ID

25947

Beschrijving

PRIOR RLS TREATMENT MEDICATIONS Ropinirole Case Report Form GSK Study ID: 100013 Clinical Study ID: RRL100013 A 12-Week, Double-Blind, Placebo-Controlled, Twice-Daily Dosing Study to Assess the Efficacy and Safety of Ropinirole in Patients Suffering from Restless Legs Syndrome (RLS) Requiring Extended Treatment Coverage

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  1. 30-09-17 30-09-17 -
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30 september 2017

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PRIOR RLS TREATMENT MEDICATIONS Ropinirole Case Report Form GSK RRL100013

Engels

PRIOR RLS TREATMENT MEDICATIONS Ropinirole Case Report Form GSK RRL100013

1 Formulieren  
RLS CONCOMITANT MEDICATIONS
Beschrijving

RLS CONCOMITANT MEDICATIONS

Alias
UMLS CUI-1
C2347852
Cabergoline. Was drug ever used?
Beschrijving

cabergoline

Datatype

boolean

Alias
UMLS CUI [1]
C0107994
Start Date:
Beschrijving

Start Date

Datatype

date

Alias
UMLS CUI [1]
C0808070
End Date:
Beschrijving

End Date

Datatype

date

Alias
UMLS CUI [1]
C0806020
Did the subject respond to treatment?
Beschrijving

respond to treatment

Datatype

boolean

Alias
UMLS CUI [1]
C0150839
Did the subject tolerate treatment?
Beschrijving

tolerate treatment

Datatype

boolean

Alias
UMLS CUI [1]
C0013220
Pergolide. Was drug ever used?
Beschrijving

Pergolide

Datatype

boolean

Alias
UMLS CUI [1]
C0031007
Start Date:
Beschrijving

Start Date

Datatype

date

Alias
UMLS CUI [1]
C0808070
End Date:
Beschrijving

End Date

Datatype

date

Alias
UMLS CUI [1]
C0806020
Did the subject respond to treatment?
Beschrijving

respond to treatment

Datatype

boolean

Alias
UMLS CUI [1]
C0150839
Did the subject tolerate treatment?
Beschrijving

tolerate treatment

Datatype

boolean

Alias
UMLS CUI [1]
C0013220
lisuride. Was drug ever used?
Beschrijving

lisuride

Datatype

boolean

Alias
UMLS CUI [1]
C0023863
Start Date:
Beschrijving

Start Date

Datatype

date

Alias
UMLS CUI [1]
C0808070
End Date:
Beschrijving

End Date

Datatype

date

Alias
UMLS CUI [1]
C0806020
Did the subject respond to treatment?
Beschrijving

respond to treatment

Datatype

boolean

Alias
UMLS CUI [1]
C0150839
Did the subject tolerate treatment?
Beschrijving

tolerate treatment

Datatype

boolean

Alias
UMLS CUI [1]
C0013220
Bromocriptine. Was drug ever used?
Beschrijving

bromocriptine

Datatype

boolean

Alias
UMLS CUI [1]
C0006230
Start Date:
Beschrijving

Start Date

Datatype

date

Alias
UMLS CUI [1]
C0808070
End Date:
Beschrijving

End Date

Datatype

date

Alias
UMLS CUI [1]
C0806020
Did the subject respond to treatment?
Beschrijving

respond to treatment

Datatype

boolean

Alias
UMLS CUI [1]
C0150839
Did the subject tolerate treatment?
Beschrijving

tolerate treatment

Datatype

boolean

Alias
UMLS CUI [1]
C0013220
Pramipexole. Was drug ever used?
Beschrijving

pramipexole

Datatype

boolean

Alias
UMLS CUI [1]
C0074710
Start Date:
Beschrijving

Start Date

Datatype

date

Alias
UMLS CUI [1]
C0808070
End Date:
Beschrijving

End Date

Datatype

date

Alias
UMLS CUI [1]
C0806020
Did the subject respond to treatment?
Beschrijving

respond to treatment

Datatype

boolean

Alias
UMLS CUI [1]
C0150839
Did the subject tolerate treatment?
Beschrijving

tolerate treatment

Datatype

boolean

Alias
UMLS CUI [1]
C0013220
Levodopa
Beschrijving

Levodopa

Datatype

boolean

Alias
UMLS CUI [1]
C0023570
Start Date:
Beschrijving

Start Date

Datatype

date

Alias
UMLS CUI [1]
C0808070
End Date:
Beschrijving

End Date

Datatype

date

Alias
UMLS CUI [1]
C0806020
Did the subject respond to treatment?
Beschrijving

respond to treatment

Datatype

boolean

Alias
UMLS CUI [1]
C0150839
Did the subject tolerate treatment?
Beschrijving

tolerate treatment

Datatype

boolean

Alias
UMLS CUI [1]
C0013220
Other RLS medications
Beschrijving

Other RLS medications

Alias
UMLS CUI-1
C2347852
Drug name
Beschrijving

Drug name

Datatype

text

Alias
UMLS CUI [1]
C0013227
Modified reported term
Beschrijving

Modified reported term

Datatype

text

Alias
UMLS CUI [1]
C2826819
GSK Drug synonym
Beschrijving

Drug synonym

Datatype

text

Alias
UMLS CUI [1,1]
C0013227
UMLS CUI [1,2]
C0871468
GSK Drug Collection code
Beschrijving

Drug Collection code

Datatype

text

Alias
UMLS CUI [1,1]
C0013227
UMLS CUI [1,2]
C1516698
UMLS CUI [1,3]
C0805701
Failed coding
Beschrijving

Failed coding Concomitant Agent

Datatype

text

Alias
UMLS CUI [1,1]
C0805701
UMLS CUI [1,2]
C0231175
UMLS CUI [1,3]
C2347852
Start Date
Beschrijving

Start Date

Datatype

date

Alias
UMLS CUI [1]
C0808070
End Date
Beschrijving

End Date

Datatype

date

Alias
UMLS CUI [1]
C0806020
Did the subject respond to treatment?
Beschrijving

respond to treatment

Datatype

boolean

Alias
UMLS CUI [1]
C0150839
Did the subject tolerate treatment?
Beschrijving

tolerate treatment

Datatype

boolean

Alias
UMLS CUI [1]
C0013220
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Similar models

PRIOR RLS TREATMENT MEDICATIONS Ropinirole Case Report Form GSK RRL100013

1 Formulieren
Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
RLS CONCOMITANT MEDICATIONS
C2347852 (UMLS CUI-1)
cabergoline
Item
Cabergoline. Was drug ever used?
boolean
C0107994 (UMLS CUI [1])
Start Date
Item
Start Date:
date
C0808070 (UMLS CUI [1])
End Date
Item
End Date:
date
C0806020 (UMLS CUI [1])
respond to treatment
Item
Did the subject respond to treatment?
boolean
C0150839 (UMLS CUI [1])
tolerate treatment
Item
Did the subject tolerate treatment?
boolean
C0013220 (UMLS CUI [1])
Pergolide
Item
Pergolide. Was drug ever used?
boolean
C0031007 (UMLS CUI [1])
Start Date
Item
Start Date:
date
C0808070 (UMLS CUI [1])
End Date
Item
End Date:
date
C0806020 (UMLS CUI [1])
respond to treatment
Item
Did the subject respond to treatment?
boolean
C0150839 (UMLS CUI [1])
tolerate treatment
Item
Did the subject tolerate treatment?
boolean
C0013220 (UMLS CUI [1])
lisuride
Item
lisuride. Was drug ever used?
boolean
C0023863 (UMLS CUI [1])
Start Date
Item
Start Date:
date
C0808070 (UMLS CUI [1])
End Date
Item
End Date:
date
C0806020 (UMLS CUI [1])
respond to treatment
Item
Did the subject respond to treatment?
boolean
C0150839 (UMLS CUI [1])
tolerate treatment
Item
Did the subject tolerate treatment?
boolean
C0013220 (UMLS CUI [1])
bromocriptine
Item
Bromocriptine. Was drug ever used?
boolean
C0006230 (UMLS CUI [1])
Start Date
Item
Start Date:
date
C0808070 (UMLS CUI [1])
End Date
Item
End Date:
date
C0806020 (UMLS CUI [1])
respond to treatment
Item
Did the subject respond to treatment?
boolean
C0150839 (UMLS CUI [1])
tolerate treatment
Item
Did the subject tolerate treatment?
boolean
C0013220 (UMLS CUI [1])
pramipexole
Item
Pramipexole. Was drug ever used?
boolean
C0074710 (UMLS CUI [1])
Start Date
Item
Start Date:
date
C0808070 (UMLS CUI [1])
End Date
Item
End Date:
date
C0806020 (UMLS CUI [1])
respond to treatment
Item
Did the subject respond to treatment?
boolean
C0150839 (UMLS CUI [1])
tolerate treatment
Item
Did the subject tolerate treatment?
boolean
C0013220 (UMLS CUI [1])
Levodopa
Item
Levodopa
boolean
C0023570 (UMLS CUI [1])
Start Date
Item
Start Date:
date
C0808070 (UMLS CUI [1])
End Date
Item
End Date:
date
C0806020 (UMLS CUI [1])
respond to treatment
Item
Did the subject respond to treatment?
boolean
C0150839 (UMLS CUI [1])
tolerate treatment
Item
Did the subject tolerate treatment?
boolean
C0013220 (UMLS CUI [1])
Item Group
Other RLS medications
C2347852 (UMLS CUI-1)
Drug name
Item
Drug name
text
C0013227 (UMLS CUI [1])
Modified reported term
Item
Modified reported term
text
C2826819 (UMLS CUI [1])
Drug synonym
Item
GSK Drug synonym
text
C0013227 (UMLS CUI [1,1])
C0871468 (UMLS CUI [1,2])
Drug Collection code
Item
GSK Drug Collection code
text
C0013227 (UMLS CUI [1,1])
C1516698 (UMLS CUI [1,2])
C0805701 (UMLS CUI [1,3])
Failed coding Concomitant Agent
Item
Failed coding
text
C0805701 (UMLS CUI [1,1])
C0231175 (UMLS CUI [1,2])
C2347852 (UMLS CUI [1,3])
Start Date
Item
Start Date
date
C0808070 (UMLS CUI [1])
End Date
Item
End Date
date
C0806020 (UMLS CUI [1])
respond to treatment
Item
Did the subject respond to treatment?
boolean
C0150839 (UMLS CUI [1])
tolerate treatment
Item
Did the subject tolerate treatment?
boolean
C0013220 (UMLS CUI [1])
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