ID
29055
Description
Ropinirole Case Report Form GSK RRL100013 GSK Study ID: 100013 Clinical Study ID: RRL100013 A 12-Week, Double-Blind, Placebo-Controlled, Twice-Daily Dosing Study to Assess the Efficacy and Safety of Ropinirole in Patients Suffering from Restless Legs Syndrome (RLS) Requiring Extended Treatment Coverage
Mots-clés
Versions (5)
- 05/10/2017 05/10/2017 -
- 22/02/2018 22/02/2018 -
- 22/02/2018 22/02/2018 -
- 22/02/2018 22/02/2018 -
- 17/09/2021 17/09/2021 -
Détendeur de droits
gsk
Téléchargé le
22 février 2018
DOI
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Licence
Creative Commons BY-NC 3.0
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Ropinirole Case Report Form GSK RRL100013
STATUS OF TREATMENT BLIND
Description
PGx-PHARMACOGENETIC RESEARCH INSTRUCTIONS
Description
The question "Has informed consent been obtained for PGx-Pharmacogenetic research?" should be completed at the beginning of the study. If the question is answered No, I/ one box for reason and do not complete the remainder of the page. WITHDRAWAL OF CONSENT The question "Has the subject withdrawn consent for PGx-Pharmacogenetic research?" must be completed immediately if the subject withdraws consent. Otherwise, it must be completed when the subject leaves the study. It must be completed for all subjects for whom informed consent was obtained for PGx-Pharmacogenetic research. If consent is withdrawn, a request for destruction must be made and Blood Sample Destruction section below completed. BLOOD SAMPLE DESTRUCT/ON Do not complete this section if a blood sample was not collected. The question "Has a request been made for sample destruction?" must be completed immediately if there is a request for sample destruction. Otherwise, it must be completed when the subject leaves the study. It must be completed for all subjects for whom a blood sample was obtained for PGx-Pharmacogenetic research. If the question is answered Yes, I/one box for reason.
Type de données
text
Alias
- UMLS CUI [1,1]
- C0031325
- UMLS CUI [1,2]
- C1442085
Description
PGx-PHARMACOGENETIC RESEARCH
Description
CONSENT FOR PGx-PHARMACOGENETIC RESEARCH
Type de données
boolean
Alias
- UMLS CUI [1,1]
- C0021430
- UMLS CUI [1,2]
- C2347500
Description
Informed consent if yes
Type de données
date
Alias
- UMLS CUI [1]
- C2985782
Description
Informed consent if no
Type de données
text
Alias
- UMLS CUI [1]
- C0021430
Description
BLOOD SAMPLE COLLECTION
Type de données
boolean
Alias
- UMLS CUI [1]
- C0005834
Description
If Yes, record the date sample taken
Type de données
date
Alias
- UMLS CUI [1,1]
- C0005834
- UMLS CUI [1,2]
- C0011008
Description
WITHDRAWAL OF CONSENT
Type de données
boolean
Alias
- UMLS CUI [1]
- C1707492
Description
BLOOD SAMPLE DESTRUCTION
Type de données
boolean
Alias
- UMLS CUI [1,1]
- C1948029
- UMLS CUI [1,2]
- C0178913
Description
If Yes: BLOOD SAMPLE DESTRUCTION
Type de données
integer
Alias
- UMLS CUI [1,1]
- C1948029
- UMLS CUI [1,2]
- C0178913
Description
The following lists of abbreviations are examples which can be used to aid the completion of the appropriate items on the Concomitant Medications page. These are not all inclusive lists and are for guidance only, other abbreviations not listed may be used if necessary.
Type de données
text
Alias
- UMLS CUI [1]
- C2347852
Description
UNITS
Type de données
text
Alias
- UMLS CUI [1]
- C1519795
Similar models
STATUS OF TREATMENT BLIND
C2347038 (UMLS CUI [1,2])
C2347038 (UMLS CUI [1,2])
(Comment:en)
(Comment:en)
C1442085 (UMLS CUI [1,2])
C2347500 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,2])
C0178913 (UMLS CUI [1,2])
C0178913 (UMLS CUI [1,2])
(Comment:en)
(Comment:en)