ID

29026

Description

A Multi-Centre, Randomised, Double-Blind, Parallel-Group, Placebo- and Active-Controlled, Flexible Dose Study Evaluating the Efficacy, Safety and Tolerability of Extended-Release Bupropion Hydrochloride (150mg - 300mg once daily), Extended-Release Venlafaxine Hydrochloride (75mg - 150mg once daily) and Placebo in Subjects with Major Depressive Disorder

Mots-clés

Versions (1)
  1. 21/02/2018 21/02/2018 -
Détendeur de droits

GlaxoSmithKline

Téléchargé le

21 février 2018

DOI

Pour une demande vous connecter.

Licence

Creative Commons BY-NC 3.0
Modèle Commentaires :

Ici, vous pouvez faire des commentaires sur le modèle. À partir des bulles de texte, vous pouvez laisser des commentaires spécifiques sur les groupes Item et les Item.

Retour au modèle Commentaires
Groupe Item commentaires pour :

Item commentaires pour :

Vous devez être connecté pour pouvoir télécharger des formulaires. Veuillez vous connecter ou s’inscrire gratuitement.

Study Evaluating Extended-Release Bupropion Hydrochloride and Extended-Release Venlafaxine Hydrochloride in Subjects with Major Depressive Disorder 101497

Allemand Anglais

Visit 5 (End of Week 4)

1 Formulaires  
Patient related scales
Description

Patient related scales

Alias
UMLS CUI-1
C0030705
UMLS CUI-2
C0450973
This section contained Clinical Outcome Assessment data collection questionnaires or indices, which are protected by copyright laws and therefore have been excluded.
Description

This section contained Clinical Outcome Assessment data collection questionnaires or indices, which are protected by copyright laws and therefore have been excluded.

Type de données

integer

Alias
UMLS CUI [1]
C4054475
This section contained Clinical Outcome Assessment data collection questionnaires or indices, which are protected by copyright laws and therefore have been excluded.
Description

This section contained Clinical Outcome Assessment data collection questionnaires or indices, which are protected by copyright laws and therefore have been excluded.

Type de données

integer

Alias
UMLS CUI [1]
C3541258
This section contained Clinical Outcome Assessment data collection questionnaires or indices, which are protected by copyright laws and therefore have been excluded
Description

This section contained Clinical Outcome Assessment data collection questionnaires or indices, which are protected by copyright laws and therefore have been excluded

Type de données

boolean

Alias
UMLS CUI [1]
C3639708
This section contained Clinical Outcome Assessment data collection questionnaires or indices, which are protected by copyright laws and therefore have been excluded.
Description

This section contained Clinical Outcome Assessment data collection questionnaires or indices, which are protected by copyright laws and therefore have been excluded.

Type de données

text

Alias
UMLS CUI [1]
C3846158
UMLS CUI [2,1]
C0278092
UMLS CUI [2,2]
C0205307
UMLS CUI [2,3]
C1705241
This section contained Clinical Outcome Assessment data collection questionnaires or indices, which are protected by copyright laws and therefore have been excluded.
Description

This section contained Clinical Outcome Assessment data collection questionnaires or indices, which are protected by copyright laws and therefore have been excluded.

Type de données

integer

Alias
UMLS CUI [1]
C3813719
Vital Signs
Description

Vital Signs

Alias
UMLS CUI-1
C0518766
Heart rate
Description

Heart rate

Type de données

integer

Unités de mesure
  • bpm
Alias
UMLS CUI [1]
C0018810
bpm
Blood Pressure Systolic
Description

Blood Pressure Systolic

Type de données

integer

Unités de mesure
  • mmHg
Alias
UMLS CUI [1]
C0871470
mmHg
Diastolic
Description

Diastolic blood pressure

Type de données

integer

Unités de mesure
  • mmHg
Alias
UMLS CUI [1]
C0428883
mmHg
Adverse Events
Description

Adverse Events

Alias
UMLS CUI-1
C0877248
Were there any adverse events observed or elicited by the following direct questions to the subject: "How are you feeling?" "Have you had any other medical problems since your last visit/assessment?"
Description

If 'Yes', please record on the Current Medical Conditions or Adverse Events panel as appropriate. NOTE: At the Baseline Visit, only serious adverse events related to study procedures must be recorded on the Adverse Events panel. All other adverse events at the Baseline visit should be recorded on the Current Medical Conditions panel.

Type de données

boolean

Alias
UMLS CUI [1]
C0877248
Concomitant Medication Prompt
Description

Concomitant Medication Prompt

Alias
UMLS CUI-1
C2347852
Were there any changes in concomitant medication since the last visit?
Description

If 'Yes', please record on the Prior and Concomitant Medications panel. Saving this panel after selecting 'Yes' will take you to the Prior and Concomitant Medications panel located in the Additional Forms section of the eCRF.

Type de données

boolean

Alias
UMLS CUI [1,1]
C2347852
UMLS CUI [1,2]
C2169461
Urine dipstick pregnancy test
Description

Urine dipstick pregnancy test

Alias
UMLS CUI-1
C0430056
Was a urine dipstick performed?
Description

If "Yes", please record result below.

Type de données

boolean

Alias
UMLS CUI [1]
C0430056
Sample Date
Description

Urine dipstick pregnancy sample date

Type de données

date

Alias
UMLS CUI [1,1]
C0430056
UMLS CUI [1,2]
C1302413
Result
Description

If "Positive", withdraw the subject and complete the paper Pregnancy Notification form. Also complete the Early Withdrawal Visit and the End of Study Record panels.

Type de données

boolean

Alias
UMLS CUI [1,1]
C0430056
UMLS CUI [1,2]
C0456984
Investigational Product Prompt
Description

Investigational Product Prompt

Alias
UMLS CUI-1
C0304229
Details of the Investigational Product dispensed at the previous visit need to be entered into the eCRF at this visit. Do you have the details available to enter the data?
Description

If 'Yes', please record on the Investigational Product panel.

Type de données

boolean

Alias
UMLS CUI [1]
C0304229
Comments
Description

Comments

Comments
Description

Research Comments

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25704
NCI Thesaurus ObjectClass
C15319
NCI Thesaurus Property
C25393
UMLS CUI [1]
C0947611
Retour au début de la page

Similar models

Visit 5 (End of Week 4)

1 Formulaires
Name
Type
Description | Question | Decode (Coded Value)
Type de données
Alias
Item Group
Patient related scales
C0030705 (UMLS CUI-1)
C0450973 (UMLS CUI-2)
Montgomery-Asberg Depression Rating Scale Questionnaire
Item
This section contained Clinical Outcome Assessment data collection questionnaires or indices, which are protected by copyright laws and therefore have been excluded.
integer
C4054475 (UMLS CUI [1])
Hamilton Anxiety Rating Scale Questionnaire
Item
This section contained Clinical Outcome Assessment data collection questionnaires or indices, which are protected by copyright laws and therefore have been excluded.
integer
C3541258 (UMLS CUI [1])
Clinical Global Impression
Item
This section contained Clinical Outcome Assessment data collection questionnaires or indices, which are protected by copyright laws and therefore have been excluded
boolean
C3639708 (UMLS CUI [1])
Changes in sexual functioning questionaire
Item
This section contained Clinical Outcome Assessment data collection questionnaires or indices, which are protected by copyright laws and therefore have been excluded.
text
C3846158 (UMLS CUI [1])
C0278092 (UMLS CUI [2,1])
C0205307 (UMLS CUI [2,2])
C1705241 (UMLS CUI [2,3])
Sheehan Disability Scale Questionnaire
Item
This section contained Clinical Outcome Assessment data collection questionnaires or indices, which are protected by copyright laws and therefore have been excluded.
integer
C3813719 (UMLS CUI [1])
Item Group
C0518766 (UMLS CUI-1)
Heart rate
Item
Heart rate
integer
C0018810 (UMLS CUI [1])
Blood Pressure Systolic
Item
Blood Pressure Systolic
integer
C0871470 (UMLS CUI [1])
Diastolic blood pressure
Item
Diastolic
integer
C0428883 (UMLS CUI [1])
Item Group
Adverse Events
C0877248 (UMLS CUI-1)
adverse events
Item
Were there any adverse events observed or elicited by the following direct questions to the subject: "How are you feeling?" "Have you had any other medical problems since your last visit/assessment?"
boolean
C0877248 (UMLS CUI [1])
Item Group
Concomitant Medication Prompt
C2347852 (UMLS CUI-1)
concomitant medication changes
Item
Were there any changes in concomitant medication since the last visit?
boolean
C2347852 (UMLS CUI [1,1])
C2169461 (UMLS CUI [1,2])
Item Group
Urine dipstick pregnancy test
C0430056 (UMLS CUI-1)
Urine dipstick pregnancy test
Item
Was a urine dipstick performed?
boolean
C0430056 (UMLS CUI [1])
Urine dipstick pregnancy sample date
Item
Sample Date
date
C0430056 (UMLS CUI [1,1])
C1302413 (UMLS CUI [1,2])
Urine dipstick pregnancy result
Item
Result
boolean
C0430056 (UMLS CUI [1,1])
C0456984 (UMLS CUI [1,2])
Item Group
Investigational Product Prompt
C0304229 (UMLS CUI-1)
Investigational Product
Item
Details of the Investigational Product dispensed at the previous visit need to be entered into the eCRF at this visit. Do you have the details available to enter the data?
boolean
C0304229 (UMLS CUI [1])
Item Group
Comments
Research Comments
Item
Comments
text
C25704 (NCI Thesaurus ValueDomain)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C0947611 (UMLS CUI [1])
Retour au début de la page 

Contact

Utilisez ce formulaire pour les retours, les questions et les améliorations suggérées.

Les champs marqués d’un * sont obligatoires.

Aide

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