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

Identification
Description

Identification

Alias
UMLS CUI-1
C1300638
Center number
Description

Center number

Data type

text

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

Subject ID

Data type

text

Alias
UMLS CUI [1]
C2348585
Treatment Number
Description

Treatment Number

Data type

text

Alias
UMLS CUI [1]
C1522541
Date of birth
Description

Date of birth

Data type

date

Alias
UMLS CUI [1]
C0421451
Gender
Description

Gender

Data type

text

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

Tracking Document Reason for non participation

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

Subject number

Data type

text

Alias
UMLS CUI [1]
C1709561
Date of birth
Description

Date of birth

Data type

date

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

Please specify below

Data type

integer

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

Specification of non-eligibility

Data type

text

Alias
UMLS CUI [1]
C3166257
Subject not willing due to: adverse events, or serious adverse event: please specify:
Description

Subject not willing due to: adverse events, or serious adverse event: please specify:

Data type

text

Alias
UMLS CUI [1]
C0877248
Subject not willing due to other: please specify:
Description

Subject not willing due to other: please specify:

Data type

text

Subject died on:
Description

Death date

Data type

date

Alias
UMLS CUI [1]
C1148348
Number of SAEs
Description

Number of SAEs

Data type

text

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0237753

Similar models

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

Name
Type
Description | Question | Decode (Coded Value)
Data type
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])
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])
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])
Subject not willing due to: adverse events, or serious adverse event: please specify:
Item
Subject not willing due to: adverse events, or serious adverse event: please specify:
text
C0877248 (UMLS CUI [1])
Subject not willing due to other: please specify:
Item
Subject not willing due to other: please specify:
text
Death date
Item
Subject died on:
date
C1148348 (UMLS CUI [1])
Number of SAEs
Item
Number of SAEs
text
C1519255 (UMLS CUI [1,1])
C0237753 (UMLS CUI [1,2])