ID

32581

Description

Study ID: 106837 Clinical Study ID: HZA106837 Study Title: A Long-Term, Randomized, Double-Blind, Parallel Group Study of Fluticasone Furoate/GW642444 Inhalation Powder Once-Daily and Fluticasone Furoate Inhalation Powder Once-Daily in Subjects with Asthma Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT01086384 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 3 Study Recruitment Status: Completed Generic Name: fluticasone furoate/vilanterol Trade Name: Relvar Study Indication: Asthma

Keywords

Versions (2)
  1. 11/7/18 11/7/18 -
  2. 12/7/18 12/7/18 -
Copyright Holder

GSK group of companies

Uploaded on

November 7, 2018

DOI

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License

Creative Commons BY-NC 3.0
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A Parallel Group Study of Fluticasone Furoate/Vilanterol in Subjects with Asthma - 106837

English

Diary Card 2: Medical Problems - Visit 1-12

1 forms  
Administrative data
Description

Administrative data

Subject Identifier
Description

Subject Identifier

Data type

integer

Medical problem
Description

Medical problem

Medical Problem
Description

Record all medical problem(s) you have experienced AND record all medication(s) you took on that date to treat the problem(s). Do NOT include study-related medications

Data type

text

Date Medical Problem Started
Description

Date Medical Problem Started

Data type

date

Date Medical Problem Stopped
Description

Date Medical Problem Stopped

Data type

date

Medications Taken for Medical Problem
Description

Medications Taken for Medical Problem

Data type

text

Date Medication Started
Description

Date Medication Started

Data type

date

Date Medication Stopped
Description

Date Medication Stopped

Data type

date

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Similar models

Diary Card 2: Medical Problems - Visit 1-12

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Administrative data
Subject Identifier
Item
Subject Identifier
integer
Item Group
Medical problem
Item
Medical Problem
text
Medical Problem
Code List
Medical Problem
CL Item
Problem 1 (1)
CL Item
Problem 2 (2)
CL Item
Problem 3 (3)
CL Item
Problem 4 (4)
CL Item
Problem 5 (5)
CL Item
Problem 6 (6)
CL Item
Problem 7 (7)
CL Item
Problem 8 (8)
CL Item
Problem 9 (9)
CL Item
Problem 10 (10)
CL Item
Problem 11 (11)
CL Item
Problem 12 (12)
CL Item
Problem 13 (13)
CL Item
Problem 14 (14)
CL Item
Problem 15 (15)
CL Item
Problem 16 (16)
CL Item
Problem 17 (17)
CL Item
Problem 18 (18)
CL Item
Problem 19 (19)
CL Item
Problem 20 (20)
Date Medical Problem Started
Item
Date Medical Problem Started
date
Date Medical Problem Stopped
Item
Date Medical Problem Stopped
date
Medications Taken for Medical Problem
Item
Medications Taken for Medical Problem
text
Date Medication Started
Item
Date Medication Started
date
Date Medication Stopped
Item
Date Medication Stopped
date
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