ID

25904

Description

Study ID: 101468/204 Clinical Study ID: 101468/204 Study Title:A 12-Week, Randomized, Double-Blind, Parallel Group, Multicentre Study to Assess the Tolerability and Clinical Benefits of Ropinirole Extended Release (XR) Tablets Compared with Ropinirole Immediate Release (IR) Tablets in Subjects with Restless Legs Syndrome (RLS) Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00314860 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: phase 3 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; Restless Legs Syndrome (RLS)

Mots-clés

Versions (1)
  1. 26/09/2017 26/09/2017 -
Détendeur de droits

GlaxoSmithKline

Téléchargé le

26 septembre 2017

DOI

Pour une demande vous connecter.

Licence

Creative Commons BY-NC 3.0
Modèle Commentaires :

Ici, vous pouvez faire des commentaires sur le modèle. À partir des bulles de texte, vous pouvez laisser des commentaires spécifiques sur les groupes Item et les Item.

Retour au modèle Commentaires
Groupe Item commentaires pour :

Item commentaires pour :

Vous devez être connecté pour pouvoir télécharger des formulaires. Veuillez vous connecter ou s’inscrire gratuitement.

GSK LKA204 Ropinirole in Subjects with Restless Legs Syndrome INFORM SCREENING (SCREEN)

Anglais

GSK LKA204 Ropinirole in Subjects with Restless Legs Syndrome INFORM SCREENING (SCREEN)

1 Formulaires  
Inform Screening
Description

Inform Screening

Subject initials
Description

initials

Type de données

text

Alias
UMLS CUI [1]
C2986440
Date of birth
Description

Date of birth

Type de données

date

Alias
UMLS CUI [1]
C0421451
Was this subject a screen failure?
Description

screening failure

Type de données

integer

Alias
UMLS CUI [1]
C1512714
If other, please specify
Description

screening failure other reason

Type de données

text

Alias
UMLS CUI [1]
C1512714
Retour au début de la page

Similar models

GSK LKA204 Ropinirole in Subjects with Restless Legs Syndrome INFORM SCREENING (SCREEN)

1 Formulaires
Name
Type
Description | Question | Decode (Coded Value)
Type de données
Alias
Item Group
Inform Screening
initials
Item
Subject initials
text
C2986440 (UMLS CUI [1])
Date of birth
Item
Date of birth
date
C0421451 (UMLS CUI [1])
Item
Was this subject a screen failure?
integer
C1512714 (UMLS CUI [1])
screening failure
Code List
Was this subject a screen failure?
CL Item
No (1)
CL Item
Yes, Adverse Event (Record details on the Non-Serious Adverse Events or Serious Adverse Events forms as appropriate.) (2)
CL Item
Yes, Lost to follow-up (4)
CL Item
Yes, Protocol violation (5)
CL Item
Yes, Subject decided to withdraw from the study (6)
CL Item
Yes, Prohibited medication use (7)
CL Item
Yes, Did not fulfill eligibility criteria (8)
CL Item
Yes, Exacerbation of medical condition under investigation. (9)
CL Item
Yes, Non-compliance (10)
CL Item
Yes, Genotype quota filled (11)
CL Item
Yes, Did not fulfill continuation criteria (12)
CL Item
Other, specify (13)
screening failure other reason
Item
If other, please specify
text
C1512714 (UMLS CUI [1])
Retour au début de la page 

Contact

Utilisez ce formulaire pour les retours, les questions et les améliorations suggérées.

Les champs marqués d’un * sont obligatoires.

Aide

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial