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Table of contents
  1. 1. Clinical Trial
  2. 2. Routine Documentation
  3. 3. Registry/Cohort Study
  4. 4. Quality Assurance
  5. 5. Data Standard
  6. 6. Patient-Reported Outcome
  7. 7. Medical Specialty
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133 Search results.

Effects of eltrombopag in children with chronic idiopathic thrombocytopenic purpura, NCT00908037 - ITP Therapy, Medical/Surgical procedures

- 10/23/19 - 1 form, 3 itemgroups, 28 items, 1 language
Itemgroups: Administrative Data, Prior ITP Therapy, Medical/Surgical procedures
Study ID: 108062 Clinical Study ID: 108062 Study Title: A three part, staggered cohort, open-label and double blind, randomized, placebo controlled study to investigate the efficacy, safety, tolerability and pharmacokinetics of eltrombopag, a thrombopoietin receptor agonist, in previously treated pediatric patients with chronic idiopathic thrombocytopenic purpura (ITP). Eltrombopag PETIT: Eltrombopag in PEdiatric patients with Thrombocytopenia from ITP Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00908037 https://clinicaltrials.gov/ct2/show/NCT00908037 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 2 Study Recruitment Status: Completed Generic Name: eltrombopag, Placebo Trade Name: N/A Study Indication: Purpura, Thrombocytopaenic, Idiopathic The study consists of a screening, Day 1 and three parts. All subjects were supposed to receive 24 weeks (6 months) of eltrombopag treatment during Part 2/3. Screening period: Up to 28 days prior to Day 1 of treatment. Day 1 Part 1 (Dose Finding Phase): A 24-week (6 months) open label treatment period for 5 subjects in each age cohort. (short: P1W1-P1W7, P1W8-23, P1W24/EW). A safety, PK and platelet count review took place after 12 weeks (3 months) of treatment. Subjects in the Dose Finding Phase did not participate in the Randomized Period. Part 2 (Randomized Period): A 7-week randomized, double-blind, placebo-controlled period involving 18 subjects per cohort (short: P2W1-P2W7). Part 3: An open-label treatment period where subjects randomized to eltrombopag in Part 2 received an additional 17 weeks of eltrombopag in Part 3 and subjects randomized to placebo in Part 2 received 24 weeks of eltrombopag in Part 3 (short: P3W8-P3W23, P3W24/EW, P3W8-30, P3W31/EW). Follow-up: 4 weeks following the last dose of eltrombopag (short: FUW1- FUW4). Additional ocular examinations were performed at 12 and 24 weeks (3 and 6 months) after the last dose of eltrombopag (short: FUM3, FUM6). The subjects were enrolled in 3 cohorts: Cohort 1: Subjects between 12 and 17 years old (<18 years of age at Day 1). Cohort 2: Subjects between 6 and 11 years old (<12 years of age at Day 1). Cohort 3: Subjects between 1 and 5 years old (<6 years of age at Day 1). The enrollment was started with the oldest cohort (Cohort 1). The younger cohorts were not enrolled until safety, PK and platelet counts had been reviewed in the older cohort(s). This document contains the ITP Therapy and the Medical/Surgical procedures form. It has to be filled in for repeating form.

Efficacy and Safety of Pazopanib (GW786034) in Subjects With Advanced Non-Small Cell Lung Cancer NCT00549328 - Screening - Subject Identification; Demography; Disease Characteristics; Status at Screening; Anti-Cancer Therapy; Anti-Cancer Radiotherapy; Medical Conditions

- 8/14/19 - 1 form, 12 itemgroups, 64 items, 1 language
Itemgroups: Inform Screening, Subject number, Date of Visit/ Assessment, Local Laboratories, Subject identification, Demography, Disease Characteristics, Metastatic Disease, Status at Screening, Anti-Cancer Therapy, Anti-Cancer Therapy , Medical Conditions
Study ID: 109609 Clinical Study ID: 109609 Study Title: A Phase II, Non-randomized, Multi-center Study to Evaluate the Efficacy and Safety of Pazopanib (GW786034) in Subjects With Advanced Non-Small Cell Lung Cancer Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00549328 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 2 Study Recruitment Status: Completed Generic Name: GW786034 Trade Name: Drug: Pazopanib Study Indication: Lung Cancer, Non-Small Cell

Safety and Activity of SRT501 Alone or in Combination with Bortezomib in Patients with Multiple Myeloma NCT00920556 - Screening - Medical and Surgical History; Disease Stage at Study Entry; Classification of Disease at Study Entry; Cancer related Surgical History; Previous Anti-Neoplastic Therapy

- 2/27/19 - 1 form, 9 itemgroups, 26 items, 1 language
Itemgroups: Adminstrative, Does the subject have any clinically significant medical or surgical history?, Medical and Surgical History, Disease Stage at Study Entry, Classification of Disease at Study Entry, Did the subject have previous cancer related surgical history?, Cancer related Surgical History, Previous Anti-Neoplastic Therapy, Previous Anti-Neoplastic Therapy
Study ID: 113222 Clinical Study ID: 113222 Study Title: A Phase II, Open Label, Clinical Study to Assess the Safety and Activity of SRT501 Alone or in Combination with Bortezomib in Patients with Multiple Myeloma Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00920556 Sponsor: GlaxoSmithKline Phase: Phase 2 Study Recruitment Status: Completed Generic Name:5.0g SRT501 Trade Name: Bortezomib Study Indication: Multiple Myeloma

Multiple sclerosis studies NCT02461069 NCT02419378 - Visit 1 (Screening) Part 2/2, Lab; Medical Examination, DIMAT-MS, Relapsing Remitting Multiple Sclerosis NCT02461069

- 1/29/19 - 18 forms, 7 itemgroups, 40 items, 1 language
Itemgroups: Date of blood sampling, Hematology, Liver Function, Renal function, Medical Examination, Expanded disability status scale (EDSS), Signature
Screening, Baseline and Visit 1 CRFs of DIMAT-MS and ALAIN studies for semantic analysis of Multiple Sclerosis study documentation. Provided by Prof. Dr. Luisa Klotz of the Department of Neurology of the University Hospital Muenster.

Visit 1 (Screening) Part 1/2, DIMAT-MS, Relapsing Remitting Multiple Sclerosis NCT02461069

7 itemgroups, 31 items31

Eligibility Medical Examination, DIMAT-MS, Relapsing Remitting Multiple Sclerosis NCT02461069

3 itemgroups, 31 items31

Eligibility Multiple Sclerosis, Relapsing-Remitting NCT02419378

2 itemgroups, 48 items31

Screening: Medical History Multiple Sclerosis ALAIN01 NCT02419378

2 itemgroups, 5 items31
13 more forms meeting the search are available in the detailed view.

Iodine-131 Anti-B1 Antibody for Non Hodgkin’s Lymphomas NCT00996593 - Infusion Record Dosimetric Dose - Day 0 (Visit 2)

- 8/18/18 - 1 form, 9 itemgroups, 32 items, 1 language
Itemgroups: Date administered, HAMA, Time started, Time finished, Doses, Infusion rate, Record Vital Signs, Adverse Experience, Compliance
Study ID: 104507 Clinical Study ID: BEX104507 Study Title: Phase II Study of Iodine-131 Anti-B1 Antibody for Non Hodgkin’s Lymphoma Patients who have Previously Received Rituximab Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00996593 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 2 Study Recruitment Status: Completed Generic Name: tositumomab Trade Name: Bexxar Study Indication: Lymphoma, Non-Hodgkin

Iodine-131 Anti-B1 Antibody for Non Hodgkin’s Lymphomas NCT00996593 - Prior Therapy

- 8/18/18 - 1 form, 3 itemgroups, 15 items, 1 language
Itemgroups: Prior Therapy, Pharmaceutical Preparations, Therapeutic radiology procedure; Before
Study ID: 104507 Clinical Study ID: BEX104507 Study Title: Phase II Study of Iodine-131 Anti-B1 Antibody for Non Hodgkin’s Lymphoma Patients who have Previously Received Rituximab Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00996593 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 2 Study Recruitment Status: Completed Generic Name: tositumomab Trade Name: Bexxar Study Indication: Lymphoma, Non-Hodgkin

Iodine 131 B1 Antibody for B-Cell Lymphomas NCT00950755 - Prior Therapy

- 7/12/18 - 1 form, 2 itemgroups, 10 items, 1 language
Itemgroups: Administrative Data, xxx
Study ID: 104505 Clinical Study ID: BEX104505 Study Title: Phase II Study of Iodine 131 Anti B1 Antibody for 1st or 2nd Relapsed Indolent B-Cell Lymphomas or B-Cell Lymphomas That Have Transformed to a More Aggressive Histology Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00950755 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 2 Study Recruitment Status: Completed Generic Name: tositumomab Trade Name: Bexxar Study Indication: Lymphoma, Non-Hodgkin Please record all prior therapies for NHL (e.g. chemotherapy, immunotherapy, steroidal therapy).

CDASH Drug accountability(1) - Drug accountability (1)

- 6/20/18 - 1 form, 3 itemgroups, 5 items, 1 language
Itemgroups: General information, Study Treatment – Returned Amount, Study Treatment – Dispensed Amount
modified from http://www.cdisc.org

CDASH Drug accountability (2) - Drug accountability (2)

- 6/20/18 - 1 form, 4 itemgroups, 8 items, 1 language
Itemgroups: Study Treatment – Returned, Study Treatment – Returned Amount, Study Treatment – Dispensed, Study Treatment – Dispensed Amount
modified from http://www.cdisc.org

CDASH Drug accountability (3) - Drug accountability (3)

- 6/20/18 - 1 form, 2 itemgroups, 5 items, 1 language
Itemgroups: General information, Study Treatment
modified from http://www.cdisc.org

Interim Visit HOMe aFers 1 NCT02905539

- 12/29/17 - 1 form, 12 itemgroups, 40 items, 1 language
Itemgroups: Administrative data, Adverse events, Pre- and concomitant therapy, Vital parameters, Physical Examination, Collection of biological samples_interim visit, Signature for interim visit, Medical history, Intercurrent diseases, Adverse events, Serious adverse events, Pre- and concomitant therapy
Interim visit form Interimsvisite NCT02905539 A Randomized, Double-blind Comparative Study Comparing Ferric Carboxymaltose (Ferinject) and Iron Isomaltoside 1000 (Monofer) for Iron Substitution in Iron-deficiency Anemia Quelle: Prof. Dr. med. Gunnar Heine Universitätsklinikum des Saarlandes

Visit 5 HOMe aFers 1 NCT02905539

- 12/29/17 - 1 form, 12 itemgroups, 49 items, 1 language
Itemgroups: Administrative data, Adverse events, Pre- and concomitant therapy, Questionnaire 1, Questionnaire 2, Questionnaire 3, Vital parameters, Anthropometric Data, Physical Examination, 12-lead ECG, Collection of biological samples_visit 5, Signature for visit 5
Visit 5 form Visite 5 NCT02905539 A Randomized, Double-blind Comparative Study Comparing Ferric Carboxymaltose (Ferinject) and Iron Isomaltoside 1000 (Monofer) for Iron Substitution in Iron-deficiency Anemia Quelle: Prof. Dr. med. Gunnar Heine Universitätsklinikum des Saarlandes