0 Evaluaciones
ID

25560

Descripción

Alcohol Consumption/Smoking History form Study ID: Clinical Study ID: 101468/198 Study Title:An open, randomised, crossover, healthy volunteer study to compare the PK and tolerability of ropinirole as 3 different new formulations with the standard marketed formulation and to study the effects of a high fat meal on a new formulation Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: Sponsor: GlaxoSmithKline Collaborators: N/A 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

Palabras clave

Versiones (5)
  1. 29/8/17 29/8/17 -
  2. 5/9/17 5/9/17 -
  3. 6/9/17 6/9/17 -
  4. 5/10/17 5/10/17 -
  5. 9/4/19 9/4/19 -
Titular de derechos de autor

GlaxoSmithKline

Subido en

5 de septiembre de 2017

DOI

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Licencia

Creative Commons BY-NC 3.0
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    Alcohol Consumption/Smoking History Ropinirole Restless Legs Syndrome 101468/198

    Inglés

    Alcohol Consumption/Smoking History Ropinirole Restless Legs Syndrome 101468/198

    1 formularios  
    Header
    Descripción

    Header

    Alias
    UMLS CUI-1
    C1320722
    Study No.:
    Descripción

    Study No.:

    Tipo de datos

    text

    Alias
    UMLS CUI [1,1]
    C0008976
    UMLS CUI [1,2]
    C0600091
    Subject No.:
    Descripción

    Subject No.:

    Tipo de datos

    integer

    Alias
    UMLS CUI [1]
    C2348585
    Panel ID:
    Descripción

    Panel ID

    Tipo de datos

    text

    Alias
    UMLS CUI [1]
    C3826248
    Visit:
    Descripción

    Visit

    Tipo de datos

    text

    Alias
    UMLS CUI [1]
    C0545082
    Date
    Descripción

    DD/MON/YY

    Tipo de datos

    date

    Alias
    UMLS CUI [1]
    C0011008
    Alcohol Consumption
    Descripción

    Alcohol Consumption

    Alias
    UMLS CUI-1
    C0001948
    Average number of units per day
    Descripción

    1 unit is equivalent to half a pint of beer (ca. 0,57 l), one measure of spirits or one glass of wine.

    Tipo de datos

    integer

    Alias
    UMLS CUI [1]
    C0560578
    Average number of units per week
    Descripción

    1 unit is equivalent to half a pint of beer (ca. 0,57 l), one measure of spirits or one glass of wine.

    Tipo de datos

    integer

    Alias
    UMLS CUI [1]
    C0560579
    Smoking History
    Descripción

    Smoking History

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

    if Yes, please complete smoking history details

    Tipo de datos

    boolean

    Alias
    UMLS CUI [1]
    C0543414
    Number of years the subject has been a smoker?
    Descripción

    Smoking years

    Tipo de datos

    integer

    Unidades de medida
    • years
    Alias
    UMLS CUI [1]
    C3694955
    years
    Average number of cigarettes smoked per day?
    Descripción

    Cigarettes per day

    Tipo de datos

    integer

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

    Type of tobacco product

    Tipo de datos

    text

    Alias
    UMLS CUI [1]
    C3166496
    Volver a la parte superior de la página

    Similar models

    Alcohol Consumption/Smoking History Ropinirole Restless Legs Syndrome 101468/198

    1 formularios
    Name
    Tipo
    Description | Question | Decode (Coded Value)
    Tipo de datos
    Alias
    Item Group
    Header
    C1320722 (UMLS CUI-1)
    Study No.:
    Item
    Study No.:
    text
    C0008976 (UMLS CUI [1,1])
    C0600091 (UMLS CUI [1,2])
    Subject No.:
    Item
    Subject No.:
    integer
    C2348585 (UMLS CUI [1])
    Panel ID
    Item
    Panel ID:
    text
    C3826248 (UMLS CUI [1])
    Visit
    Item
    Visit:
    text
    C0545082 (UMLS CUI [1])
    Date
    Item
    Date
    date
    C0011008 (UMLS CUI [1])
    Item Group
    Alcohol Consumption
    C0001948 (UMLS CUI-1)
    Units per day
    Item
    Average number of units per day
    integer
    C0560578 (UMLS CUI [1])
    Units per week
    Item
    Average number of units per week
    integer
    C0560579 (UMLS CUI [1])
    Item Group
    Smoking History
    C1519384 (UMLS CUI-1)
    Smoker
    Item
    Is the subject a smoker?
    boolean
    C0543414 (UMLS CUI [1])
    Smoking years
    Item
    Number of years the subject has been a smoker?
    integer
    C3694955 (UMLS CUI [1])
    Cigarettes per day
    Item
    Average number of cigarettes smoked per day?
    integer
    C3694146 (UMLS CUI [1])
    Type of tobacco product
    Item
    Please state what type of tobacco product (eg. pipe, chigar, chewing tobacco or cigarette)
    text
    C3166496 (UMLS CUI [1])
    Volver a la parte superior de la página 

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