ID

19427

Description

NCT01117584 Astellas Phase 2b, Double-Blind, Randomized, Multicenter, Parallel Group, Placebo-Controlled, Dose-Finding Study to Evaluate the Efficacy, Safety and Tolerability of a 12- Week Treatment with ASP1941 in Combination with Metformin in Patients with Type 2 Diabetes Mellitus Who Have Inadequate Glycemic Control on Metformin Alone.

Keywords

  1. 12/31/16 12/31/16 -
  2. 2/4/17 2/4/17 -
Uploaded on

December 31, 2016

DOI

To request one please log in.

License

Creative Commons BY-NC 3.0

Model comments :

You can comment on the data model here. Via the speech bubbles at the itemgroups and items you can add comments to those specificially.

Itemgroup comments for :

Item comments for :

In order to download data models you must be logged in. Please log in or register for free.

Screen Failure Log: Adverse Events [AE_1] NCT01117584

Screen Failure Log: Adverse Events [AE_1] NCT01117584

General Information
Description

General Information

Was any adverse event reported or observed?
Description

Any Adverse Event

Data type

boolean

Adverse Event
Description

Adverse Event

Data type

text

Onset Date
Description

Onset Date

Data type

date

End Date
Description

End Date

Data type

date

Outcome
Description

Outcome

Data type

text

Course of Event
Description

Course of Event

Data type

text

Severity
Description

Severity

Data type

text

Serious AE?
Description

If Seriousness is "yes", tick all that apply.

Data type

boolean

Serious AE Number
Description

Serious AE Number

Data type

integer

Death
Description

Death

Data type

boolean

Requires or prolongs hospitalization
Description

Requires or prolongs hospitalization

Data type

boolean

Congenital anomaly
Description

Congenital anomaly

Data type

boolean

Life-threatening
Description

Life-threatening

Data type

boolean

Persistent or significant disability/incapacity
Description

Disability

Data type

boolean

Other medical importance
Description

Medical Importance

Data type

boolean

Action Taken for Study Drug
Description

Action Taken for Study Drug

Data type

text

Was there any treatment required?
Description

If Yes, please select all that apply.

Data type

boolean

Medication Therapy
Description

Medication Therapy

Data type

boolean

Non-Medication Therapy
Description

Non-Medication Therapy

Data type

boolean

Relationship to Study Drug
Description

Relationship to Study Drug

Data type

text

Similar models

Screen Failure Log: Adverse Events [AE_1] NCT01117584

Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
General Information
Any Adverse Event
Item
Was any adverse event reported or observed?
boolean
Adverse Event
Item
Adverse Event
text
Onset Date
Item
Onset Date
date
End Date
Item
End Date
date
Item
Outcome
text
Code List
Outcome
CL Item
Recovered/Resolved (1)
CL Item
Recovering/Resolving (2)
CL Item
Not Recovered/Not Resolved  (3)
CL Item
Recovered/Resolved with Sequelae (4)
CL Item
Fatal (5)
CL Item
Unknown (6)
Item
Course of Event
text
Code List
Course of Event
CL Item
Single Episode (1)
CL Item
Intermittent (2)
CL Item
Continous (3)
Item
Severity
text
Code List
Severity
CL Item
Mild (1)
CL Item
Moderate (2)
CL Item
Severe (3)
Serious AE
Item
Serious AE?
boolean
Serious AE Number
Item
Serious AE Number
integer
Death
Item
Death
boolean
Requires or prolongs hospitalization
Item
Requires or prolongs hospitalization
boolean
Congenital anomaly
Item
Congenital anomaly
boolean
Life-threatening
Item
Life-threatening
boolean
Disability
Item
Persistent or significant disability/incapacity
boolean
Medical Importance
Item
Other medical importance
boolean
Item
Action Taken for Study Drug
text
Code List
Action Taken for Study Drug
CL Item
Dose Not Changed (1)
CL Item
Drug Interrupted (2)
CL Item
Drug Withdrawn  (3)
CL Item
Not Applicable (4)
CL Item
Unknown (5)
Treatment
Item
Was there any treatment required?
boolean
Medication Therapy
Item
Medication Therapy
boolean
Non-Medication Therapy
Item
Non-Medication Therapy
boolean
Item
Relationship to Study Drug
text
Code List
Relationship to Study Drug
CL Item
Not Related (1)
CL Item
Possible (2)
CL Item
Probable (3)

Please use this form for feedback, questions and suggestions for improvements.

Fields marked with * are required.

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