ID

32632

Beschrijving

Study ID: 106904 Clinical Study ID: CRV106904 Study Title: A Randomized, Open-Label, Single-Dose, Four-Period Cross-Over Study to Determine the Effects of Alcohol on the Pharmacokinetics of Carvedilol CR Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier:  Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 1 Study Recruitment Status: Completed Generic Name: carvedilol Trade Name: Coreg CR,Coreg Study Indication: Hypertension

Trefwoorden

Versies (2)
  1. 09-11-18 09-11-18 -
  2. 11-01-19 11-01-19 -
Houder van rechten

GSK group of companies

Geüploaded op

9 november 2018

DOI

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Licentie

Creative Commons BY-NC 3.0
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A Cross-Over Study of Alcohol Effect on the Pharmacokinetics of Carvedilol - 106904

Engels

Follow-Up: Study Conclusion

1 Formulieren  
Administrative data
Beschrijving

Administrative data

Site
Beschrijving

Site

Datatype

text

Patient
Beschrijving

Patient

Datatype

text

Patient Number
Beschrijving

Patient Number

Datatype

integer

Study Conclusion Data
Beschrijving

Study Conclusion Data

Date of subject completion or withdrawal
Beschrijving

Date of subject completion or withdrawal

Datatype

date

Time of subject completion or withdrawal
Beschrijving

Time of subject completion or withdrawal

Datatype

time

Was the subject withdrawn from the study?
Beschrijving

Was the subject withdrawn from the study?

Datatype

boolean

If YES, specify primary reason for withdrawal
Beschrijving

If YES, specify primary reason for withdrawal

Datatype

text

If OTHER, specify
Beschrijving

If OTHER, specify

Datatype

text

Case book ready for signature
Beschrijving

Data owner should check the box when data cleaning is complete

Datatype

text

Office Use 1
Beschrijving

Office Use 1

Datatype

boolean

Office Use 2
Beschrijving

Office Use 2

Datatype

text

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Similar models

Follow-Up: Study Conclusion

1 Formulieren
Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
Administrative data
Site
Item
Site
text
Patient
Item
Patient
text
Patient Number
Item
Patient Number
integer
Item Group
Study Conclusion Data
Date of subject completion or withdrawal
Item
Date of subject completion or withdrawal
date
Time of subject completion or withdrawal
Item
Time of subject completion or withdrawal
time
Was the subject withdrawn from the study?
Item
Was the subject withdrawn from the study?
boolean
Item
If YES, specify primary reason for withdrawal
text
If YES, specify primary reason for withdrawal
Code List
If YES, specify primary reason for withdrawal
CL Item
Adverse event (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
Sponsor terminated study (5)
CL Item
Other (6)
If OTHER, specify
Item
If OTHER, specify
text
Item
Case book ready for signature
text
Case book ready for signature
Code List
Case book ready for signature
CL Item
Yes (1)
Office Use 1
Item
Office Use 1
boolean
Item
Office Use 2
text
Office Use 2
Code List
Office Use 2
CL Item
1 (1)
CL Item
2 (2)
CL Item
3 (3)
CL Item
4 (4)
CL Item
5 (5)
CL Item
6 (6)
CL Item
7 (7)
CL Item
8 (8)
CL Item
9 (9)
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