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NCT00334568/ GSK-AVA100193: M.Alzheimer GSK - Book 3

1 forms  
General information
Description

General information

Subject Identifier
Description

Subject Identifier

Data type

integer

Visit Date
Description

Visit Date

Data type

date

Visit Description: Visit 3
Description

Visit Description

Data type

boolean

Investigator Instructions
Description

Telephone the IVRS system to register the visit. (Note that if the subject is not continuing in the study, you should make a withdrawal call rather that a Visit Registration call).

Data type

boolean

Subject Continuation
Description

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 completely appropriately. Schedule an early withdrawal follow-up visit for 14 +/- 7 days after this visit.

Data type

boolean

Vital Signs
Description

Vital Signs

Weight
Description

Weight

Data type

float

Measurement units
  • kg
kg
Blood pressure: Systolic
Description

Blood pressure and heart rate will be measured once, after the subject sits quietly for at least 5 minutes.

Data type

integer

Blood pressure: Diastolic
Description

Blood pressure

Data type

integer

Measurement units
  • mmHg
mmHg
Heart Rate
Description

Heart Rate

Data type

integer

Measurement units
  • bpm
bpm
Concomitant Medications
Description

Concomitant Medications

Concomitant Medications
Description

Concomitant Medications

Data type

text

Adverse Events
Description

Adverse Events

Adverse Events
Description

Adverse Events

Data type

text

Physical Examination
Description

Physical Examination

Results from Physical Examination
Description

Results from Physical Examination

Data type

text

Pedal Oedema
Description

Pedal Oedema

Depth of Indentation
Description

Depth of Indentation

Data type

text

Indicate which ankle was assessed at this visit
Description

Ankle

Data type

text

End of visit reminder
Description

End of visit reminder

Next Visit Scheduled
Description

Next Visit Scheduled

Data type

boolean

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NCT00334568/ GSK-AVA100193: M.Alzheimer GSK - Book 3

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
General information
Subject Identifier
Item
Subject Identifier
integer
Visit Date
Item
Visit Date
date
Visit Description
Item
Visit Description: Visit 3
boolean
Investigator Instructions
Item
Investigator Instructions
boolean
Subject Continuation
Item
Subject Continuation
boolean
Item Group
Vital Signs
Weight
Item
Weight
float
Blood pressure
Item
Blood pressure: Systolic
integer
Blood pressure
Item
Blood pressure: Diastolic
integer
Heart Rate
Item
Heart Rate
integer
Item Group
Concomitant Medications
Concomitant Medications
Item
Concomitant Medications
text
Item Group
Adverse Events
Adverse Events
Item
Adverse Events
text
Item Group
Physical Examination
Results from Physical Examination
Item
Results from Physical Examination
text
Item Group
Pedal Oedema
Item
Depth of Indentation
text
Depth of Indentation
Code List
Depth of Indentation
CL Item
< 1 mm (1)
CL Item
1-2 mm (2)
CL Item
3-5 mm (3)
CL Item
6-10 mm (4)
CL Item
> 10 mm (5)
Item
Indicate which ankle was assessed at this visit
text
Ankle
Code List
Indicate which ankle was assessed at this visit
CL Item
Right Ankle (1)
CL Item
Left Ankle (2)
Item Group
End of visit reminder
Next Visit Scheduled
Item
Next Visit Scheduled
boolean
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