0 Bedömningar
ID

43736

Beskrivning

Protocol Identifier RRL 100013 A 12 Week, Double-Blind, Placebo Controlled, Twice Daily Dosing Study to Assess the Efficacy and Safety of Ropinirole in Patients Suffering from Restless Legs Syndrome (RLS) Requiring Extended Treatment Coverage

Nyckelord

Versioner (2)
  1. 2017-05-09 2017-05-09 -
  2. 2021-09-20 2021-09-20 -
Uppladdad den

20 september 2021

DOI

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Licens

Creative Commons BY-NC 3.0
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    Case Report Form GSK

    Tysk Engelsk

    Case report form RRL 100013

    1 Formulär  
    Patient demographics
    Beskrivning

    Patient demographics

    Subject Identifier
    Beskrivning

    Subject Identifier

    Datatyp

    integer

    Alias
    UMLS CUI [1]
    C2348585 (Clinical Trial Subject Unique Identifier)
    Date of birth
    Beskrivning

    Date of birth

    Datatyp

    date

    Alias
    UMLS CUI [1]
    C0421451 (Patient date of birth)
    SNOMED
    184099003
    LOINC
    LP57552-9
    Date of visit
    Beskrivning

    Date of visit

    Datatyp

    date

    Alias
    UMLS CUI [1]
    C1320303 (Date of visit)
    SNOMED
    406543005
    Gender
    Beskrivning

    Gender

    Datatyp

    integer

    Alias
    UMLS CUI [1]
    C0079399 (Gender)
    SNOMED
    263495000
    LOINC
    LP61312-2
    Ethnicity
    Beskrivning

    Please tick on box

    Datatyp

    integer

    Alias
    UMLS CUI [1]
    C0015031 (Ethnic group)
    SNOMED
    398089004
    LOINC
    LP36231-6
    Race
    Beskrivning

    check all that apply

    Datatyp

    integer

    Alias
    UMLS CUI [1]
    C0034510 (Racial group)
    SNOMED
    415229000
    LOINC
    LP7528-5
    Tillbaka till toppen

    Similar models

    Case report form RRL 100013

    1 Formulär
    Name
    Typ
    Description | Question | Decode (Coded Value)
    Datatyp
    Alias
    Item Group
    Patient demographics
    Subject Identifier
    Item
    Subject Identifier
    integer
    C2348585 (UMLS CUI [1])
    Date of birth
    Item
    Date of birth
    date
    C0421451 (UMLS CUI [1])
    Date of visit
    Item
    Date of visit
    date
    C1320303 (UMLS CUI [1])
    Item
    Gender
    integer
    C0079399 (UMLS CUI [1])
    Gender
    Code List
    Gender
    CL Item
    male (m)
    C0086582 (UMLS CUI-1)
    CL Item
    female (f)
    C0086287 (UMLS CUI-1)
    Item
    Ethnicity
    integer
    C0015031 (UMLS CUI [1])
    Ethnicity
    Code List
    Ethnicity
    CL Item
    Hispanic or Latino (1)
    C0019576 (UMLS CUI-1)
    CL Item
    Not Hispanic or Latino (2)
    C1518424 (UMLS CUI-1)
    Item
    Race
    integer
    C0034510 (UMLS CUI [1])
    Race
    Code List
    Race
    CL Item
    African American/African Heritage (1)
    C0085756 (UMLS CUI-1)
    CL Item
    American Indian or Alaskan Native (2)
    C0682125 (UMLS CUI-1)
    CL Item
    Asian - Central/South Asian Heritage (3)
    CL Item
    Asian - East Asian Heritage (4)
    CL Item
    Asian - Japanese Heritage (5)
    CL Item
    Asian - South East Asian Heritage (6)
    CL Item
    Native Hawaiian or Other Pacific Islander (7)
    CL Item
    White - Arabic/North African Heritage (8)
    CL Item
    White - White/Caucasian/European Heritage (9)
    Tillbaka till toppen 

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