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Pre-study PD medications GSK study Dyskinesia in Parkinson's disease NCT00363727

1 Formulários  
General information
Descrição

General information

Protocol identifier
Descrição

Protocol identifier

Tipo de dados

text

Subject Identifier
Descrição

Subject Identifier

Tipo de dados

text

Alias
UMLS CUI [1]
C2348585
Visit Description
Descrição

Visit Description

Tipo de dados

text

Prior L-Dopa medication
Descrição

Prior L-Dopa medication

Was any L-Dopa taken by the subject within 30 days prior to the study?
Descrição

If Yes, record information below.

Tipo de dados

boolean

Drug name
Descrição

(Trade Name preferred)

Tipo de dados

text

Unit Dose
Descrição

Unit Dose

Tipo de dados

float

Units
Descrição

The following lists of abbreviations are examples which can be used to aid the completion of the appropriate items on the L-Dopa page.These are not all inclusive lists and are for guidance only, other abbreviations may be used if necessary. Abbreviation Label: TAB = Tablet, MCL = Microlitre, ML = Millilitre, L = Litre, MCG = Microgram, MG = Milligram, G = Gram

Tipo de dados

text

Frequency
Descrição

The following lists of abbreviations are examples which can be used to aid the completion of the appropriate items on the L-Dopa page.These are not all inclusive lists and are for guidance only, other abbreviations may be used if necessary. Abbreviation Label: OD = 1 x Daily, BID = 2 x Daily, TIO = 3x Daily, QID = 4x Daily, PRN = As required

Tipo de dados

text

Route
Descrição

The following lists of abbreviations are examples which can be used to aid the completion of the appropriate items on the L-Dopa page.These are not all inclusive lists and are for guidance only, other abbreviations may be used if necessary. Abbreviation Label: IM = Intramuscular, IH = Inhalation, IV = Intravenous, NS = Nasal, TP = Topical, PO = Oral, VG = Vaginal

Tipo de dados

text

Reason for Medication
Descrição

Parkinson's

Tipo de dados

text

Start Date
Descrição

Start Date

Tipo de dados

date

Stop Date
Descrição

Stop Date

Tipo de dados

date

Ongoing Medication?
Descrição

Ongoing Medication

Tipo de dados

boolean

Prior Parkinson's medication
Descrição

Prior Parkinson's medication

Has the subject taken any prior Parkinson's medication (excluding L-Dopa) within 30 days prior to the study?
Descrição

If Yes, record each medication on a separate line using Trade Names where possible.

Tipo de dados

boolean

Drug name
Descrição

(Trade Name preferred)

Tipo de dados

text

Unit Dose
Descrição

Unit Dose

Tipo de dados

float

Units
Descrição

The following lists of abbreviations are examples which can be used to aid the completion of the appropriate items on the L-Dopa page.These are not all inclusive lists and are for guidance only, other abbreviations may be used if necessary. Abbreviation Label: TAB = Tablet, MCL = Microlitre, ML = Millilitre, L = Litre, MCG = Microgram, MG = Milligram, G = Gram

Tipo de dados

text

Frequency
Descrição

The following lists of abbreviations are examples which can be used to aid the completion of the appropriate items on the L-Dopa page.These are not all inclusive lists and are for guidance only, other abbreviations may be used if necessary. Abbreviation Label: OD = 1 x Daily, BID = 2 x Daily, TIO = 3x Daily, QID = 4x Daily, PRN = As required

Tipo de dados

text

Reason for Medication
Descrição

Parkinson's

Tipo de dados

text

Stop Date
Descrição

Stop Date

Tipo de dados

date

Ongoing Medication?
Descrição

Ongoing Medication

Tipo de dados

boolean

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Pre-study PD medications GSK study Dyskinesia in Parkinson's disease NCT00363727

1 Formulários
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de dados
Alias
Item Group
General information
Protocol identifier
Item
Protocol identifier
text
Subject Identifier
Item
Subject Identifier
text
C2348585 (UMLS CUI [1])
Visit Description
Item
Visit Description
text
Item Group
Prior L-Dopa medication
L-Dopa within 30 days prior to study
Item
Was any L-Dopa taken by the subject within 30 days prior to the study?
boolean
Drug name
Item
Drug name
text
Unit Dose
Item
Unit Dose
float
Units
Item
Units
text
Frequency
Item
Frequency
text
Route
Item
Route
text
Reason for Medication
Item
Reason for Medication
text
Start Date
Item
Start Date
date
Stop Date
Item
Stop Date
date
Ongoing Medication
Item
Ongoing Medication?
boolean
Item Group
Prior Parkinson's medication
Parkinson's medication within 30 days prior to study
Item
Has the subject taken any prior Parkinson's medication (excluding L-Dopa) within 30 days prior to the study?
boolean
Drug name
Item
Drug name
text
Unit Dose
Item
Unit Dose
float
Units
Item
Units
text
Frequency
Item
Frequency
text
Reason for Medication
Item
Reason for Medication
text
Stop Date
Item
Stop Date
date
Ongoing Medication
Item
Ongoing Medication?
boolean
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