1. StudyEvent: ODM
    1. ODM-Form
General
Beskrivning

General

Alias
UMLS CUI-1
C0205246
Date of Visit
Beskrivning

Date of Visit

Datatyp

integer

Alias
UMLS CUI [1]
C1320303
Subject number
Beskrivning

Subject number

Datatyp

integer

Alias
UMLS CUI [1]
C2348585
PREVIOUS STUDY
Beskrivning

PREVIOUS STUDY

Datatyp

text

Alias
UMLS CUI [1,1]
C2348568
UMLS CUI [1,2]
C0205156
DEMOGRAPHICS
Beskrivning

DEMOGRAPHICS

Alias
UMLS CUI-1
C1704791
Center number
Beskrivning

Center number

Datatyp

integer

Alias
UMLS CUI [1,1]
C1301943
UMLS CUI [1,2]
C0600091
Date of Birth
Beskrivning

Date of Birth

Datatyp

date

Alias
UMLS CUI [1]
C0421451
Gender
Beskrivning

Gender

Datatyp

text

Alias
UMLS CUI [1]
C0079399
Has the subject had any serious adverse event between end of visit 3 and inter-visit contact 2?
Beskrivning

Has the subject had any serious adverse event between end of visit 3 and inter-visit contact 2?

Datatyp

boolean

Alias
UMLS CUI [1]
C1519255
Serious Adverse Events: Specify number of SAEs:
Beskrivning

Serious Adverse Events

Datatyp

integer

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0449788
Serious Adverse Events: Check SAE forms have been submitted to GSK Biologicals
Beskrivning

Serious Adverse Events

Datatyp

boolean

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0449788
RANDOMISATION / TREATMENT ALLOCATION
Beskrivning

RANDOMISATION / TREATMENT ALLOCATION

Alias
UMLS CUI-1
C0034656
Record treatment number
Beskrivning

Record treatment number

Datatyp

text

Alias
UMLS CUI [1,1]
C1522541
UMLS CUI [1,2]
C0600091
INCENTIVE CONCOMITANT VACCINATION
Beskrivning

INCENTIVE CONCOMITANT VACCINATION

Alias
UMLS CUI-1
C0042196
UMLS CUI-2
C2347852
Has the Flu incentive vaccine been administered ?
Beskrivning

Flu incentive vaccine

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0042200
UMLS CUI [1,2]
C1533734
flu vaccination date
Beskrivning

flu vaccination date

Datatyp

date

Alias
UMLS CUI [1,1]
C0042200
UMLS CUI [1,2]
C1533734
UMLS CUI [1,3]
C0011008

Similar models

ODM-Form

  1. StudyEvent: ODM
    1. ODM-Form
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
General
C0205246 (UMLS CUI-1)
Date of Visit
Item
Date of Visit
integer
C1320303 (UMLS CUI [1])
Subject number
Item
Subject number
integer
C2348585 (UMLS CUI [1])
Item
PREVIOUS STUDY
text
C2348568 (UMLS CUI [1,1])
C0205156 (UMLS CUI [1,2])
Code List
PREVIOUS STUDY
CL Item
HIB-MENAC-TT-020 (105239 (DTPw-HBV)
CL Item
BST:011 (24-30 M Mencev)) (BST:011 (24-30 M Mencev)))
Item Group
DEMOGRAPHICS
C1704791 (UMLS CUI-1)
Center number
Item
Center number
integer
C1301943 (UMLS CUI [1,1])
C0600091 (UMLS CUI [1,2])
Date of Birth
Item
Date of Birth
date
C0421451 (UMLS CUI [1])
Item
Gender
text
C0079399 (UMLS CUI [1])
Code List
Gender
CL Item
Female (F)
CL Item
Male (M)
Has the subject had any serious adverse event between end of visit 3 and inter-visit contact 2?
Item
Has the subject had any serious adverse event between end of visit 3 and inter-visit contact 2?
boolean
C1519255 (UMLS CUI [1])
Serious Adverse Events
Item
Serious Adverse Events: Specify number of SAEs:
integer
C1519255 (UMLS CUI [1,1])
C0449788 (UMLS CUI [1,2])
Serious Adverse Events
Item
Serious Adverse Events: Check SAE forms have been submitted to GSK Biologicals
boolean
C1519255 (UMLS CUI [1,1])
C0449788 (UMLS CUI [1,2])
Item Group
RANDOMISATION / TREATMENT ALLOCATION
C0034656 (UMLS CUI-1)
Record treatment number
Item
Record treatment number
text
C1522541 (UMLS CUI [1,1])
C0600091 (UMLS CUI [1,2])
Item Group
INCENTIVE CONCOMITANT VACCINATION
C0042196 (UMLS CUI-1)
C2347852 (UMLS CUI-2)
Flu incentive vaccine
Item
Has the Flu incentive vaccine been administered ?
boolean
C0042200 (UMLS CUI [1,1])
C1533734 (UMLS CUI [1,2])
flu vaccination date
Item
flu vaccination date
date
C0042200 (UMLS CUI [1,1])
C1533734 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])