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Reason for non participation "Safety and Immunogenicity Study of a Booster Dose of GSK Biologicals' 10-valent Pneumococcal Conjugate Vaccine" NCT00370396

1 Formulär  
Identification
Beskrivning

Identification

Alias
UMLS CUI-1
C1300638
Center number
Beskrivning

Center number

Datatyp

text

Alias
UMLS CUI [1,1]
C1301943
UMLS CUI [1,2]
C0805701
Subject ID
Beskrivning

Subject ID

Datatyp

text

Alias
UMLS CUI [1]
C2348585
Treatment Number
Beskrivning

Treatment Number

Datatyp

text

Alias
UMLS CUI [1]
C1522541
Date of birth
Beskrivning

Date of birth

Datatyp

date

Alias
UMLS CUI [1]
C0421451
Gender
Beskrivning

Gender

Datatyp

text

Alias
UMLS CUI [1]
C0079399
Tracking Document Reason for non participation
Beskrivning

Tracking Document Reason for non participation

Alias
UMLS CUI-1
C0679823
UMLS CUI-2
C3166257
Previous subject number:
Beskrivning

Subject number

Datatyp

text

Alias
UMLS CUI [1]
C1709561
Date of birth
Beskrivning

Date of birth

Datatyp

date

Alias
UMLS CUI [1]
C0421451
Please document reason for non participation
Beskrivning

Please specify below

Datatyp

integer

Alias
UMLS CUI [1]
C3166257
please specify criteria that are not fullfilled
Beskrivning

Specification of non-eligibility

Datatyp

text

Alias
UMLS CUI [1]
C3166257
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Similar models

Reason for non participation "Safety and Immunogenicity Study of a Booster Dose of GSK Biologicals' 10-valent Pneumococcal Conjugate Vaccine" NCT00370396

1 Formulär
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Identification
C1300638 (UMLS CUI-1)
Center number
Item
Center number
text
C1301943 (UMLS CUI [1,1])
C0805701 (UMLS CUI [1,2])
Subject ID
Item
Subject ID
text
C2348585 (UMLS CUI [1])
Treatment Number
Item
Treatment Number
text
C1522541 (UMLS CUI [1])
Date of birth
Item
Date of birth
date
C0421451 (UMLS CUI [1])
Item
Gender
text
C0079399 (UMLS CUI [1])
Gender
Code List
Gender
CL Item
Male (m)
CL Item
Female (f)
Item Group
Tracking Document Reason for non participation
C0679823 (UMLS CUI-1)
C3166257 (UMLS CUI-2)
Subject number
Item
Previous subject number:
text
C1709561 (UMLS CUI [1])
Date of birth
Item
Date of birth
date
C0421451 (UMLS CUI [1])
Item
Please document reason for non participation
integer
C3166257 (UMLS CUI [1])
Reason for non participation
Code List
Please document reason for non participation
CL Item
Subject not eligible (1)
CL Item
Subject lost to follow-up or not reached (2)
CL Item
Subject eligible but not willing to participate (3)
CL Item
Adverse events, or serious adverse event (4)
CL Item
Other (5)
CL Item
Subject died (6)
Specification of non-eligibility
Item
please specify criteria that are not fullfilled
text
C3166257 (UMLS CUI [1])
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