ID
29055
Beskrivning
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
Nyckelord
Versioner (5)
- 2017-10-05 2017-10-05 -
- 2018-02-22 2018-02-22 -
- 2018-02-22 2018-02-22 -
- 2018-02-22 2018-02-22 -
- 2021-09-17 2021-09-17 -
Rättsinnehavare
gsk
Uppladdad den
22 februari 2018
DOI
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Licens
Creative Commons BY-NC 3.0
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Ropinirole Case Report Form GSK RRL100013
STATUS OF TREATMENT BLIND
Beskrivning
PGx-PHARMACOGENETIC RESEARCH INSTRUCTIONS
Beskrivning
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 WITHDRAWAL OF CONSENT The question "Has the subject withdrawn consent for PGx-Pharmacogenetic research?"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 If consent is withdrawn, a request for destruction must be made and Blood Sample Destruction section below completed.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.
Datatyp
text
Alias
- UMLS CUI [1,1]
- C0031325
- UMLS CUI [1,2]
- C1442085
Beskrivning
PGx-PHARMACOGENETIC RESEARCH
Beskrivning
CONSENT FOR PGx-PHARMACOGENETIC RESEARCH
Datatyp
boolean
Alias
- UMLS CUI [1,1]
- C0021430
- UMLS CUI [1,2]
- C2347500
Beskrivning
Informed consent if yes
Datatyp
date
Alias
- UMLS CUI [1]
- C2985782
Beskrivning
Informed consent if no
Datatyp
text
Alias
- UMLS CUI [1]
- C0021430
Beskrivning
BLOOD SAMPLE COLLECTION
Datatyp
boolean
Alias
- UMLS CUI [1]
- C0005834
Beskrivning
If Yes, record the date sample taken
Datatyp
date
Alias
- UMLS CUI [1,1]
- C0005834
- UMLS CUI [1,2]
- C0011008
Beskrivning
WITHDRAWAL OF CONSENT
Datatyp
boolean
Alias
- UMLS CUI [1]
- C1707492
Beskrivning
BLOOD SAMPLE DESTRUCTION
Datatyp
boolean
Alias
- UMLS CUI [1,1]
- C1948029
- UMLS CUI [1,2]
- C0178913
Beskrivning
If Yes: BLOOD SAMPLE DESTRUCTION
Datatyp
integer
Alias
- UMLS CUI [1,1]
- C1948029
- UMLS CUI [1,2]
- C0178913
Beskrivning
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.
Datatyp
text
Alias
- UMLS CUI [1]
- C2347852
Beskrivning
UNITS
Datatyp
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)