ID

30555

Beschreibung

https://clinicaltrials.gov/ct2/show/NCT00344006 Study ID : CDA 714703/005 Clinical Study ID :714703/005 Study Title :A multi-centre, randomised, double-blind, double dummy study comparing the efficacy and safety of chlorproguanil-dapsone-artesunate versus artemether-lumefantrine in the treatment of acute uncomplicated Plasmodium falciparum malaria in children and adolescents in Africa. Patient Level Data : Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier : NCT00344006 Sponsor : GlaxoSmithKline Collaborators : N/A Phase phase :3 Study Recruitment Status : Completed Generic Name : artesunate/chlorproguanil/dapsone Trade Name : LAPDAP + ARTESUNATE Study Indication : Malaria, Falciparum

Link

https://clinicaltrials.gov/ct2/show/NCT00344006

Stichworte

Versionen (1)
  1. 14.06.18 14.06.18 - Halim Ugurlu
Rechteinhaber

GlaxoSmithKline (GSK)

Hochgeladen am

14. Juni 2018

DOI

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Lizenz

Creative Commons BY-NC 3.0
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NCT00344006-Chlorproguanil-Dapsone-Artesunate Versus COARTEM For Uncomplicated Malaria

Englisch

Case Report From, Module Number 2.0 (Investigational Product Discontinuation, Status of Treatment Blind, Pregnancy Information, Study Conclusion, Investigator Comment Log, Investigator's Signature)

1 Formulare  
Administrative Information
Beschreibung

Administrative Information

Alias
UMLS CUI-1
C1320722
Subject Identifier
Beschreibung

Subject Identifier

Datentyp

text

Alias
UMLS CUI [1]
C2348585
Visit Date
Beschreibung

Visit Date

Datentyp

date

Alias
UMLS CUI [1]
C1320303
Investigational Product Discontinuation-Coartem or Placebo
Beschreibung

Investigational Product Discontinuation-Coartem or Placebo

Alias
UMLS CUI-1
C0304229
UMLS CUI-2
C0457454
Was the investigational product stopped permanently before the end of the scheduled treatment period?
Beschreibung

investigational product stopped

Datentyp

boolean

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C0304229
UMLS CUI [1,3]
C0457454
If yes, select the primary reason the investigational product was stopped:
Beschreibung

if yes, select primary reason

Datentyp

text

Alias
UMLS CUI [1,1]
C1518544
UMLS CUI [1,2]
C0566251
Investigational Product Discontinuation-Chlorproguanil-Dapsone-Artesunate or Placebo
Beschreibung

Investigational Product Discontinuation-Chlorproguanil-Dapsone-Artesunate or Placebo

Alias
UMLS CUI-1
C0304229
UMLS CUI-2
C0457454
Was the investigational product stopped permanently before the end of the scheduled treatment period?
Beschreibung

investigational product stopped

Datentyp

boolean

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C0304229
UMLS CUI [1,3]
C0457454
If yes, select the primary reason the investigational product was stopped:
Beschreibung

if yes, select primary reason

Datentyp

text

Alias
UMLS CUI [1,1]
C1518544
UMLS CUI [1,2]
C0566251
Status of Treatment Blind
Beschreibung

Status of Treatment Blind

Alias
UMLS CUI-1
C0749659
UMLS CUI-2
C2347038
Was the treatment blind broken during the study?
Beschreibung

blind broken

Datentyp

boolean

Alias
UMLS CUI [1]
C3897431
Date blind broken
Beschreibung

If yes, complete the following

Datentyp

date

Alias
UMLS CUI [1,1]
C3897431
UMLS CUI [1,2]
C0011008
Reason blind broken
Beschreibung

If yes, complete the following

Datentyp

text

Alias
UMLS CUI [1,1]
C3897431
UMLS CUI [1,2]
C0392360
Pregnancy Information
Beschreibung

Pregnancy Information

Alias
UMLS CUI-1
C0032961
UMLS CUI-2
C1533716
Did the subject become pregnant during the study?
Beschreibung

Pregnancy Information

Datentyp

text

Alias
UMLS CUI [1,1]
C0032961
UMLS CUI [1,2]
C1533716
Study Conclusion
Beschreibung

Study Conclusion

Alias
UMLS CUI-1
C1707478
UMLS CUI-2
C0008972
Date of study completion or withdrawal
Beschreibung

Date of study completion or withdrawal

Datentyp

date

Alias
UMLS CUI [1]
C2983670
Was the subject withdrawn from study?
Beschreibung

Was the subject withdrawn from study?

Datentyp

boolean

Alias
UMLS CUI [1]
C0422727
If yes, select primary reason for withdrawal
Beschreibung

If yes, select primary reason for withdrawal

Datentyp

text

Alias
UMLS CUI [1,1]
C0392360
UMLS CUI [1,2]
C0422727
Investigator Comment Log
Beschreibung

Investigator Comment Log

Alias
UMLS CUI-1
C0008961
UMLS CUI-2
C0947611
CRF Page Number if applicable
Beschreibung

CRF Page Number if applicable

Datentyp

integer

Alias
UMLS CUI [1,1]
C1704732
UMLS CUI [1,2]
C1516308
Comment
Beschreibung

Comment

Datentyp

text

Alias
UMLS CUI [1]
C0947611
Investigator's Signature
Beschreibung

Investigator's Signature

Alias
UMLS CUI-1
C2346576
Investigator's Signature
Beschreibung

Investigator's Signature

Datentyp

text

Alias
UMLS CUI [1]
C2346576
Date
Beschreibung

Date

Datentyp

date

Alias
UMLS CUI [1]
C0011008
Investigator's Name
Beschreibung

Investigator's Name

Datentyp

text

Alias
UMLS CUI [1]
C2826892
Zum Seitenanfang zurückkehren

Ähnliche Modelle

Case Report From, Module Number 2.0 (Investigational Product Discontinuation, Status of Treatment Blind, Pregnancy Information, Study Conclusion, Investigator Comment Log, Investigator's Signature)

1 Formulare
Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
Alias
Item Group
Administrative Information
C1320722 (UMLS CUI-1)
Subject Identifier
Item
Subject Identifier
text
C2348585 (UMLS CUI [1])
Visit Date
Item
Visit Date
date
C1320303 (UMLS CUI [1])
Item Group
Investigational Product Discontinuation-Coartem or Placebo
C0304229 (UMLS CUI-1)
C0457454 (UMLS CUI-2)
investigational product stopped
Item
Was the investigational product stopped permanently before the end of the scheduled treatment period?
boolean
C0011008 (UMLS CUI [1,1])
C0304229 (UMLS CUI [1,2])
C0457454 (UMLS CUI [1,3])
Item
If yes, select the primary reason the investigational product was stopped:
text
C1518544 (UMLS CUI [1,1])
C0566251 (UMLS CUI [1,2])
if yes, select primary reason
Code List
If yes, select the primary reason the investigational product was stopped:
CL Item
Adverse Event (1)
CL Item
Lost to follow-up (2)
CL Item
Protocol Violation (3)
CL Item
Subject decided to withdraw from study (4)
CL Item
Other, specify (Z)
Item Group
Investigational Product Discontinuation-Chlorproguanil-Dapsone-Artesunate or Placebo
C0304229 (UMLS CUI-1)
C0457454 (UMLS CUI-2)
investigational product stopped
Item
Was the investigational product stopped permanently before the end of the scheduled treatment period?
boolean
C0011008 (UMLS CUI [1,1])
C0304229 (UMLS CUI [1,2])
C0457454 (UMLS CUI [1,3])
Item
If yes, select the primary reason the investigational product was stopped:
text
C1518544 (UMLS CUI [1,1])
C0566251 (UMLS CUI [1,2])
if yes, select primary reason
Code List
If yes, select the primary reason the investigational product was stopped:
CL Item
Adverse Event (1)
CL Item
Lost to follow-up (2)
CL Item
Protocol Violation (3)
CL Item
Subject decided to withdraw from study (4)
CL Item
Other, specify (Z)
Item Group
Status of Treatment Blind
C0749659 (UMLS CUI-1)
C2347038 (UMLS CUI-2)
blind broken
Item
Was the treatment blind broken during the study?
boolean
C3897431 (UMLS CUI [1])
If yes, complete the following
Item
Date blind broken
date
C3897431 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Item
Reason blind broken
text
C3897431 (UMLS CUI [1,1])
C0392360 (UMLS CUI [1,2])
If yes, complete the following
Code List
Reason blind broken
CL Item
Medical emergency requiring identification of investigational product for further treatment. (1)
CL Item
Other, specify (2)
Item Group
Pregnancy Information
C0032961 (UMLS CUI-1)
C1533716 (UMLS CUI-2)
Item
Did the subject become pregnant during the study?
text
C0032961 (UMLS CUI [1,1])
C1533716 (UMLS CUI [1,2])
Pregnancy Information
Code List
Did the subject become pregnant during the study?
CL Item
Yes (Y)
CL Item
No (N)
CL Item
Not Applicable (not of childbearing potential or male) (X)
Item Group
Study Conclusion
C1707478 (UMLS CUI-1)
C0008972 (UMLS CUI-2)
Date of study completion or withdrawal
Item
Date of study completion or withdrawal
date
C2983670 (UMLS CUI [1])
Was the subject withdrawn from study?
Item
Was the subject withdrawn from study?
boolean
C0422727 (UMLS CUI [1])
Item
If yes, select primary reason for withdrawal
text
C0392360 (UMLS CUI [1,1])
C0422727 (UMLS CUI [1,2])
If yes, select primary reason for withdrawal
Code List
If yes, select primary reason for withdrawal
CL Item
Adverse event (Record details on the Non-Serious Adverse Events or Serious Adverse Event pages as appropriate. (1)
CL Item
Lost to follow-up (2)
CL Item
Protocol violation (3)
CL Item
Subject decided to withdraw from the study (4)
CL Item
Other, specify... (Z)
Item Group
Investigator Comment Log
C0008961 (UMLS CUI-1)
C0947611 (UMLS CUI-2)
CRF Page Number if applicable
Item
CRF Page Number if applicable
integer
C1704732 (UMLS CUI [1,1])
C1516308 (UMLS CUI [1,2])
Comment
Item
Comment
text
C0947611 (UMLS CUI [1])
Item Group
Investigator's Signature
C2346576 (UMLS CUI-1)
Investigator's Signature
Item
Investigator's Signature
text
C2346576 (UMLS CUI [1])
Date
Item
Date
date
C0011008 (UMLS CUI [1])
Investigator's Name
Item
Investigator's Name
text
C2826892 (UMLS CUI [1])
Zum Seitenanfang zurückkehren 

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