ID

25205

Descripción

Study part: CRF Tracking/ Review Form (TRF) Study Conclusion. A 52 Week Open-Label Extension Study of the Long-Term Safety of Ropinirole in Subjects Suffering from Restless Legs Syndrome (RLS). Patient Level Data: Study Listed on ClinicalStudyDataRequest.com. 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: 101468/192. Clinical Study ID: 101468/192

Palabras clave

Versiones (2)
  1. 28/8/17 28/8/17 -
  2. 15/3/19 15/3/19 -
Titular de derechos de autor

GlaxoSmithKline

Subido en

28 de agosto de 2017

DOI

Para solicitar uno, por favor iniciar sesión.

Licencia

Creative Commons BY-NC 3.0
Comentarios del modelo :

Puede comentar sobre el modelo de datos aquí. A través de las burbujas de diálogo en los grupos de elementos y elementos, puede agregar comentarios específicos.

Volver a los comentarios del modelo
Comentarios de grupo de elementos para :

Comentarios del elemento para :

Para descargar modelos de datos, debe haber iniciado sesión. Por favor iniciar sesión o Registrate gratis.

CRF Tracking/ Review Form (TRF) Study Conclusion Ropinirole Restless Legs Syndrom 101468/192

Inglés

CRF Tracking/ Review Form (TRF) Study Conclusion

1 formularios  
CRF TRACKING/REVIEW FORM (TRF)
Descripción

CRF TRACKING/REVIEW FORM (TRF)

Alias
UMLS CUI-1
C3258859
Centre Number
Descripción

Centre Number

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C0600091
UMLS CUI [1,2]
C0019994
Patient Initials
Descripción

Patient Initials

Tipo de datos

text

Alias
UMLS CUI [1]
C2986440
Investigator
Descripción

Investigator

Tipo de datos

text

Alias
UMLS CUI [1]
C2826892
Screening Failure (archive only)
Descripción

Screening Failure

Tipo de datos

boolean

Alias
UMLS CUI [1]
C1512714
MOD6
Descripción

Module Description: Wk 12 - Wk 24 to Cont/Wthd

Tipo de datos

text

Alias
UMLS CUI [1]
C1709061
Missing pages (if applicable)
Descripción

pages

Tipo de datos

text

Alias
UMLS CUI [1]
C1548329
MOD6A
Descripción

Module Description: Wk 12

Tipo de datos

text

Alias
UMLS CUI [1]
C1709061
Missing pages (if applicable)
Descripción

pages

Tipo de datos

text

Alias
UMLS CUI [1]
C1548329
MOD6B
Descripción

Module Description: Wk 24

Tipo de datos

text

Alias
UMLS CUI [1]
C1709061
Missing pages (if applicable)
Descripción

pages

Tipo de datos

text

Alias
UMLS CUI [1]
C1548329
MOD7
Descripción

Module Description: Wk 12 - Wk 24 RLS Scale

Tipo de datos

text

Alias
UMLS CUI [1]
C1709061
Missing pages (if applicable)
Descripción

pages

Tipo de datos

text

Alias
UMLS CUI [1]
C1548329
MOD8
Descripción

Module Description: Wk 12 - Wk 24 Patient Rating Scale

Tipo de datos

text

Alias
UMLS CUI [1]
C1709061
Missing pages (if applicable)
Descripción

pages

Tipo de datos

text

Alias
UMLS CUI [1]
C1548329
SAE3
Descripción

Module Description: Serious Adverse Experiences

Tipo de datos

text

Alias
UMLS CUI [1]
C1709061
Missing pages (if applicable)
Descripción

pages

Tipo de datos

text

Alias
UMLS CUI [1]
C1548329
SAE4
Descripción

Module Description: Serious Adverse Experiences

Tipo de datos

text

Alias
UMLS CUI [1]
C1709061
Missing pages (if applicable)
Descripción

pages

Tipo de datos

text

Alias
UMLS CUI [1]
C1548329
FORMD
Descripción

Module Description: Form D

Tipo de datos

text

Alias
UMLS CUI [1]
C1709061
Missing pages (if applicable)
Descripción

pages

Tipo de datos

text

Alias
UMLS CUI [1]
C1548329
Site Monitor’s comments (eg. protocol violations or deviations)
Descripción

comment

Tipo de datos

text

Alias
UMLS CUI [1]
C0947611
Site Monitor’s Name
Descripción

Name

Tipo de datos

text

Alias
UMLS CUI [1]
C0027365
Site Monitor’s Signature
Descripción

Signature

Tipo de datos

text

Alias
UMLS CUI [1]
C1519316
Date Submitted
Descripción

Date Submitted

Tipo de datos

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C1515022
Volver a la parte superior de la página

Similar models

CRF Tracking/ Review Form (TRF) Study Conclusion

1 formularios
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
CRF TRACKING/REVIEW FORM (TRF)
C3258859 (UMLS CUI-1)
Centre Number
Item
Centre Number
integer
C0600091 (UMLS CUI [1,1])
C0019994 (UMLS CUI [1,2])
Patient Initials
Item
Patient Initials
text
C2986440 (UMLS CUI [1])
Investigator
Item
Investigator
text
C2826892 (UMLS CUI [1])
Screening Failure
Item
Screening Failure (archive only)
boolean
C1512714 (UMLS CUI [1])
Item
MOD6
text
C1709061 (UMLS CUI [1])
Module
Code List
MOD6
CL Item
Sent to DM (Sent to DM)
CL Item
Unused (Unused)
pages
Item
Missing pages (if applicable)
text
C1548329 (UMLS CUI [1])
Item
MOD6A
text
C1709061 (UMLS CUI [1])
Module
Code List
MOD6A
CL Item
Sent to DM (Sent to DM)
CL Item
Unused (Unused)
pages
Item
Missing pages (if applicable)
text
C1548329 (UMLS CUI [1])
Item
MOD6B
text
C1709061 (UMLS CUI [1])
Module
Code List
MOD6B
CL Item
Sent to DM (Sent to DM)
CL Item
Unused (Unused)
pages
Item
Missing pages (if applicable)
text
C1548329 (UMLS CUI [1])
Item
MOD7
text
C1709061 (UMLS CUI [1])
Module
Code List
MOD7
CL Item
Sent to DM (Sent to DM)
CL Item
Unused (Unused)
pages
Item
Missing pages (if applicable)
text
C1548329 (UMLS CUI [1])
Item
MOD8
text
C1709061 (UMLS CUI [1])
Module
Code List
MOD8
CL Item
Sent to DM (Sent to DM)
CL Item
Unused (Unused)
pages
Item
Missing pages (if applicable)
text
C1548329 (UMLS CUI [1])
Item
SAE3
text
C1709061 (UMLS CUI [1])
Module
Code List
SAE3
CL Item
Sent to DM (Sent to DM)
CL Item
Unused (Unused)
pages
Item
Missing pages (if applicable)
text
C1548329 (UMLS CUI [1])
Item
SAE4
text
C1709061 (UMLS CUI [1])
Module
Code List
SAE4
CL Item
Sent to DM (Sent to DM)
CL Item
Unused (Unused)
pages
Item
Missing pages (if applicable)
text
C1548329 (UMLS CUI [1])
Item
FORMD
text
C1709061 (UMLS CUI [1])
Module
Code List
FORMD
CL Item
Sent to DM (Sent to DM)
CL Item
Unused (Unused)
pages
Item
Missing pages (if applicable)
text
C1548329 (UMLS CUI [1])
comment
Item
Site Monitor’s comments (eg. protocol violations or deviations)
text
C0947611 (UMLS CUI [1])
Name
Item
Site Monitor’s Name
text
C0027365 (UMLS CUI [1])
Signature
Item
Site Monitor’s Signature
text
C1519316 (UMLS CUI [1])
Date Submitted
Item
Date Submitted
date
C0011008 (UMLS CUI [1,1])
C1515022 (UMLS CUI [1,2])
Volver a la parte superior de la página 

Contacto

Utilice este formulario para comentarios, preguntas y sugerencias.

Los campos marcados con * son obligatorios.

Ayuda

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