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ID

17385

Beschrijving

NCT00428090 / GSK-AVA105640 A 24-week, double-blind, double-dummy, randomized, parallel-group study to investigate the effects of rosiglitazone (extended release tablets), donepezil, and placebo as monotherapy on cognition and overall clinical response in APOE e4-stratified subjects with mild to moderate Alzheimer’s disease. (REFLECT-1) Schedule Visit 3 for 14 days (+- 3 days) after this visit. It is not necessary for the subject to be fasted.

Trefwoorden

  1. 11-09-16 11-09-16 -
  2. 11-09-16 11-09-16 -
  3. 25-09-16 25-09-16 -
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11 september 2016

DOI

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Licentie

Creative Commons BY-NC-ND 3.0

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    GSK Visit 3 NCT00428090

    GSK Visit 3 NCT00428090

    Patient Information
    Beschrijving

    Patient Information

    Alias
    UMLS CUI-1
    C1955348 (Patient Information)
    Subject Identifier
    Beschrijving

    Patient Study ID

    Datatype

    text

    Alias
    UMLS CUI [1]
    C2348585 (Clinical Trial Subject Unique Identifier)
    Visit Date
    Beschrijving

    Visit Date

    Datatype

    date

    Maateenheden
    • dd/MMM/yy
    Alias
    UMLS CUI [1]
    C1320303 (Date of visit)
    SNOMED
    406543005
    dd/MMM/yy
    Investigator Instructions
    Beschrijving

    Investigator Instructions

    Alias
    UMLS CUI-1
    C1442085 (Instructions)
    LOINC
    LP6820-7
    Telephone the IVRS system to register the visit. (Note that if the subject is not continuiing in the study, you should make a Withdrawal call rather than a Visit Registration call). Review study medication compliance.
    Beschrijving

    Investigator Instructions

    Datatype

    text

    Alias
    UMLS CUI [1]
    C1442085 (Instructions)
    LOINC
    LP6820-7
    Subject Continuation
    Beschrijving

    Subject Continuation

    Alias
    UMLS CUI-1
    C0805733 (Continuation status)
    LOINC
    MTHU008303
    If the subject is not continuing in the study, complete all assessments and ensure that all sections of the CRF (including the Study Conclusion section) are completed appropriately. Schedule an early withdrawal follow-up visit for 14 +/- 7 days after thsi visit.
    Beschrijving

    Subject Continuation

    Datatype

    text

    Alias
    UMLS CUI [1]
    C0805733 (Continuation status)
    LOINC
    MTHU008303
    Vital signs
    Beschrijving

    Vital signs

    Alias
    UMLS CUI-1
    C0518766 (Vital signs)
    LOINC
    LP30605-7
    Weight
    Beschrijving

    Weight

    Datatype

    float

    Maateenheden
    • kg
    Alias
    UMLS CUI [1]
    C0005910 (Body Weight)
    SNOMED
    27113001
    kg
    Systolic Blood Pressure. Blood Pressure and heart rate will be measured once, after the subject sits queitly for at least 5 minutes.
    Beschrijving

    Systolic Blood Pressure

    Datatype

    float

    Maateenheden
    • mmHg
    Alias
    UMLS CUI [1]
    C0871470 (Systolic Pressure)
    SNOMED
    271649006
    mmHg
    Diastolic Blood Pressure. Blood Pressure and heart rate will be measured once, after the subject sits queitly for at least 5 minutes.
    Beschrijving

    Diastolic Blood Pressure

    Datatype

    float

    Maateenheden
    • mmHg
    Alias
    UMLS CUI [1]
    C0428883 (Diastolic blood pressure)
    SNOMED
    271650006
    mmHg
    Patient Position: Sitting. Blood Pressure and heart rate will be measured once, after the subject sits queitly for at least 5 minutes.
    Beschrijving

    Patient Position

    Datatype

    boolean

    Alias
    UMLS CUI [1]
    C0449850 (Patient position finding)
    SNOMED
    246273001
    Heart rate. Blood Pressure and heart rate will be measured once, after the subject sits queitly for at least 5 minutes.
    Beschrijving

    Heart Rate

    Datatype

    float

    Maateenheden
    • Beats/Min
    Alias
    UMLS CUI [1]
    C0018810 (heart rate)
    SNOMED
    364075005
    LOINC
    LP29713-2
    Beats/Min
    Central Laboratory (Non Fasting Samples)
    Beschrijving

    Central Laboratory (Non Fasting Samples)

    Alias
    UMLS CUI-1
    C1880016 (Central Laboratory)
    Dates sample taken
    Beschrijving

    Dates sample taken

    Datatype

    date

    Maateenheden
    • dd/MMM/yy
    Alias
    UMLS CUI [1]
    C0460065 (Date sample received in laboratory)
    SNOMED
    281271004
    dd/MMM/yy
    Concomitant medication
    Beschrijving

    Concomitant medication

    Alias
    UMLS CUI-1
    C2347852 (Concomitant Agent)
    Record any changes to the subject's concomitant medications or any new medications taken since the last visit in the apporpriate Concomitant Medications sections.
    Beschrijving

    Concomitant medication

    Datatype

    text

    Alias
    UMLS CUI [1]
    C2347852 (Concomitant Agent)
    Adverse Event
    Beschrijving

    Adverse Event

    Alias
    UMLS CUI-1
    C0877248 (Adverse event)
    LOINC
    MTHU014542
    Record details of any new non-serious adverse events/serious adverse events observed or reported by the subject or any changes to ongoing non-serious adverse events in the appropriate Non-Serious Adverse Events/ Serious Adverse Events section.
    Beschrijving

    Adverse Event

    Datatype

    text

    Alias
    UMLS CUI [1]
    C0877248 (Adverse event)
    LOINC
    MTHU014542
    Physical Examination
    Beschrijving

    Physical Examination

    Alias
    UMLS CUI-1
    C0031809 (Physical Examination)
    SNOMED
    5880005
    LOINC
    MTHU028014
    Perform a physical examination on the subject, including auscultation of heart and lungs. Note: If any abnormalities are found as a result of the physical examination, these must be recorded on the Non-Serious Adverse Events page.
    Beschrijving

    Physical Examination

    Datatype

    text

    Alias
    UMLS CUI [1]
    C0031809 (Physical Examination)
    SNOMED
    5880005
    LOINC
    MTHU028014
    Pedal Oedema
    Beschrijving

    Pedal Oedema

    Alias
    UMLS CUI-1
    C0574002 (Edema of foot (finding))
    SNOMED
    102576009
    Press firmly with thumb anterior to the worst affected ankle until further pressure produces no greater indentation. Visually estimate depth of pit and record the Estimated Depth of Indentation below. Note: Use the same ankle thoughout the study. Tick one:
    Beschrijving

    Pedal Oedema: depth

    Datatype

    text

    Alias
    UMLS CUI [1,1]
    C0574002 (Edema of foot (finding))
    SNOMED
    102576009
    UMLS CUI [1,2]
    C0205125 (Deep (qualifier value))
    SNOMED
    795002
    LOINC
    LP18009-8
    Press firmly with thumb anterior to the worst affected ankle until further pressure produces no greater indentation. Visually estimate depth of pit and record the Estimated Depth of Indentation below. Note: Use the same ankle thoughout the study. Tick the appropriate box below to indicate which ankle was assessed at this visit:
    Beschrijving

    Pedal Oedema: Site

    Datatype

    text

    Alias
    UMLS CUI [1,1]
    C0574002 (Edema of foot (finding))
    SNOMED
    102576009
    UMLS CUI [1,2]
    C1515974 (Anatomic Site)
    Investigational Product - dispense Weeks 5 - 8 study medication as specified by the IVRS system. Record start date, container number and number of tablets dispensed below (stop date and tablets returned will be completed when the bottle is returned)
    Beschrijving

    Investigational Product - dispense Weeks 5 - 8 study medication as specified by the IVRS system. Record start date, container number and number of tablets dispensed below (stop date and tablets returned will be completed when the bottle is returned)

    Alias
    UMLS CUI-1
    C0304229 (Experimental drug)
    Investigational Product (e.g Bottle 1)
    Beschrijving

    Investigational Product

    Datatype

    text

    Alias
    UMLS CUI [1]
    C0304229 (Experimental drug)
    Start Date
    Beschrijving

    Start Date

    Datatype

    date

    Maateenheden
    • dd/MMM/yy
    Alias
    UMLS CUI [1]
    C0808070 (Start Date)
    dd/MMM/yy
    Stop Date
    Beschrijving

    Stop Date

    Datatype

    date

    Maateenheden
    • dd/MMM/yy
    Alias
    UMLS CUI [1]
    C0806020 (End date)
    SNOMED
    454551000124105
    LOINC
    MTHU008302
    dd/MMM/yy
    Dose
    Beschrijving

    Dose

    Datatype

    float

    Maateenheden
    • mg
    Alias
    UMLS CUI [1]
    C3174092 (Medication dose)
    LOINC
    LP116765-1
    mg
    IP Container No.
    Beschrijving

    IP Container No.

    Datatype

    float

    Alias
    UMLS CUI [1]
    C0180098 (Containers)
    SNOMED
    706437002
    Has the subject missed investigational product for > 7 consecutive days?
    Beschrijving

    Discontinuation

    Datatype

    boolean

    Alias
    UMLS CUI [1]
    C0457454 (Discontinuation (procedure))
    Compliance - dispense Weeks 5 - 8 study medication as specified by the IVRS system. Record start date, container number and number of tablets dispensed below (stop date and tablets returned will be completed when the bottle is returned)
    Beschrijving

    Compliance - dispense Weeks 5 - 8 study medication as specified by the IVRS system. Record start date, container number and number of tablets dispensed below (stop date and tablets returned will be completed when the bottle is returned)

    Alias
    UMLS CUI-1
    C1321605 (Compliance behavior)
    SNOMED
    405078008
    Total number of Tablets Dispensed
    Beschrijving

    Total number of Tablets Dispensed

    Datatype

    float

    Alias
    UMLS CUI [1,1]
    C0805077 (Dispensed Amount)
    UMLS CUI [1,2]
    C0039225 (Tablet Dosage Form)
    SNOMED
    385055001
    LOINC
    LP136501-6
    Total number of Tablets Returned
    Beschrijving

    Total number of Tablets Returned

    Datatype

    float

    Alias
    UMLS CUI [1,1]
    C2699071 (Returned Amount)
    UMLS CUI [1,2]
    C0039225 (Tablet Dosage Form)
    SNOMED
    385055001
    LOINC
    LP136501-6

    Similar models

    GSK Visit 3 NCT00428090

    Name
    Type
    Description | Question | Decode (Coded Value)
    Datatype
    Alias
    Item Group
    Patient Information
    C1955348 (UMLS CUI-1)
    Patient Study ID
    Item
    Subject Identifier
    text
    C2348585 (UMLS CUI [1])
    Visit Date
    Item
    Visit Date
    date
    C1320303 (UMLS CUI [1])
    Item Group
    Investigator Instructions
    C1442085 (UMLS CUI-1)
    Investigator Instructions
    Item
    Telephone the IVRS system to register the visit. (Note that if the subject is not continuiing in the study, you should make a Withdrawal call rather than a Visit Registration call). Review study medication compliance.
    text
    C1442085 (UMLS CUI [1])
    Item Group
    Subject Continuation
    C0805733 (UMLS CUI-1)
    Subject Continuation
    Item
    If the subject is not continuing in the study, complete all assessments and ensure that all sections of the CRF (including the Study Conclusion section) are completed appropriately. Schedule an early withdrawal follow-up visit for 14 +/- 7 days after thsi visit.
    text
    C0805733 (UMLS CUI [1])
    Item Group
    Vital signs
    C0518766 (UMLS CUI-1)
    Weight
    Item
    Weight
    float
    C0005910 (UMLS CUI [1])
    Systolic Blood Pressure
    Item
    Systolic Blood Pressure. Blood Pressure and heart rate will be measured once, after the subject sits queitly for at least 5 minutes.
    float
    C0871470 (UMLS CUI [1])
    Diastolic Blood Pressure
    Item
    Diastolic Blood Pressure. Blood Pressure and heart rate will be measured once, after the subject sits queitly for at least 5 minutes.
    float
    C0428883 (UMLS CUI [1])
    Patient Position
    Item
    Patient Position: Sitting. Blood Pressure and heart rate will be measured once, after the subject sits queitly for at least 5 minutes.
    boolean
    C0449850 (UMLS CUI [1])
    Heart Rate
    Item
    Heart rate. Blood Pressure and heart rate will be measured once, after the subject sits queitly for at least 5 minutes.
    float
    C0018810 (UMLS CUI [1])
    Item Group
    Central Laboratory (Non Fasting Samples)
    C1880016 (UMLS CUI-1)
    Dates sample taken
    Item
    Dates sample taken
    date
    C0460065 (UMLS CUI [1])
    Item Group
    Concomitant medication
    C2347852 (UMLS CUI-1)
    Concomitant medication
    Item
    Record any changes to the subject's concomitant medications or any new medications taken since the last visit in the apporpriate Concomitant Medications sections.
    text
    C2347852 (UMLS CUI [1])
    Item Group
    Adverse Event
    C0877248 (UMLS CUI-1)
    Adverse Event
    Item
    Record details of any new non-serious adverse events/serious adverse events observed or reported by the subject or any changes to ongoing non-serious adverse events in the appropriate Non-Serious Adverse Events/ Serious Adverse Events section.
    text
    C0877248 (UMLS CUI [1])
    Item Group
    Physical Examination
    C0031809 (UMLS CUI-1)
    Physical Examination
    Item
    Perform a physical examination on the subject, including auscultation of heart and lungs. Note: If any abnormalities are found as a result of the physical examination, these must be recorded on the Non-Serious Adverse Events page.
    text
    C0031809 (UMLS CUI [1])
    Item Group
    Pedal Oedema
    C0574002 (UMLS CUI-1)
    Pedal Oedema: depth
    Item
    Press firmly with thumb anterior to the worst affected ankle until further pressure produces no greater indentation. Visually estimate depth of pit and record the Estimated Depth of Indentation below. Note: Use the same ankle thoughout the study. Tick one:
    text
    C0574002 (UMLS CUI [1,1])
    C0205125 (UMLS CUI [1,2])
    Item
    Press firmly with thumb anterior to the worst affected ankle until further pressure produces no greater indentation. Visually estimate depth of pit and record the Estimated Depth of Indentation below. Note: Use the same ankle thoughout the study. Tick the appropriate box below to indicate which ankle was assessed at this visit:
    text
    C0574002 (UMLS CUI [1,1])
    C1515974 (UMLS CUI [1,2])
    Code List
    Press firmly with thumb anterior to the worst affected ankle until further pressure produces no greater indentation. Visually estimate depth of pit and record the Estimated Depth of Indentation below. Note: Use the same ankle thoughout the study. Tick the appropriate box below to indicate which ankle was assessed at this visit:
    CL Item
    Right Ankle (Right Ankle)
    CL Item
    Left Ankle (Left Ankle)
    Item Group
    Investigational Product - dispense Weeks 5 - 8 study medication as specified by the IVRS system. Record start date, container number and number of tablets dispensed below (stop date and tablets returned will be completed when the bottle is returned)
    C0304229 (UMLS CUI-1)
    Investigational Product
    Item
    Investigational Product (e.g Bottle 1)
    text
    C0304229 (UMLS CUI [1])
    Start Date
    Item
    Start Date
    date
    C0808070 (UMLS CUI [1])
    Stop Date
    Item
    Stop Date
    date
    C0806020 (UMLS CUI [1])
    Dose
    Item
    Dose
    float
    C3174092 (UMLS CUI [1])
    IP Container No.
    Item
    IP Container No.
    float
    C0180098 (UMLS CUI [1])
    Discontinuation
    Item
    Has the subject missed investigational product for > 7 consecutive days?
    boolean
    C0457454 (UMLS CUI [1])
    Item Group
    Compliance - dispense Weeks 5 - 8 study medication as specified by the IVRS system. Record start date, container number and number of tablets dispensed below (stop date and tablets returned will be completed when the bottle is returned)
    C1321605 (UMLS CUI-1)
    Total number of Tablets Dispensed
    Item
    Total number of Tablets Dispensed
    float
    C0805077 (UMLS CUI [1,1])
    C0039225 (UMLS CUI [1,2])
    Total number of Tablets Returned
    Item
    Total number of Tablets Returned
    float
    C2699071 (UMLS CUI [1,1])
    C0039225 (UMLS CUI [1,2])

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