ID
25151
Beschreibung
DEMOGRAPHY Ropinirole Case Report Form GSK Study ID: 100013 Clinical Study ID: RRL100013 A 12-Week, Double-Blind, Placebo-Controlled, Twice-Daily Dosing Study to Assess the Efficacy and Safety of Ropinirole in Patients Suffering from Restless Legs Syndrome (RLS) Requiring Extended Treatment Coverage
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- 27.08.17 27.08.17 -
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27. August 2017
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DEMOGRAPHY Ropinirole Case Report Form GSK RRL100013
DEMOGRAPHY Ropinirole Case Report Form GSK
- StudyEvent: ODM
Beschreibung
VITAL SIGNS
Beschreibung
Height
Datentyp
integer
Maßeinheiten
- cm
Alias
- UMLS CUI [1]
- C0005890
Beschreibung
Weight
Datentyp
integer
Maßeinheiten
- kg
Alias
- UMLS CUI [1]
- C0005910
Beschreibung
Blood pressure Semi-Supine
Datentyp
integer
Maßeinheiten
- mmHg
Alias
- UMLS CUI [1,1]
- C0005823
- UMLS CUI [1,2]
- C0038846
Beschreibung
Blood pressure Standing position
Datentyp
integer
Maßeinheiten
- mmHg
Alias
- UMLS CUI [1,1]
- C0005823
- UMLS CUI [1,2]
- C0231472
Beschreibung
Heart rate standing position
Datentyp
integer
Maßeinheiten
- beats/minute
Alias
- UMLS CUI [1,1]
- C0018810
- UMLS CUI [1,2]
- C0231472
Beschreibung
Heart rate Semi-Supine
Datentyp
integer
Maßeinheiten
- beats/minute
Alias
- UMLS CUI [1,1]
- C0018810
- UMLS CUI [1,2]
- C0038846
Beschreibung
RLS DIAGNOSTIC CLINICAL INTERVIEW - WORKSHEET
Beschreibung
Final diagnosis
Datentyp
integer
Alias
- UMLS CUI [1]
- C0011900
Beschreibung
Does subject report growing pains:
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0423693
Beschreibung
Have you ever had unpleasant or uncomfortable feelings in your legs that occurred mainly while you were either sitting or lying down?
Datentyp
boolean
Alias
- UMLS CUI [1]
- C2112857
Beschreibung
Are these feelings painful rather than just uncomfortable?
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0030193
- UMLS CUI [2]
- C2051418
Beschreibung
How would you describe these feelings or sensations?
Datentyp
text
Alias
- UMLS CUI [1,1]
- C0036659
- UMLS CUI [1,2]
- C0678257
Beschreibung
Have you ever felt the need or urge to move your legs that occurred mainly while you were either sitting or lying down?
Datentyp
boolean
Alias
- UMLS CUI [1]
- C4289280
Beschreibung
Do these feelings in your legs ever become overwhelming to the point that you cannot resist moving your legs?
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0030193
Beschreibung
If you developed these feelings in your legs and you could not move your legs, or if someone were to hold your legs down, how would this effect the feelings in your legs?:
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0560841
Beschreibung
ALCOHOL INTAKE
Beschreibung
CAFFEINE INTAKE INVEST/GA TOR INSTRUCTIONS
Beschreibung
RLS SCREEN HISTORY
Beschreibung
What was the subject's age at the onset of RLS?
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C0206132
- UMLS CUI [1,2]
- C0035258
Beschreibung
Did the subject start any new medication near the time of their first onset of RLS symptoms that may have caused RLS?
Datentyp
boolean
Alias
- UMLS CUI [1,1]
- C0035258
- UMLS CUI [1,2]
- C0420250
Beschreibung
If female, did RLS symptoms develop during pregnancy?
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C0035258
- UMLS CUI [1,2]
- C0032961
Beschreibung
Has any first degree relative (mother/father, brother/sister, son/daughter) of the subject ever been diagnosed with or had symptoms of RLS?
Datentyp
boolean
Alias
- UMLS CUI [1,1]
- C0035258
- UMLS CUI [1,2]
- C0080103
Beschreibung
Has the subject ever had PLMS (Periodic Limb Movements during Sleep)?
Datentyp
boolean
Alias
- UMLS CUI [1]
- C1970020
Beschreibung
Has any first degree relative (mother/father, brother/sister, son/daughter) of the subject ever been diagnosed with or had symptoms of PLMS?
Datentyp
boolean
Alias
- UMLS CUI [1,1]
- C1970020
- UMLS CUI [1,2]
- C0080103
Beschreibung
Does the subject have any sleep disorder as defined by DSM IV other than qualifying disease state for this study?
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0851578
Beschreibung
When are the subject's current RLS symptoms mainly present?
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C0035258
- UMLS CUI [1,2]
- C1457887
Beschreibung
Have any of the following parts of the subject's body ever been affected by RLS symptoms?
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C0035258
- UMLS CUI [1,2]
- C0035258
Beschreibung
Does the subject consume alcohol?
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0001948
Beschreibung
If Yes, record the average number of units of alcohol' consumed per week
Datentyp
text
Alias
- UMLS CUI [1,1]
- C0001948
- UMLS CUI [1,2]
- C0556331
Beschreibung
Does the subject consume caffeine (coffee, tea, other caffeinated substances)?
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0948365
Beschreibung
INTERNATIONAL RESTLESS LEG SYNDROME STUDY GROUP (IRLSSG) DIAGNOSTIC CRITERIA
Beschreibung
An urge to move the legs, usually accompanied or caused by uncomfortable and unpleasant sensations in the legs.
Datentyp
boolean
Alias
- UMLS CUI [1,1]
- C0518561
- UMLS CUI [1,2]
- C0035258
Beschreibung
The urge to move or unpleasant sensations begin or worsen during periods of rest or inactivity such as lying or sitting.
Datentyp
boolean
Alias
- UMLS CUI [1,1]
- C0035258
- UMLS CUI [1,2]
- C3890554
Beschreibung
The urge to move or unpleasant sensations are partially or totally relieved by movement, such as walking or stretching, at least as long as the activity continues.
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C0080331
- UMLS CUI [1,2]
- C0600080
Beschreibung
The urge to move or unpleasant sensations are worse in the evening or night than during the day or only occur in the evening or night.
Datentyp
boolean
Alias
- UMLS CUI [1,1]
- C1457887
- UMLS CUI [1,2]
- C3845371
Beschreibung
CARDIOVASCULAR MEDICAL HISTORY
Beschreibung
Myocardial infarction
Datentyp
integer
Alias
- UMLS CUI [1]
- C0027051
Beschreibung
Atherosclerosis
Datentyp
integer
Alias
- UMLS CUI [1]
- C0004153
Beschreibung
Cardiac valve disease
Datentyp
integer
Alias
- UMLS CUI [1]
- C0018824
Beschreibung
Peripheral vascular disease
Datentyp
integer
Alias
- UMLS CUI [1]
- C0085096
Beschreibung
Unspecified cerebrovascular disease
Datentyp
integer
Alias
- UMLS CUI [1]
- C0007820
Beschreibung
Transient ischaemic attack
Datentyp
integer
Alias
- UMLS CUI [1]
- C0007787
Beschreibung
Stroke
Datentyp
integer
Alias
- UMLS CUI [1]
- C0038454
Beschreibung
Cardiac arrest
Datentyp
integer
Alias
- UMLS CUI [1]
- C0018790
Beschreibung
Coronary artery disease
Datentyp
integer
Alias
- UMLS CUI [1]
- C1956346
Beschreibung
ischaemic heart disease
Datentyp
integer
Alias
- UMLS CUI [1]
- C0151744
Beschreibung
ischaemic heart disease with cardiomyopathy
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C0151744
- UMLS CUI [1,2]
- C0878544
Beschreibung
Stable angina pectoris
Datentyp
integer
Alias
- UMLS CUI [1]
- C0340288
Beschreibung
Unstable angina
Datentyp
integer
Alias
- UMLS CUI [1]
- C0002965
Beschreibung
Heart failure
Datentyp
integer
Alias
- UMLS CUI [1]
- C0018801
Beschreibung
Arrhythmia
Datentyp
integer
Alias
- UMLS CUI [1]
- C0003811
Beschreibung
Left ventricular dysfunction
Datentyp
integer
Alias
- UMLS CUI [1]
- C0242698
Beschreibung
Pulmonary oedema
Datentyp
integer
Alias
- UMLS CUI [1]
- C0034063
Beschreibung
Hypertension
Datentyp
integer
Alias
- UMLS CUI [1]
- C0020538
Beschreibung
Oedema
Datentyp
text
Alias
- UMLS CUI [1]
- C0013604
Beschreibung
Left ventricular hypertrophy
Datentyp
integer
Alias
- UMLS CUI [1]
- C0149721
Beschreibung
Cardiomegaly
Datentyp
integer
Alias
- UMLS CUI [1]
- C0018800
Beschreibung
Cardiomyopathy
Datentyp
integer
Alias
- UMLS CUI [1]
- C0878544
Beschreibung
Diastolic dysfunction
Datentyp
integer
Alias
- UMLS CUI [1]
- C0520863
Beschreibung
Coronary artery by-pass
Datentyp
integer
Alias
- UMLS CUI [1]
- C0010055
Beschreibung
Angioplasty
Datentyp
integer
Alias
- UMLS CUI [1]
- C0162577
Beschreibung
STENT insertion
Datentyp
integer
Alias
- UMLS CUI [1]
- C0398087
Beschreibung
Cardiac transplantation
Datentyp
integer
Alias
- UMLS CUI [1]
- C3275052
Beschreibung
Amputation
Datentyp
integer
Alias
- UMLS CUI [1]
- C0002688
Beschreibung
Pacemaker insertion
Datentyp
integer
Alias
- UMLS CUI [1]
- C0189843
Beschreibung
Carotid endarterectomy
Datentyp
integer
Alias
- UMLS CUI [1]
- C3275052
Beschreibung
Vascular bypass graft (other than coronary)
Datentyp
integer
Alias
- UMLS CUI [1]
- C0863745
Ähnliche Modelle
DEMOGRAPHY Ropinirole Case Report Form GSK
- StudyEvent: ODM
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C0231472 (UMLS CUI [1,2])
C0038846 (UMLS CUI [1,2])
C0439544 (UMLS CUI-2)
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C0332148 (UMLS CUI-2)
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C2362652 (UMLS CUI-2)
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C0497153 (UMLS CUI-2)
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C0439544 (UMLS CUI-2)
C0332138 (UMLS CUI-3)
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C2362652 (UMLS CUI-2)
C0332138 (UMLS CUI-3)
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C0439673 (UMLS CUI-2)
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C2051418 (UMLS CUI [2])
C0678257 (UMLS CUI [1,2])
C0035258 (UMLS CUI [1,2])
C0420250 (UMLS CUI [1,2])
C0032961 (UMLS CUI [1,2])
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C0080103 (UMLS CUI [1,2])
C0080103 (UMLS CUI [1,2])
C1457887 (UMLS CUI [1,2])
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C0587117 (UMLS CUI-2)
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C0587117 (UMLS CUI-2)
C0332169 (UMLS CUI-3)
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C0035258 (UMLS CUI [1,2])
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C0027530 (UMLS CUI-3)
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C0556331 (UMLS CUI [1,2])
C0035258 (UMLS CUI [1,2])
C3890554 (UMLS CUI [1,2])
C0600080 (UMLS CUI [1,2])
C3845371 (UMLS CUI [1,2])
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C0878544 (UMLS CUI [1,2])
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C0012634 (UMLS CUI-2)
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C0012634 (UMLS CUI-2)
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C0012634 (UMLS CUI-2)
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C0012634 (UMLS CUI-2)
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C0012634 (UMLS CUI-2)
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C0012634 (UMLS CUI-2)
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C0012634 (UMLS CUI-2)
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C0012634 (UMLS CUI-2)
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C0012634 (UMLS CUI-2)
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C0012634 (UMLS CUI-2)
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C0012634 (UMLS CUI-2)
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C0012634 (UMLS CUI-2)
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C0012634 (UMLS CUI-2)
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C0012634 (UMLS CUI-2)
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C0012634 (UMLS CUI-2)
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C0012634 (UMLS CUI-2)
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C0012634 (UMLS CUI-2)
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C0012634 (UMLS CUI-2)
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C0012634 (UMLS CUI-2)
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C0012634 (UMLS CUI-2)
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C0012634 (UMLS CUI-2)
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C0012634 (UMLS CUI-2)
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C0012634 (UMLS CUI-2)
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C0012634 (UMLS CUI-2)
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