ID

32645

Descrizione

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

Keywords

  1. 09/11/18 09/11/18 -
  2. 11/01/19 11/01/19 -
Titolare del copyright

GSK group of companies

Caricato su

9 novembre 2018

DOI

Per favore, per richiedere un accesso.

Licenza

Creative Commons BY-NC 3.0

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A Cross-Over Study of Alcohol Effect on the Pharmacokinetics of Carvedilol - 106904

Pharmacogenetics Research Consent Form

Administrative data
Descrizione

Administrative data

Site
Descrizione

Site

Tipo di dati

text

Patient
Descrizione

Patient

Tipo di dati

text

Patient Number
Descrizione

Patient Number

Tipo di dati

integer

Date of Visit/Assessment
Descrizione

Date of Visit/Assessment

Tipo di dati

date

Date of Visit/Assessment
Descrizione

Date of Visit/Assessment

Date
Descrizione

Date

Tipo di dati

date

PGx Research Consent
Descrizione

PGx Research Consent

Has informed consent been obtained for PGx-Pharmacogenetic research?
Descrizione

Has informed consent been obtained for PGx-Pharmacogenetic research?

Tipo di dati

boolean

If YES, record date informed consent obtained for PGx-Pharmacogenetic research
Descrizione

If YES, record date informed consent obtained for PGx-Pharmacogenetic research

Tipo di dati

date

Has a blood sample been collected for PGx-Pharmacogenetic (DNA) research
Descrizione

Has a blood sample been collected for PGx-Pharmacogenetic (DNA) research

Tipo di dati

boolean

If YES, record date sample taken
Descrizione

If YES, record date sample taken

Tipo di dati

date

If NO informed consent obtained, check reason
Descrizione

If NO informed consent obtained, check reason

Tipo di dati

text

If Other, specify
Descrizione

If Other, specify

Tipo di dati

text

Genetics Type
Descrizione

Genetics Type

Tipo di dati

text

Similar models

Pharmacogenetics Research Consent Form

Name
genere
Description | Question | Decode (Coded Value)
Tipo di dati
Alias
Item Group
Administrative data
Site
Item
Site
text
Patient
Item
Patient
text
Patient Number
Item
Patient Number
integer
Date of Visit/Assessment
Item
Date of Visit/Assessment
date
Item Group
Date of Visit/Assessment
Date
Item
Date
date
Item Group
PGx Research Consent
Has informed consent been obtained for PGx-Pharmacogenetic research?
Item
Has informed consent been obtained for PGx-Pharmacogenetic research?
boolean
If YES, record date informed consent obtained for PGx-Pharmacogenetic research
Item
If YES, record date informed consent obtained for PGx-Pharmacogenetic research
date
Has a blood sample been collected for PGx-Pharmacogenetic (DNA) research
Item
Has a blood sample been collected for PGx-Pharmacogenetic (DNA) research
boolean
If YES, record date sample taken
Item
If YES, record date sample taken
date
Item
If NO informed consent obtained, check reason
text
Code List
If NO informed consent obtained, check reason
CL Item
Subject declined (1)
CL Item
Subject not asked by Investigator (2)
CL Item
Other (3)
If Other, specify
Item
If Other, specify
text
Genetics Type
Item
Genetics Type
text

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