0 Ratings
ID

26167

Description

Study ID: 101468/196 Clinical Study ID: 101468/196 Study Title: 101468/196: A Long-Term, Open-Label Continuation Study of Once Daily Administration of Ropinirole CR Tablets to Patients with Parkinson's Disease who Completed the Previous Ropinirole CR Studies 167 or 164 Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00650104 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: phase 3 Study Recruitment Status: Completed Generic Name: ropinirole Trade Name: Zygara,ZIPEREVE,ZEPREVE,Requip Depot,REQUIP,REPREVE,Modutab,ADARTREL Study Indication : Parkinson DiseaseA Long-Term, Open-Label Continuation Study of Once Daily Adminstration of Ropinirole CR Tablets to Patients with Parkinson's Disease Who Completed the Previous Ropinirole CR Studies - 167 & 164 End of Re-Enrollment Titration Period

Keywords

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

GlaxoSmithKline

Uploaded on

October 10, 2017

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License

Creative Commons BY-NC-ND 3.0
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    End of Re-Enrollment Titration Period Ropinirole in Parkinson's Disease GSK 101468/196

    English

    End of Re-Enrollment Titration Period Ropinirole in Parkinson's Disease GSK 101468/196

    1 forms  
    Patient Information
    Description

    Patient Information

    Alias
    UMLS CUI-1
    C1955348 (Patient Information)
    Patient No.
    Description

    Patient Number

    Data type

    text

    Alias
    UMLS CUI [1]
    C1830427 (undefined)
    Date of Visit
    Description

    Date of Visit

    Data type

    date

    Measurement units
    • dd-mmm-yyyy
    Alias
    UMLS CUI [1]
    C1320303 (Date of visit)
    SNOMED
    406543005
    dd-mmm-yyyy
    End of Re-Enrollment Titration Period
    Description

    End of Re-Enrollment Titration Period

    Alias
    UMLS CUI-1
    C1516879 (Enrollment)
    UMLS CUI-2
    C1272693 (Ended - status)
    SNOMED
    385656004
    UMLS CUI-3
    C2983683 (Titration Study)
    Dose of Study Medication prescribed for Maintenance period:
    Description

    Dosage of study drug

    Data type

    float

    Measurement units
    • mg/d
    Alias
    UMLS CUI [1,1]
    C0178602 (Dosage)
    SNOMED
    260911001
    LOINC
    LP7180-5
    UMLS CUI [1,2]
    C0304229 (Experimental drug)
    mg/d
    At which week did Titration end?
    Description

    End Date of Titration

    Data type

    float

    Measurement units
    • week
    Alias
    UMLS CUI [1,1]
    C2983683 (Titration Study)
    UMLS CUI [1,2]
    C0806020 (End date)
    SNOMED
    454551000124105
    LOINC
    MTHU008302
    week
    Investigator Signature
    Description

    Investigator Signature

    Alias
    UMLS CUI-1
    C2346576 (Investigator Signature)
    To be completed by the Principal Investigator: I have assumed responsibility for completeness and accurancy of all data recorded on these Titration Case Report Forms. Signature
    Description

    Signature

    Data type

    text

    Alias
    UMLS CUI [1]
    C1519316 (Signature)
    LOINC
    LP248948-4
    To be completed by the Principal Investigator: I have assumed responsibility for completeness and accurancy of all data recorded on these Titration Case Report Forms. Print Name:
    Description

    Investigator's Name

    Data type

    text

    Alias
    UMLS CUI [1]
    C2826892 (Investigator Name)
    Date
    Description

    Date of Report

    Data type

    date

    Measurement units
    • dd-mmm-yyyy
    Alias
    UMLS CUI [1]
    C1302584 (Date of report)
    SNOMED
    399651003
    dd-mmm-yyyy
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    Similar models

    End of Re-Enrollment Titration Period Ropinirole in Parkinson's Disease GSK 101468/196

    1 forms
    Name
    Type
    Description | Question | Decode (Coded Value)
    Data type
    Alias
    Item Group
    Patient Information
    C1955348 (UMLS CUI-1)
    Patient Number
    Item
    Patient No.
    text
    C1830427 (UMLS CUI [1])
    Date of Visit
    Item
    Date of Visit
    date
    C1320303 (UMLS CUI [1])
    Item Group
    End of Re-Enrollment Titration Period
    C1516879 (UMLS CUI-1)
    C1272693 (UMLS CUI-2)
    C2983683 (UMLS CUI-3)
    Dosage of study drug
    Item
    Dose of Study Medication prescribed for Maintenance period:
    float
    C0178602 (UMLS CUI [1,1])
    C0304229 (UMLS CUI [1,2])
    End Date of Titration
    Item
    At which week did Titration end?
    float
    C2983683 (UMLS CUI [1,1])
    C0806020 (UMLS CUI [1,2])
    Item Group
    Investigator Signature
    C2346576 (UMLS CUI-1)
    Signature
    Item
    To be completed by the Principal Investigator: I have assumed responsibility for completeness and accurancy of all data recorded on these Titration Case Report Forms. Signature
    text
    C1519316 (UMLS CUI [1])
    Investigator's Name
    Item
    To be completed by the Principal Investigator: I have assumed responsibility for completeness and accurancy of all data recorded on these Titration Case Report Forms. Print Name:
    text
    C2826892 (UMLS CUI [1])
    Date of Report
    Item
    Date
    date
    C1302584 (UMLS CUI [1])
    Back to the top of the page 

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