ID

19427

Beschrijving

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.

Trefwoorden

  1. 31-12-16 31-12-16 -
  2. 04-02-17 04-02-17 -
Geüploaded op

31 december 2016

DOI

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Licentie

Creative Commons BY-NC 3.0

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Screen Failure Log: Adverse Events [AE_1] NCT01117584

Screen Failure Log: Adverse Events [AE_1] NCT01117584

General Information
Beschrijving

General Information

Was any adverse event reported or observed?
Beschrijving

Any Adverse Event

Datatype

boolean

Adverse Event
Beschrijving

Adverse Event

Datatype

text

Onset Date
Beschrijving

Onset Date

Datatype

date

End Date
Beschrijving

End Date

Datatype

date

Outcome
Beschrijving

Outcome

Datatype

text

Course of Event
Beschrijving

Course of Event

Datatype

text

Severity
Beschrijving

Severity

Datatype

text

Serious AE?
Beschrijving

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

Datatype

boolean

Serious AE Number
Beschrijving

Serious AE Number

Datatype

integer

Death
Beschrijving

Death

Datatype

boolean

Requires or prolongs hospitalization
Beschrijving

Requires or prolongs hospitalization

Datatype

boolean

Congenital anomaly
Beschrijving

Congenital anomaly

Datatype

boolean

Life-threatening
Beschrijving

Life-threatening

Datatype

boolean

Persistent or significant disability/incapacity
Beschrijving

Disability

Datatype

boolean

Other medical importance
Beschrijving

Medical Importance

Datatype

boolean

Action Taken for Study Drug
Beschrijving

Action Taken for Study Drug

Datatype

text

Was there any treatment required?
Beschrijving

If Yes, please select all that apply.

Datatype

boolean

Medication Therapy
Beschrijving

Medication Therapy

Datatype

boolean

Non-Medication Therapy
Beschrijving

Non-Medication Therapy

Datatype

boolean

Relationship to Study Drug
Beschrijving

Relationship to Study Drug

Datatype

text

Similar models

Screen Failure Log: Adverse Events [AE_1] NCT01117584

Name
Type
Description | Question | Decode (Coded Value)
Datatype
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)

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