL Item
Bouth eyes (OU)
CL Item
Epidural (EP)
CL Item
Gastrostomy tube (GTT)
CL Item
Inhalation (IH)
CL Item
Injection (INJ)
CL Item
Intra-arterial (IA)
CL Item
Intra-bursa (IB)
CL Item
Intramuscular (IM)
CL Item
Intranasal (IN)
CL Item
Inraocular (IO)
CL Item
Intraosteal (IOS)
CL Item
Intrathekal (IT)
CL Item
Intrauterine (IU)
CL Item
Intravenous (IV)
CL Item
Nasal (NS)
CL Item
Oral (PO)
CL Item
Rectal (PR)
CL Item
Subcutaneous (SC)
CL Item
Sublingual (SL)
CL Item
Topical (TP)
CL Item
Transdermal (TD)
CL Item
Unknown (UNK)
CL Item
Vaginal (VG)
Reason for medication
Item
Reason for Medication
text
C0392360 (UMLS CUI [1,1])
C0013227 (UMLS CUI [1,2])
Start date
Item
Start date
date
C0808070 (UMLS CUI [1])
Item
Ongoing?
text
C0549178 (UMLS CUI [1])
Ongoing?
Code List
Ongoing?
CL Item
Yes (Y)
CL Item
No (N)
End date
Item
If "No", specify End date
date
C0806020 (UMLS CUI [1])
Tillbaka till toppen 

Kontakt

Använd detta formulär för feedback, frågor och förslag på förbättringar.

Fält markerade med * är obligatoriska.

Hjälp

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial