Englisch

GSK Ropinirole in Subjects with Restless Legs Syndrome 101468/191 Week 6 Day -1 (Form 10)

1 Formulare  
General Information
Beschreibung

General Information

Center Number
Beschreibung

Center Number

Datentyp

integer

Patient Number
Beschreibung

Patient Number

Datentyp

integer

Patient Initials
Beschreibung

Patient Initials

Datentyp

text

Visit Date
Beschreibung

Visit Date

Datentyp

date

Orthostatic Vital Signs
Beschreibung

Orthostatic Vital Signs

Time of dose
Beschreibung

Time of dose

Datentyp

time

Pre-Dose (Reading 1) Blood pressure after 10 minutes semi-supine (systolic)
Beschreibung

Pre-Dose (Reading 1) Blood pressure after 10 minutes semi-supine (systolic)

Datentyp

integer

Pre-Dose (Reading 1) Blood pressure after 10 minutes semi-supine (diastolic)
Beschreibung

Pre-Dose (Reading 1) Blood pressure after 10 minutes semi-supine (diastolic)

Datentyp

integer

Pre-Dose (Reading 1) After 10 minutes semi-supine Pulse
Beschreibung

Pre-Dose (Reading 1) After 10 minutes semi-supine Pulse

Datentyp

integer

Maßeinheiten
  • beats/min
beats/min
Pre-Dose (Reading 1) Blood pressure after erect for 1 minute (systolic)
Beschreibung

Pre-Dose (Reading 1) Blood pressure after erect for 1 minute (systolic)

Datentyp

integer

Pre-Dose (Reading 1) Blood pressure after erect for 1 minute (diastolic)
Beschreibung

Pre-Dose (Reading 1) Blood pressure after erect for 1 minute (diastolic)

Datentyp

integer

Pre-Dose (Reading 1) pulse after erect for 1 minute
Beschreibung

Pre-Dose (Reading 1) pulse after erect for 1 minute

Datentyp

integer

Maßeinheiten
  • beats/min
beats/min
Pre-Dose (Reading 2) Blood pressure after 10 minutes semi-supine (systolic)
Beschreibung

Pre-Dose (Reading 2) Blood pressure after 10 minutes semi-supine (systolic)

Datentyp

integer

Pre-Dose (Reading 2) Blood pressure after 10 minutes semi-supine (diastolic)
Beschreibung

Pre-Dose (Reading 2) Blood pressure after 10 minutes semi-supine (diastolic)

Datentyp

integer

Pre-Dose (Reading 2) After 10 minutes semi-supine Pulse
Beschreibung

Pre-Dose (Reading 2) After 10 minutes semi-supine Pulse

Datentyp

integer

Maßeinheiten
  • beats/min
beats/min
Pre-Dose (Reading 2) Blood pressure after erect for 1 minute (systolic)
Beschreibung

Pre-Dose (Reading 2) Blood pressure after erect for 1 minute (systolic)

Datentyp

integer

Pre-Dose (Reading 2) Blood pressure after erect for 1 minute (diastolic)
Beschreibung

Pre-Dose (Reading 2) Blood pressure after erect for 1 minute (diastolic)

Datentyp

integer

Pre-Dose (Reading 2) Pulse after erect for 1 minute
Beschreibung

Pre-Dose (Reading 2) Pulse after erect for 1 minute

Datentyp

integer

Maßeinheiten
  • beats/min
beats/min
2 hours Post-Dose (Reading 1) Blood pressure after 10 minutes semi-supine (systolic)
Beschreibung

2 hours Post-Dose (Reading 1) Blood pressure after 10 minutes semi-supine (systolic)

Datentyp

integer

2 hours Post-Dose (Reading 1) Blood pressure after 10 minutes semi-supine (diastolic)
Beschreibung

2 hours Post-Dose (Reading 1) Blood pressure after 10 minutes semi-supine (diastolic)

Datentyp

integer

2 hours Post-Dose (Reading 1) After 10 minutes semi-supine Pulse
Beschreibung

2 hours Post-Dose (Reading 1) After 10 minutes semi-supine Pulse

Datentyp

integer

Maßeinheiten
  • beats/min
beats/min
2 hours Post-Dose (Reading 1) Blood pressure after erect for 1 minute (systolic)
Beschreibung

2 hours Post-Dose (Reading 1) Blood pressure after erect for 1 minute (systolic)

Datentyp

integer

2 hours Post-Dose (Reading 1) Blood pressure after erect for 1 minute (diastolic)
Beschreibung

2 hours Post-Dose (Reading 1) Blood pressure after erect for 1 minute (diastolic)

Datentyp

integer

2 hours Post-Dose (Reading 1) Pulse after erect for 1 minute
Beschreibung

2 hours Post-Dose (Reading 1) Pulse after erect for 1 minute

Datentyp

integer

Maßeinheiten
  • beats/min
beats/min
2 hours Post-Dose (Reading 2) Blood pressure after 10 minutes semi-supine (systolic)
Beschreibung

2 hours Post-Dose (Reading 2) Blood pressure after 10 minutes semi-supine (systolic)

Datentyp

integer

2 hours Post-Dose (Reading 2) Blood pressure after 10 minutes semi-supine (diastolic)
Beschreibung

2 hours Post-Dose (Reading 2) Blood pressure after 10 minutes semi-supine (diastolic)

Datentyp

integer

2 hours Post-Dose (Reading 2) After 10 minutes semi-supine Pulse
Beschreibung

2 hours Post-Dose (Reading 2) After 10 minutes semi-supine Pulse

Datentyp

integer

Maßeinheiten
  • beats/min
beats/min
2 hours Post-Dose (Reading 2) Blood pressure after erect for 1 minute (systolic)
Beschreibung

2 hours Post-Dose (Reading 2) Blood pressure after erect for 1 minute (systolic)

Datentyp

integer

2 hours Post-Dose (Reading 2) Blood pressure after erect for 1 minute (diastolic)
Beschreibung

2 hours Post-Dose (Reading 2) Blood pressure after erect for 1 minute (diastolic)

Datentyp

integer

2 hours Post-Dose (Reading 2) Pulse after erect for 1 minute
Beschreibung

2 hours Post-Dose (Reading 2) Pulse after erect for 1 minute

Datentyp

integer

Maßeinheiten
  • beats/min
beats/min
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Ähnliche Modelle

GSK Ropinirole in Subjects with Restless Legs Syndrome 101468/191 Week 6 Day -1 (Form 10)

1 Formulare
Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
Alias
Item Group
General Information
Center Number
Item
Center Number
integer
Patient Number
Item
Patient Number
integer
Patient Initials
Item
Patient Initials
text
Visit Date
Item
Visit Date
date
Item Group
Orthostatic Vital Signs
Time of dose
Item
Time of dose
time
Pre-Dose (Reading 1) Blood pressure after 10 minutes semi-supine (systolic)
Item
Pre-Dose (Reading 1) Blood pressure after 10 minutes semi-supine (systolic)
integer
Pre-Dose (Reading 1) Blood pressure after 10 minutes semi-supine (diastolic)
Item
Pre-Dose (Reading 1) Blood pressure after 10 minutes semi-supine (diastolic)
integer
Pre-Dose (Reading 1) After 10 minutes semi-supine Pulse
Item
Pre-Dose (Reading 1) After 10 minutes semi-supine Pulse
integer
Pre-Dose (Reading 1) Blood pressure after erect for 1 minute (systolic)
Item
Pre-Dose (Reading 1) Blood pressure after erect for 1 minute (systolic)
integer
Pre-Dose (Reading 1) Blood pressure after erect for 1 minute (diastolic)
Item
Pre-Dose (Reading 1) Blood pressure after erect for 1 minute (diastolic)
integer
Pre-Dose (Reading 1) pulse after erect for 1 minute
Item
Pre-Dose (Reading 1) pulse after erect for 1 minute
integer
Pre-Dose (Reading 2) Blood pressure after 10 minutes semi-supine (systolic)
Item
Pre-Dose (Reading 2) Blood pressure after 10 minutes semi-supine (systolic)
integer
Pre-Dose (Reading 2) Blood pressure after 10 minutes semi-supine (diastolic)
Item
Pre-Dose (Reading 2) Blood pressure after 10 minutes semi-supine (diastolic)
integer
Pre-Dose (Reading 2) After 10 minutes semi-supine Pulse
Item
Pre-Dose (Reading 2) After 10 minutes semi-supine Pulse
integer
Pre-Dose (Reading 2) Blood pressure after erect for 1 minute (systolic)
Item
Pre-Dose (Reading 2) Blood pressure after erect for 1 minute (systolic)
integer
Pre-Dose (Reading 2) Blood pressure after erect for 1 minute (diastolic)
Item
Pre-Dose (Reading 2) Blood pressure after erect for 1 minute (diastolic)
integer
Pre-Dose (Reading 2) Pulse after erect for 1 minute
Item
Pre-Dose (Reading 2) Pulse after erect for 1 minute
integer
2 hours Post-Dose (Reading 1) Blood pressure after 10 minutes semi-supine (systolic)
Item
2 hours Post-Dose (Reading 1) Blood pressure after 10 minutes semi-supine (systolic)
integer
2 hours Post-Dose (Reading 1) Blood pressure after 10 minutes semi-supine (diastolic)
Item
2 hours Post-Dose (Reading 1) Blood pressure after 10 minutes semi-supine (diastolic)
integer
2 hours Post-Dose (Reading 1) After 10 minutes semi-supine Pulse
Item
2 hours Post-Dose (Reading 1) After 10 minutes semi-supine Pulse
integer
2 hours Post-Dose (Reading 1) Blood pressure after erect for 1 minute (systolic)
Item
2 hours Post-Dose (Reading 1) Blood pressure after erect for 1 minute (systolic)
integer
2 hours Post-Dose (Reading 1) Blood pressure after erect for 1 minute (diastolic)
Item
2 hours Post-Dose (Reading 1) Blood pressure after erect for 1 minute (diastolic)
integer
2 hours Post-Dose (Reading 1) Pulse after erect for 1 minute
Item
2 hours Post-Dose (Reading 1) Pulse after erect for 1 minute
integer
2 hours Post-Dose (Reading 2) Blood pressure after 10 minutes semi-supine (systolic)
Item
2 hours Post-Dose (Reading 2) Blood pressure after 10 minutes semi-supine (systolic)
integer
2 hours Post-Dose (Reading 2) Blood pressure after 10 minutes semi-supine (diastolic)
Item
2 hours Post-Dose (Reading 2) Blood pressure after 10 minutes semi-supine (diastolic)
integer
2 hours Post-Dose (Reading 2) After 10 minutes semi-supine Pulse
Item
2 hours Post-Dose (Reading 2) After 10 minutes semi-supine Pulse
integer
2 hours Post-Dose (Reading 2) Blood pressure after erect for 1 minute (systolic)
Item
2 hours Post-Dose (Reading 2) Blood pressure after erect for 1 minute (systolic)
integer
2 hours Post-Dose (Reading 2) Blood pressure after erect for 1 minute (diastolic)
Item
2 hours Post-Dose (Reading 2) Blood pressure after erect for 1 minute (diastolic)
integer
2 hours Post-Dose (Reading 2) Pulse after erect for 1 minute
Item
2 hours Post-Dose (Reading 2) Pulse after erect for 1 minute
integer
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