ID

26699

Description

Study ID: 100601 Clinical Study ID: LPL100601 Study Title: LPL100601, A Clinical Outcomes Study of Darapladib versus Placebo in Subjects with Chronic Coronary Heart Disease to Compare the Incidence of Major Adverse Cardiovascular Events (MACE) Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00799903 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: phase 3 Study Recruitment Status: Completed Generic Name: darapladib Trade Name: darapladib Study Indication: Atherosclerosis Study part: Cancer Report Form - Repeating form (Scheduled visits)

Keywords

Versions (4)
  1. 10/4/17 10/4/17 -
  2. 10/13/17 10/13/17 -
  3. 10/23/17 10/23/17 -
  4. 1/1/18 1/1/18 -
Copyright Holder

GlaxoSmithKline

Uploaded on

October 23, 2017

DOI

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License

Creative Commons BY-NC 3.0
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Cancer Report Form Repeating form GSK study Chronic Coronary Heart Disease NCT00799903

English

Cancer Report Form Repeating form GSK study Chronic Coronary Heart Disease NCT00799903

1 forms  
1. Diagnosis of a new, recurrence of, or metastatic cancer
Description

1. Diagnosis of a new, recurrence of, or metastatic cancer

Diagnosis of a new, recurrence of, or metastatic cancer
Description

Cancer diagnosis

Data type

integer

2. New cancer details
Description

2. New cancer details

Date of diagnosis
Description

Date of diagnosis new cancer

Data type

date

Site
Description

Site new cancer

Data type

integer

Other site
Description

Other site new cancer

Data type

boolean

Other site, specify
Description

Other site new cancer specification

Data type

text

Was the pathology report obtained for the source documentation?
Description

pathology report new cancer

Data type

boolean

3. Recurrence of cancer details
Description

3. Recurrence of cancer details

Date of recurrence
Description

Date of recurrence

Data type

date

Site
Description

Site recurrence

Data type

integer

Other site
Description

Other site recurrence

Data type

boolean

Other site, specify
Description

Other site recurrence specification

Data type

text

Was the pathology report obtained for the source documentation?
Description

pathology report recurrence

Data type

boolean

Was the pathology report for primary diagnosis obtained for the source documentation?
Description

pathology report primary diagnosis recurrence

Data type

boolean

4. Metastatic cancer details
Description

4. Metastatic cancer details

Date of diagnosis of metastasis
Description

Date of diagnosis of metastasis

Data type

date

Site
Description

Site of metastasis

Data type

integer

Other site
Description

Other site metastasis

Data type

boolean

Other site, specify
Description

Other site specification

Data type

text

Was the pathology report obtained for the source documentation?
Description

pathology report metastasis

Data type

boolean

Date of diagnosis of primary site
Description

Date of diagnosis primary site

Data type

date

Primary site
Description

Primary site metastasis

Data type

integer

Other primary site
Description

Other primary site

Data type

boolean

Other primary site, specify
Description

Other primary site specification

Data type

text

Was the pathology report for primary diagnosis obtained for the source documentation?
Description

pathology report primary diagnosis metastasis

Data type

boolean

5. Was the subject hospitalised related to this diagnosis?
Description

5. Was the subject hospitalised related to this diagnosis?

Was the subject hospitalised related to this diagnosis?
Description

Hospitalisation related to diagnosis

Data type

boolean

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Similar models

Cancer Report Form Repeating form GSK study Chronic Coronary Heart Disease NCT00799903

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
1. Diagnosis of a new, recurrence of, or metastatic cancer
Item
Diagnosis of a new, recurrence of, or metastatic cancer
integer
Cancer diagnosis
Code List
Diagnosis of a new, recurrence of, or metastatic cancer
CL Item
New cancer (1)
CL Item
Recurrence of cancer (2)
CL Item
Metastatic cancer (3)
Item Group
2. New cancer details
Date of diagnosis new cancer
Item
Date of diagnosis
date
Item
Site
integer
Site new cancer
Code List
Site
CL Item
Benign neoplasm (1)
CL Item
Bile duct cancer (2)
CL Item
Bladder cancer (3)
CL Item
Bowel cancer (4)
CL Item
Breast cancer (5)
CL Item
Cervical cancer (6)
CL Item
Endometrial cancer (7)
CL Item
Esophageal cancer (8)
CL Item
Fallopian tube cancer (9)
CL Item
Gallbladder cancer (10)
CL Item
Gastric cancer (11)
CL Item
Hodgkin's disease (12)
CL Item
Leukemia (13)
CL Item
Lip cancer (14)
CL Item
Liver cancer (15)
CL Item
Lung cancer (16)
CL Item
Lymphoma (17)
CL Item
Multiple myeloma (18)
CL Item
Myelodysplastic syndrome (19)
CL Item
Non-melanoma skin cancer (20)
CL Item
Oral cancer (21)
CL Item
Ovarian cancer (22)
CL Item
Pancreatic cancer (23)
CL Item
Penile cancer (24)
CL Item
Pharyngeal cancer (25)
CL Item
Prostate cancer (26)
CL Item
Renal cancer (27)
CL Item
Scrotum cancer (28)
CL Item
Skin melanoma (29)
CL Item
Testicular cancer (30)
CL Item
Vaginal cancer (31)
CL Item
Vulval cancer (32)
Other site new cancer
Item
Other site
boolean
Other site new cancer specification
Item
Other site, specify
text
pathology report new cancer
Item
Was the pathology report obtained for the source documentation?
boolean
Item Group
3. Recurrence of cancer details
Date of recurrence
Item
Date of recurrence
date
Item
Site
integer
Site new cancer
Code List
Site
CL Item
Benign neoplasm (1)
CL Item
Bile duct cancer (2)
CL Item
Bladder cancer (3)
CL Item
Bowel cancer (4)
CL Item
Breast cancer (5)
CL Item
Cervical cancer (6)
CL Item
Endometrial cancer (7)
CL Item
Esophageal cancer (8)
CL Item
Fallopian tube cancer (9)
CL Item
Gallbladder cancer (10)
CL Item
Gastric cancer (11)
CL Item
Hodgkin's disease (12)
CL Item
Leukemia (13)
CL Item
Lip cancer (14)
CL Item
Liver cancer (15)
CL Item
Lung cancer (16)
CL Item
Lymphoma (17)
CL Item
Multiple myeloma (18)
CL Item
Myelodysplastic syndrome (19)
CL Item
Non-melanoma skin cancer (20)
CL Item
Oral cancer (21)
CL Item
Ovarian cancer (22)
CL Item
Pancreatic cancer (23)
CL Item
Penile cancer (24)
CL Item
Pharyngeal cancer (25)
CL Item
Prostate cancer (26)
CL Item
Renal cancer (27)
CL Item
Scrotum cancer (28)
CL Item
Skin melanoma (29)
CL Item
Testicular cancer (30)
CL Item
Vaginal cancer (31)
CL Item
Vulval cancer (32)
Other site recurrence
Item
Other site
boolean
Other site recurrence specification
Item
Other site, specify
text
pathology report recurrence
Item
Was the pathology report obtained for the source documentation?
boolean
pathology report primary diagnosis recurrence
Item
Was the pathology report for primary diagnosis obtained for the source documentation?
boolean
Item Group
4. Metastatic cancer details
Date of diagnosis of metastasis
Item
Date of diagnosis of metastasis
date
Item
Site
integer
Site new cancer
Code List
Site
CL Item
Benign neoplasm (1)
CL Item
Bile duct cancer (2)
CL Item
Bladder cancer (3)
CL Item
Bowel cancer (4)
CL Item
Breast cancer (5)
CL Item
Cervical cancer (6)
CL Item
Endometrial cancer (7)
CL Item
Esophageal cancer (8)
CL Item
Fallopian tube cancer (9)
CL Item
Gallbladder cancer (10)
CL Item
Gastric cancer (11)
CL Item
Hodgkin's disease (12)
CL Item
Leukemia (13)
CL Item
Lip cancer (14)
CL Item
Liver cancer (15)
CL Item
Lung cancer (16)
CL Item
Lymphoma (17)
CL Item
Multiple myeloma (18)
CL Item
Myelodysplastic syndrome (19)
CL Item
Non-melanoma skin cancer (20)
CL Item
Oral cancer (21)
CL Item
Ovarian cancer (22)
CL Item
Pancreatic cancer (23)
CL Item
Penile cancer (24)
CL Item
Pharyngeal cancer (25)
CL Item
Prostate cancer (26)
CL Item
Renal cancer (27)
CL Item
Scrotum cancer (28)
CL Item
Skin melanoma (29)
CL Item
Testicular cancer (30)
CL Item
Vaginal cancer (31)
CL Item
Vulval cancer (32)
Other site metastasis
Item
Other site
boolean
Other site specification
Item
Other site, specify
text
pathology report metastasis
Item
Was the pathology report obtained for the source documentation?
boolean
Date of diagnosis primary site
Item
Date of diagnosis of primary site
date
Item
Primary site
integer
Site new cancer
Code List
Primary site
CL Item
Benign neoplasm (1)
CL Item
Bile duct cancer (2)
CL Item
Bladder cancer (3)
CL Item
Bowel cancer (4)
CL Item
Breast cancer (5)
CL Item
Cervical cancer (6)
CL Item
Endometrial cancer (7)
CL Item
Esophageal cancer (8)
CL Item
Fallopian tube cancer (9)
CL Item
Gallbladder cancer (10)
CL Item
Gastric cancer (11)
CL Item
Hodgkin's disease (12)
CL Item
Leukemia (13)
CL Item
Lip cancer (14)
CL Item
Liver cancer (15)
CL Item
Lung cancer (16)
CL Item
Lymphoma (17)
CL Item
Multiple myeloma (18)
CL Item
Myelodysplastic syndrome (19)
CL Item
Non-melanoma skin cancer (20)
CL Item
Oral cancer (21)
CL Item
Ovarian cancer (22)
CL Item
Pancreatic cancer (23)
CL Item
Penile cancer (24)
CL Item
Pharyngeal cancer (25)
CL Item
Prostate cancer (26)
CL Item
Renal cancer (27)
CL Item
Scrotum cancer (28)
CL Item
Skin melanoma (29)
CL Item
Testicular cancer (30)
CL Item
Vaginal cancer (31)
CL Item
Vulval cancer (32)
Other primary site
Item
Other primary site
boolean
Other primary site specification
Item
Other primary site, specify
text
pathology report primary diagnosis metastasis
Item
Was the pathology report for primary diagnosis obtained for the source documentation?
boolean
Item Group
5. Was the subject hospitalised related to this diagnosis?
Hospitalisation related to diagnosis
Item
Was the subject hospitalised related to this diagnosis?
boolean
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