ID

34923

Beskrivning

Study ID: 101888 Clinical Study ID: FFR101888 Study Title: A randomised, placebo-controlled, four way crossover study to evaluate the effect of double-blind 4000 mcg of orally inhaled GW685698X and of 6.25 mg cellobiose octa-acetate on electrocardiographic parameters, with single-blind 400 mg of oral moxifloxacin as a positive control, in 40 healthy male and female subjects. 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: fluticasone furoate Trade Name: Veramyst,Avamys,Allermist Study Indication: Rhinitis, Allergic, Perennial The study consists of a screening, 4 treatment periods (TP) and a follow-up visit. For each TP there is a Day-1 (D-1) and a Day1 (D1). This document contains the Urine pregnancy test and Urine test for drugs and alcohol form. It has to be filled in for treatment periods 1-4 for Day-1.

Nyckelord

  1. 2019-02-04 2019-02-04 -
Rättsinnehavare

GlaxoSmithKline

Uppladdad den

4 februari 2019

DOI

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Licens

Creative Commons BY-NC 3.0

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Effect of inhaled Fluticasone furoate and cellobiose octa-acetate on electrocardiographic parameters in healthy subjects, Study-ID: 101888

Urine pregnancy test, Urine test for drugs and alcohol

Administrative data
Beskrivning

Administrative data

Alias
UMLS CUI-1
C1320722
Subject identifier
Beskrivning

Subject identifier

Datatyp

text

Alias
UMLS CUI [1]
C2348585
Visit type
Beskrivning

Visit type

Datatyp

integer

Alias
UMLS CUI [1,1]
C0332307
UMLS CUI [1,2]
C0545082
Urine pregnancy test
Beskrivning

Urine pregnancy test

Alias
UMLS CUI-1
C0430056
Date of test
Beskrivning

day month year

Datatyp

date

Alias
UMLS CUI [1,1]
C0032976
UMLS CUI [1,2]
C0011008
Results
Beskrivning

Results

Datatyp

integer

Alias
UMLS CUI [1]
C0427777
Urine test for drugs and alcohol
Beskrivning

Urine test for drugs and alcohol

Alias
UMLS CUI-1
C0202274
UMLS CUI-2
C0042036
UMLS CUI-3
C0202304
Date of sample taken
Beskrivning

day month year

Datatyp

date

Alias
UMLS CUI [1]
C1302413
Drugs/Alcohol
Beskrivning

Note a result for each test

Datatyp

integer

Alias
UMLS CUI [1]
C0086190
UMLS CUI [2]
C0001975
Result of test
Beskrivning

Tick appropriate boxes

Datatyp

integer

Alias
UMLS CUI [1]
C0587081

Similar models

Urine pregnancy test, Urine test for drugs and alcohol

Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Administrative data
C1320722 (UMLS CUI-1)
Subject identifier
Item
Subject identifier
text
C2348585 (UMLS CUI [1])
Item
Visit type
integer
C0332307 (UMLS CUI [1,1])
C0545082 (UMLS CUI [1,2])
Code List
Visit type
CL Item
TP1D-1 (1)
CL Item
TP2D-1 (2)
CL Item
TP3D-1 (3)
CL Item
TP4D-1 (4)
Item Group
Urine pregnancy test
C0430056 (UMLS CUI-1)
Date of test
Item
Date of test
date
C0032976 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Item
Results
integer
C0427777 (UMLS CUI [1])
Code List
Results
CL Item
Positive (1)
CL Item
Negative (2)
CL Item
Not Required (3)
Item Group
Urine test for drugs and alcohol
C0202274 (UMLS CUI-1)
C0042036 (UMLS CUI-2)
C0202304 (UMLS CUI-3)
Date of sample taken
Item
Date of sample taken
date
C1302413 (UMLS CUI [1])
Item
Drugs/Alcohol
integer
C0086190 (UMLS CUI [1])
C0001975 (UMLS CUI [2])
Code List
Drugs/Alcohol
CL Item
Cannabinoids (1)
CL Item
Amphetamines (2)
CL Item
Benzodiazepines (3)
CL Item
Cocaine (4)
CL Item
Opiates (5)
CL Item
Barbiturates (6)
CL Item
Urine Alcohol (7)
Item
Result of test
integer
C0587081 (UMLS CUI [1])
Code List
Result of test
CL Item
Positive (1)
CL Item
Negative (2)

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