ID
21087
Beskrivning
Documentation Part: Pregnancy Notification Form (Subject) An Open Label, Repeat Dose, Dose Escalation Study Conducted in Parkinson's Disease Patients to Characterize the Pharmacokinetics and Effect of Food on Ropinirole Prolonged Release (PR/CR) 12mg Tablets. ClinicalTrials.gov Identifier: NCT00460148 https://clinicaltrials.gov/ct2/show/NCT00460148?term=NCT00460148&rank=1 Responsible Party: GlaxoSmithKline
Länk
https://clinicaltrials.gov/ct2/show/NCT00460148?term=NCT00460148&rank=1
Nyckelord
Versioner (2)
- 2017-04-10 2017-04-10 -
- 2017-04-10 2017-04-10 -
Uppladdad den
10 april 2017
DOI
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Licens
Creative Commons BY-NC 3.0
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Pregnancy Notification Form (Subject) Parkinson's Disease Patient Study On Absorption, Distribution, Metabolism And Excretion Of Ropinirole NCT00460148
Pregnancy Notification Form (Subject) Parkinson's Disease Patient Study On Absorption, Distribution, Metabolism And Excretion Of Ropinirole NCT00460148
Beskrivning
Mother's relevant medical/family history
Alias
- UMLS CUI-1
- C0262926
- UMLS CUI-2
- C0241889
- UMLS CUI-3
- C0026591
Beskrivning
Mother's date of birth
Datatyp
date
Måttenheter
- Day Month Year
Alias
- UMLS CUI [1,1]
- C0026591
- UMLS CUI [1,2]
- C0421451
Beskrivning
Date of last menstrual period
Datatyp
date
Måttenheter
- Day Month Year
Alias
- UMLS CUI [1]
- C0425932
Beskrivning
Estimated date of delivery
Datatyp
date
Måttenheter
- Day Month Year
Alias
- UMLS CUI [1]
- C1287845
Beskrivning
Was the mother using a method of contraception?
Datatyp
boolean
Alias
- UMLS CUI [1]
- C0700589
Beskrivning
If Yes, specify:
Datatyp
text
Alias
- UMLS CUI [1,1]
- C0700589
- UMLS CUI [1,2]
- C2348235
Beskrivning
Type of conception, tick one:
Datatyp
text
Alias
- UMLS CUI [1]
- C2598844
Beskrivning
Relevant laboratory tests and procedures (e.g., ultrasound, amniocentesis and chorionic villi sampling, including dates of tests and procedures).
Datatyp
text
Alias
- UMLS CUI [1,1]
- C0022885
- UMLS CUI [1,2]
- C0430022
Beskrivning
Number of previous pregnancies: Pre-term
Datatyp
integer
Alias
- UMLS CUI [1,1]
- C0032961
- UMLS CUI [1,2]
- C1547235
- UMLS CUI [1,3]
- C0449788
Beskrivning
Number of previous pragnancies: Full-term
Datatyp
text
Alias
- UMLS CUI [1,1]
- C0032961
- UMLS CUI [1,2]
- C3814420
- UMLS CUI [1,3]
- C0449788
Beskrivning
Normal births
Datatyp
integer
Alias
- UMLS CUI [1]
- C3665337
Beskrivning
Stillbirths
Datatyp
integer
Alias
- UMLS CUI [1]
- C0595939
Beskrivning
Children born with defects
Datatyp
integer
Alias
- UMLS CUI [1,1]
- C0000768
- UMLS CUI [1,2]
- C2229974
Beskrivning
Record details of children born with defects
Datatyp
text
Alias
- UMLS CUI [1,1]
- C1522508
- UMLS CUI [1,2]
- C0000768
- UMLS CUI [1,3]
- C2229974
Beskrivning
Spontaneous abortion
Datatyp
integer
Alias
- UMLS CUI [1]
- C0000786
Beskrivning
Elective abortion
Datatyp
integer
Alias
- UMLS CUI [1]
- C0269439
Beskrivning
Other
Datatyp
integer
Alias
- UMLS CUI [1,1]
- C0205394
- UMLS CUI [1,2]
- C0156543
Beskrivning
Are there any additional factors that may have an impact on the outcome of this pregnancy?
Datatyp
boolean
Alias
- UMLS CUI [1,1]
- C0032972
- UMLS CUI [1,2]
- C1521761
Beskrivning
If Yes, specify
Datatyp
text
Alias
- UMLS CUI [1,1]
- C2348235
- UMLS CUI [1,2]
- C0032972
- UMLS CUI [1,3]
- C1521761
Beskrivning
Father's Relevant Medical/Family History
Alias
- UMLS CUI-1
- C0262926
- UMLS CUI-2
- C0241889
- UMLS CUI-3
- C0015671
Beskrivning
Drug Exposures
Alias
- UMLS CUI-1
- C0743284
Beskrivning
Trade Name preferred
Datatyp
text
Alias
- UMLS CUI [1]
- C0013227
Beskrivning
Route of Admin. or Formulation
Datatyp
text
Alias
- UMLS CUI [1]
- C0013153
Beskrivning
Total Daily Dose
Datatyp
text
Alias
- UMLS CUI [1]
- C2348070
Beskrivning
Units
Datatyp
text
Alias
- UMLS CUI [1]
- C1519795
Beskrivning
Started Pre-Study
Datatyp
text
Alias
- UMLS CUI [1,1]
- C0013227
- UMLS CUI [1,2]
- C0451613
Beskrivning
Start Date
Datatyp
date
Måttenheter
- Day Month Year
Alias
- UMLS CUI [1,1]
- C0013227
- UMLS CUI [1,2]
- C0808070
Beskrivning
Stop Date
Datatyp
date
Måttenheter
- Day Month Year
Alias
- UMLS CUI [1,1]
- C0013227
- UMLS CUI [1,2]
- C0806020
Beskrivning
Ongoing Medication
Datatyp
text
Alias
- UMLS CUI [1]
- C2826666
Beskrivning
Reason for Medication
Datatyp
text
Alias
- UMLS CUI [1,1]
- C0392360
- UMLS CUI [1,2]
- C0013227
Beskrivning
Subject withdrawal
Alias
- UMLS CUI-1
- C0422727
Beskrivning
Reporting Investigator Information
Alias
- UMLS CUI-1
- C0008961
- UMLS CUI-2
- C1533716
Beskrivning
Name
Datatyp
text
Alias
- UMLS CUI [1]
- C2826892
Beskrivning
Title
Datatyp
text
Alias
- UMLS CUI [1,1]
- C3888414
- UMLS CUI [1,2]
- C0008961
Beskrivning
Speciality
Datatyp
text
Alias
- UMLS CUI [1,1]
- C0037778
- UMLS CUI [1,2]
- C0008961
Beskrivning
Address
Datatyp
text
Alias
- UMLS CUI [1,1]
- C1442065
- UMLS CUI [1,2]
- C0008961
Beskrivning
City or State/Province
Datatyp
text
Alias
- UMLS CUI [1,1]
- C1555315
- UMLS CUI [1,2]
- C1301808
Beskrivning
Country
Datatyp
text
Alias
- UMLS CUI [1,1]
- C0454664
- UMLS CUI [1,2]
- C0008961
Beskrivning
Post or Zip Code
Datatyp
text
Alias
- UMLS CUI [1,1]
- C3166855
- UMLS CUI [1,2]
- C0008961
Beskrivning
Telephone No
Datatyp
text
Alias
- UMLS CUI [1,1]
- C1515258
- UMLS CUI [1,2]
- C0008961
Beskrivning
Fax No
Datatyp
text
Alias
- UMLS CUI [1,1]
- C1549619
- UMLS CUI [1,2]
- C0008961
Beskrivning
(confirming that the data on these pages are accurate and complete)
Datatyp
text
Alias
- UMLS CUI [1]
- C2346576
Beskrivning
Date
Datatyp
date
Måttenheter
- Day Month Year
Alias
- UMLS CUI [1,1]
- C0011008
- UMLS CUI [1,2]
- C2346576
Beskrivning
Investigator's name (print)
Datatyp
text
Alias
- UMLS CUI [1]
- C2826892
Similar models
Pregnancy Notification Form (Subject) Parkinson's Disease Patient Study On Absorption, Distribution, Metabolism And Excretion Of Ropinirole NCT00460148
C0019994 (UMLS CUI [1,2])
C0237753 (UMLS CUI [1,2])
C0241889 (UMLS CUI-2)
C0026591 (UMLS CUI-3)
C0421451 (UMLS CUI [1,2])
C2348235 (UMLS CUI [1,2])
C0430022 (UMLS CUI [1,2])
C1547235 (UMLS CUI [1,2])
C0449788 (UMLS CUI [1,3])
C3814420 (UMLS CUI [1,2])
C0449788 (UMLS CUI [1,3])
C2229974 (UMLS CUI [1,2])
C0000768 (UMLS CUI [1,2])
C2229974 (UMLS CUI [1,3])
C0156543 (UMLS CUI [1,2])
C1521761 (UMLS CUI [1,2])
C0032972 (UMLS CUI [1,2])
C1521761 (UMLS CUI [1,3])
C0241889 (UMLS CUI-2)
C0015671 (UMLS CUI-3)
C0241889 (UMLS CUI [1,2])
C0015671 (UMLS CUI [1,3])
C0808070 (UMLS CUI [1,2])
C0806020 (UMLS CUI [1,2])
C0013227 (UMLS CUI [1,2])
C1533716 (UMLS CUI-2)
C0008961 (UMLS CUI [1,2])
C0008961 (UMLS CUI [1,2])
C0008961 (UMLS CUI [1,2])
C1301808 (UMLS CUI [1,2])
C0008961 (UMLS CUI [1,2])
C0008961 (UMLS CUI [1,2])
C0008961 (UMLS CUI [1,2])
C0008961 (UMLS CUI [1,2])
C2346576 (UMLS CUI [1,2])