ID

25759

Descrição

Study ID: 101468/191 Clinical Study ID: SKF-101468/191 Study Title:A 12 Week, Double-Blind, Placebo-Controlled, Parallel Group Study to Assess the Efficacy, Safety and Tolerability of Ropinirole in Subjects with Restless Legs Syndrome (RLS) Suffering from Periodic Leg Movements of Sleep (PLMS) Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: Sponsor: GlaxoSmithKline Collaborators: N/A Phase: phase 3 Study Recruitment Status: Completed Generic Name: ropinirole Trade Name: Requip Study Indication: Restless Legs Syndrome

Palavras-chave

  1. 17/09/2017 17/09/2017 -
Titular dos direitos

GlaxoSmithKline

Transferido a

17 de setembro de 2017

DOI

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Licença

Creative Commons BY-NC 3.0

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GSK Ropinirole in Subjects with Restless Legs Syndrome 101468/191 Form D (Form 23)

GSK Ropinirole in Subjects with Restless Legs Syndrome 101468/191 Form D (Form 23)

General Information
Descrição

General Information

Center Number
Descrição

Center Number

Tipo de dados

integer

Patient No
Descrição

patient number

Tipo de dados

integer

Patient Initials
Descrição

Patient Initials

Tipo de dados

text

Form D
Descrição

Form D

Certified cause of death
Descrição

Certified cause of death

Tipo de dados

text

Date of death
Descrição

Date of death

Tipo de dados

date

Was a post-mortem carried out?
Descrição

Post-mortem

Tipo de dados

text

If post-mortem was carried out, please summarize findings (include diagnosis)
Descrição

Post-mortem findings

Tipo de dados

text

Reporting Physician´s Signature
Descrição

Reporting Physician´s Signature

Tipo de dados

text

Date
Descrição

Date

Tipo de dados

date

Similar models

GSK Ropinirole in Subjects with Restless Legs Syndrome 101468/191 Form D (Form 23)

Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de dados
Alias
Item Group
General Information
Center Number
Item
Center Number
integer
patient number
Item
Patient No
integer
Patient Initials
Item
Patient Initials
text
Item Group
Form D
Certified cause of death
Item
Certified cause of death
text
Date of death
Item
Date of death
date
Item
Was a post-mortem carried out?
text
Code List
Was a post-mortem carried out?
CL Item
No (1)
CL Item
Yes -> If "Yes" please summarize findings (including diagnosis) below (2)
Post-mortem findings
Item
If post-mortem was carried out, please summarize findings (include diagnosis)
text
Reporting Physician´s Signature
Item
Reporting Physician´s Signature
text
Date
Item
Date
date

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