ID

33913

Beskrivning

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

Nyckelord

  1. 2019-01-07 2019-01-07 -
Rättsinnehavare

GSK group of companies

Uppladdad den

7 januari 2019

DOI

För en begäran logga in.

Licens

Creative Commons BY-NC 3.0

Modellkommentarer :

Här kan du kommentera modellen. Med hjälp av pratbubblor i Item-grupperna och Item kan du lägga in specifika kommentarer.

Itemgroup-kommentar för :

Item-kommentar för :

Du måste vara inloggad för att kunna ladda ner formulär. Var vänlig logga in eller registrera dig utan kostnad.

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

Adjudication Events - Coronary Revascularization

Administrative data
Beskrivning

Administrative data

Site
Beskrivning

Site

Datatyp

text

Subject
Beskrivning

Subject

Datatyp

text

Visit Name
Beskrivning

Visit Name

Datatyp

text

Status
Beskrivning

Status

Datatyp

text

Document Number
Beskrivning

Document Number

Datatyp

text

Coronary Revascularization
Beskrivning

Coronary Revascularization

Please document all coronary revascularizations
Beskrivning

e.g., elective, planned, non-urgent, non-emergency, and non-elective, non-planned, urgent, emergency. Please complete a separate Coronary Revascularization form for each coronary revascularization procedure.

Datatyp

text

Percutaneous coronary intervention
Beskrivning

Percutaneous coronary intervention

Date
Beskrivning

Date

Datatyp

date

Time
Beskrivning

Time

Datatyp

time

Were stents placed?
Beskrivning

Were stents placed?

Datatyp

boolean

If Yes, type of stent
Beskrivning

If Yes, type of stent

Datatyp

text

Number of stents
Beskrivning

Number of stents

Datatyp

integer

Coronary artery bypass graft procedure
Beskrivning

Coronary artery bypass graft procedure

Date
Beskrivning

Date

Datatyp

date

Time
Beskrivning

Time

Datatyp

time

Number of bypassed vessels
Beskrivning

Number of bypassed vessels

Datatyp

integer

Specify other coronary revascularization procedure
Beskrivning

Specify other coronary revascularization procedure

Type
Beskrivning

Type

Datatyp

text

Date
Beskrivning

Date

Datatyp

date

Time
Beskrivning

Time

Datatyp

time

AE Details
Beskrivning

AE Details

AE / SAE Number
Beskrivning

AE / SAE Number

Datatyp

integer

Did the subject have this coronary revascularization procedure during a hospitalization for an acute myocardial infraction or angina or chest pain?
Beskrivning

Did the subject have this coronary revascularization procedure during a hospitalization for an acute myocardial infraction or angina or chest pain?

Datatyp

text

Was this an elective/non-emergency procedure?
Beskrivning

Was this an elective/non-emergency procedure?

Datatyp

boolean

Did the subject have this procedure as a result of another Adverse Event or Serious Adverse Event?
Beskrivning

Did the subject have this procedure as a result of another Adverse Event or Serious Adverse Event?

Datatyp

boolean

If Yes, please record AE/SAE number
Beskrivning

If Yes, please record AE/SAE number

Datatyp

integer

Did myocardial infraction occur during or after the procedure?
Beskrivning

please submit a copy of the cardiac enzyme/marker report, if available

Datatyp

text

Enzyme Value Data
Beskrivning

Enzyme Value Data

Did a cerebrovascular accident (CVA) occur after the procedure?
Beskrivning

Did a cerebrovascular accident (CVA) occur after the procedure?

Datatyp

integer

Did the subject die as a direct consequence of the procedure?
Beskrivning

Did the subject die as a direct consequence of the procedure?

Datatyp

text

CK-MB
Beskrivning

CK-MB

Was the value examination done?
Beskrivning

Was the value examination done?

Datatyp

boolean

Pre-Procedure value
Beskrivning

the lab result value that most immediately precede the procedure

Datatyp

text

Date sample taken
Beskrivning

Date sample taken

Datatyp

date

Time
Beskrivning

Time

Datatyp

time

Post-Procedure peak value
Beskrivning

Post-Procedure peak value

Datatyp

text

Date sample taken
Beskrivning

Date sample taken

Datatyp

date

Time
Beskrivning

Time

Datatyp

time

Upper Limit of Normal
Beskrivning

Upper Limit of Normal

Datatyp

text

Enzyme Unit
Beskrivning

Enzyme Unit

Datatyp

text

Troponin I
Beskrivning

Troponin I

Was the value examination done?
Beskrivning

Was the value examination done?

Datatyp

boolean

Pre-Procedure value
Beskrivning

the lab result value that most immediately precede the procedure

Datatyp

text

Date sample taken
Beskrivning

Date sample taken

Datatyp

date

Time
Beskrivning

Time

Datatyp

time

Post-Procedure peak value
Beskrivning

Post-Procedure peak value

Datatyp

text

Date sample taken
Beskrivning

Date sample taken

Datatyp

date

Time
Beskrivning

Time

Datatyp

time

Upper Limit of Normal
Beskrivning

Upper Limit of Normal

Datatyp

text

Enzyme Unit
Beskrivning

Enzyme Unit

Datatyp

text

Troponin T
Beskrivning

Troponin T

Was the value examination done?
Beskrivning

Was the value examination done?

Datatyp

boolean

Pre-Procedure value
Beskrivning

the lab result value that most immediately precede the procedure

Datatyp

text

Date sample taken
Beskrivning

Date sample taken

Datatyp

date

Time
Beskrivning

Time

Datatyp

time

Post-Procedure peak value
Beskrivning

Post-Procedure peak value

Datatyp

text

Date sample taken
Beskrivning

Date sample taken

Datatyp

date

Time
Beskrivning

Time

Datatyp

time

Upper Limit of Normal
Beskrivning

Upper Limit of Normal

Datatyp

text

Enzyme Unit
Beskrivning

Enzyme Unit

Datatyp

text

Similar models

Adjudication Events - Coronary Revascularization

Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Administrative data
Site
Item
Site
text
Subject
Item
Subject
text
Item
Visit Name
text
Code List
Visit Name
CL Item
Adjudication (1)
Status
Item
Status
text
Document Number
Item
Document Number
text
Item Group
Coronary Revascularization
Item
Please document all coronary revascularizations
text
Code List
Please document all coronary revascularizations
CL Item
Percutaneous coronary intervention (1)
CL Item
Coronary artery bypass graft procedure (2)
CL Item
Other coronary revascularization procedure (3)
Item Group
Percutaneous coronary intervention
Date
Item
Date
date
Time
Item
Time
time
Were stents placed?
Item
Were stents placed?
boolean
Item
If Yes, type of stent
text
Code List
If Yes, type of stent
CL Item
Bare-metal (1)
CL Item
Drug-eluting (2)
Number of stents
Item
Number of stents
integer
Item Group
Coronary artery bypass graft procedure
Date
Item
Date
date
Time
Item
Time
time
Number of bypassed vessels
Item
Number of bypassed vessels
integer
Item Group
Specify other coronary revascularization procedure
Type
Item
Type
text
Date
Item
Date
date
Time
Item
Time
time
Item Group
AE Details
AE / SAE Number
Item
AE / SAE Number
integer
Item
Did the subject have this coronary revascularization procedure during a hospitalization for an acute myocardial infraction or angina or chest pain?
text
Code List
Did the subject have this coronary revascularization procedure during a hospitalization for an acute myocardial infraction or angina or chest pain?
CL Item
Yes (please complete this form and provide the AE/SAE event number) (1)
CL Item
No (2)
Was this an elective/non-emergency procedure?
Item
Was this an elective/non-emergency procedure?
boolean
Did the subject have this procedure as a result of another Adverse Event or Serious Adverse Event?
Item
Did the subject have this procedure as a result of another Adverse Event or Serious Adverse Event?
boolean
If Yes, please record AE/SAE number
Item
If Yes, please record AE/SAE number
integer
Item
Did myocardial infraction occur during or after the procedure?
text
Code List
Did myocardial infraction occur during or after the procedure?
CL Item
Yes (please record event on Acute Myocardial Infraction/Hospitalized Angina or Chest Pain form) (1)
CL Item
No (please fill in all the cardiac enzyme/marker measurements available. For a specific enzyme/marker both the peak value and the upper limit of normal should be stated in the same unit) (2)
Item Group
Enzyme Value Data
Item
Did a cerebrovascular accident (CVA) occur after the procedure?
integer
Code List
Did a cerebrovascular accident (CVA) occur after the procedure?
CL Item
Yes (record event on the Stroke/TIA form) (1)
CL Item
No (2)
Item
Did the subject die as a direct consequence of the procedure?
text
Code List
Did the subject die as a direct consequence of the procedure?
CL Item
Yes, complete the Death form (1)
CL Item
No (2)
Item Group
CK-MB
Was the value examination done?
Item
Was the value examination done?
boolean
Pre-Procedure value
Item
Pre-Procedure value
text
Date sample taken
Item
Date sample taken
date
Time
Item
Time
time
Post-Procedure peak value
Item
Post-Procedure peak value
text
Date sample taken
Item
Date sample taken
date
Time
Item
Time
time
Upper Limit of Normal
Item
Upper Limit of Normal
text
Enzyme Unit
Item
Enzyme Unit
text
Item Group
Troponin I
Was the value examination done?
Item
Was the value examination done?
boolean
Pre-Procedure value
Item
Pre-Procedure value
text
Date sample taken
Item
Date sample taken
date
Time
Item
Time
time
Post-Procedure peak value
Item
Post-Procedure peak value
text
Date sample taken
Item
Date sample taken
date
Time
Item
Time
time
Upper Limit of Normal
Item
Upper Limit of Normal
text
Enzyme Unit
Item
Enzyme Unit
text
Item Group
Troponin T
Was the value examination done?
Item
Was the value examination done?
boolean
Pre-Procedure value
Item
Pre-Procedure value
text
Date sample taken
Item
Date sample taken
date
Time
Item
Time
time
Post-Procedure peak value
Item
Post-Procedure peak value
text
Date sample taken
Item
Date sample taken
date
Time
Item
Time
time
Upper Limit of Normal
Item
Upper Limit of Normal
text
Enzyme Unit
Item
Enzyme Unit
text

Använd detta formulär för feedback, frågor och förslag på förbättringar.

Fält markerade med * är obligatoriska.

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