ID

35345

Beskrivning

Study ID: 111364 Clinical Study ID: 111364 Study Title: A 28-Day, Polysomnographic and subjective assessment of Vestipitant (15mg/day) for the treatment of Primary Insomnia in adult Outpatients Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00992160 Clinicaltrials.gov Links: https://clinicaltrials.gov/ct2/show/NCT00992160 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 2 Study Recruitment Status: Completed Generic Name: Vestipitant, Placebo Trade Name: N/A Study Indication: Primary Insomnia, Sleep Disorders The purpose of this form is to record the subjects demographic and should be filled out at visit 1.

Länk

https://clinicaltrials.gov/ct2/show/NCT00992160

Nyckelord

Versioner (3)
  1. 2019-02-20 2019-02-20 -
  2. 2019-03-01 2019-03-01 -
  3. 2019-11-10 2019-11-10 -
Rättsinnehavare

GlaxoSmithKline

Uppladdad den

1 mars 2019

DOI

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Licens

Creative Commons BY-NC 3.0
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Polysomnographic Assessment of Vestipitant for the Treatment of Primary Insomnia NCT00992160

Engelsk

Demography

1 Formulär  
  1. StudyEvent: ODM
    1. Demography
Administrative Data
Beskrivning

Administrative Data

Alias
UMLS CUI-1
C1320722
Date of Visit/Assessment
Beskrivning

Date of Visit/Assessment

Datatyp

date

Alias
UMLS CUI [1,1]
C1320303
UMLS CUI [1,2]
C2985720
Site
Beskrivning

Site

Datatyp

text

Alias
UMLS CUI [1]
C2825164
Patient
Beskrivning

Patient

Datatyp

text

Alias
UMLS CUI [1]
C1299487
Patient No.
Beskrivning

Patient No.

Datatyp

text

Alias
UMLS CUI [1]
C1269815
Demography
Beskrivning

Demography

Alias
UMLS CUI-1
C0011298
Date of Birth
Beskrivning

Date of Birth

Datatyp

date

Alias
UMLS CUI [1]
C0421451
Sex
Beskrivning

If female, record child-bearing potential

Datatyp

integer

Alias
UMLS CUI [1]
C0079399
Child Bearing Potential
Beskrivning

If subject is female

Datatyp

text

Alias
UMLS CUI [1]
C1960468
Ethnicity
Beskrivning

Ethnicity

Datatyp

text

Alias
UMLS CUI [1]
C0015031
African American/African Heritage
Beskrivning

African American/African Heritage

Datatyp

boolean

Alias
UMLS CUI [1]
C0085756
UMLS CUI [2]
C0027567
American Indian or Alaskan Native
Beskrivning

American Indian or Alaskan Native

Datatyp

boolean

Alias
UMLS CUI [1]
C1515945
Asian - Central/South Asian Heritage
Beskrivning

Asian - Central/South Asian Heritage

Datatyp

boolean

Alias
UMLS CUI [1]
C0238696
UMLS CUI [2]
C1519427
Asian - East Asian Heritage
Beskrivning

Asian - East Asian Heritage

Datatyp

boolean

Alias
UMLS CUI [1]
C4540996
Asian - Japanase Heritage
Beskrivning

Asian - Japanase Heritage

Datatyp

boolean

Alias
UMLS CUI [1]
C1556094
Asian - South East Asian Heritage
Beskrivning

Asian - South East Asian Heritage

Datatyp

boolean

Alias
UMLS CUI [1]
C0238697
Native Hawaiian or Other Pacific Islander
Beskrivning

Native Hawaiian or Other Pacific Islander

Datatyp

boolean

Alias
UMLS CUI [1]
C1513907
White - Arabic/North African Heritage
Beskrivning

White - Arabic/North African Heritage

Datatyp

boolean

Alias
UMLS CUI [1]
C0238604
UMLS CUI [2]
C2698217
White - White/Caucasian/European Heritage
Beskrivning

White - White/Caucasian/European Heritage

Datatyp

boolean

Alias
UMLS CUI [1]
C0043157
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Similar models

Demography

1 Formulär
  1. StudyEvent: ODM
    1. Demography
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Administrative Data
C1320722 (UMLS CUI-1)
Date of Visit/Assessment
Item
Date of Visit/Assessment
date
C1320303 (UMLS CUI [1,1])
C2985720 (UMLS CUI [1,2])
Site
Item
Site
text
C2825164 (UMLS CUI [1])
Patient
Item
Patient
text
C1299487 (UMLS CUI [1])
Patient No.
Item
Patient No.
text
C1269815 (UMLS CUI [1])
Item Group
Demography
C0011298 (UMLS CUI-1)
Date of Birth
Item
Date of Birth
date
C0421451 (UMLS CUI [1])
Item
Sex
integer
C0079399 (UMLS CUI [1])
Sex
Code List
Sex
CL Item
Male (1)
CL Item
Female (2)
Item
Child Bearing Potential
text
C1960468 (UMLS CUI [1])
Child Bearing Potential
Code List
Child Bearing Potential
CL Item
Post-menopausal (Post-menopausal)
CL Item
Sterile (of child bearing age) (Sterile (of child bearing age))
CL Item
Potentially able to bear children (Potentially able to bear children)
Item
Ethnicity
text
C0015031 (UMLS CUI [1])
Ethnicity
Code List
Ethnicity
CL Item
Hispanic or Latino (Hispanic or Latino)
CL Item
Not Hispanic or Latino (Not Hispanic or Latino)
African American/African Heritage
Item
African American/African Heritage
boolean
C0085756 (UMLS CUI [1])
C0027567 (UMLS CUI [2])
American Indian or Alaskan Native
Item
American Indian or Alaskan Native
boolean
C1515945 (UMLS CUI [1])
Asian - Central/South Asian Heritage
Item
Asian - Central/South Asian Heritage
boolean
C0238696 (UMLS CUI [1])
C1519427 (UMLS CUI [2])
Asian - East Asian Heritage
Item
Asian - East Asian Heritage
boolean
C4540996 (UMLS CUI [1])
Asian - Japanase Heritage
Item
Asian - Japanase Heritage
boolean
C1556094 (UMLS CUI [1])
Asian - South East Asian Heritage
Item
Asian - South East Asian Heritage
boolean
C0238697 (UMLS CUI [1])
Native Hawaiian or Other Pacific Islander
Item
Native Hawaiian or Other Pacific Islander
boolean
C1513907 (UMLS CUI [1])
White - Arabic/North African Heritage
Item
White - Arabic/North African Heritage
boolean
C0238604 (UMLS CUI [1])
C2698217 (UMLS CUI [2])
White - White/Caucasian/European Heritage
Item
White - White/Caucasian/European Heritage
boolean
C0043157 (UMLS CUI [1])
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