ID

32946

Description

Study ID: 107085 Clinical Study ID: GLP107085 Study Title: A Randomized, Double-blind, Parallel, Nested Crossover Study to Investigate the Effect of Albiglutide on Cardiac Repolarization (corrected QT Interval) Compared With Placebo in Healthy Male and Female Subjects: A Thorough ECG Study Employing Placebo, Albiglutide, and a Positive Control (Moxifloxacin) Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT01406262 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 1 Study Recruitment Status: Completed Generic Name: albiglutide Trade Name: Tanzeum,Eperzan Study Indication: Diabetes Mellitus, Type 2

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Versions (1)
  1. 11/21/18 11/21/18 -
Copyright Holder

GSK group of companies

Uploaded on

November 21, 2018

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Creative Commons BY-NC 3.0
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The Effect of Albiglutide on Cardiac Repolarisation Compared with Placebo 107085

English

Liver Imaging Form 1

1 forms  
  1. StudyEvent: ODM
    1. Liver Imaging Form 1
Administrative data
Description

Administrative data

Study Name
Description

Study Name

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text

Site
Description

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Data type

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Subject
Description

Subject

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Visit Name

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integer

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Visit #

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float

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Liver Imaging Form 1

1 forms
  1. StudyEvent: ODM
    1. Liver Imaging Form 1
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Administrative data
Study Name
Item
Study Name
text
Site
Item
Site
text
Subject
Item
Subject
text
Visit Name
Item
Visit Name
text
DCI Name/Shortname
Item
DCI Name/Shortname
text
Status
Item
Status
text
Doc#
Item
Doc#
integer
Visit #
Item
Visit #
float
Item Group
Complete a separate form for each individual imaging test performed.
Date of hepatic or liver imaging test
Item
Date of hepatic or liver imaging test
date
Item
What method was used for this imaging test?
text
What method was used for this imaging test?
Code List
What method was used for this imaging test?
CL Item
Ultrasound - transabdominal (1)
CL Item
Ultrasound - endoscopic (2)
CL Item
Magnetic Resonance Imaging (MRI) (3)
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Computerised Tomography (CT) (4)
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Endoscopic Retrograde Cholangiopancreatography (ERCP) (5)
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CL Item
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If Other, specify
Item
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text
Item Group
Image Quality
Item
Are images technically adequate?
text
Are images technically adequate?
Code List
Are images technically adequate?
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Optimal (1)
CL Item
Readable, but not optimal (2)
CL Item
Not readable (3)
CL Item
Other (4)
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