ID

25954

Description

Neurological Examination Early Withdrawal 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

Keywords

Versions (1)
  1. 10/1/17 10/1/17 -
Copyright Holder

gsk

Uploaded on

October 1, 2017

DOI

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License

Creative Commons BY-NC 3.0
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Neurological Examination Early Withdrawal Ropinirole Case Report Form GSK RRL100013

English

Neurological Examination Early Withdrawal Ropinirole Case Report Form GSK RRL100013

1 forms  
Neurological Examination
Description

Neurological Examination

Alias
UMLS CUI-1
C0027853
Subject Identifier
Description

Subject Identifier

Data type

integer

Alias
UMLS CUI [1]
C2348585
Visit Date
Description

Visit Date

Data type

date

Alias
UMLS CUI [1]
C1320303
Mental Status
Description

Mental Status

Data type

text

Alias
UMLS CUI [1]
C0278060
Comments Mental state
Description

Comments Mental state

Data type

text

Alias
UMLS CUI [1,1]
C0947611
UMLS CUI [1,2]
C0278060
Gait
Description

Gait

Data type

text

Alias
UMLS CUI [1]
C0016928
Comments Gait
Description

Comments Gait

Data type

text

Alias
UMLS CUI [1,1]
C0947611
UMLS CUI [1,2]
C0016928
Balance
Description

Balance

Data type

text

Alias
UMLS CUI [1]
C0560184
Comments balance
Description

Comments balance

Data type

integer

Alias
UMLS CUI [1,1]
C0947611
UMLS CUI [1,2]
C0560184
Coordination
Description

Coordination

Data type

text

Alias
UMLS CUI [1]
C0242414
Comments Coordination
Description

Comments Coordination

Data type

text

Alias
UMLS CUI [1,1]
C0947611
UMLS CUI [1,2]
C0242414
Cranial nerves
Description

Cranial nerves

Data type

text

Alias
UMLS CUI [1]
C0010268
Comments Cranial Nerves
Description

Comments Cranial Nerves

Data type

text

Alias
UMLS CUI [1,1]
C0947611
UMLS CUI [1,2]
C0010268
Motor
Description

Motor

Data type

text

Alias
UMLS CUI [1]
C0026606
Comments Motor
Description

Comments Motor

Data type

text

Alias
UMLS CUI [1,1]
C0947611
UMLS CUI [1,2]
C0026606
Reflexes
Description

Reflexes

Data type

text

Alias
UMLS CUI [1]
C0034929
Comments Reflex
Description

Comments Reflex

Data type

text

Alias
UMLS CUI [1,1]
C0947611
UMLS CUI [1,2]
C0034929
Sensory
Description

Sensory

Data type

text

Alias
UMLS CUI [1]
C0682648
Comments sensory
Description

Comments sensory

Data type

text

Alias
UMLS CUI [1,1]
C0947611
UMLS CUI [1,2]
C0682648
Was the neurological examination consistent with the diagnosis of Parkinson's disease?
Description

If NO, the subject is not eligible to participate in the study

Data type

boolean

Alias
UMLS CUI [1,1]
C0027853
UMLS CUI [1,2]
C0030567
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Similar models

Neurological Examination Early Withdrawal Ropinirole Case Report Form GSK RRL100013

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Neurological Examination
C0027853 (UMLS CUI-1)
Subject Identifier
Item
Subject Identifier
integer
C2348585 (UMLS CUI [1])
Visit Date
Item
Visit Date
date
C1320303 (UMLS CUI [1])
Item
Mental Status
text
C0278060 (UMLS CUI [1])
Mental Status
Code List
Mental Status
CL Item
Normal (Normal)
C0205307 (UMLS CUI-1)
(Comment:en)
CL Item
Abnormal (Abnormal)
C0205161 (UMLS CUI-1)
(Comment:en)
Comments Mental state
Item
Comments Mental state
text
C0947611 (UMLS CUI [1,1])
C0278060 (UMLS CUI [1,2])
Item
Gait
text
C0016928 (UMLS CUI [1])
Mental Status
Code List
Gait
CL Item
Normal (Normal)
C0205307 (UMLS CUI-1)
(Comment:en)
CL Item
Abnormal (Abnormal)
C0205161 (UMLS CUI-1)
(Comment:en)
Comments Gait
Item
Comments Gait
text
C0947611 (UMLS CUI [1,1])
C0016928 (UMLS CUI [1,2])
Item
Balance
text
C0560184 (UMLS CUI [1])
Mental Status
Code List
Balance
CL Item
Normal (Normal)
C0205307 (UMLS CUI-1)
(Comment:en)
CL Item
Abnormal (Abnormal)
C0205161 (UMLS CUI-1)
(Comment:en)
Comments balance
Item
Comments balance
integer
C0947611 (UMLS CUI [1,1])
C0560184 (UMLS CUI [1,2])
Item
Coordination
text
C0242414 (UMLS CUI [1])
Mental Status
Code List
Coordination
CL Item
Normal (Normal)
C0205307 (UMLS CUI-1)
(Comment:en)
CL Item
Abnormal (Abnormal)
C0205161 (UMLS CUI-1)
(Comment:en)
Comments Coordination
Item
Comments Coordination
text
C0947611 (UMLS CUI [1,1])
C0242414 (UMLS CUI [1,2])
Item
Cranial nerves
text
C0010268 (UMLS CUI [1])
Mental Status
Code List
Cranial nerves
CL Item
Normal (Normal)
C0205307 (UMLS CUI-1)
(Comment:en)
CL Item
Abnormal (Abnormal)
C0205161 (UMLS CUI-1)
(Comment:en)
Comments Cranial Nerves
Item
Comments Cranial Nerves
text
C0947611 (UMLS CUI [1,1])
C0010268 (UMLS CUI [1,2])
Item
Motor
text
C0026606 (UMLS CUI [1])
Mental Status
Code List
Motor
CL Item
Normal (Normal)
C0205307 (UMLS CUI-1)
(Comment:en)
CL Item
Abnormal (Abnormal)
C0205161 (UMLS CUI-1)
(Comment:en)
Comments Motor
Item
Comments Motor
text
C0947611 (UMLS CUI [1,1])
C0026606 (UMLS CUI [1,2])
Item
Reflexes
text
C0034929 (UMLS CUI [1])
Mental Status
Code List
Reflexes
CL Item
Normal (Normal)
C0205307 (UMLS CUI-1)
(Comment:en)
CL Item
Abnormal (Abnormal)
C0205161 (UMLS CUI-1)
(Comment:en)
Comments Reflex
Item
Comments Reflex
text
C0947611 (UMLS CUI [1,1])
C0034929 (UMLS CUI [1,2])
Item
Sensory
text
C0682648 (UMLS CUI [1])
Mental Status
Code List
Sensory
CL Item
Normal (Normal)
C0205307 (UMLS CUI-1)
(Comment:en)
CL Item
Abnormal (Abnormal)
C0205161 (UMLS CUI-1)
(Comment:en)
Comments sensory
Item
Comments sensory
text
C0947611 (UMLS CUI [1,1])
C0682648 (UMLS CUI [1,2])
neurological examination Parkinson Disease
Item
Was the neurological examination consistent with the diagnosis of Parkinson's disease?
boolean
C0027853 (UMLS CUI [1,1])
C0030567 (UMLS CUI [1,2])
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