ID

27948

Beschrijving

Study ID: 101468/168 Clinical Study ID: 101468/168 Study Title: A Randomised, Double Blind, Three Period, Cross-Over Study of Ropinirole CR and Ropinirole IR Monotherapy 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: Modutab,ZIPEREVE,ZEPREVE,REPREVE,ADARTREL,REQUIP,Zygara Study Indication: Parkinson Disease

Trefwoorden

Versies (2)
  1. 02-11-17 02-11-17 -
  2. 06-12-17 06-12-17 -
Houder van rechten

GlaxoSmithKline

Geüploaded op

6 december 2017

DOI

Voor een aanvraag inloggen.

Licentie

Creative Commons BY-NC 3.0
Model Commentaren :

Hier kunt u commentaar leveren op het model. U kunt de tekstballonnen bij de itemgroepen en items gebruiken om er specifiek commentaar op te geven.

Terug naar het model Commentaren
Itemgroep Commentaren voor :

Item Commentaren voor :

U moet ingelogd zijn om formulieren te downloaden. AUB inloggen of schrijf u gratis in.

Medication and food diary Ropinirole CR Ropinirole IR Monotherapy 101468/168

Engels

Medication and food diary Ropinirole CR Ropinirole IR Monotherapy 101468/168

1 Formulieren  
Administrative Data
Beschrijving

Administrative Data

Alias
UMLS CUI-1
C1320722
Subject Number
Beschrijving

subject number

Datatype

integer

Alias
UMLS CUI [1]
C2348585
Diary for week:
Beschrijving

Visit Description

Datatype

text

Alias
UMLS CUI [1,1]
C0545082
UMLS CUI [1,2]
C0678257
COMPLETE THE TIME YOU TOOK YOUR STUDY MEDICATION AND THE TIME OF FINISHING YOUR MEALS ON THE DAY BEFORE YOUR NEXT CLINIC VISIT.
Beschrijving

COMPLETE THE TIME YOU TOOK YOUR STUDY MEDICATION AND THE TIME OF FINISHING YOUR MEALS ON THE DAY BEFORE YOUR NEXT CLINIC VISIT.

Date of food diary
Beschrijving

Date of food diary

Datatype

date

Alias
UMLS CUI [1]
C0458244
Time 1st study medication taken
Beschrijving

time of first study medication

Datatype

time

Alias
UMLS CUI [1,1]
C0013230
UMLS CUI [1,2]
C1290952
Time 2nd study medication taken
Beschrijving

time of second study medication

Datatype

time

Alias
UMLS CUI [1,1]
C0013230
UMLS CUI [1,2]
C1290952
Time 3rd study medication taken
Beschrijving

time of third study medication

Datatype

time

Alias
UMLS CUI [1,1]
C0013230
UMLS CUI [1,2]
C1290952
Time of finishing breakfast:
Beschrijving

Time of finishing breakfast

Datatype

time

Alias
UMLS CUI [1,1]
C0040223
UMLS CUI [1,2]
C2698559
Time of finishing lunch:
Beschrijving

Time of finishing lunch

Datatype

time

Alias
UMLS CUI [1,1]
C0040223
UMLS CUI [1,2]
C2697949
Time of finishing dinner:
Beschrijving

Time of finishing dinner

Datatype

time

Alias
UMLS CUI [1,1]
C0040223
UMLS CUI [1,2]
C4048877
COMPLETE THE TIME YOU TOOK YOUR STUDY MEDICATION AND THE TIME OF FINISHING YOUR MEALS ON THE DAY OF YOUR CLINIC VISIT IF IT IS IN THE AFTERNOON.
Beschrijving

COMPLETE THE TIME YOU TOOK YOUR STUDY MEDICATION AND THE TIME OF FINISHING YOUR MEALS ON THE DAY OF YOUR CLINIC VISIT IF IT IS IN THE AFTERNOON.

Date of food diary
Beschrijving

Date of food diary

Datatype

date

Alias
UMLS CUI [1]
C0458244
Time 1st study medication taken
Beschrijving

time of first study medication

Datatype

time

Alias
UMLS CUI [1,1]
C0013230
UMLS CUI [1,2]
C1290952
Time 2nd study medication taken
Beschrijving

time of second study medication

Datatype

time

Alias
UMLS CUI [1,1]
C0013230
UMLS CUI [1,2]
C1290952
Time 3rd study medication taken
Beschrijving

time of third study medication

Datatype

time

Alias
UMLS CUI [1,1]
C0013230
UMLS CUI [1,2]
C1290952
Time of finishing breakfast:
Beschrijving

Time of finishing breakfast

Datatype

time

Alias
UMLS CUI [1,1]
C0040223
UMLS CUI [1,2]
C2698559
Time of finishing lunch:
Beschrijving

Time of finishing lunch

Datatype

time

Alias
UMLS CUI [1,1]
C0040223
UMLS CUI [1,2]
C2697949
Time of finishing dinner:
Beschrijving

Time of finishing dinner

Datatype

time

Alias
UMLS CUI [1,1]
C0040223
UMLS CUI [1,2]
C4048877
Terug naar het begin van de pagina

Similar models

Medication and food diary Ropinirole CR Ropinirole IR Monotherapy 101468/168

1 Formulieren
Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
Administrative Data
C1320722 (UMLS CUI-1)
subject number
Item
Subject Number
integer
C2348585 (UMLS CUI [1])
Visit Description
Item
Diary for week:
text
C0545082 (UMLS CUI [1,1])
C0678257 (UMLS CUI [1,2])
Item Group
COMPLETE THE TIME YOU TOOK YOUR STUDY MEDICATION AND THE TIME OF FINISHING YOUR MEALS ON THE DAY BEFORE YOUR NEXT CLINIC VISIT.
Date of food diary
Item
Date of food diary
date
C0458244 (UMLS CUI [1])
time of first study medication
Item
Time 1st study medication taken
time
C0013230 (UMLS CUI [1,1])
C1290952 (UMLS CUI [1,2])
time of second study medication
Item
Time 2nd study medication taken
time
C0013230 (UMLS CUI [1,1])
C1290952 (UMLS CUI [1,2])
time of third study medication
Item
Time 3rd study medication taken
time
C0013230 (UMLS CUI [1,1])
C1290952 (UMLS CUI [1,2])
Time of finishing breakfast
Item
Time of finishing breakfast:
time
C0040223 (UMLS CUI [1,1])
C2698559 (UMLS CUI [1,2])
Time of finishing lunch
Item
Time of finishing lunch:
time
C0040223 (UMLS CUI [1,1])
C2697949 (UMLS CUI [1,2])
Time of finishing dinner
Item
Time of finishing dinner:
time
C0040223 (UMLS CUI [1,1])
C4048877 (UMLS CUI [1,2])
Item Group
COMPLETE THE TIME YOU TOOK YOUR STUDY MEDICATION AND THE TIME OF FINISHING YOUR MEALS ON THE DAY OF YOUR CLINIC VISIT IF IT IS IN THE AFTERNOON.
Date of food diary
Item
Date of food diary
date
C0458244 (UMLS CUI [1])
time of first study medication
Item
Time 1st study medication taken
time
C0013230 (UMLS CUI [1,1])
C1290952 (UMLS CUI [1,2])
time of second study medication
Item
Time 2nd study medication taken
time
C0013230 (UMLS CUI [1,1])
C1290952 (UMLS CUI [1,2])
time of third study medication
Item
Time 3rd study medication taken
time
C0013230 (UMLS CUI [1,1])
C1290952 (UMLS CUI [1,2])
Time of finishing breakfast
Item
Time of finishing breakfast:
time
C0040223 (UMLS CUI [1,1])
C2698559 (UMLS CUI [1,2])
Time of finishing lunch
Item
Time of finishing lunch:
time
C0040223 (UMLS CUI [1,1])
C2697949 (UMLS CUI [1,2])
Time of finishing dinner
Item
Time of finishing dinner:
time
C0040223 (UMLS CUI [1,1])
C4048877 (UMLS CUI [1,2])
Terug naar het begin van de pagina 

Contact

Gebruik dit formulier voor feedback, vragen en verbeteringsvoorstellen.

Velden gemarkeerd met een * zijn verplicht.

Help

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