ID

25288

Description

Study part: Demography Screening. A Single Blind, Parallel Group, Up-titration, Phase 1 Study in Healthy Volunteers to Determine a Starting Dose and Select an Up-titration Regimen for a new Formulation of Ropinirole. Patient Level Data: Study Listed on ClinicalStudyDataRequest.com. Phase: phase 1. 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: 101468/201. Clinical Study ID: 101468/201

Keywords

Versions (2)
  1. 8/31/17 8/31/17 -
  2. 5/10/19 5/10/19 -
Copyright Holder

GlaxoSmithKline

Uploaded on

August 31, 2017

DOI

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License

Creative Commons BY-NC 3.0
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Demography Screening Ropinirole Restless Legs Syndrome 101468/201

English

Demography Screening

1 forms  
  1. StudyEvent: ODM
    1. Demography Screening
DEMOGRAPHY
Description

DEMOGRAPHY

Alias
UMLS CUI-1
C0011298
Volunteer panel number
Description

Identification number

Data type

integer

Alias
UMLS CUI [1]
C1300638
Subject number
Description

Subject number

Data type

integer

Alias
UMLS CUI [1]
C2348585
Date of birth
Description

Date of birth

Data type

date

Alias
UMLS CUI [1]
C0421451
Gender
Description

Gender

Data type

text

Alias
UMLS CUI [1]
C0079399
Race
Description

Race

Data type

integer

Alias
UMLS CUI [1]
C0034510
Other
Description

Other

Data type

text

Alias
UMLS CUI [1]
C0205394
Height
Description

Height

Data type

integer

Measurement units
  • cm
Alias
UMLS CUI [1]
C0005890
cm
Weight
Description

Weight

Data type

float

Measurement units
  • kg
Alias
UMLS CUI [1]
C0005910
kg
Body mass index
Description

Body mass index

Data type

float

Measurement units
  • kg/m 2
Alias
UMLS CUI [1]
C1305855
kg/m 2
Clinical Staff Signature
Description

Clinical Staff Signature

Data type

text

Alias
UMLS CUI [1,1]
C0025106
UMLS CUI [1,2]
C1519316
Date
Description

Date

Data type

date

Alias
UMLS CUI [1]
C0011008
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Similar models

Demography Screening

1 forms
  1. StudyEvent: ODM
    1. Demography Screening
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
DEMOGRAPHY
C0011298 (UMLS CUI-1)
Identification number
Item
Volunteer panel number
integer
C1300638 (UMLS CUI [1])
Subject number
Item
Subject number
integer
C2348585 (UMLS CUI [1])
Date of birth
Item
Date of birth
date
C0421451 (UMLS CUI [1])
Item
Gender
text
C0079399 (UMLS CUI [1])
Gender
Code List
Gender
CL Item
Female (F)
CL Item
Male (M)
Item
Race
integer
C0034510 (UMLS CUI [1])
Race
Code List
Race
CL Item
American Hispanic (1)
C0019576 (UMLS CUI-1)
(Comment:en)
CL Item
Arabic/North African (2)
C0238604 (UMLS CUI-1)
(Comment:en)
CL Item
Black (3)
C0005680 (UMLS CUI-1)
(Comment:en)
CL Item
East & South East Asian (4)
C0003983 (UMLS CUI-1)
(Comment:en)
CL Item
Japanese (5)
C1556094 (UMLS CUI-1)
(Comment:en)
CL Item
South Asian (6)
C1519427 (UMLS CUI-1)
(Comment:en)
CL Item
White/Caucasian (7)
C0043157 (UMLS CUI-1)
(Comment:en)
CL Item
Other (8)
C0205394 (UMLS CUI-1)
(Comment:en)
Other
Item
Other
text
C0205394 (UMLS CUI [1])
Height
Item
Height
integer
C0005890 (UMLS CUI [1])
Weight
Item
Weight
float
C0005910 (UMLS CUI [1])
Body mass index
Item
Body mass index
float
C1305855 (UMLS CUI [1])
Clinical Staff Signature
Item
Clinical Staff Signature
text
C0025106 (UMLS CUI [1,1])
C1519316 (UMLS CUI [1,2])
Date
Item
Date
date
C0011008 (UMLS CUI [1])
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