ID

27452

Beschreibung

Study ID: 103094 Clinical Study ID: ARI103094 Study Title: ARI103094-Follow-Up Study for REDUCE Study Subjects Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00883909 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 3 Study Recruitment Status: Completed Generic Name: dutasteride Trade Name: Zytefor,Zyfetor,Duagen,Avolve,Avodart,Avidart Study Indication: Neoplasms, Prostate

Stichworte

Versionen (2)
  1. 15.11.17 15.11.17 -
  2. 26.11.17 26.11.17 -
Rechteinhaber

GlaxoSmithKline

Hochgeladen am

15. November 2017

DOI

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Creative Commons BY-NC 3.0
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Concomitant Medications GSK study Prostatic neoplasms NCT00883909

Englisch

Concomitant Medications GSK study Prostatic neoplasms NCT00883909

1 Formulare  
Administrative data
Beschreibung

Administrative data

Session number
Beschreibung

Session number

Datentyp

integer

Subject number
Beschreibung

Subject number

Datentyp

text

Intake of concomitant Medications
Beschreibung

Intake of concomitant Medications

Were any chronic concomitant medications taken by the subject during the Follow-Up study?
Beschreibung

Check that either the YES or NO box at the top of the page is selected. • If NO is selected, check that no applicable concomitant medications are present. • If YES is selected, check that at least one applicable concomitant medication is present. If YES, record below.

Datentyp

text

Record of Concomitant Medications
Beschreibung

Record of Concomitant Medications

Drug (Trade name preferred)
Beschreibung

Check that the drug name (trade name preferred) is spelled correctly. If medication is given to treat a serious adverse event (SAE), then the event must be recorded on the SERIOUS ADVERSE EVENT page(s).

Datentyp

text

Dose
Beschreibung

Dose

Datentyp

float

Units
Beschreibung

Units

Datentyp

text

Frequency
Beschreibung

Frequency

Datentyp

text

Route
Beschreibung

Route

Datentyp

text

Date Started
Beschreibung

Check that either the ‘Date started’ is completed or ‘started Pre-Follow Up Study’ is completed. At least one must be completed, but it is acceptable if both are completed. • If both ‘Date started’ and ‘started Pre-Follow Up Study’ are completed, check that the start date is pre-study.

Datentyp

date

Started Pre- Follow Up Study
Beschreibung

Check that either the ‘Date started’ is completed or ‘started Pre-Follow Up Study’ is completed. At least one must be completed, but it is acceptable if both are completed. • If both ‘Date started’ and ‘started Pre-Follow Up Study’ are completed, check that the start date is pre-study.

Datentyp

boolean

Date Stopped
Beschreibung

Check that either the ‘Date stopped’ box is completed or the ‘continued Post-Follow Up Study’ is completed. Only one must be completed. • Check that the drug start date is before or equal to the drug stop date.

Datentyp

date

Continued Post- Follow Up Study
Beschreibung

Check that either the ‘Date stopped’ box is completed or the ‘continued Post-Follow Up Study’ is completed. Only one must be completed.

Datentyp

boolean

Conditions Treated / Indication
Beschreibung

Indication

Datentyp

text

Prophylaxis
Beschreibung

Prophylaxis

Datentyp

text

Was drug administered for an SAE?
Beschreibung

If the concomitant medication was taken for a serious adverse event (SAE), check that the event is entered on the SERIOUS ADVERSE EVENT page(s) and that the dates are consistent with the event.

Datentyp

text

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Ähnliche Modelle

Concomitant Medications GSK study Prostatic neoplasms NCT00883909

1 Formulare
Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
Alias
Item Group
Administrative data
Session number
Item
Session number
integer
Subject number
Item
Subject number
text
Item Group
Intake of concomitant Medications
Item
Were any chronic concomitant medications taken by the subject during the Follow-Up study?
text
concomitant medications intake
Code List
Were any chronic concomitant medications taken by the subject during the Follow-Up study?
CL Item
Yes (Y)
CL Item
No (N)
Item Group
Record of Concomitant Medications
Drug
Item
Drug (Trade name preferred)
text
Dose
Item
Dose
float
Units
Item
Units
text
Frequency
Item
Frequency
text
Route
Item
Route
text
Date Started
Item
Date Started
date
Started Pre- Follow Up Study
Item
Started Pre- Follow Up Study
boolean
Date Stopped
Item
Date Stopped
date
Continued Post- Follow Up Study
Item
Continued Post- Follow Up Study
boolean
Indication
Item
Conditions Treated / Indication
text
Item
Prophylaxis
text
concomitant medications intake
Code List
Prophylaxis
CL Item
Yes (Y)
CL Item
No (N)
Item
Was drug administered for an SAE?
text
concomitant medications intake
Code List
Was drug administered for an SAE?
CL Item
Yes (Y)
CL Item
No (N)
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