ID

32428

Description

This ODM-file contains the form to document the demography of the subject. To be assessed at screening. Study ID: 101999 Clinical Study ID: 101999 Study Title: A randomized, double-blind, parallel group, placebo-controlled, single-attack evaluation of the efficacy and tolerability of TREXIMA™ (sumatriptan 85mg/naproxen sodium 500mg)* tablets vs placebo when administered during the mild pain phase of a migraine Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 3 Study Recruitment Status: Completed Generic Name: sumatriptan Trade Name: Imitrex ,Imiject ,Imigran Study Indication: Migraine Disorders

Mots-clés

Versions (2)
  1. 31/10/2018 31/10/2018 -
  2. 09/11/2018 09/11/2018 - Sarah Riepenhausen
Détendeur de droits

GlaxoSmithKline

Téléchargé le

31 octobre 2018

DOI

Pour une demande vous connecter.

Licence

Creative Commons BY-NC 3.0
Modèle Commentaires :

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Efficacy and Tolerability of TREXIMA™ (sumatriptan 85mg/naproxen sodium 500mg) ID 101999

Anglais

Demography

1 Formulaires  
  1. StudyEvent: ODM
    1. Demography
Administrative Data
Description

Administrative Data

Alias
UMLS CUI-1
C1320722
Visit Date
Description

Visit Date

Type de données

date

Alias
UMLS CUI [1]
C1320303
Subject Identifier
Description

Subject Identifier

Type de données

text

Alias
UMLS CUI [1]
C2348585
Demography
Description

Demography

Alias
UMLS CUI-1
C0011298
Date of birth
Description

Date of birth

Type de données

date

Alias
UMLS CUI [1]
C0421451
Sex
Description

Sex

Type de données

text

Alias
UMLS CUI [1]
C0079399
Ethnicity ✔ one:
Description

ETHNICITY • Hispanic or Latino A person of Cuban, Mexican, Puerto Rican, South American or other Spanish culture or origin, regardless of race Note: If the subject does not meet the definition above, ✔ Not Hispanic or Latino. • Not Hispanic or Latino Neither Hispanic or Latino

Type de données

text

Alias
UMLS CUI [1]
C0015031
Race: African American/African Heritage
Description

The racial groups below are based on the FDA and ICH Guidelines. Note: In order to provide for all eventualities, it is permissible to ✔ multiple boxes. A person having origins in any of the black racial groups of Africa

Type de données

boolean

Alias
UMLS CUI [1]
C0085756
UMLS CUI [2]
C0027567
Race: American Indian or Alaskan Native
Description

The racial groups below are based on the FDA and ICH Guidelines. Note: In order to provide for all eventualities, it is permissible to ✔ multiple boxes. A person having origins in any of the original peoples of North and South America (including Central America) and who maintains tribal affiliation or community attachment

Type de données

boolean

Alias
UMLS CUI [1]
C1515945
Race: Asian - Central/South Asian Heritage
Description

The racial groups below are based on the FDA and ICH Guidelines. Note: In order to provide for all eventualities, it is permissible to ✔ multiple boxes. A person having origins in Central Asia and Indian Subcontinent (India, Pakistan, Bangladesh and Sri Lanka)

Type de données

boolean

Alias
UMLS CUI [1]
C0238696
UMLS CUI [2]
C1519427
Race: Asian - East Asian Heritage
Description

The racial groups below are based on the FDA and ICH Guidelines. Note: In order to provide for all eventualities, it is permissible to ✔ multiple boxes. A person having origins in China, Korea

Type de données

boolean

Alias
UMLS CUI [1]
C4540996
Race: Asian - Japanese Heritage
Description

The racial groups below are based on the FDA and ICH Guidelines. Note: In order to provide for all eventualities, it is permissible to ✔ multiple boxes. A person having origins in Japan

Type de données

boolean

Alias
UMLS CUI [1]
C1556094
Race: Asian - South East Asian Heritage
Description

The racial groups below are based on the FDA and ICH Guidelines. Note: In order to provide for all eventualities, it is permissible to ✔ multiple boxes. A person having origins in Malaysia, the Philippines, Indonesia, Thailand, Vietnam, Laos, Burma or Cambodia

Type de données

boolean

Alias
UMLS CUI [1]
C0238697
Race: Native Hawaiian or Other Pacific Islander
Description

The racial groups below are based on the FDA and ICH Guidelines. Note: In order to provide for all eventualities, it is permissible to ✔ multiple boxes. A person having origins in any of the original peoples of Hawaii, Guam, Samoa or other Pacific Islands, Australia (Aborigines), Papua New Guinea, New Zealand, Marshalls and other island groups west and south of Japan

Type de données

boolean

Alias
UMLS CUI [1]
C1513907
Race: White - Arabic/North African Heritage
Description

The racial groups below are based on the FDA and ICH Guidelines. Note: In order to provide for all eventualities, it is permissible to ✔ multiple boxes. A person having origins in any of the original peoples of Middle East or North Africa

Type de données

boolean

Alias
UMLS CUI [1]
C0238604
UMLS CUI [2]
C0026068
Race: White - White/Caucasian/European Heritage
Description

The racial groups below are based on the FDA and ICH Guidelines. Note: In order to provide for all eventualities, it is permissible to ✔ multiple boxes. A person having origins in any of the original peoples of Europe

Type de données

boolean

Alias
UMLS CUI [1]
C0043157
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Similar models

Demography

1 Formulaires
  1. StudyEvent: ODM
    1. Demography
Name
Type
Description | Question | Decode (Coded Value)
Type de données
Alias
Item Group
Administrative Data
C1320722 (UMLS CUI-1)
Visit Date
Item
Visit Date
date
C1320303 (UMLS CUI [1])
Subject Identifier
Item
Subject Identifier
text
C2348585 (UMLS CUI [1])
Item Group
Demography
C0011298 (UMLS CUI-1)
Date of birth
Item
Date of birth
date
C0421451 (UMLS CUI [1])
Item
Sex
text
C0079399 (UMLS CUI [1])
Sex
Code List
Sex
CL Item
Male (M)
CL Item
Female (F)
Item
Ethnicity ✔ one:
text
C0015031 (UMLS CUI [1])
Ethnicity
Code List
Ethnicity ✔ one:
CL Item
Hispanic or Latino (1)
CL Item
Not Hispanic or Latino (2)
Race: African American/African Heritage
Item
Race: African American/African Heritage
boolean
C0085756 (UMLS CUI [1])
C0027567 (UMLS CUI [2])
Race: American Indian or Alaskan Native
Item
Race: American Indian or Alaskan Native
boolean
C1515945 (UMLS CUI [1])
Race: Asian - Central/South Asian Heritage
Item
Race: Asian - Central/South Asian Heritage
boolean
C0238696 (UMLS CUI [1])
C1519427 (UMLS CUI [2])
Race: Asian - East Asian Heritage
Item
Race: Asian - East Asian Heritage
boolean
C4540996 (UMLS CUI [1])
Race: Asian - Japanese Heritage
Item
Race: Asian - Japanese Heritage
boolean
C1556094 (UMLS CUI [1])
Race: Asian - South East Asian Heritage
Item
Race: Asian - South East Asian Heritage
boolean
C0238697 (UMLS CUI [1])
Race: Native Hawaiian or Other Pacific Islander
Item
Race: Native Hawaiian or Other Pacific Islander
boolean
C1513907 (UMLS CUI [1])
Race: White - Arabic/North African Heritage
Item
Race: White - Arabic/North African Heritage
boolean
C0238604 (UMLS CUI [1])
C0026068 (UMLS CUI [2])
Race: White - White/Caucasian/European Heritage
Item
Race: White - White/Caucasian/European Heritage
boolean
C0043157 (UMLS CUI [1])
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