ID

25289

Description

Study part: Smoking History 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. 6/21/19 6/21/19 -
Copyright Holder

GlaxoSmithKline

Uploaded on

August 31, 2017

DOI

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License

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

English

Smoking History Screening

1 forms  
SMOKING HISTORY
Description

SMOKING HISTORY

Alias
UMLS CUI-1
C1519384
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
Is the subject a smoker?
Description

smoking status

Data type

boolean

Alias
UMLS CUI [1]
C1519386
Number of years subject has been smoking?
Description

Number of years smoking

Data type

integer

Measurement units
  • years
Alias
UMLS CUI [1,1]
C0037369
UMLS CUI [1,2]
C0439234
UMLS CUI [1,3]
C0449788
years
Average number of cigarettes smoked per day?
Description

number of cigarettes smoked per day

Data type

integer

Alias
UMLS CUI [1]
C3694146
Please state type of tobacco product (eg. pipe, cigar, chewing tobacco or cigarette)
Description

tobacco product

Data type

text

Alias
UMLS CUI [1]
C3166496
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Similar models

Smoking History Screening

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
SMOKING HISTORY
C1519384 (UMLS CUI-1)
Identification number
Item
Volunteer panel number
integer
C1300638 (UMLS CUI [1])
Subject number
Item
Subject number
integer
C2348585 (UMLS CUI [1])
smoking status
Item
Is the subject a smoker?
boolean
C1519386 (UMLS CUI [1])
Number of years smoking
Item
Number of years subject has been smoking?
integer
C0037369 (UMLS CUI [1,1])
C0439234 (UMLS CUI [1,2])
C0449788 (UMLS CUI [1,3])
number of cigarettes smoked per day
Item
Average number of cigarettes smoked per day?
integer
C3694146 (UMLS CUI [1])
tobacco product
Item
Please state type of tobacco product (eg. pipe, cigar, chewing tobacco or cigarette)
text
C3166496 (UMLS CUI [1])
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