ID

26169

Descripción

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 xx Months After Initial Titration

Palabras clave

Versiones (1)
  1. 10/10/17 10/10/17 -
Titular de derechos de autor

GlaxoSmithKline

Subido en

10 de octubre de 2017

DOI

Para solicitar uno, por favor iniciar sesión.

Licencia

Creative Commons BY-NC-ND 3.0
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After Initial Titration Ropinirole in Parkinson's Disease GSK 101468/196

Inglés

After Initial Titration Ropinirole in Parkinson's Disease GSK 101468/196

1 formularios  
Patient Information
Descripción

Patient Information

Alias
UMLS CUI-1
C1955348
__Months After Initial Titration (i.e. M36, M39, M42, etc.)
Descripción

Months After Initial Titration

Tipo de datos

text

Alias
UMLS CUI [1,1]
C2983683
UMLS CUI [1,2]
C0439231
Patient No.
Descripción

Patient Number

Tipo de datos

text

Alias
UMLS CUI [1]
C1830427
Date of Visit
Descripción

Date of Visit

Tipo de datos

date

Unidades de medida
  • dd-mmm-yyyy
Alias
UMLS CUI [1]
C1320303
dd-mmm-yyyy
Clinical Global Impression
Descripción

Clinical Global Impression

Alias
UMLS CUI-1
C3639708
Enter the results from the CGI Worksheet. 1. Severity of illness (0 - 7)
Descripción

Severity of Illness

Tipo de datos

integer

Alias
UMLS CUI [1]
C0521117
Enter the results for each category from the CGI Worksheet. 2. Global improvement (0-7)
Descripción

Global Improvement

Tipo de datos

integer

Alias
UMLS CUI [1]
C3639888
Study Drug Compliance
Descripción

Study Drug Compliance

Alias
UMLS CUI-1
C1321605
Total number of tablets dispensed at last visit.
Descripción

Split up in groups of 2, 3, 4 or 8 mg.

Tipo de datos

text

Alias
UMLS CUI [1]
C0805077
Total Number of tablets returned at visit.
Descripción

Split up in groups of 2, 3, 4 or 8mg.

Tipo de datos

text

Alias
UMLS CUI [1]
C2699071
Number of tablets patient should have taken (assuming 100% compliance).
Descripción

Compliance

Tipo de datos

text

Alias
UMLS CUI [1]
C1321605
If there were missed doses, please record. Date
Descripción

Missed Dose: Date

Tipo de datos

date

Unidades de medida
  • dd-mmm-yyyy
Alias
UMLS CUI [1,1]
C1709043
UMLS CUI [1,2]
C0011008
dd-mmm-yyyy
If there were missed doses, please record. Tablet(s)
Descripción

Missed Dose: Tablet

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1709043
UMLS CUI [1,2]
C0039225
If there were missed doses, please record. Dose in mg
Descripción

Missed Dose: Dosage

Tipo de datos

float

Unidades de medida
  • mg
Alias
UMLS CUI [1,1]
C1709043
UMLS CUI [1,2]
C0178602
mg
If there were missed doses, please record. Reason
Descripción

Missed Dose: Reason

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1709043
UMLS CUI [1,2]
C0566251
Study Drug Dosing
Descripción

Study Drug Dosing

Alias
UMLS CUI-1
C0178602
Last study drug dose:
Descripción

Last Dosage of Ropinirole

Tipo de datos

float

Unidades de medida
  • mg/d
Alias
UMLS CUI [1,1]
C0244821
UMLS CUI [1,2]
C0178602
UMLS CUI [1,3]
C1517741
mg/d
Date of last study drug dose:
Descripción

Date of Last Dose

Tipo de datos

date

Unidades de medida
  • dd-mmm-yyyy
Alias
UMLS CUI [1]
C1762893
dd-mmm-yyyy
Time of last study drug dose (24 hour clock):
Descripción

Time of Last Dose

Tipo de datos

time

Unidades de medida
  • 24hr:min
Alias
UMLS CUI [1]
C0946444
24hr:min
Enter the dose of study drug prescribed at this visit:
Descripción

Prescribed Dose

Tipo de datos

float

Unidades de medida
  • mg/d
Alias
UMLS CUI [1,1]
C0678766
UMLS CUI [1,2]
C0278329
mg/d
Orthostatic Blood Pressure/ Pulse
Descripción

Orthostatic Blood Pressure/ Pulse

Alias
UMLS CUI-1
C1095971
is the patient being up titrated at this visit?
Descripción

If YES, please document pre and post dose Blood Pressure/Pulse measurements.

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0205217
UMLS CUI [1,2]
C2983683
Time Point (Time [24-hour clock])
Descripción

Repeat on General. If patient is being up titrated, specify pre and post dose. A1 Predose A2 Predose 1h Post-Dose Post-Dose

Tipo de datos

time

Unidades de medida
  • 24hr:min
Alias
UMLS CUI [1,1]
C0040223
UMLS CUI [1,2]
C0430022
24hr:min
Semi-Supine Heart Rate
Descripción

Semi-Supine Heart Rate

Tipo de datos

float

Unidades de medida
  • bpm
Alias
UMLS CUI [1,1]
C0522019
UMLS CUI [1,2]
C0018810
bpm
Standing Heart Rate
Descripción

Erect Heart Rate

Tipo de datos

float

Unidades de medida
  • bpm
Alias
UMLS CUI [1,1]
C0522014
UMLS CUI [1,2]
C0018810
bpm
Semi-Supine Systolic Blood Pressure
Descripción

Semi-Supine Systolic Blood Pressure

Tipo de datos

float

Unidades de medida
  • mmHg
Alias
UMLS CUI [1]
C0871470
mmHg
Semi-Supine Diastolic Blood Pressure
Descripción

Semi-Supine Diastolic Blood Pressure

Tipo de datos

float

Unidades de medida
  • mmHg
Alias
UMLS CUI [1,1]
C0522019
UMLS CUI [1,2]
C0428883
mmHg
Standing Systolic Blood Pressure
Descripción

Erect Systolic Blood Pressure

Tipo de datos

float

Unidades de medida
  • mmHg
Alias
UMLS CUI [1,1]
C0522014
UMLS CUI [1,2]
C0871470
mmHg
Standing Diastolic Blood Pressure
Descripción

Erect Diastolic Blood Pressure

Tipo de datos

float

Unidades de medida
  • mmHg
Alias
UMLS CUI [1,1]
C0522014
UMLS CUI [1,2]
C0428883
mmHg
Unified Parkinson's Disease Rating Scale (UPDRS)
Descripción

Unified Parkinson's Disease Rating Scale (UPDRS)

Alias
UMLS CUI-1
C3639721
Unified Parkinson's Disease Rating Scale (UPDRS)
Descripción

Unified Parkinson's Disease Rating Scale

Tipo de datos

text

Alias
UMLS CUI [1]
C3639721
Laboratory Evaluations: Hematology - Complete this page only if this is a 6-months visit. Obtain blood samples at the Month 36 visit or the Study Completion Visit and then every 6 months after that. Note: Please complete the clinically significant (Clin Sig) columni for values out of normal range.
Descripción

Laboratory Evaluations: Hematology - Complete this page only if this is a 6-months visit. Obtain blood samples at the Month 36 visit or the Study Completion Visit and then every 6 months after that. Note: Please complete the clinically significant (Clin Sig) columni for values out of normal range.

Alias
UMLS CUI-1
C0474523
Hematology. Performed?
Descripción

Hematology

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0474523
Date of Sample:
Descripción

Hematology: Collection Date

Tipo de datos

date

Unidades de medida
  • dd-mmm-yyyy
Alias
UMLS CUI [1,1]
C0474523
UMLS CUI [1,2]
C1317250
dd-mmm-yyyy
Hemoglobin: Result
Descripción

Hemoglobin

Tipo de datos

float

Alias
UMLS CUI [1]
C0019046
Hemoglobin: Units
Descripción

Hemoglobin: Unit

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0518015
UMLS CUI [1,2]
C1519795
Hemoglobin: Clin Sig
Descripción

Hemoglobin: Clinically Significant

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0518015
UMLS CUI [1,2]
C2826633
Hematocrit: Result
Descripción

Hematocrit

Tipo de datos

float

Alias
UMLS CUI [1]
C0518014
Hematocrit: Units
Descripción

Hematocrit: Unit

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0518014
UMLS CUI [1,2]
C1519795
Hematocrit: Clin Sig
Descripción

Hematocrit: Clinically Significant

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0518014
UMLS CUI [1,2]
C2826633
RBC: Result
Descripción

Red Blood Count

Tipo de datos

float

Alias
UMLS CUI [1]
C1287262
RBC: Units
Descripción

Red Blood Count: Unit

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1287262
UMLS CUI [1,2]
C1519795
RBC: Clin Sig
Descripción

Red Blood Count: Clinically Significant

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C1287262
UMLS CUI [1,2]
C2826633
WBC: Result
Descripción

White Blood Count

Tipo de datos

float

Alias
UMLS CUI [1]
C0023508
WBC: Units
Descripción

White Blood Count: Unit

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0023508
UMLS CUI [1,2]
C1519795
WBC: Clin Sig
Descripción

White Blood Count: Clinically Significant

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0023508
UMLS CUI [1,2]
C2826633
Platelets: Result
Descripción

Platelets

Tipo de datos

float

Alias
UMLS CUI [1]
C0005821
Platelets: Units
Descripción

Platelets: Unit

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0005821
UMLS CUI [1,2]
C1519795
Platelets: Clin Sig
Descripción

Platelets: Clinically Significant

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0005821
UMLS CUI [1,2]
C2826633
Laboratory Evaluations: Serum Chemistry - Complete this page only if this is a 6-months visit. Obtain blood samples at the Month 36 visit or the Study Completion Visit and then every 6 months after that. Note: Please complete the clinically significant (Clin Sig) columni for values out of normal range.
Descripción

Laboratory Evaluations: Serum Chemistry - Complete this page only if this is a 6-months visit. Obtain blood samples at the Month 36 visit or the Study Completion Visit and then every 6 months after that. Note: Please complete the clinically significant (Clin Sig) columni for values out of normal range.

Alias
UMLS CUI-1
C1883010
Serum Chemistry: Performed?
Descripción

Serum Chemistry

Tipo de datos

boolean

Alias
UMLS CUI [1]
C1883010
Date of Sample:
Descripción

Serum Chemistry: Collection Date

Tipo de datos

date

Unidades de medida
  • dd-mmm-yyyy
Alias
UMLS CUI [1,1]
C1883010
UMLS CUI [1,2]
C1317250
dd-mmm-yyyy
Sodium: Result
Descripción

Sodium

Tipo de datos

float

Alias
UMLS CUI [1]
C0337443
Sodium: Units
Descripción

Sodium: Unit

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0337443
UMLS CUI [1,2]
C1519795
Sodium: Clin Sig
Descripción

Sodium: Clinically Significant

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0337443
UMLS CUI [1,2]
C2826633
Potassium: Result
Descripción

Potassium

Tipo de datos

float

Alias
UMLS CUI [1]
C0202194
Potassium: Units
Descripción

Potassium: Unit

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0202194
UMLS CUI [1,2]
C1519795
Potassium: Clin Sig
Descripción

Potassium: Clinically Significant

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0202194
UMLS CUI [1,2]
C2826633
Urea: Results
Descripción

Urea

Tipo de datos

float

Alias
UMLS CUI [1]
C0523961
Urea: Units
Descripción

Urea: Unit

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0523961
UMLS CUI [1,2]
C1519795
Urea: Clin Sig
Descripción

Urea: Clinically Significant

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0523961
UMLS CUI [1,2]
C2826633
Creatinine: Results
Descripción

Creatinine

Tipo de datos

float

Alias
UMLS CUI [1]
C0201976
Creatinine: Units
Descripción

Creatinine: Unit

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0201976
UMLS CUI [1,2]
C1519795
Creatinine: Clin Sig
Descripción

Creatinine: Clinically Significant

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0201976
UMLS CUI [1,2]
C2826633
Protein, total: Result
Descripción

Total Protein

Tipo de datos

float

Alias
UMLS CUI [1]
C0555903
Protein, total: Units
Descripción

Total Protein: Unit

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0555903
UMLS CUI [1,2]
C1519795
Protein, total: Clin Sig
Descripción

Total Protein: Clinically Significant

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0555903
UMLS CUI [1,2]
C2826633
Albumin: Result
Descripción

Albumin

Tipo de datos

float

Alias
UMLS CUI [1]
C0201838
Albumin: Units
Descripción

Albumin: Unit

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0201838
UMLS CUI [1,2]
C1519795
Albumin: Clin Sig
Descripción

Albumin: Clinically Significant

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0201838
UMLS CUI [1,2]
C2826633
Globulin: Results
Descripción

Globulin

Tipo de datos

float

Alias
UMLS CUI [1]
C0877347
Globulin: Units
Descripción

Globulin: Unit

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0877347
UMLS CUI [1,2]
C1519795
Globulin: Clin Sig
Descripción

Globulin: Clinically Significant

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0877347
UMLS CUI [1,2]
C2826633
Bilirubin, total: Result
Descripción

Total Bilirubin

Tipo de datos

float

Alias
UMLS CUI [1]
C0201913
Bilirubin, total: Units
Descripción

Total Bilirubin: Unit

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0201913
UMLS CUI [1,2]
C1519795
Bilirubin, total: Clin Sig
Descripción

Total Bilirubin: Clinically Significant

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0201913
UMLS CUI [1,2]
C2826633
AST (SGOT): Result
Descripción

AST

Tipo de datos

float

Alias
UMLS CUI [1]
C0201899
AST (SGOT): Units
Descripción

AST: Unit

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0201899
UMLS CUI [1,2]
C1519795
AST (SGOT): Clin Sig
Descripción

AST: Clinically Significant

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0201899
UMLS CUI [1,2]
C2826633
ALT (SGPT): Result
Descripción

ALT

Tipo de datos

float

Alias
UMLS CUI [1]
C0201836
ALT (SGPT): Units
Descripción

ALT: Unit

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0201836
UMLS CUI [1,2]
C1519795
ALT (SGPT): Clin Sig
Descripción

ALT: Clinically Significant

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0201836
UMLS CUI [1,2]
C2826633
Alkaline Phosphatase: Result
Descripción

Alkaline Phosphatase

Tipo de datos

float

Alias
UMLS CUI [1]
C0201850
Alkaline Phosphatase: Units
Descripción

Alkaline Phosphatase: Unit

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0201850
UMLS CUI [1,2]
C1519795
Alkaline Phosphatase: Clin Sig
Descripción

Alkaline Phosphatase: Clinically Significant

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0201850
UMLS CUI [1,2]
C2826633
Calcium: Result
Descripción

Calcium

Tipo de datos

float

Alias
UMLS CUI [1]
C0201925
Calcium: Units
Descripción

Calcium: Unit

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0201925
UMLS CUI [1,2]
C1519795
Calcium: Clin Sig
Descripción

Calcium: Clinically Significant

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0201925
UMLS CUI [1,2]
C2826633
Phosphate: Result
Descripción

Phosphate

Tipo de datos

float

Alias
UMLS CUI [1]
C0523826
Phosphate: Units
Descripción

Phosphate: Unit

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0523826
UMLS CUI [1,2]
C1519795
Phosphate: Clin Sig
Descripción

Phosphate: Clinically Significant

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0523826
UMLS CUI [1,2]
C2826633
Glucose (non-fasting): Results
Descripción

Non-Fasting Glucose

Tipo de datos

float

Alias
UMLS CUI [1,1]
C2347359
UMLS CUI [1,2]
C0337438
Glucose (non-fasting): Units
Descripción

Non-Fasting Glucose: Unit

Tipo de datos

text

Alias
UMLS CUI [1,1]
C2347359
UMLS CUI [1,2]
C0337438
UMLS CUI [1,3]
C1519795
Glucose (non-fasting): Clin Sig
Descripción

Non-Fasting Glucose: Clinically Significant

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C2347359
UMLS CUI [1,2]
C0337438
UMLS CUI [1,3]
C2826633
Pregnancy Test (betaHCG)
Descripción

Pregnancy Test (betaHCG)

Alias
UMLS CUI-1
C0032976
Was a pregnancy test performed?
Descripción

Pregnancy Test

Tipo de datos

integer

Alias
UMLS CUI [1]
C0032976
If YES, what type of pregnancy was performed?
Descripción

Type of Pregnancy Test

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C0032976
UMLS CUI [1,2]
C0332307
If YES, Date of Test:
Descripción

Date of Pregnancy Test

Tipo de datos

date

Unidades de medida
  • dd-mmm-yyyy
Alias
UMLS CUI [1,1]
C0032976
UMLS CUI [1,2]
C0011008
dd-mmm-yyyy
If YES, Result:
Descripción

Pregnancy Test Finding

Tipo de datos

integer

Alias
UMLS CUI [1]
C0427777
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Similar models

After Initial Titration Ropinirole in Parkinson's Disease GSK 101468/196

1 formularios
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
Patient Information
C1955348 (UMLS CUI-1)
Months After Initial Titration
Item
__Months After Initial Titration (i.e. M36, M39, M42, etc.)
text
C2983683 (UMLS CUI [1,1])
C0439231 (UMLS CUI [1,2])
Patient Number
Item
Patient No.
text
C1830427 (UMLS CUI [1])
Date of Visit
Item
Date of Visit
date
C1320303 (UMLS CUI [1])
Item Group
Clinical Global Impression
C3639708 (UMLS CUI-1)
Severity of Illness
Item
Enter the results from the CGI Worksheet. 1. Severity of illness (0 - 7)
integer
C0521117 (UMLS CUI [1])
Global Improvement
Item
Enter the results for each category from the CGI Worksheet. 2. Global improvement (0-7)
integer
C3639888 (UMLS CUI [1])
Item Group
Study Drug Compliance
C1321605 (UMLS CUI-1)
Dispensed Amount
Item
Total number of tablets dispensed at last visit.
text
C0805077 (UMLS CUI [1])
Returned Amount
Item
Total Number of tablets returned at visit.
text
C2699071 (UMLS CUI [1])
Compliance
Item
Number of tablets patient should have taken (assuming 100% compliance).
text
C1321605 (UMLS CUI [1])
Missed Dose: Date
Item
If there were missed doses, please record. Date
date
C1709043 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Missed Dose: Tablet
Item
If there were missed doses, please record. Tablet(s)
text
C1709043 (UMLS CUI [1,1])
C0039225 (UMLS CUI [1,2])
Missed Dose: Dosage
Item
If there were missed doses, please record. Dose in mg
float
C1709043 (UMLS CUI [1,1])
C0178602 (UMLS CUI [1,2])
Missed Dose: Reason
Item
If there were missed doses, please record. Reason
text
C1709043 (UMLS CUI [1,1])
C0566251 (UMLS CUI [1,2])
Item Group
Study Drug Dosing
C0178602 (UMLS CUI-1)
Last Dosage of Ropinirole
Item
Last study drug dose:
float
C0244821 (UMLS CUI [1,1])
C0178602 (UMLS CUI [1,2])
C1517741 (UMLS CUI [1,3])
Date of Last Dose
Item
Date of last study drug dose:
date
C1762893 (UMLS CUI [1])
Time of Last Dose
Item
Time of last study drug dose (24 hour clock):
time
C0946444 (UMLS CUI [1])
Prescribed Dose
Item
Enter the dose of study drug prescribed at this visit:
float
C0678766 (UMLS CUI [1,1])
C0278329 (UMLS CUI [1,2])
Item Group
Orthostatic Blood Pressure/ Pulse
C1095971 (UMLS CUI-1)
Up Titration
Item
is the patient being up titrated at this visit?
boolean
C0205217 (UMLS CUI [1,1])
C2983683 (UMLS CUI [1,2])
Time of Examination
Item
Time Point (Time [24-hour clock])
time
C0040223 (UMLS CUI [1,1])
C0430022 (UMLS CUI [1,2])
Semi-Supine Heart Rate
Item
Semi-Supine Heart Rate
float
C0522019 (UMLS CUI [1,1])
C0018810 (UMLS CUI [1,2])
Erect Heart Rate
Item
Standing Heart Rate
float
C0522014 (UMLS CUI [1,1])
C0018810 (UMLS CUI [1,2])
Semi-Supine Systolic Blood Pressure
Item
Semi-Supine Systolic Blood Pressure
float
C0871470 (UMLS CUI [1])
Semi-Supine Diastolic Blood Pressure
Item
Semi-Supine Diastolic Blood Pressure
float
C0522019 (UMLS CUI [1,1])
C0428883 (UMLS CUI [1,2])
Erect Systolic Blood Pressure
Item
Standing Systolic Blood Pressure
float
C0522014 (UMLS CUI [1,1])
C0871470 (UMLS CUI [1,2])
Erect Diastolic Blood Pressure
Item
Standing Diastolic Blood Pressure
float
C0522014 (UMLS CUI [1,1])
C0428883 (UMLS CUI [1,2])
Item Group
Unified Parkinson's Disease Rating Scale (UPDRS)
C3639721 (UMLS CUI-1)
Unified Parkinson's Disease Rating Scale
Item
Unified Parkinson's Disease Rating Scale (UPDRS)
text
C3639721 (UMLS CUI [1])
Item Group
Laboratory Evaluations: Hematology - Complete this page only if this is a 6-months visit. Obtain blood samples at the Month 36 visit or the Study Completion Visit and then every 6 months after that. Note: Please complete the clinically significant (Clin Sig) columni for values out of normal range.
C0474523 (UMLS CUI-1)
Hematology
Item
Hematology. Performed?
boolean
C0474523 (UMLS CUI [1])
Hematology: Collection Date
Item
Date of Sample:
date
C0474523 (UMLS CUI [1,1])
C1317250 (UMLS CUI [1,2])
Hemoglobin
Item
Hemoglobin: Result
float
C0019046 (UMLS CUI [1])
Hemoglobin: Unit
Item
Hemoglobin: Units
text
C0518015 (UMLS CUI [1,1])
C1519795 (UMLS CUI [1,2])
Hemoglobin: Clinically Significant
Item
Hemoglobin: Clin Sig
boolean
C0518015 (UMLS CUI [1,1])
C2826633 (UMLS CUI [1,2])
Hematocrit
Item
Hematocrit: Result
float
C0518014 (UMLS CUI [1])
Hematocrit: Unit
Item
Hematocrit: Units
text
C0518014 (UMLS CUI [1,1])
C1519795 (UMLS CUI [1,2])
Hematocrit: Clinically Significant
Item
Hematocrit: Clin Sig
boolean
C0518014 (UMLS CUI [1,1])
C2826633 (UMLS CUI [1,2])
Red Blood Count
Item
RBC: Result
float
C1287262 (UMLS CUI [1])
Red Blood Count: Unit
Item
RBC: Units
text
C1287262 (UMLS CUI [1,1])
C1519795 (UMLS CUI [1,2])
Red Blood Count: Clinically Significant
Item
RBC: Clin Sig
boolean
C1287262 (UMLS CUI [1,1])
C2826633 (UMLS CUI [1,2])
White Blood Count
Item
WBC: Result
float
C0023508 (UMLS CUI [1])
White Blood Count: Unit
Item
WBC: Units
text
C0023508 (UMLS CUI [1,1])
C1519795 (UMLS CUI [1,2])
White Blood Count: Clinically Significant
Item
WBC: Clin Sig
boolean
C0023508 (UMLS CUI [1,1])
C2826633 (UMLS CUI [1,2])
Platelets
Item
Platelets: Result
float
C0005821 (UMLS CUI [1])
Platelets: Unit
Item
Platelets: Units
text
C0005821 (UMLS CUI [1,1])
C1519795 (UMLS CUI [1,2])
Platelets: Clinically Significant
Item
Platelets: Clin Sig
boolean
C0005821 (UMLS CUI [1,1])
C2826633 (UMLS CUI [1,2])
Item Group
Laboratory Evaluations: Serum Chemistry - Complete this page only if this is a 6-months visit. Obtain blood samples at the Month 36 visit or the Study Completion Visit and then every 6 months after that. Note: Please complete the clinically significant (Clin Sig) columni for values out of normal range.
C1883010 (UMLS CUI-1)
Serum Chemistry
Item
Serum Chemistry: Performed?
boolean
C1883010 (UMLS CUI [1])
Serum Chemistry: Collection Date
Item
Date of Sample:
date
C1883010 (UMLS CUI [1,1])
C1317250 (UMLS CUI [1,2])
Sodium
Item
Sodium: Result
float
C0337443 (UMLS CUI [1])
Sodium: Unit
Item
Sodium: Units
text
C0337443 (UMLS CUI [1,1])
C1519795 (UMLS CUI [1,2])
Sodium: Clinically Significant
Item
Sodium: Clin Sig
boolean
C0337443 (UMLS CUI [1,1])
C2826633 (UMLS CUI [1,2])
Potassium
Item
Potassium: Result
float
C0202194 (UMLS CUI [1])
Potassium: Unit
Item
Potassium: Units
text
C0202194 (UMLS CUI [1,1])
C1519795 (UMLS CUI [1,2])
Potassium: Clinically Significant
Item
Potassium: Clin Sig
boolean
C0202194 (UMLS CUI [1,1])
C2826633 (UMLS CUI [1,2])
Urea
Item
Urea: Results
float
C0523961 (UMLS CUI [1])
Urea: Unit
Item
Urea: Units
text
C0523961 (UMLS CUI [1,1])
C1519795 (UMLS CUI [1,2])
Urea: Clinically Significant
Item
Urea: Clin Sig
boolean
C0523961 (UMLS CUI [1,1])
C2826633 (UMLS CUI [1,2])
Creatinine
Item
Creatinine: Results
float
C0201976 (UMLS CUI [1])
Creatinine: Unit
Item
Creatinine: Units
text
C0201976 (UMLS CUI [1,1])
C1519795 (UMLS CUI [1,2])
Creatinine: Clinically Significant
Item
Creatinine: Clin Sig
boolean
C0201976 (UMLS CUI [1,1])
C2826633 (UMLS CUI [1,2])
Total Protein
Item
Protein, total: Result
float
C0555903 (UMLS CUI [1])
Total Protein: Unit
Item
Protein, total: Units
text
C0555903 (UMLS CUI [1,1])
C1519795 (UMLS CUI [1,2])
Total Protein: Clinically Significant
Item
Protein, total: Clin Sig
boolean
C0555903 (UMLS CUI [1,1])
C2826633 (UMLS CUI [1,2])
Albumin
Item
Albumin: Result
float
C0201838 (UMLS CUI [1])
Albumin: Unit
Item
Albumin: Units
text
C0201838 (UMLS CUI [1,1])
C1519795 (UMLS CUI [1,2])
Albumin: Clinically Significant
Item
Albumin: Clin Sig
boolean
C0201838 (UMLS CUI [1,1])
C2826633 (UMLS CUI [1,2])
Globulin
Item
Globulin: Results
float
C0877347 (UMLS CUI [1])
Globulin: Unit
Item
Globulin: Units
text
C0877347 (UMLS CUI [1,1])
C1519795 (UMLS CUI [1,2])
Globulin: Clinically Significant
Item
Globulin: Clin Sig
boolean
C0877347 (UMLS CUI [1,1])
C2826633 (UMLS CUI [1,2])
Total Bilirubin
Item
Bilirubin, total: Result
float
C0201913 (UMLS CUI [1])
Total Bilirubin: Unit
Item
Bilirubin, total: Units
text
C0201913 (UMLS CUI [1,1])
C1519795 (UMLS CUI [1,2])
Total Bilirubin: Clinically Significant
Item
Bilirubin, total: Clin Sig
boolean
C0201913 (UMLS CUI [1,1])
C2826633 (UMLS CUI [1,2])
AST
Item
AST (SGOT): Result
float
C0201899 (UMLS CUI [1])
AST: Unit
Item
AST (SGOT): Units
text
C0201899 (UMLS CUI [1,1])
C1519795 (UMLS CUI [1,2])
AST: Clinically Significant
Item
AST (SGOT): Clin Sig
boolean
C0201899 (UMLS CUI [1,1])
C2826633 (UMLS CUI [1,2])
ALT
Item
ALT (SGPT): Result
float
C0201836 (UMLS CUI [1])
ALT: Unit
Item
ALT (SGPT): Units
text
C0201836 (UMLS CUI [1,1])
C1519795 (UMLS CUI [1,2])
ALT: Clinically Significant
Item
ALT (SGPT): Clin Sig
boolean
C0201836 (UMLS CUI [1,1])
C2826633 (UMLS CUI [1,2])
Alkaline Phosphatase
Item
Alkaline Phosphatase: Result
float
C0201850 (UMLS CUI [1])
Alkaline Phosphatase: Unit
Item
Alkaline Phosphatase: Units
text
C0201850 (UMLS CUI [1,1])
C1519795 (UMLS CUI [1,2])
Alkaline Phosphatase: Clinically Significant
Item
Alkaline Phosphatase: Clin Sig
boolean
C0201850 (UMLS CUI [1,1])
C2826633 (UMLS CUI [1,2])
Calcium
Item
Calcium: Result
float
C0201925 (UMLS CUI [1])
Calcium: Unit
Item
Calcium: Units
text
C0201925 (UMLS CUI [1,1])
C1519795 (UMLS CUI [1,2])
Calcium: Clinically Significant
Item
Calcium: Clin Sig
boolean
C0201925 (UMLS CUI [1,1])
C2826633 (UMLS CUI [1,2])
Phosphate
Item
Phosphate: Result
float
C0523826 (UMLS CUI [1])
Phosphate: Unit
Item
Phosphate: Units
text
C0523826 (UMLS CUI [1,1])
C1519795 (UMLS CUI [1,2])
Phosphate: Clinically Significant
Item
Phosphate: Clin Sig
boolean
C0523826 (UMLS CUI [1,1])
C2826633 (UMLS CUI [1,2])
Non-Fasting Glucose
Item
Glucose (non-fasting): Results
float
C2347359 (UMLS CUI [1,1])
C0337438 (UMLS CUI [1,2])
Non-Fasting Glucose: Unit
Item
Glucose (non-fasting): Units
text
C2347359 (UMLS CUI [1,1])
C0337438 (UMLS CUI [1,2])
C1519795 (UMLS CUI [1,3])
Non-Fasting Glucose: Clinically Significant
Item
Glucose (non-fasting): Clin Sig
boolean
C2347359 (UMLS CUI [1,1])
C0337438 (UMLS CUI [1,2])
C2826633 (UMLS CUI [1,3])
Item Group
Pregnancy Test (betaHCG)
C0032976 (UMLS CUI-1)
Item
Was a pregnancy test performed?
integer
C0032976 (UMLS CUI [1])
Pregnancy Test
Code List
Was a pregnancy test performed?
CL Item
Yes (1)
CL Item
No (2)
CL Item
NA (male or female not of childbearing potential) (3)
Item
If YES, what type of pregnancy was performed?
integer
C0032976 (UMLS CUI [1,1])
C0332307 (UMLS CUI [1,2])
Type of Pregnancy Test
Code List
If YES, what type of pregnancy was performed?
CL Item
Serum (1)
CL Item
Urine (2)
Date of Pregnancy Test
Item
If YES, Date of Test:
date
C0032976 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Item
If YES, Result:
integer
C0427777 (UMLS CUI [1])
Pregnancy Test Finding
Code List
If YES, Result:
CL Item
Negative (1)
CL Item
Positive (2)
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