ID
21087
Beschrijving
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
Link
https://clinicaltrials.gov/ct2/show/NCT00460148?term=NCT00460148&rank=1
Trefwoorden
Versies (2)
- 10-04-17 10-04-17 -
- 10-04-17 10-04-17 -
Geüploaded op
10 april 2017
DOI
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Licentie
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
Beschrijving
Mother's relevant medical/family history
Alias
- UMLS CUI-1
- C0262926
- UMLS CUI-2
- C0241889
- UMLS CUI-3
- C0026591
Beschrijving
Mother's date of birth
Datatype
date
Maateenheden
- Day Month Year
Alias
- UMLS CUI [1,1]
- C0026591
- UMLS CUI [1,2]
- C0421451
Beschrijving
Date of last menstrual period
Datatype
date
Maateenheden
- Day Month Year
Alias
- UMLS CUI [1]
- C0425932
Beschrijving
Estimated date of delivery
Datatype
date
Maateenheden
- Day Month Year
Alias
- UMLS CUI [1]
- C1287845
Beschrijving
Was the mother using a method of contraception?
Datatype
boolean
Alias
- UMLS CUI [1]
- C0700589
Beschrijving
If Yes, specify:
Datatype
text
Alias
- UMLS CUI [1,1]
- C0700589
- UMLS CUI [1,2]
- C2348235
Beschrijving
Type of conception, tick one:
Datatype
text
Alias
- UMLS CUI [1]
- C2598844
Beschrijving
Relevant laboratory tests and procedures (e.g., ultrasound, amniocentesis and chorionic villi sampling, including dates of tests and procedures).
Datatype
text
Alias
- UMLS CUI [1,1]
- C0022885
- UMLS CUI [1,2]
- C0430022
Beschrijving
Number of previous pregnancies: Pre-term
Datatype
integer
Alias
- UMLS CUI [1,1]
- C0032961
- UMLS CUI [1,2]
- C1547235
- UMLS CUI [1,3]
- C0449788
Beschrijving
Number of previous pragnancies: Full-term
Datatype
text
Alias
- UMLS CUI [1,1]
- C0032961
- UMLS CUI [1,2]
- C3814420
- UMLS CUI [1,3]
- C0449788
Beschrijving
Normal births
Datatype
integer
Alias
- UMLS CUI [1]
- C3665337
Beschrijving
Stillbirths
Datatype
integer
Alias
- UMLS CUI [1]
- C0595939
Beschrijving
Children born with defects
Datatype
integer
Alias
- UMLS CUI [1,1]
- C0000768
- UMLS CUI [1,2]
- C2229974
Beschrijving
Record details of children born with defects
Datatype
text
Alias
- UMLS CUI [1,1]
- C1522508
- UMLS CUI [1,2]
- C0000768
- UMLS CUI [1,3]
- C2229974
Beschrijving
Spontaneous abortion
Datatype
integer
Alias
- UMLS CUI [1]
- C0000786
Beschrijving
Elective abortion
Datatype
integer
Alias
- UMLS CUI [1]
- C0269439
Beschrijving
Other
Datatype
integer
Alias
- UMLS CUI [1,1]
- C0205394
- UMLS CUI [1,2]
- C0156543
Beschrijving
Are there any additional factors that may have an impact on the outcome of this pregnancy?
Datatype
boolean
Alias
- UMLS CUI [1,1]
- C0032972
- UMLS CUI [1,2]
- C1521761
Beschrijving
If Yes, specify
Datatype
text
Alias
- UMLS CUI [1,1]
- C2348235
- UMLS CUI [1,2]
- C0032972
- UMLS CUI [1,3]
- C1521761
Beschrijving
Father's Relevant Medical/Family History
Alias
- UMLS CUI-1
- C0262926
- UMLS CUI-2
- C0241889
- UMLS CUI-3
- C0015671
Beschrijving
Drug Exposures
Alias
- UMLS CUI-1
- C0743284
Beschrijving
Trade Name preferred
Datatype
text
Alias
- UMLS CUI [1]
- C0013227
Beschrijving
Route of Admin. or Formulation
Datatype
text
Alias
- UMLS CUI [1]
- C0013153
Beschrijving
Total Daily Dose
Datatype
text
Alias
- UMLS CUI [1]
- C2348070
Beschrijving
Units
Datatype
text
Alias
- UMLS CUI [1]
- C1519795
Beschrijving
Started Pre-Study
Datatype
text
Alias
- UMLS CUI [1,1]
- C0013227
- UMLS CUI [1,2]
- C0451613
Beschrijving
Start Date
Datatype
date
Maateenheden
- Day Month Year
Alias
- UMLS CUI [1,1]
- C0013227
- UMLS CUI [1,2]
- C0808070
Beschrijving
Stop Date
Datatype
date
Maateenheden
- Day Month Year
Alias
- UMLS CUI [1,1]
- C0013227
- UMLS CUI [1,2]
- C0806020
Beschrijving
Ongoing Medication
Datatype
text
Alias
- UMLS CUI [1]
- C2826666
Beschrijving
Reason for Medication
Datatype
text
Alias
- UMLS CUI [1,1]
- C0392360
- UMLS CUI [1,2]
- C0013227
Beschrijving
Subject withdrawal
Alias
- UMLS CUI-1
- C0422727
Beschrijving
Reporting Investigator Information
Alias
- UMLS CUI-1
- C0008961
- UMLS CUI-2
- C1533716
Beschrijving
Name
Datatype
text
Alias
- UMLS CUI [1]
- C2826892
Beschrijving
Title
Datatype
text
Alias
- UMLS CUI [1,1]
- C3888414
- UMLS CUI [1,2]
- C0008961
Beschrijving
Speciality
Datatype
text
Alias
- UMLS CUI [1,1]
- C0037778
- UMLS CUI [1,2]
- C0008961
Beschrijving
Address
Datatype
text
Alias
- UMLS CUI [1,1]
- C1442065
- UMLS CUI [1,2]
- C0008961
Beschrijving
City or State/Province
Datatype
text
Alias
- UMLS CUI [1,1]
- C1555315
- UMLS CUI [1,2]
- C1301808
Beschrijving
Country
Datatype
text
Alias
- UMLS CUI [1,1]
- C0454664
- UMLS CUI [1,2]
- C0008961
Beschrijving
Post or Zip Code
Datatype
text
Alias
- UMLS CUI [1,1]
- C3166855
- UMLS CUI [1,2]
- C0008961
Beschrijving
Telephone No
Datatype
text
Alias
- UMLS CUI [1,1]
- C1515258
- UMLS CUI [1,2]
- C0008961
Beschrijving
Fax No
Datatype
text
Alias
- UMLS CUI [1,1]
- C1549619
- UMLS CUI [1,2]
- C0008961
Beschrijving
(confirming that the data on these pages are accurate and complete)
Datatype
text
Alias
- UMLS CUI [1]
- C2346576
Beschrijving
Date
Datatype
date
Maateenheden
- Day Month Year
Alias
- UMLS CUI [1,1]
- C0011008
- UMLS CUI [1,2]
- C2346576
Beschrijving
Investigator's name (print)
Datatype
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])