ID

24693

Description

Study part: RLS Symptoms on the first day of the patient RLS Symptoms diary prior to the Baseline Visit. A 52-Week, Open-Label Study to Assess the Long-Term Safety of Ropinirole Extended Release (XR) in Patients with Restless Legs Syndrome (RLS). Patient Level Data: Study Listed on ClinicalStudyDataRequest.com. Clinicaltrials.gov Identifier: NCT00355641. Phase: phase 3. Study Recruitment Status: Completed. Generic Name: ropinirole. Trade Name Modutab, ZIPEREVE, ZEPREVE, REPREVE, ADARTREL, REQUIP, Zygara; Zygara, ZIPEREVE, ZEPREVE, Requip Depot, REQUIP, REPREVE, Modutab, ADARTREL. Study Indication : Restless Legs Syndrome. Study ID: 101468/206. Clinical Study ID: 101468/206.

Keywords

  1. 8/13/17 8/13/17 -
Copyright Holder

GlaxoSmithKline

Uploaded on

August 13, 2017

DOI

To request one please log in.

License

Creative Commons BY-NC 3.0

Model comments :

You can comment on the data model here. Via the speech bubbles at the itemgroups and items you can add comments to those specificially.

Itemgroup comments for :

Item comments for :

In order to download data models you must be logged in. Please log in or register for free.

RLS Symptoms on the first day of the patient RLS Symptoms diary prior to the Baseline Visit Ropinirole Restless Legs Syndrom NCT00355641

RLS Symptoms on the first day of the patient RLS Symptoms diary prior to the Baseline Visit

General Information
Description

General Information

Alias
UMLS CUI-1
C1508263
Doctor’s Name:
Description

Physician name

Data type

text

Alias
UMLS CUI [1]
C2361125
Telephone Number:
Description

Telephone Number

Data type

integer

Alias
UMLS CUI [1]
C1515258
Study Contact:
Description

Study Contact

Data type

text

Alias
UMLS CUI [1]
C0337611
Subject Identifier
Description

Subject Identifier

Data type

text

Alias
UMLS CUI [1]
C2348585
RLS Symptoms on the first day of the patient
Description

RLS Symptoms on the first day of the patient

Alias
UMLS CUI-1
C1457887
UMLS CUI-2
C0035258
Date
Description

From 07:00 on the morning to 06:59 of the next morning.

Data type

date

Alias
UMLS CUI [1]
C0011008
1. Did you experience any RLS symptoms during the period listed above?
Description

Symptoms RLS

Data type

boolean

Alias
UMLS CUI [1,1]
C1457887
UMLS CUI [1,2]
C0035258
2. What was the first time your RLS symptoms began?
Description

time

Data type

time

Alias
UMLS CUI [1]
C0040223
3. What time did you fall asleep?
Description

time fall sleep

Data type

time

Alias
UMLS CUI [1,1]
C0040223
UMLS CUI [1,2]
C3830397
4. What time did you wake up the following morning?
Description

time wake up

Data type

time

Alias
UMLS CUI [1,1]
C0040223
UMLS CUI [1,2]
C1170730
5. Which parts of your body were affected by RLS symptoms during the period listed above?
Description

site

Data type

integer

Alias
UMLS CUI [1]
C1515974
6. Did you have RLS symptoms in this time frame?- 7 a.m. to 11:59 a.m.
Description

time frame

Data type

boolean

Alias
UMLS CUI [1]
C0332168
7. What was the maximum severity of your RLS symptoms during this time frame?
Description

symptom severity

Data type

text

Alias
UMLS CUI [1]
C1319166
8. At any times you were sitting or resting, how soon afterwards did your RLS symptoms start during this time frame?
Description

symptom Beginning

Data type

integer

Alias
UMLS CUI [1,1]
C1457887
UMLS CUI [1,2]
C0439659
6. Did you have RLS symptoms in this time frame?- 12 p.m. to 2:59 p.m.Noon
Description

time frame

Data type

boolean

Alias
UMLS CUI [1]
C0332168
7. What was the maximum severity of your RLS symptoms during this time frame?
Description

symptom severity

Data type

text

Alias
UMLS CUI [1]
C1319166
8. At any times you were sitting or resting, how soon afterwards did your RLS symptoms start during this time frame?
Description

symptom Beginning

Data type

integer

Alias
UMLS CUI [1,1]
C1457887
UMLS CUI [1,2]
C0439659
6. Did you have RLS symptoms in this time frame?- 3 p.m. to 5:59 p.m.
Description

time frame

Data type

boolean

Alias
UMLS CUI [1]
C0332168
7. What was the maximum severity of your RLS symptoms during this time frame?
Description

symptom severity

Data type

text

Alias
UMLS CUI [1]
C1319166
8. At any times you were sitting or resting, how soon afterwards did your RLS symptoms start during this time frame?
Description

symptom Beginning

Data type

integer

Alias
UMLS CUI [1,1]
C1457887
UMLS CUI [1,2]
C0439659
6. Did you have RLS symptoms in this time frame?- 6 p.m. to 8:59 p.m.
Description

time frame

Data type

boolean

Alias
UMLS CUI [1]
C0332168
7. What was the maximum severity of your RLS symptoms during this time frame?
Description

symptom severity

Data type

text

Alias
UMLS CUI [1]
C1319166
8. At any times you were sitting or resting, how soon afterwards did your RLS symptoms start during this time frame?
Description

symptom Beginning

Data type

integer

Alias
UMLS CUI [1,1]
C1457887
UMLS CUI [1,2]
C0439659
6. Did you have RLS symptoms in this time frame?- 9 p.m. to 11:59 p.m.
Description

time frame

Data type

boolean

Alias
UMLS CUI [1]
C0332168
7. What was the maximum severity of your RLS symptoms during this time frame?
Description

symptom severity

Data type

text

Alias
UMLS CUI [1]
C1319166
8. At any times you were sitting or resting, how soon afterwards did your RLS symptoms start during this time frame?
Description

symptom Beginning

Data type

integer

Alias
UMLS CUI [1,1]
C1457887
UMLS CUI [1,2]
C0439659
6. Did you have RLS symptoms in this time frame?- 12 a.m. to 6:59 a.m. Midnight
Description

time frame

Data type

boolean

Alias
UMLS CUI [1]
C0332168
7. What was the maximum severity of your RLS symptoms during this time frame?
Description

symptom severity

Data type

text

Alias
UMLS CUI [1]
C1319166
8. At any times you were sitting or resting, how soon afterwards did your RLS symptoms start during this time frame?
Description

symptom Beginning

Data type

integer

Alias
UMLS CUI [1,1]
C1457887
UMLS CUI [1,2]
C0439659

Similar models

RLS Symptoms on the first day of the patient RLS Symptoms diary prior to the Baseline Visit

Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
General Information
C1508263 (UMLS CUI-1)
Physician name
Item
Doctor’s Name:
text
C2361125 (UMLS CUI [1])
Telephone Number
Item
Telephone Number:
integer
C1515258 (UMLS CUI [1])
Study Contact
Item
Study Contact:
text
C0337611 (UMLS CUI [1])
Subject Identifier
Item
Subject Identifier
text
C2348585 (UMLS CUI [1])
Item Group
RLS Symptoms on the first day of the patient
C1457887 (UMLS CUI-1)
C0035258 (UMLS CUI-2)
date
Item
Date
date
C0011008 (UMLS CUI [1])
Symptoms RLS
Item
1. Did you experience any RLS symptoms during the period listed above?
boolean
C1457887 (UMLS CUI [1,1])
C0035258 (UMLS CUI [1,2])
time
Item
2. What was the first time your RLS symptoms began?
time
C0040223 (UMLS CUI [1])
time fall sleep
Item
3. What time did you fall asleep?
time
C0040223 (UMLS CUI [1,1])
C3830397 (UMLS CUI [1,2])
time wake up
Item
4. What time did you wake up the following morning?
time
C0040223 (UMLS CUI [1,1])
C1170730 (UMLS CUI [1,2])
Item
5. Which parts of your body were affected by RLS symptoms during the period listed above?
integer
C1515974 (UMLS CUI [1])
Code List
5. Which parts of your body were affected by RLS symptoms during the period listed above?
CL Item
None (1)
CL Item
Below the knees (2)
CL Item
Below the hips (3)
CL Item
Arms and legs (4)
CL Item
Most of the body (5)
time frame
Item
6. Did you have RLS symptoms in this time frame?- 7 a.m. to 11:59 a.m.
boolean
C0332168 (UMLS CUI [1])
Item
7. What was the maximum severity of your RLS symptoms during this time frame?
text
C1319166 (UMLS CUI [1])
Code List
7. What was the maximum severity of your RLS symptoms during this time frame?
CL Item
None (None)
CL Item
Mild (Mild)
CL Item
Moderate (Moderate)
CL Item
Severe (Severe)
CL Item
Very Severe (Very Severe)
Item
8. At any times you were sitting or resting, how soon afterwards did your RLS symptoms start during this time frame?
integer
C1457887 (UMLS CUI [1,1])
C0439659 (UMLS CUI [1,2])
Code List
8. At any times you were sitting or resting, how soon afterwards did your RLS symptoms start during this time frame?
CL Item
After a very long time or never (1)
CL Item
After about an hour (2)
CL Item
After about half an hour (3)
CL Item
Within a few minutes (4)
CL Item
Immediately or almost immediately (5)
CL Item
Did not sit or rest during this time frame (6)
time frame
Item
6. Did you have RLS symptoms in this time frame?- 12 p.m. to 2:59 p.m.Noon
boolean
C0332168 (UMLS CUI [1])
Item
7. What was the maximum severity of your RLS symptoms during this time frame?
text
C1319166 (UMLS CUI [1])
Code List
7. What was the maximum severity of your RLS symptoms during this time frame?
CL Item
None (None)
CL Item
Mild (Mild)
CL Item
Moderate (Moderate)
CL Item
Severe (Severe)
CL Item
Very Severe (Very Severe)
Item
8. At any times you were sitting or resting, how soon afterwards did your RLS symptoms start during this time frame?
integer
C1457887 (UMLS CUI [1,1])
C0439659 (UMLS CUI [1,2])
Code List
8. At any times you were sitting or resting, how soon afterwards did your RLS symptoms start during this time frame?
CL Item
After a very long time or never (1)
CL Item
After about an hour (2)
CL Item
After about half an hour (3)
CL Item
Within a few minutes (4)
CL Item
Immediately or almost immediately (5)
CL Item
Did not sit or rest during this time frame (6)
time frame
Item
6. Did you have RLS symptoms in this time frame?- 3 p.m. to 5:59 p.m.
boolean
C0332168 (UMLS CUI [1])
Item
7. What was the maximum severity of your RLS symptoms during this time frame?
text
C1319166 (UMLS CUI [1])
Code List
7. What was the maximum severity of your RLS symptoms during this time frame?
CL Item
None (None)
CL Item
Mild (Mild)
CL Item
Moderate (Moderate)
CL Item
Severe (Severe)
CL Item
Very Severe (Very Severe)
Item
8. At any times you were sitting or resting, how soon afterwards did your RLS symptoms start during this time frame?
integer
C1457887 (UMLS CUI [1,1])
C0439659 (UMLS CUI [1,2])
Code List
8. At any times you were sitting or resting, how soon afterwards did your RLS symptoms start during this time frame?
CL Item
After a very long time or never (1)
CL Item
After about an hour (2)
CL Item
After about half an hour (3)
CL Item
Within a few minutes (4)
CL Item
Immediately or almost immediately (5)
CL Item
Did not sit or rest during this time frame (6)
time frame
Item
6. Did you have RLS symptoms in this time frame?- 6 p.m. to 8:59 p.m.
boolean
C0332168 (UMLS CUI [1])
Item
7. What was the maximum severity of your RLS symptoms during this time frame?
text
C1319166 (UMLS CUI [1])
Code List
7. What was the maximum severity of your RLS symptoms during this time frame?
CL Item
None (None)
CL Item
Mild (Mild)
CL Item
Moderate (Moderate)
CL Item
Severe (Severe)
CL Item
Very Severe (Very Severe)
Item
8. At any times you were sitting or resting, how soon afterwards did your RLS symptoms start during this time frame?
integer
C1457887 (UMLS CUI [1,1])
C0439659 (UMLS CUI [1,2])
Code List
8. At any times you were sitting or resting, how soon afterwards did your RLS symptoms start during this time frame?
CL Item
After a very long time or never (1)
CL Item
After about an hour (2)
CL Item
After about half an hour (3)
CL Item
Within a few minutes (4)
CL Item
Immediately or almost immediately (5)
CL Item
Did not sit or rest during this time frame (6)
time frame
Item
6. Did you have RLS symptoms in this time frame?- 9 p.m. to 11:59 p.m.
boolean
C0332168 (UMLS CUI [1])
Item
7. What was the maximum severity of your RLS symptoms during this time frame?
text
C1319166 (UMLS CUI [1])
Code List
7. What was the maximum severity of your RLS symptoms during this time frame?
CL Item
None (None)
CL Item
Mild (Mild)
CL Item
Moderate (Moderate)
CL Item
Severe (Severe)
CL Item
Very Severe (Very Severe)
Item
8. At any times you were sitting or resting, how soon afterwards did your RLS symptoms start during this time frame?
integer
C1457887 (UMLS CUI [1,1])
C0439659 (UMLS CUI [1,2])
Code List
8. At any times you were sitting or resting, how soon afterwards did your RLS symptoms start during this time frame?
CL Item
After a very long time or never (1)
CL Item
After about an hour (2)
CL Item
After about half an hour (3)
CL Item
Within a few minutes (4)
CL Item
Immediately or almost immediately (5)
CL Item
Did not sit or rest during this time frame (6)
time frame
Item
6. Did you have RLS symptoms in this time frame?- 12 a.m. to 6:59 a.m. Midnight
boolean
C0332168 (UMLS CUI [1])
Item
7. What was the maximum severity of your RLS symptoms during this time frame?
text
C1319166 (UMLS CUI [1])
Code List
7. What was the maximum severity of your RLS symptoms during this time frame?
CL Item
None (None)
CL Item
Mild (Mild)
CL Item
Moderate (Moderate)
CL Item
Severe (Severe)
CL Item
Very Severe (Very Severe)
Item
8. At any times you were sitting or resting, how soon afterwards did your RLS symptoms start during this time frame?
integer
C1457887 (UMLS CUI [1,1])
C0439659 (UMLS CUI [1,2])
Code List
8. At any times you were sitting or resting, how soon afterwards did your RLS symptoms start during this time frame?
CL Item
After a very long time or never (1)
CL Item
After about an hour (2)
CL Item
After about half an hour (3)
CL Item
Within a few minutes (4)
CL Item
Immediately or almost immediately (5)
CL Item
Did not sit or rest during this time frame (6)

Please use this form for feedback, questions and suggestions for improvements.

Fields marked with * are required.

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