ID

26227

Beskrivning

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

Nyckelord

Versioner (1)
  1. 2017-10-12 2017-10-12 -
Rättsinnehavare

GlaxoSmithKline

Uppladdad den

12 oktober 2017

DOI

För en begäran logga in.

Licens

Creative Commons BY-NC-ND 3.0
Modellkommentarer :

Här kan du kommentera modellen. Med hjälp av pratbubblor i Item-grupperna och Item kan du lägga in specifika kommentarer.

Tillbaka till modellkommentarer
Itemgroup-kommentar för :

Item-kommentar för :

Du måste vara inloggad för att kunna ladda ner formulär. Var vänlig logga in eller registrera dig utan kostnad.

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

Engelsk

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

1 Formulär  
Patient Information
Beskrivning

Patient Information

Alias
UMLS CUI-1
C1955348
Patient No.
Beskrivning

Patient Number

Datatyp

text

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

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

Alias
UMLS CUI-1
C0011065
Date of Death:
Beskrivning

Date of Death

Datatyp

date

Måttenheter
  • dd-mmm-yyyy
Alias
UMLS CUI [1]
C1148348
dd-mmm-yyyy
Was an autopsy performed?
Beskrivning

If YES, attach a copy of the autopsy report.

Datatyp

boolean

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

Primary Cause of Death

Datatyp

text

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

Cause of Death

Datatyp

text

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

Death related to Study Drug

Datatyp

boolean

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

Investigator's Signature

Datatyp

text

Alias
UMLS CUI [1]
C2346576
Date
Beskrivning

Date of Report

Datatyp

date

Måttenheter
  • dd-mmm-yyyy
Alias
UMLS CUI [1]
C1302584
dd-mmm-yyyy
Tillbaka till toppen

Similar models

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

1 Formulär
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
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])
Tillbaka till toppen 

Kontakt

Använd detta formulär för feedback, frågor och förslag på förbättringar.

Fält markerade med * är obligatoriska.

Hjälp

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