ID

22460

Beschrijving

Study part: PGx- Pharmacogenetic Research.A Phase 2 Multicenter, Double-blind, Placebo-controlled, Study to to Evaluate the Corticosteroid- sparing effects of Mepolizumab in Subjects with Hypereosinophilic Syndromes (HES) and Evaluate Efficacy and Safety of Mepolizumab in Controlling the Clinical Signs and Symptoms of subjects with HES Patient Level Data: Study Listed on ClinicalStudyDataRequest.com. Sponsor: GlaxoSmithKline. Study ID: 100185, Clinical Study ID:MHE100185.

Trefwoorden

Versies (1)
  1. 05-06-17 05-06-17 -
Houder van rechten

GlaxoSmithKline

Geüploaded op

5 juni 2017

DOI

Voor een aanvraag inloggen.

Licentie

Creative Commons BY-NC 3.0
Model Commentaren :

Hier kunt u commentaar leveren op het model. U kunt de tekstballonnen bij de itemgroepen en items gebruiken om er specifiek commentaar op te geven.

Terug naar het model Commentaren
Itemgroep Commentaren voor :

Item Commentaren voor :

U moet ingelogd zijn om formulieren te downloaden. AUB inloggen of schrijf u gratis in.

Pharmacogenetic Research Mepolizumab HES NCT00086658

Engels

PGx- Pharmacogenetic Research

1 Formulieren  
CONSENT FOR PGx-PHARMACOGENETIC RESEARCH
Beschrijving

CONSENT FOR PGx-PHARMACOGENETIC RESEARCH

Alias
UMLS CUI-1
C0021430
UMLS CUI-2
C2347500
Study ID
Beschrijving

Study ID

Datatype

text

Alias
UMLS CUI [1]
C2826693
Has informed consent been obtained for PGx-Pharmacogenetic research?
Beschrijving

informed consent Pharmacogenetic Test

Datatype

boolean

Alias
UMLS CUI [1,1]
C0021430
UMLS CUI [1,2]
C2347500
If Yes,the date informed consent obtained for PGx-Pharmacogenetic research
Beschrijving

date Pharmacogenetic Test

Datatype

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C2347500
If No,reason:
Beschrijving

reason Pharmacogenetic Test

Datatype

text

Alias
UMLS CUI [1,1]
C0392360
UMLS CUI [1,2]
C2347500
If other, please specify
Beschrijving

Other

Datatype

text

Alias
UMLS CUI [1]
C0205394
BLOOD SAMPLE COLLECTION (DNA)
Beschrijving

BLOOD SAMPLE COLLECTION (DNA)

Alias
UMLS CUI-1
C0005834
Has a blood sample been collected for PGx-pharmacogenetic research?
Beschrijving

BLOOD SAMPLE COLLECTION

Datatype

boolean

Alias
UMLS CUI [1]
C0005834
If Yes, the date sample taken
Beschrijving

date BLOOD SAMPLE COLLECTION

Datatype

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C0005834
WITHDRAWAL OF CONSENT
Beschrijving

WITHDRAWAL OF CONSENT

Alias
UMLS CUI-1
C1707492
Has subject withdrawn consent for PGx-Pharmacogenetic research?
Beschrijving

WITHDRAWAL OF CONSENT

Datatype

boolean

Alias
UMLS CUI [1]
C1707492
BLOOD SAMPLE DESTRUCTION
Beschrijving

BLOOD SAMPLE DESTRUCTION

Alias
UMLS CUI-1
C1948029
UMLS CUI-2
C0178913
Has a request been made for sample destruction?
Beschrijving

BLOOD SAMPLE DESTRUCTION

Datatype

boolean

Alias
UMLS CUI [1,1]
C1948029
UMLS CUI [1,2]
C0178913
If Yes,reason:
Beschrijving

reason BLOOD SAMPLE DESTRUCTION

Datatype

text

Alias
UMLS CUI [1,1]
C0392360
UMLS CUI [1,2]
C1948029
UMLS CUI [1,3]
C0178913
If other, please specify
Beschrijving

Other

Datatype

text

Alias
UMLS CUI [1]
C0205394
Terug naar het begin van de pagina

Similar models

PGx- Pharmacogenetic Research

1 Formulieren
Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
CONSENT FOR PGx-PHARMACOGENETIC RESEARCH
C0021430 (UMLS CUI-1)
C2347500 (UMLS CUI-2)
Study ID
Item
Study ID
text
C2826693 (UMLS CUI [1])
informed consent Pharmacogenetic Test
Item
Has informed consent been obtained for PGx-Pharmacogenetic research?
boolean
C0021430 (UMLS CUI [1,1])
C2347500 (UMLS CUI [1,2])
date Pharmacogenetic Test
Item
If Yes,the date informed consent obtained for PGx-Pharmacogenetic research
date
C0011008 (UMLS CUI [1,1])
C2347500 (UMLS CUI [1,2])
Item
If No,reason:
text
C0392360 (UMLS CUI [1,1])
C2347500 (UMLS CUI [1,2])
reason
Code List
If No,reason:
CL Item
Subject declined (Subject declined)
CL Item
Subject not asked by Investigator (Subject not asked by Investigator)
CL Item
Other, specify (Other, specify)
Other
Item
If other, please specify
text
C0205394 (UMLS CUI [1])
Item Group
BLOOD SAMPLE COLLECTION (DNA)
C0005834 (UMLS CUI-1)
BLOOD SAMPLE COLLECTION
Item
Has a blood sample been collected for PGx-pharmacogenetic research?
boolean
C0005834 (UMLS CUI [1])
date BLOOD SAMPLE COLLECTION
Item
If Yes, the date sample taken
date
C0011008 (UMLS CUI [1,1])
C0005834 (UMLS CUI [1,2])
Item Group
WITHDRAWAL OF CONSENT
C1707492 (UMLS CUI-1)
WITHDRAWAL OF CONSENT
Item
Has subject withdrawn consent for PGx-Pharmacogenetic research?
boolean
C1707492 (UMLS CUI [1])
Item Group
BLOOD SAMPLE DESTRUCTION
C1948029 (UMLS CUI-1)
C0178913 (UMLS CUI-2)
BLOOD SAMPLE DESTRUCTION
Item
Has a request been made for sample destruction?
boolean
C1948029 (UMLS CUI [1,1])
C0178913 (UMLS CUI [1,2])
Item
If Yes,reason:
text
C0392360 (UMLS CUI [1,1])
C1948029 (UMLS CUI [1,2])
C0178913 (UMLS CUI [1,3])
reason BLOOD SAMPLE DESTRUCTION
Code List
If Yes,reason:
CL Item
Subject requested (Subject requested)
CL Item
Screen failure (Screen failure)
C1710476 (UMLS CUI-1)
CL Item
Other, specify (Other, specify)
C0205394 (UMLS CUI-1)
Other
Item
If other, please specify
text
C0205394 (UMLS CUI [1])
Terug naar het begin van de pagina 

Contact

Gebruik dit formulier voor feedback, vragen en verbeteringsvoorstellen.

Velden gemarkeerd met een * zijn verplicht.

Help

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