- 12/7/20 - 1 form, 13 itemgroups, 92 items, 1 language
Itemgroups: Date of Visit/ Assessment, Adverse Event/ Concomitant Medication/ Repeat Assessment Check Questions, Non-Serious Adverse Event, Serious Adverse Event - Type of Report, Serious Adverse Event - Randomisation, Serious Adverse Event, Serious Adverse Event - Seriousness, Serious Adverse Event - Relevant Concomitant/ Treatment Medications, Serious Adverse Events - Relevant Medical Conditions/ Risk Factors, Serious Adverse Event - Relevant Diagnostic Results, Serious Adverse Event - Investigational Product, General Narrative Comments, Serious Adverse Event - Non clinical
- 7/29/20 - 1 form, 16 itemgroups, 59 items, 1 language
Itemgroups: Administrative, Non-serious Adverse Events (AE), Non-serious Adverse Events (AE) , Serious Adverse Event (SAE), Serious Adverse Event (SAE) - Section 1, Serious Adverse Event (SAE) - Section 2 Seriousness, Serious Adverse Event (SAE) - Section 3 Demography Data, Serious Adverse Event (SAE) - Section 4, Serious Adverse Event (SAE) - Section 5 , Serious Adverse Event (SAE) - Section 6 Relevant Medical Conditions, Serious Adverse Event (SAE) - Section 7 Other relevant risk factors, Serious Adverse Event (SAE) - Section 8 Concomitant medications , Serious Adverse Event (SAE) - Section 9 Details of investigational product(s), Serious Adverse Event (SAE) - Section 10, Serious Adverse Event (SAE) - Section 11 Narrative remarks, Investigator's signature
- 12/10/18 - 1 form, 12 itemgroups, 39 items, 1 language
Itemgroups: Serious Adverse Event, Serious Adverse Event, Seriousness of Adverse Event, Serious Adverse Event, Demographics Domain, Serious Adverse Event, Experimental drug, Serious Adverse Event, Causations, Serious Adverse Event, Disease, Serious Adverse Event, Risk Factors, Serious Adverse Event, Concomitant Agent, Serious Adverse Event, Experimental Drug, Details, Serious Adverse Event, Evaluation, Details, Serious Adverse Event, Comment, Serious Adverse Event, Investigator Signature, Investigator Name
- 5/1/19 - 1 form, 16 itemgroups, 137 items, 1 language
Itemgroups: Logs ad Repeats, Logs and Repeats - Adverse event/ Concomitant Medication/ Repeat Assessment Check Questions, Non-serious Adverse Event (AE), Serious Adverse Events (SAE), Serious Adverse Event - Concomitant Medication, Serious Adverse Event - Medical Conditions/ Risk Factors, Serious Adverse Events - Relevant diagnostic results, Serious Adverse Events - Investigational Products, Serious Adverse Events - General narrative comments, Serious Adverse Events - Non clinical, Concomitant Medication, Electronically Transferred Lab Data, Vital signs, 12-Lead ECG, ECG Abnormalities, Repeat Pharmacokinetics Blood - GW856553
- 12/12/18 - 1 form, 13 itemgroups, 62 items, 1 language
Itemgroups: Administrative data, Section 1 Serious Adverse Events, Section 2 Seriousness, Section 3 Demography Data, Section 4 Recurrence of Adverse event after further investigational product, SECTION 5 Possible Causes of SAE other than Investigational Product(s), Section 6 Relevant Medical Conditions, SECTION 7 Other Relevant Risk Factors, SECTION 8 Relevant Concomitant Medications, SECTION 9 Details of Investigational Product(s), SECTION 10 Details of Relevant Assessments, SECTION 11 Narrative Remarks, Section 12 Additional/Follow-up information
- 5/28/19 - 1 form, 16 itemgroups, 166 items, 1 language
Itemgroups: Administrative documentation, Non-serious Adverse Event, Serious Adverse Event, COPD exacerbation, Concomitant Agent, Date of visit, Assessment Date, Fracture, Pharmacogenetics, Informed Consent; Sampling, Experimental drug, Compliance behavior, Experimental drug, Compliance behavior, Investigational Medicinal Product Documentation, Device Malfunction, Plain chest X-ray, Pneumonia, Evaluation, Event Log, Status, Serious Adverse Event, Status, Study Subject Participation Status

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