ID

30826

Beschreibung

Study part: Adverse Event. A phase 1 single-masked, randomized (with respect to placebo), placebo-controlled, parallel-group, dose-rising study to evaluate the safety, tolerability and pharmacokinetics of repeat oral doses of GW786034 in elderly healthy volunteers. Trade Name: Votrient. Clinical Study ID: MD1103367.

Stichworte

Versionen (1)
  1. 24.06.18 24.06.18 -
Rechteinhaber

GlaxoSmithKline

Hochgeladen am

24. Juni 2018

DOI

Für eine Beantragung loggen Sie sich ein.

Lizenz

Creative Commons BY-NC 3.0
Modell Kommentare :

Hier können Sie das Modell kommentieren. Über die Sprechblasen an den Itemgruppen und Items können Sie diese spezifisch kommentieren.

Zurück zu Modell Kommentaren
Itemgroup Kommentare für :

Item Kommentare für :

Um Formulare herunterzuladen müssen Sie angemeldet sein. Bitte loggen Sie sich ein oder registrieren Sie sich kostenlos.

Adverse Event (AE) Pazopanib Macular Degeneration MD1103367

Englisch

Adverse Event

1 Formulare  
  1. StudyEvent: ODM
    1. Adverse Event
ADVERSE EVENTS (AE)
Beschreibung

ADVERSE EVENTS (AE)

Alias
UMLS CUI-1
C0877248
Sequence Number
Beschreibung

Sequence Number

Datentyp

integer

Alias
UMLS CUI [1]
C2348184
Event
Beschreibung

Diagnosis Only (if known) Otherwise Sign/Symptom

Datentyp

text

Alias
UMLS CUI [1]
C0011900
UMLS CUI [2]
C1457887
Modified term
Beschreibung

MedDRA synonym; MedDRA lower level term code; Coding failed

Datentyp

text

Alias
UMLS CUI [1]
C2826302
Start Date and Time
Beschreibung

Start Date and Time

Datentyp

datetime

Alias
UMLS CUI [1]
C3897500
Outcome
Beschreibung

Outcome

Datentyp

integer

Alias
UMLS CUI [1]
C1705586
When resolved/ recovered, provide end date and time
Beschreibung

end date and time

Datentyp

datetime

Alias
UMLS CUI [1]
C2826793
When resolved/ recovered with sequelae, provide end date and time
Beschreibung

end date and time

Datentyp

datetime

Alias
UMLS CUI [1]
C2826793
If Fatal, record date and time of death
Beschreibung

date and time of death

Datentyp

datetime

Alias
UMLS CUI [1]
C3899439
Frequency
Beschreibung

Adverse event Frequency

Datentyp

integer

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C0439603
Maximum Intensity
Beschreibung

Adverse event Intensity

Datentyp

text

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C0518690
Action taken with lnvestigational Product(s) as a result of the AE
Beschreibung

Action taken with lnvestigational Product

Datentyp

text

Alias
UMLS CUI [1]
C1704758
Did the subject withdraw from study as a result of this AE?
Beschreibung

Withdrawal by Subject; Non-serious Adverse Event

Datentyp

text

Alias
UMLS CUI [1,1]
C1710677
UMLS CUI [1,2]
C1518404
Is there a reasonable possibility that the AE may have been caused by the investigational product?
Beschreibung

Adverse event study drug

Datentyp

text

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C0013227
UMLS CUI [1,3]
C0008972
Does this Adverse Event meet the definition of serious?
Beschreibung

serious adverse event

Datentyp

text

Alias
UMLS CUI [1]
C1519255
Yes, check all that apply
Beschreibung

serious adverse event

Datentyp

text

Alias
UMLS CUI [1]
C1519255
Other, specify
Beschreibung

specify

Datentyp

text

Alias
UMLS CUI [1]
C1521902
Zum Seitenanfang zurückkehren

Ähnliche Modelle

Adverse Event

1 Formulare
  1. StudyEvent: ODM
    1. Adverse Event
Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
Alias
Item Group
ADVERSE EVENTS (AE)
C0877248 (UMLS CUI-1)
Sequence Number
Item
Sequence Number
integer
C2348184 (UMLS CUI [1])
Diagnosis; Symptoms
Item
Event
text
C0011900 (UMLS CUI [1])
C1457887 (UMLS CUI [2])
Modified term
Item
Modified term
text
C2826302 (UMLS CUI [1])
Start Date and Time
Item
Start Date and Time
datetime
C3897500 (UMLS CUI [1])
Item
Outcome
integer
C1705586 (UMLS CUI [1])
Outcome
Code List
Outcome
CL Item
Recovered/ Resolved (1)
CL Item
Recovering/ Resolving (2)
CL Item
Not recovered/ Not resolved (3)
CL Item
Recovered/ Resolved with sequelae (4)
CL Item
Fatal (5)
end date and time
Item
When resolved/ recovered, provide end date and time
datetime
C2826793 (UMLS CUI [1])
end date and time
Item
When resolved/ recovered with sequelae, provide end date and time
datetime
C2826793 (UMLS CUI [1])
date and time of death
Item
If Fatal, record date and time of death
datetime
C3899439 (UMLS CUI [1])
Item
Frequency
integer
C0877248 (UMLS CUI [1,1])
C0439603 (UMLS CUI [1,2])
Frequency
Code List
Frequency
CL Item
Single  (1)
CL Item
lntermillent (2)
Item
Maximum Intensity
text
C0877248 (UMLS CUI [1,1])
C0518690 (UMLS CUI [1,2])
Intensity
Code List
Maximum Intensity
CL Item
Mild  (1)
CL Item
Moderate  (2)
CL Item
Severe  (3)
CL Item
Not applicable (X)
Item
Action taken with lnvestigational Product(s) as a result of the AE
text
C1704758 (UMLS CUI [1])
Action taken with lnvestigational Product
Code List
Action taken with lnvestigational Product(s) as a result of the AE
CL Item
Investigational product(s) withdrawn  (1)
CL Item
Dose reduced (2)
CL Item
Dose increased  (3)
CL Item
Dose not changed  (4)
CL Item
Dose interrupted  (5)
CL Item
Not applicable (X)
Item
Did the subject withdraw from study as a result of this AE?
text
C1710677 (UMLS CUI [1,1])
C1518404 (UMLS CUI [1,2])
Withdrawal by Subject; Non-serious Adverse Event
Code List
Did the subject withdraw from study as a result of this AE?
CL Item
Yes (Y)
CL Item
No (N)
Item
Is there a reasonable possibility that the AE may have been caused by the investigational product?
text
C0877248 (UMLS CUI [1,1])
C0013227 (UMLS CUI [1,2])
C0008972 (UMLS CUI [1,3])
Withdrawal by Subject; Non-serious Adverse Event
Code List
Is there a reasonable possibility that the AE may have been caused by the investigational product?
CL Item
Yes (Y)
CL Item
No (N)
Item
Does this Adverse Event meet the definition of serious?
text
C1519255 (UMLS CUI [1])
Withdrawal by Subject; Non-serious Adverse Event
Code List
Does this Adverse Event meet the definition of serious?
CL Item
Yes (Y)
CL Item
No (N)
Item
Yes, check all that apply
text
C1519255 (UMLS CUI [1])
serious adverse event
Code List
Yes, check all that apply
CL Item
Results in death (A)
C0011065 (UMLS CUI-1)
(Comment:en)
CL Item
Is life-threatening  (B)
C1517874 (UMLS CUI-1)
(Comment:en)
CL Item
Requires hospitalisation or prolongation of existing hospitalisation (C)
C0019993 (UMLS CUI-1)
(Comment:en)
CL Item
Results in disability/incapacity  (D)
C0231170 (UMLS CUI-1)
(Comment:en)
CL Item
Congenital anomaly/birth defect  (E)
C0000768 (UMLS CUI-1)
(Comment:en)
CL Item
Other (F)
C0205394 (UMLS CUI-1)
(Comment:en)
specify
Item
Other, specify
text
C1521902 (UMLS CUI [1])
Zum Seitenanfang zurückkehren 

Kontakt

Benutzen Sie dieses Formular für Rückmeldungen, Fragen und Verbesserungsvorschläge.

Mit * gekennzeichnete Felder sind notwendig.

Hilfe

Benötigen Sie Hilfe bei der Suche? Um mehr Details zu erfahren und die Suche effektiver nutzen zu können schauen Sie sich doch das entsprechende Video auf unserer Tutorial Seite an.

Zum Video