ID

26477

Descripción

Study ID: 101468/190 Clinical Study ID: SKF-101468/190 Study Title:A 12 Week, Double-Blind, Placebo-Controlled, Parallel Group Study to Assess the Efficacy and Safety of Ropinirole in Patients Suffering from Restless Legs Syndrome (RLS). Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: Sponsor: GlaxoSmithKline Collaborators: N/A Phase: phase 3 Study Recruitment Status: Completed Generic Name: ropinirole Trade Name: Requip Study Indication: Restless Legs Syndrome This is the Patient enrollment form.

Palabras clave

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

GlaxoSmithKline

Subido en

18 de octubre de 2017

DOI

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Licencia

Creative Commons BY-NC 3.0
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Patient enrollment form GSK Ropinirole in Patients Suffering from Restless Legs Syndrome 101468/190

Inglés

Patient enrollment form GSK Ropinirole in Patients Suffering from Restless Legs Syndrome 101468/190

1 formularios  
Patient enrollment
Descripción

Patient enrollment

Alias
UMLS CUI-1
C1516879
sponsor study contact
Descripción

sponsor study contact

Tipo de datos

text

Alias
UMLS CUI [1]
C4288370
sponsor study contact fax
Descripción

sponsor study contact fax

Tipo de datos

text

Alias
UMLS CUI [1,1]
C4288370
UMLS CUI [1,2]
C1549619
enroled in study:
Descripción

enroled in study:

Tipo de datos

integer

Alias
UMLS CUI [1]
C1516879
Patient Initials
Descripción

Patient Initials

Tipo de datos

text

Alias
UMLS CUI [1]
C2986440
Patient Number
Descripción

Patient Number

Tipo de datos

text

Alias
UMLS CUI [1]
C1830427
Centre Number
Descripción

Centre Number

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0600091
UMLS CUI [1,2]
C0019994
Date of enrollment
Descripción

Date of enrollment

Tipo de datos

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C0679646
UMLS CUI [1,3]
C1516879
Signed:
Descripción

Signed

Tipo de datos

text

Alias
UMLS CUI [1]
C1519316
Signed Date
Descripción

Signed Date

Tipo de datos

date

Alias
UMLS CUI [1,1]
C1519316
UMLS CUI [1,2]
C0011008
Institution
Descripción

Institution

Tipo de datos

text

Alias
UMLS CUI [1]
C1301943
Volver a la parte superior de la página

Similar models

Patient enrollment form GSK Ropinirole in Patients Suffering from Restless Legs Syndrome 101468/190

1 formularios
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
Patient enrollment
C1516879 (UMLS CUI-1)
sponsor study contact
Item
sponsor study contact
text
C4288370 (UMLS CUI [1])
sponsor study contact fax
Item
sponsor study contact fax
text
C4288370 (UMLS CUI [1,1])
C1549619 (UMLS CUI [1,2])
enroled in study:
Item
enroled in study:
integer
C1516879 (UMLS CUI [1])
Patient Initials
Item
Patient Initials
text
C2986440 (UMLS CUI [1])
Patient Number
Item
Patient Number
text
C1830427 (UMLS CUI [1])
Centre Number
Item
Centre Number
text
C0600091 (UMLS CUI [1,1])
C0019994 (UMLS CUI [1,2])
Date of enrollment
Item
Date of enrollment
date
C0011008 (UMLS CUI [1,1])
C0679646 (UMLS CUI [1,2])
C1516879 (UMLS CUI [1,3])
Signed
Item
Signed:
text
C1519316 (UMLS CUI [1])
Signed Date
Item
Signed Date
date
C1519316 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Institution
Item
Institution
text
C1301943 (UMLS CUI [1])
Volver a la parte superior de la página 

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