ID

26227

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 Patient Death

Palabras clave

Versiones (1)
  1. 12/10/17 12/10/17 -
Titular de derechos de autor

GlaxoSmithKline

Subido en

12 de octubre de 2017

DOI

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Licencia

Creative Commons BY-NC-ND 3.0
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Patient Death Ropinirole in Parkinson's Disease GSK 101468/196

Inglés

Patient Death Ropinirole in Parkinson's Disease GSK 101468/196

1 formularios  
Patient Information
Descripción

Patient Information

Alias
UMLS CUI-1
C1955348
Patient No.
Descripción

Patient Number

Tipo de datos

text

Alias
UMLS CUI [1]
C1830427
Patient Death - In case of patient death, please complete the following information:
Descripción

Patient Death - In case of patient death, please complete the following information:

Alias
UMLS CUI-1
C0011065
Date of Death:
Descripción

Date of Death

Tipo de datos

date

Unidades de medida
  • dd-mmm-yyyy
Alias
UMLS CUI [1]
C1148348
dd-mmm-yyyy
Was an autopsy performed?
Descripción

If YES, attach a copy of the autopsy report.

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0004398
Primary Cause of Death:
Descripción

Primary Cause of Death

Tipo de datos

text

Alias
UMLS CUI [1]
C3262229
Underlying cause(s) of Death:
Descripción

Cause of Death

Tipo de datos

text

Alias
UMLS CUI [1]
C0007465
Was death related to study drug?
Descripción

Death related to Study Drug

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0011065
UMLS CUI [1,2]
C0304229
Signature of Investigator:
Descripción

Investigator's Signature

Tipo de datos

text

Alias
UMLS CUI [1]
C2346576
Date
Descripción

Date of Report

Tipo de datos

date

Unidades de medida
  • dd-mmm-yyyy
Alias
UMLS CUI [1]
C1302584
dd-mmm-yyyy
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Similar models

Patient Death 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)
Patient Number
Item
Patient No.
text
C1830427 (UMLS CUI [1])
Item Group
Patient Death - In case of patient death, please complete the following information:
C0011065 (UMLS CUI-1)
Date of Death
Item
Date of Death:
date
C1148348 (UMLS CUI [1])
Autopsy
Item
Was an autopsy performed?
boolean
C0004398 (UMLS CUI [1])
Primary Cause of Death
Item
Primary Cause of Death:
text
C3262229 (UMLS CUI [1])
Cause of Death
Item
Underlying cause(s) of Death:
text
C0007465 (UMLS CUI [1])
Death related to Study Drug
Item
Was death related to study drug?
boolean
C0011065 (UMLS CUI [1,1])
C0304229 (UMLS CUI [1,2])
Investigator's Signature
Item
Signature of Investigator:
text
C2346576 (UMLS CUI [1])
Date of Report
Item
Date
date
C1302584 (UMLS CUI [1])
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