ID

33844

Beschrijving

Study ID: 107032 Clinical Study ID: GLP107032 Study Title: An open-label study to evaluate the pharmacokinetics of an oral contraceptive containing Norethindrone and Ethinyl Estradiol when co-administered with GSK716155 in healthy adult female subjects Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT01077505 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

Trefwoorden

  1. 03-01-19 03-01-19 -
Houder van rechten

GSK group of companies

Geüploaded op

3 januari 2019

DOI

Voor een aanvraag inloggen.

Licentie

Creative Commons BY-NC 3.0

Model Commentaren :

Hier kunt u commentaar leveren op het model. U kunt de tekstballonnen bij de itemgroepen en items gebruiken om er specifiek commentaar op te geven.

Itemgroep Commentaren voor :

Item Commentaren voor :

U moet ingelogd zijn om formulieren te downloaden. AUB inloggen of schrijf u gratis in.

Pharmacokinetics of an oral contraceptive co-administered with Albiglutide in women - 107032

Liver Imaging Form + Liver Chemistries Follow-Up

Administrative data
Beschrijving

Administrative data

Site
Beschrijving

Site

Datatype

text

Subject
Beschrijving

Subject

Datatype

text

Visit Name
Beschrijving

Visit Name

Datatype

text

Status
Beschrijving

Status

Datatype

text

Document Number
Beschrijving

Document Number

Datatype

text

Liver Imaging
Beschrijving

Liver Imaging

Date of hepatic or liver imaging test
Beschrijving

Date of hepatic or liver imaging test

Datatype

date

What method was used for this imaging test?
Beschrijving

method for imaging test?

Datatype

text

If Other, specify
Beschrijving

If Other, specify

Datatype

text

Liver Imaging Quality
Beschrijving

Liver Imaging Quality

Are images technically adequate?
Beschrijving

check one

Datatype

text

If Other, specify
Beschrijving

If Other, specify

Datatype

text

Liver Imaging Results
Beschrijving

Liver Imaging Results

A. Indicate the liver size
Beschrijving

A. Indicate the liver size

Datatype

text

If Other, specify
Beschrijving

If Other, specify

Datatype

text

B. Indicate the liver texture
Beschrijving

B. Indicate the liver texture

Datatype

text

If Other, specify
Beschrijving

If Other, specify

Datatype

text

C. Grade the diffuse and/or geographic fatty infiltrate of the liver
Beschrijving

Check one

Datatype

text

If Other, specify
Beschrijving

If Other, specify

Datatype

text

D. Ascites present
Beschrijving

check one

Datatype

text

If Other, specify
Beschrijving

If Other, specify

Datatype

text

E. Are Focal Hepatic Lesions characterisable?
Beschrijving

E. Are Focal Hepatic Lesions characterisable?

Datatype

text

If Other, specify
Beschrijving

If Other, specify

Datatype

text

F. Gallstones or gallbladder lesions?
Beschrijving

F. Gallstones or gallbladder lesions?

Datatype

text

If Other, specify
Beschrijving

If Other, specify

Datatype

text

G. Biliary ductal lesions
Beschrijving

Check all that apply

Datatype

text

If Other, specify
Beschrijving

If Other, specify

Datatype

text

H. Portal/Hepatic vein abnormalities
Beschrijving

Check all that apply

Datatype

text

If Other, specify
Beschrijving

If Other, specify

Datatype

text

Liver Chemistry Follow-Up Chemistries
Beschrijving

Liver Chemistry Follow-Up Chemistries

Date sample taken
Beschrijving

Date sample taken

Datatype

date

Were liver chemistries (ALT, AST, ALP, bilirubin) performed?
Beschrijving

Were liver chemistries (ALT, AST, ALP, bilirubin) performed?

Datatype

boolean

Did liver chemistries (ALT, AST, ALP, bilirubin) resolve, stabilize, or return to within Baseline values?
Beschrijving

Did liver chemistries (ALT, AST, ALP, bilirubin) resolve, stabilize, or return to within Baseline values?

Datatype

boolean

Similar models

Liver Imaging Form + Liver Chemistries Follow-Up

Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
Administrative data
Site
Item
Site
text
Subject
Item
Subject
text
Item
Visit Name
text
Code List
Visit Name
CL Item
Liver Imaging (1)
Status
Item
Status
text
Document Number
Item
Document Number
text
Item Group
Liver Imaging
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
Code List
What method was used for this imaging test?
CL Item
Ultrasound - transdominal (1)
CL Item
Ultrasound - endoscopic (2)
CL Item
Magnetic Resonance Imaging (MRI) (3)
CL Item
Computerised Tomography (CT) (4)
CL Item
Endoscopic Retrograde CHolangiopancreatography (ERCP) (5)
CL Item
Positron Emission Tomography (PET) (6)
CL Item
Positron Emission Tomography/Computed Tomography (PET/CT) (7)
CL Item
Other (8)
If Other, specify
Item
If Other, specify
text
Item Group
Liver Imaging Quality
Item
Are images technically adequate?
text
Code List
Are images technically adequate?
CL Item
Optimal (1)
CL Item
Readable, but not optimal (2)
CL Item
Not readable (3)
CL Item
Other (4)
If Other, specify
Item
If Other, specify
text
Item Group
Liver Imaging Results
Item
A. Indicate the liver size
text
Code List
A. Indicate the liver size
CL Item
Normal size (1)
CL Item
Hypertrophy (or enlarged) (2)
CL Item
Atrophy (or smaller than normal) (3)
CL Item
Segmental hypertrophy (4)
CL Item
Other (5)
If Other, specify
Item
If Other, specify
text
Item
B. Indicate the liver texture
text
Code List
B. Indicate the liver texture
CL Item
Normal (1)
CL Item
Heterogeneous (2)
CL Item
Suggestive of fibrosis (3)
CL Item
Nodular or suggestive of cirrhosis (4)
CL Item
Other (5)
If Other, specify
Item
If Other, specify
text
Item
C. Grade the diffuse and/or geographic fatty infiltrate of the liver
text
Code List
C. Grade the diffuse and/or geographic fatty infiltrate of the liver
CL Item
Not applicable - no fatty infiltration (1)
CL Item
Mild (>=25%) (2)
CL Item
Moderate (>25% to <75%) (3)
CL Item
Severe (>=75%) (4)
CL Item
Other (5)
If Other, specify
Item
If Other, specify
text
Item
D. Ascites present
text
Code List
D. Ascites present
CL Item
None present (1)
CL Item
Yes - small amount (2)
CL Item
Yes - moderate or severe amount (3)
CL Item
Other (4)
If Other, specify
Item
If Other, specify
text
Item
E. Are Focal Hepatic Lesions characterisable?
text
Code List
E. Are Focal Hepatic Lesions characterisable?
CL Item
Not applicable - no hepatic lesions (1)
CL Item
Solid (2)
CL Item
Cystic (3)
CL Item
Hemangioma (4)
CL Item
Focal nodular hyperplasia (5)
CL Item
Other (6)
If Other, specify
Item
If Other, specify
text
Item
F. Gallstones or gallbladder lesions?
text
Code List
F. Gallstones or gallbladder lesions?
CL Item
None (1)
CL Item
Gallstones (2)
CL Item
Gallbladder polyps (3)
CL Item
Sludge (4)
CL Item
Gallbladder wall thickening/Oedema (5)
CL Item
Gallbladder wall gas (6)
CL Item
Cholecystitis  (7)
CL Item
Gallbladder wall calcification (8)
CL Item
Gallbladder mass (9)
CL Item
Other (10)
If Other, specify
Item
If Other, specify
text
Item
G. Biliary ductal lesions
text
Code List
G. Biliary ductal lesions
CL Item
None (1)
CL Item
Intrahepatic ductal dilation (focal involving the right hepatic lobe) (2)
CL Item
Intrahepatic ductal dilation (focal involving the left hepatic lobe) (3)
CL Item
Intrahepatic ductal dilation (involving both right and left hepatic lobes) (4)
CL Item
Extrahepatic ductal dilation (5)
CL Item
Diffuse ductal dilation (involving both intrahepatic and extrahepatic ducts) (6)
CL Item
Acute cholangitis (7)
CL Item
Primary sclerosing cholangitis (8)
CL Item
Choledocholitiasis (gullstone in duct) (9)
CL Item
Ductal filling defect(s), other than gallstone (10)
CL Item
Ductal wall thickening or oedema (11)
CL Item
Choledochal cyst (12)
CL Item
Ductal mass (13)
CL Item
Extrinsic mass compressing bile duct(s) (14)
CL Item
Other (15)
If Other, specify
Item
If Other, specify
text
Item
H. Portal/Hepatic vein abnormalities
text
Code List
H. Portal/Hepatic vein abnormalities
CL Item
None (1)
CL Item
Portal vein enlargement (2)
CL Item
Hepatic vein enlargement (3)
CL Item
Nonocclusive portal vein thrombosis (4)
CL Item
Occlusive portal vein thrombosis - bland (5)
CL Item
Hepatic vein thrombosis - bland (6)
CL Item
Occlusive portal vein thrombosis - malignant (7)
CL Item
Hepatic vein thrombosis - malignant (8)
CL Item
Involvement of the main portal vein (9)
CL Item
Involvement of the right portal vein (10)
CL Item
Involvement of the left portal vein (11)
CL Item
Budd-Chiari syndrome (12)
CL Item
Other (13)
If Other, specify
Item
If Other, specify
text
Item Group
Liver Chemistry Follow-Up Chemistries
Date sample taken
Item
Date sample taken
date
Were liver chemistries (ALT, AST, ALP, bilirubin) performed?
Item
Were liver chemistries (ALT, AST, ALP, bilirubin) performed?
boolean
Did liver chemistries (ALT, AST, ALP, bilirubin) resolve, stabilize, or return to within Baseline values?
Item
Did liver chemistries (ALT, AST, ALP, bilirubin) resolve, stabilize, or return to within Baseline values?
boolean

Gebruik dit formulier voor feedback, vragen en verbeteringsvoorstellen.

Velden gemarkeerd met een * zijn verplicht.

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial