Information: Detta är inte den senaste versionen av datamodellen. Du hittar en versionsöversikt till vänster under versioner. Den senaste versionen hittar du här.
Information:
Fel:
ID
25838
Beskrivning
Study ID: 100601 Clinical Study ID: LPL100601 Study Title: LPL100601, A Clinical Outcomes Study of Darapladib versus Placebo in Subjects with Chronic Coronary Heart Disease to Compare the Incidence of Major Adverse Cardiovascular Events (MACE) Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00799903 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: phase 3 Study Recruitment Status: Completed Generic Name: darapladib Trade Name: darapladib Study Indication: Atherosclerosis Study part: Lifestyle Questionnaire.
Nyckelord
Versioner (4)
- 2017-09-20 2017-09-20 -
- 2017-10-23 2017-10-23 -
- 2017-12-20 2017-12-20 -
- 2021-09-20 2021-09-20 -
Rättsinnehavare
GlaxoSmithKline
Uppladdad den
20 september 2017
DOI
För en begäran logga in.
Licens
Creative Commons BY-NC 3.0
Modellkommentarer :
Här kan du kommentera modellen. Med hjälp av pratbubblor i Item-grupperna och Item kan du lägga in specifika kommentarer.
Itemgroup-kommentar för :
Item-kommentar för :
Du måste vara inloggad för att kunna ladda ner formulär. Var vänlig logga in eller registrera dig utan kostnad.
Lifestyle Questionnaire GSK study Chronic Coronary Heart Disease NCT00799903
Lifestyle Questionnaire GSK study Chronic Coronary Heart Disease NCT00799903
Similar models
Lifestyle Questionnaire GSK study Chronic Coronary Heart Disease NCT00799903
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Code List
1. Meat/poultry (e.g. beef, pork, lamb, chicken)
CL Item
Never or rarely (<1/week) ([A00])
CL Item
About 1 servings each week ([A01])
CL Item
Several servings each week ([A02])
CL Item
1-2 servings each day ([A03])
CL Item
3 or more servings each day ([A04])
Code List
2. Fish (fresh-water and ocean fish, including dried and canned fish)
CL Item
Never or rarely (<1/week) ([A00])
CL Item
About 1 servings each week ([A01])
CL Item
Several servings each week ([A02])
CL Item
1-2 servings each day ([A03])
CL Item
3 or more servings each day ([A04])
CL Item
Never or rarely (<1/week) ([A00])
CL Item
About 1 servings each week ([A01])
CL Item
Several servings each week ([A02])
CL Item
1-2 servings each day ([A03])
CL Item
3 or more servings each day ([A04])
Code List
4. Dairy products (Milk, yogurt, cheese, etc.)
CL Item
Never or rarely (<1/week) ([A00])
CL Item
About 1 servings each week ([A01])
CL Item
Several servings each week ([A02])
CL Item
1-2 servings each day ([A03])
CL Item
3 or more servings each day ([A04])
Code List
5. Whole grains (whole wheat flour, brown/white rice, corn, oats, etc.)
CL Item
Never or rarely (<1/week) ([A00])
CL Item
About 1 servings each week ([A01])
CL Item
Several servings each week ([A02])
CL Item
1-2 servings each day ([A03])
CL Item
3 or more servings each day ([A04])
Item
6. Refined/milled grains (white flour, white rice, pasta, noodles, etc.)
text
Code List
6. Refined/milled grains (white flour, white rice, pasta, noodles, etc.)
CL Item
Never or rarely (<1/week) ([A00])
CL Item
About 1 servings each week ([A01])
CL Item
Several servings each week ([A02])
CL Item
1-2 servings each day ([A03])
CL Item
3 or more servings each day ([A04])
Code List
7. Tofu/soybean curd (textured vegetable protein, soya milk, etc.)
CL Item
Never or rarely (<1/week) ([A00])
CL Item
About 1 servings each week ([A01])
CL Item
Several servings each week ([A02])
CL Item
1-2 servings each day ([A03])
CL Item
3 or more servings each day ([A04])
CL Item
Never or rarely (<1/week) ([A00])
CL Item
About 1 servings each week ([A01])
CL Item
Several servings each week ([A02])
CL Item
1-2 servings each day ([A03])
CL Item
3 or more servings each day ([A04])
CL Item
Never or rarely (<1/week) ([A00])
CL Item
About 1 servings each week ([A01])
CL Item
Several servings each week ([A02])
CL Item
1-2 servings each day ([A03])
CL Item
3 or more servings each day ([A04])
CL Item
Never or rarely (<1/week) ([A00])
CL Item
About 1 servings each week ([A01])
CL Item
Several servings each week ([A02])
CL Item
1-2 servings each day ([A03])
CL Item
3 or more servings each day ([A04])
Item
11. Deep fried food (e.g. French fries, potato chips, samosas, egg rolls, etc.)
text
Code List
11. Deep fried food (e.g. French fries, potato chips, samosas, egg rolls, etc.)
CL Item
Never or rarely (<1/week) ([A00])
CL Item
About 1 servings each week ([A01])
CL Item
Several servings each week ([A02])
CL Item
1-2 servings each day ([A03])
CL Item
3 or more servings each day ([A04])
Code List
12. Dessert/sweet snacks (cake, cookie, pie, chocolates, etc.)
CL Item
Never or rarely (<1/week) ([A00])
CL Item
About 1 servings each week ([A01])
CL Item
Several servings each week ([A02])
CL Item
1-2 servings each day ([A03])
CL Item
3 or more servings each day ([A04])
Code List
13. Sweetened drinks (excluding diet drinks)
CL Item
Never or rarely (<1/week) ([A00])
CL Item
About 1 servings each week ([A01])
CL Item
Several servings each week ([A02])
CL Item
1-2 servings each day ([A03])
CL Item
3 or more servings each day ([A04])
Item Group
During a typical week, how much of the following alcoholic drinks do you have?
Beers
Item
14. Beers
integer
Red wine
Item
15. Red wine
integer
White wine
Item
16. White wine
integer
Spirits or liquor
Item
17. Spirits or liquor (gin, rum, vodka, whisky, etc)
integer
Item
18. How often do you have six or more standard drinks on one occasion?
text
Code List
18. How often do you have six or more standard drinks on one occasion?
CL Item
Never ([B00])
CL Item
Less than monthly ([B01])
CL Item
Monthly ([B02])
CL Item
Weekly ([B03])
CL Item
Daily or almost daily ([B04])
Item Group
How many hours during a TYPICAL WEEK do you spend on the following activities?
travelling time
Item
19. Travelling by car, motorcycle, bus, train or other vehicle (including your routine commute)
integer
Relaxation
Item
20. Relaxing while talking with friends or family
integer
exposure to cigarette smoke
Item
21. In an environment where someone is smoking
integer
Watching TV
Item
22. Watching TV
integer
time spent on cmputer
Item
23. On the computer (including time spent at work and during leisure time)
integer
Item Group
How many hours during a TYPICAL WEEK do you spend doing the following physical activities for 10 minutes or more?
mild physical activity
Item
24. Doing MILD physical activity such as easy walking, yoga or Tai Chi
integer
moderate physical activity
Item
Doing MODERATE physical activity such as fast walking, jogging, aerobics, gardening, bicycling, dancing, swimming or house cleaning
integer
vigorous physical activity
Item
26. Doing VIGOROUS physical activity such as running, lifting heavy objects, playing strenuous sports or strenuous work
integer
CL Item
Mainly sedentary ([C00])
CL Item
Predominantly walking on one level, no heavy lifting ([C01])
CL Item
Mainly walking, including climbing stairs, or walking uphill or lifting heavy objects ([C02])
CL Item
Heavy physical activity ([C03])
CL Item
I do not work ([C04])
CL Item
Mainly sedentary ([C00])
CL Item
Mild exercise ([C05])
CL Item
Moderate exercise ([C06])
CL Item
Strenuous physical exercise ([C07])
Item Group
Does your health limit you in the following activities?
CL Item
Not limited ([C08])
CL Item
Limited a little ([C09])
CL Item
Limited a lot ([C10])
CL Item
Do not do for non-health reasons ([C20])
CL Item
Not limited ([C08])
CL Item
Limited a little ([C09])
CL Item
Limited a lot ([C10])
CL Item
Do not do for non-health reasons ([C20])
CL Item
Not limited ([C08])
CL Item
Limited a little ([C09])
CL Item
Limited a lot ([C10])
CL Item
Do not do for non-health reasons ([C20])
CL Item
Not limited ([C08])
CL Item
Limited a little ([C09])
CL Item
Limited a lot ([C10])
CL Item
Do not do for non-health reasons ([C20])
CL Item
Not limited ([C08])
CL Item
Limited a little ([C09])
CL Item
Limited a lot ([C10])
CL Item
Do not do for non-health reasons ([C20])
Item Group
Are your activities limited by the following symptoms?
CL Item
Not limited ([C08])
CL Item
Limited a little ([C09])
CL Item
Limited a lot ([C10])
CL Item
Not limited ([C08])
CL Item
Limited a little ([C09])
CL Item
Limited a lot ([C10])
CL Item
Not limited ([C08])
CL Item
Limited a little ([C09])
CL Item
Limited a lot ([C10])
CL Item
Not limited ([C08])
CL Item
Limited a little ([C09])
CL Item
Limited a lot ([C10])
CL Item
Not limited ([C08])
CL Item
Limited a little ([C09])
CL Item
Limited a lot ([C10])
CL Item
Not limited ([C08])
CL Item
Limited a little ([C09])
CL Item
Limited a lot ([C10])
CL Item
Never/rarely ([C11])
CL Item
Sometimes ([C12])
CL Item
Often ([C13])
CL Item
Always ([C14])
CL Item
26-32 (all) ([C15])
CL Item
20 to 25 ([C16])
CL Item
15 to 19 ([C17])
CL Item
Less than 15 ([C18])
CL Item
No teeth ([C19])
Item Group
Choose one answer for each question to describe your sleep pattern OVER THE LAST YEAR
CL Item
Never/rarely ([D01])
CL Item
Sometimes ([D02])
CL Item
Often ([D03])
CL Item
Always ([D04])
CL Item
Never/rarely ([D01])
CL Item
Sometimes ([D02])
CL Item
Often ([D03])
CL Item
Always ([D04])
CL Item
Never/rarely ([D01])
CL Item
Sometimes ([D02])
CL Item
Often ([D03])
CL Item
Always ([D04])
CL Item
Never/rarely ([D01])
CL Item
Sometimes ([D02])
CL Item
Often ([D03])
CL Item
Always ([D04])
Item
46. Have you been told you gasp, choke or stop breathing when asleep?
text
CL Item
Never/rarely ([D01])
CL Item
Sometimes ([D02])
CL Item
Often ([D03])
CL Item
Always ([D04])
Item Group
Choose one answer for each question to describe your condition over the last year
CL Item
Never/rarely ([E01])
CL Item
Sometimes ([E02])
CL Item
Often ([E03])
CL Item
Always ([E04])
CL Item
Don't work ([E05])
CL Item
Never/rarely ([E01])
CL Item
Sometimes ([E02])
CL Item
Often ([E03])
CL Item
Always ([E04])
CL Item
Never/rarely ([E01])
CL Item
Sometimes ([E02])
CL Item
Often ([E03])
CL Item
Always ([E04])
CL Item
Never/rarely ([E01])
CL Item
Sometimes ([E02])
CL Item
Often ([E03])
CL Item
Always ([E04])
CL Item
Don't work ([E05])
CL Item
Never/rarely ([E01])
CL Item
Sometimes ([E02])
CL Item
Often ([E03])
CL Item
Always ([E04])
CL Item
Never/rarely ([E01])
CL Item
Sometimes ([E02])
CL Item
Often ([E03])
CL Item
Always ([E04])
Item
53. Have you lost interest in hobbies, work or activities that previously gave you pleasure?
text
Code List
53. Have you lost interest in hobbies, work or activities that previously gave you pleasure?
CL Item
Never/rarely ([E01])
CL Item
Sometimes ([E02])
CL Item
Often ([E03])
CL Item
Always ([E04])
Item Group
Comparing your current lifestyle to your lifestyle before your first heart problem, DO YOU
CL Item
Less now ([E06])
CL Item
About same ([E07])
CL Item
More now ([E08])
CL Item
Less now ([E06])
CL Item
About same ([E07])
CL Item
More now ([E08])
CL Item
Less now ([E06])
CL Item
About same ([E07])
CL Item
More now ([E08])
CL Item
Less now ([E06])
CL Item
About same ([E07])
CL Item
More now ([E08])
CL Item
Less now ([E06])
CL Item
About same ([E07])
CL Item
More now ([E08])
CL Item
Less now ([E06])
CL Item
About same ([E07])
CL Item
More now ([E08])
CL Item
Less now ([E06])
CL Item
About same ([E07])
CL Item
More now ([E08])
CL Item
Less now ([E06])
CL Item
About same ([E07])
CL Item
More now ([E08])
CL Item
Less now ([E06])
CL Item
About same ([E07])
CL Item
More now ([E08])
CL Item
Less now ([E06])
CL Item
About same ([E07])
CL Item
More now ([E08])
CL Item
Stopped smoking completely ([E09])
CL Item
Smoked intermittently ([E10])
CL Item
Continued to smoke ([E11])
CL Item
Did not smoke at the time ([E12])
CL Item
Decreased ([E13])
CL Item
Fluctuated/varied ([E14])
CL Item
Stayed about the same ([E15])
CL Item
Increased ([E16])
Cardiac rehabilitation program
Item
66. Have you ever participated in a cardiac rehabilitation program?
boolean
CL Item
Excellent ([E17])
CL Item
Very good ([E18])
CL Item
Good ([E19])
CL Item
Fair ([E20])
CL Item
Poor ([E21])
CL Item
Single ([F01])
CL Item
Married or living with a partner ([F02])
CL Item
Divorced or separated ([F03])
CL Item
Widowed ([F04])
living alone
Item
69. Are you living alone?
boolean
CL Item
None ([F05])
CL Item
1-8 years ([F06])
CL Item
9-12 years ([F07])
CL Item
Trade school ([F08])
CL Item
College/university ([F09])
internet access
Item
71. Do you have access to the internet?
boolean
CL Item
[F10] I am in paid employment - full time. ([F10] I am in paid employment - full time.)
CL Item
I am in paid employment - part time. ([F11])
CL Item
I am self employed. ([F12])
CL Item
I am unemployed. ([F13])
CL Item
I am not working because of my health. ([F14])
CL Item
I choose not to work. ([F15])
CL Item
I am retired. ([F16])
Postal code / ZIP code
Item
73. Postal code / ZIP code
text