Patient Number
Item
Patient Number
text
C2348585 (UMLS CUI [1])
Patient initials
Item
Patient initials
text
C2986440 (UMLS CUI [1])
Centre Number
Item
Centre Number
integer
C0600091 (UMLS CUI [1,1])
C0019994 (UMLS CUI [1,2])
Visit Date
Item
Visit Date
date
C1320303 (UMLS CUI [1])
Item
Visit type
integer
C0545082 (UMLS CUI [1,1])
C0332307 (UMLS CUI [1,2])
CL Item
Early withdrawal (16)
Concomitant Medication
Item
Please record any changes in concomitant medication since the last visit in the Concomitant Medication section
boolean
C2347852 (UMLS CUI [1])
Medical Procedure
Item
Please record any medical procedures performed since the last visit
text
C0199171 (UMLS CUI [1])
Scales RLS
Item
Please complete the appropriate RLS Rating Scale from the RLS Rating Scale Book.
integer
C0450973 (UMLS CUI [1,1])
C0035258 (UMLS CUI [1,2])
Adverse Events
Item
Please record any adverse experiences observed or elicited by the following direct question to the patient: "Have you felt different in any way since the last visit?" in the Adverse Experience and/or SAE section.
boolean
Item
Clinical Global Impression Questionaire completed?
text
C3639708 (UMLS CUI [1])
Code List
Clinical Global Impression Questionaire completed?
Item
Patient has clinically significant abnormal laboratory findings not resolved prior to baseline examinations.
text
C0680251 (UMLS CUI [1])
Code List
Patient has clinically significant abnormal laboratory findings not resolved prior to baseline examinations.