ID

26025

Descripción

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: Cancer Report Form - Repeating form (Scheduled visits)

Palabras clave

Versiones (4)
  1. 4/10/17 4/10/17 -
  2. 13/10/17 13/10/17 -
  3. 23/10/17 23/10/17 -
  4. 1/1/18 1/1/18 -
Titular de derechos de autor

GlaxoSmithKline

Subido en

4 de octubre de 2017

DOI

Para solicitar uno, por favor iniciar sesión.

Licencia

Creative Commons BY-NC 3.0
Comentarios del modelo :

Puede comentar sobre el modelo de datos aquí. A través de las burbujas de diálogo en los grupos de elementos y elementos, puede agregar comentarios específicos.

Volver a los comentarios del modelo
Comentarios de grupo de elementos para :

Comentarios del elemento para :

Para descargar modelos de datos, debe haber iniciado sesión. Por favor iniciar sesión o Registrate gratis.

Cancer Report Form Repeating form GSK study Chronic Coronary Heart Disease NCT00799903

Inglés

Cancer Report Form Repeating form GSK study Chronic Coronary Heart Disease NCT00799903

1 formularios  
1. Diagnosis of a new, recurrence of, or metastatic cancer
Descripción

1. Diagnosis of a new, recurrence of, or metastatic cancer

Diagnosis of a new, recurrence of, or metastatic cancer
Descripción

Cancer diagnosis

Tipo de datos

integer

2. New cancer details
Descripción

2. New cancer details

Date of diagnosis
Descripción

Date of diagnosis new cancer

Tipo de datos

date

Site
Descripción

Site new cancer

Tipo de datos

integer

Other site
Descripción

Other site new cancer

Tipo de datos

boolean

Other site, specify
Descripción

Other site new cancer specification

Tipo de datos

text

Was the pathology report obtained for the source documentation?
Descripción

pathology report new cancer

Tipo de datos

boolean

3. Recurrence of cancer details
Descripción

3. Recurrence of cancer details

Date of recurrence
Descripción

Date of recurrence

Tipo de datos

date

Site
Descripción

Site recurrence

Tipo de datos

integer

Other site
Descripción

Other site recurrence

Tipo de datos

boolean

Other site, specify
Descripción

Other site recurrence specification

Tipo de datos

text

Was the pathology report obtained for the source documentation?
Descripción

pathology report recurrence

Tipo de datos

boolean

Was the pathology report for primary diagnosis obtained for the source documentation?
Descripción

pathology report primary diagnosis recurrence

Tipo de datos

boolean

4. Metastatic cancer details
Descripción

4. Metastatic cancer details

Date of diagnosis of metastasis
Descripción

Date of diagnosis of metastasis

Tipo de datos

date

Site
Descripción

Site of metastasis

Tipo de datos

integer

Other site
Descripción

Other site metastasis

Tipo de datos

boolean

Other site, specify
Descripción

Other site specification

Tipo de datos

text

Was the pathology report obtained for the source documentation?
Descripción

pathology report metastasis

Tipo de datos

boolean

Date of diagnosis of primary site
Descripción

Date of diagnosis primary site

Tipo de datos

date

Primary site
Descripción

Primary site metastasis

Tipo de datos

integer

Other primary site
Descripción

Other primary site

Tipo de datos

boolean

Other primary site, specify
Descripción

Other primary site specification

Tipo de datos

text

Was the pathology report for primary diagnosis obtained for the source documentation?
Descripción

pathology report primary diagnosis metastasis

Tipo de datos

boolean

5. Was the subject hospitalised related to this diagnosis?
Descripción

5. Was the subject hospitalised related to this diagnosis?

Was the subject hospitalised related to this diagnosis?
Descripción

Hospitalisation related to diagnosis

Tipo de datos

boolean

Volver a la parte superior de la página

Similar models

Cancer Report Form Repeating form GSK study Chronic Coronary Heart Disease NCT00799903

1 formularios
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
1. Diagnosis of a new, recurrence of, or metastatic cancer
Item
Diagnosis of a new, recurrence of, or metastatic cancer
integer
Cancer diagnosis
Code List
Diagnosis of a new, recurrence of, or metastatic cancer
CL Item
New cancer (1)
CL Item
Recurrence of cancer (2)
CL Item
Metastatic cancer (3)
Item Group
2. New cancer details
Date of diagnosis new cancer
Item
Date of diagnosis
date
Item
Site
integer
Site new cancer
Code List
Site
CL Item
Benign neoplasm (1)
CL Item
Bile duct cancer (2)
CL Item
Bladder cancer (3)
CL Item
Bowel cancer (4)
CL Item
Breast cancer (5)
CL Item
Cervical cancer (6)
CL Item
Endometrial cancer (7)
CL Item
Esophageal cancer (8)
CL Item
Fallopian tube cancer (9)
CL Item
Gallbladder cancer (10)
CL Item
Gastric cancer (11)
CL Item
Hodgkin's disease (12)
CL Item
Leukemia (13)
CL Item
Lip cancer (14)
CL Item
Liver cancer (15)
CL Item
Lung cancer (16)
CL Item
Lymphoma (17)
CL Item
Multiple myeloma (18)
CL Item
Myelodysplastic syndrome (19)
CL Item
Non-melanoma skin cancer (20)
CL Item
Oral cancer (21)
CL Item
Ovarian cancer (22)
CL Item
Pancreatic cancer (23)
CL Item
Penile cancer (24)
CL Item
Pharyngeal cancer (25)
CL Item
Prostate cancer (26)
CL Item
Renal cancer (27)
CL Item
Scrotum cancer (28)
CL Item
Skin melanoma (29)
CL Item
Testicular cancer (30)
CL Item
Vaginal cancer (31)
CL Item
Vulval cancer (32)
Other site new cancer
Item
Other site
boolean
Other site new cancer specification
Item
Other site, specify
text
pathology report new cancer
Item
Was the pathology report obtained for the source documentation?
boolean
Item Group
3. Recurrence of cancer details
Date of recurrence
Item
Date of recurrence
date
Item
Site
integer
Site new cancer
Code List
Site
CL Item
Benign neoplasm (1)
CL Item
Bile duct cancer (2)
CL Item
Bladder cancer (3)
CL Item
Bowel cancer (4)
CL Item
Breast cancer (5)
CL Item
Cervical cancer (6)
CL Item
Endometrial cancer (7)
CL Item
Esophageal cancer (8)
CL Item
Fallopian tube cancer (9)
CL Item
Gallbladder cancer (10)
CL Item
Gastric cancer (11)
CL Item
Hodgkin's disease (12)
CL Item
Leukemia (13)
CL Item
Lip cancer (14)
CL Item
Liver cancer (15)
CL Item
Lung cancer (16)
CL Item
Lymphoma (17)
CL Item
Multiple myeloma (18)
CL Item
Myelodysplastic syndrome (19)
CL Item
Non-melanoma skin cancer (20)
CL Item
Oral cancer (21)
CL Item
Ovarian cancer (22)
CL Item
Pancreatic cancer (23)
CL Item
Penile cancer (24)
CL Item
Pharyngeal cancer (25)
CL Item
Prostate cancer (26)
CL Item
Renal cancer (27)
CL Item
Scrotum cancer (28)
CL Item
Skin melanoma (29)
CL Item
Testicular cancer (30)
CL Item
Vaginal cancer (31)
CL Item
Vulval cancer (32)
Other site recurrence
Item
Other site
boolean
Other site recurrence specification
Item
Other site, specify
text
pathology report recurrence
Item
Was the pathology report obtained for the source documentation?
boolean
pathology report primary diagnosis recurrence
Item
Was the pathology report for primary diagnosis obtained for the source documentation?
boolean
Item Group
4. Metastatic cancer details
Date of diagnosis of metastasis
Item
Date of diagnosis of metastasis
date
Item
Site
integer
Site new cancer
Code List
Site
CL Item
Benign neoplasm (1)
CL Item
Bile duct cancer (2)
CL Item
Bladder cancer (3)
CL Item
Bowel cancer (4)
CL Item
Breast cancer (5)
CL Item
Cervical cancer (6)
CL Item
Endometrial cancer (7)
CL Item
Esophageal cancer (8)
CL Item
Fallopian tube cancer (9)
CL Item
Gallbladder cancer (10)
CL Item
Gastric cancer (11)
CL Item
Hodgkin's disease (12)
CL Item
Leukemia (13)
CL Item
Lip cancer (14)
CL Item
Liver cancer (15)
CL Item
Lung cancer (16)
CL Item
Lymphoma (17)
CL Item
Multiple myeloma (18)
CL Item
Myelodysplastic syndrome (19)
CL Item
Non-melanoma skin cancer (20)
CL Item
Oral cancer (21)
CL Item
Ovarian cancer (22)
CL Item
Pancreatic cancer (23)
CL Item
Penile cancer (24)
CL Item
Pharyngeal cancer (25)
CL Item
Prostate cancer (26)
CL Item
Renal cancer (27)
CL Item
Scrotum cancer (28)
CL Item
Skin melanoma (29)
CL Item
Testicular cancer (30)
CL Item
Vaginal cancer (31)
CL Item
Vulval cancer (32)
Other site metastasis
Item
Other site
boolean
Other site specification
Item
Other site, specify
text
pathology report metastasis
Item
Was the pathology report obtained for the source documentation?
boolean
Date of diagnosis primary site
Item
Date of diagnosis of primary site
date
Item
Primary site
integer
Site new cancer
Code List
Primary site
CL Item
Benign neoplasm (1)
CL Item
Bile duct cancer (2)
CL Item
Bladder cancer (3)
CL Item
Bowel cancer (4)
CL Item
Breast cancer (5)
CL Item
Cervical cancer (6)
CL Item
Endometrial cancer (7)
CL Item
Esophageal cancer (8)
CL Item
Fallopian tube cancer (9)
CL Item
Gallbladder cancer (10)
CL Item
Gastric cancer (11)
CL Item
Hodgkin's disease (12)
CL Item
Leukemia (13)
CL Item
Lip cancer (14)
CL Item
Liver cancer (15)
CL Item
Lung cancer (16)
CL Item
Lymphoma (17)
CL Item
Multiple myeloma (18)
CL Item
Myelodysplastic syndrome (19)
CL Item
Non-melanoma skin cancer (20)
CL Item
Oral cancer (21)
CL Item
Ovarian cancer (22)
CL Item
Pancreatic cancer (23)
CL Item
Penile cancer (24)
CL Item
Pharyngeal cancer (25)
CL Item
Prostate cancer (26)
CL Item
Renal cancer (27)
CL Item
Scrotum cancer (28)
CL Item
Skin melanoma (29)
CL Item
Testicular cancer (30)
CL Item
Vaginal cancer (31)
CL Item
Vulval cancer (32)
Other primary site
Item
Other primary site
boolean
Other primary site specification
Item
Other primary site, specify
text
pathology report primary diagnosis metastasis
Item
Was the pathology report for primary diagnosis obtained for the source documentation?
boolean
Item Group
5. Was the subject hospitalised related to this diagnosis?
Hospitalisation related to diagnosis
Item
Was the subject hospitalised related to this diagnosis?
boolean
Volver a la parte superior de la página 

Contacto

Utilice este formulario para comentarios, preguntas y sugerencias.

Los campos marcados con * son obligatorios.

Ayuda

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