Visit 21 Immunogenicity and reactogenicity of GlaxoSmithKline Biologicals' inactivated hepatitis A vaccine 111028

Informed Consent
Descripción

Informed Consent

Alias
UMLS CUI-1
C0021430
UMLS CUI-2
C0170300
Subject Number
Descripción

Subject Number

Tipo de datos

text

Alias
UMLS CUI [1]
C2348585
Center number
Descripción

Center number

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1301943
UMLS CUI [1,2]
C0600091
Date of Visit
Descripción

Date of Visit

Tipo de datos

date

Alias
UMLS CUI [1]
C1320303
Informed Consent Date
Descripción

I certify that Informed Consent has been obtained prior to any study procedure.

Tipo de datos

time

Alias
UMLS CUI [1,1]
C0021430
UMLS CUI [1,2]
C0011008
Demographics
Descripción

Demographics

Alias
UMLS CUI-1
C0011298
UMLS CUI-2
C0170300
Date of birth
Descripción

Date of birth

Tipo de datos

date

Alias
UMLS CUI [1]
C0421451
Gender
Descripción

Gender

Tipo de datos

text

Alias
UMLS CUI [1]
C0079399
Race
Descripción

Race

Tipo de datos

text

Alias
UMLS CUI [1]
C0034510
Race, if other please specify
Descripción

Race

Tipo de datos

text

Alias
UMLS CUI [1]
C0034510
Laboratory Tests
Descripción

Laboratory Tests

Alias
UMLS CUI-1
C0022885
UMLS CUI-2
C0005834
UMLS CUI-3
C0170300
Has a blood sample been taken for serology?
Descripción

blood sample

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0005834
Has the subject received since the last visit: A dose of Hepatitis A immunoglobulins within 6 months prior to bleeding?
Descripción

Hepatitis A immunoglobulins

Tipo de datos

boolean

Alias
UMLS CUI [1]
C3652495
Has the subject received a dose of monovalent or combined Hepatitis A vaccine since the last visit?
Descripción

Hepatitis A vaccine

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0170300
Has the subject received a dose of monovalent or combined Hepatitis A vaccine since the last visit? If Yes, please specify
Descripción

Hepatitis vaccine

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C0170300
UMLS CUI [1,2]
C3543421
Did the subject suffer from Hepatitis A since last visit?
Descripción

Hepatitis A

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0019159

Similar models

Visit 21 Immunogenicity and reactogenicity of GlaxoSmithKline Biologicals' inactivated hepatitis A vaccine 111028

Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
Informed Consent
C0021430 (UMLS CUI-1)
C0170300 (UMLS CUI-2)
Subject Number
Item
Subject Number
text
C2348585 (UMLS CUI [1])
Center number
Item
Center number
text
C1301943 (UMLS CUI [1,1])
C0600091 (UMLS CUI [1,2])
Date of Visit
Item
Date of Visit
date
C1320303 (UMLS CUI [1])
Informed Consent Date
Item
Informed Consent Date
time
C0021430 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Item Group
Demographics
C0011298 (UMLS CUI-1)
C0170300 (UMLS CUI-2)
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
Race
text
C0034510 (UMLS CUI [1])
Code List
Race
CL Item
White (WH)
CL Item
Black (BL)
CL Item
Oriental (OR)
CL Item
Other (OT)
Race
Item
Race, if other please specify
text
C0034510 (UMLS CUI [1])
Item Group
Laboratory Tests
C0022885 (UMLS CUI-1)
C0005834 (UMLS CUI-2)
C0170300 (UMLS CUI-3)
blood sample
Item
Has a blood sample been taken for serology?
boolean
C0005834 (UMLS CUI [1])
Hepatitis A immunoglobulins
Item
Has the subject received since the last visit: A dose of Hepatitis A immunoglobulins within 6 months prior to bleeding?
boolean
C3652495 (UMLS CUI [1])
Hepatitis A vaccine
Item
Has the subject received a dose of monovalent or combined Hepatitis A vaccine since the last visit?
boolean
C0170300 (UMLS CUI [1])
Item
Has the subject received a dose of monovalent or combined Hepatitis A vaccine since the last visit? If Yes, please specify
integer
C0170300 (UMLS CUI [1,1])
C3543421 (UMLS CUI [1,2])
Code List
Has the subject received a dose of monovalent or combined Hepatitis A vaccine since the last visit? If Yes, please specify
CL Item
Hepatitis A vaccine (1)
CL Item
Combined Hepatitis A (or other) vaccine (2)
Hepatitis A
Item
Did the subject suffer from Hepatitis A since last visit?
boolean
C0019159 (UMLS CUI [1])