ID

29000

Description

A phase IV, open, multicentre study to assess the immunogenicity and reactogenicity of GlaxoSmithKline Biologicals’ DTPa-HBV-IPV/Hib vaccine (Infanrix hexa) given as a booster at 18-24 months of age to pre-term children who have received a three-dose primary immunization course with the same vaccine in study 217744/090.

Mots-clés

  1. 20/02/2018 20/02/2018 -
Détendeur de droits

GlaxoSmithKline (GSK)

Téléchargé le

20 février 2018

DOI

Pour une demande vous connecter.

Licence

Creative Commons BY-NC 3.0

Modèle Commentaires :

Ici, vous pouvez faire des commentaires sur le modèle. À partir des bulles de texte, vous pouvez laisser des commentaires spécifiques sur les groupes Item et les Item.

Groupe Item commentaires pour :

Item commentaires pour :

Vous devez être connecté pour pouvoir télécharger des formulaires. Veuillez vous connecter ou s’inscrire gratuitement.

Biologicals’ DTPa-HBV-IPV/Hib vaccine (Infanrix-hexa) Study ID: 101518

Study conclusion

  1. StudyEvent: ODM
    1. Study conclusion
Study conclusion
Description

Study conclusion

Alias
UMLS CUI-1
C1707478
UMLS CUI-2
C0008972
Did the subject experience any Serious Adverse Event during the study period ?
Description

Occurrence of serious adverse events

Type de données

integer

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C2745955
Did any elimination criteria become applicable during the study ?
Description

Elimination criteria

Type de données

integer

Alias
UMLS CUI [1]
C0680251
Was the subject withdrawn from study ?
Description

study subject withdrawal

Type de données

boolean

Alias
UMLS CUI [1]
C2348568
UMLS CUI [2]
C0422727
Please tick the ONE most appropriate category for withdrawal.
Description

If you answered the previous question with yes, please specify:

Type de données

text

Alias
UMLS CUI [1]
C2348568
UMLS CUI [2]
C0422727
Please tick who took decision:
Description

Decision holder

Type de données

text

Alias
UMLS CUI [1,1]
C0422727
UMLS CUI [1,2]
C0679006
Date of last contact
Description

Date of last contact

Type de données

date

Alias
UMLS CUI [1]
C0805839
Was the subject in good condition at date of last contact?
Description

study subject condition at last contact

Type de données

text

Alias
UMLS CUI [1,1]
C1142435
UMLS CUI [1,2]
C0681850
Investigators signature date
Description

Investigators signature date

Type de données

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C2346576
Investigators signature
Description

Investigators signature

Type de données

text

Alias
UMLS CUI [1]
C2346576

Similar models

Study conclusion

  1. StudyEvent: ODM
    1. Study conclusion
Name
Type
Description | Question | Decode (Coded Value)
Type de données
Alias
Item Group
C1707478 (UMLS CUI-1)
C0008972 (UMLS CUI-2)
Item
Did the subject experience any Serious Adverse Event during the study period ?
integer
C1519255 (UMLS CUI [1,1])
C2745955 (UMLS CUI [1,2])
Code List
Did the subject experience any Serious Adverse Event during the study period ?
CL Item
No  (1)
CL Item
Yes, Specify total number of SAE's: |__|__| (2)
Item
Did any elimination criteria become applicable during the study ?
integer
C0680251 (UMLS CUI [1])
Code List
Did any elimination criteria become applicable during the study ?
CL Item
No (1)
CL Item
Yes, Specify: __________________________________________________ (2)
study subject withdrawal
Item
Was the subject withdrawn from study ?
boolean
C2348568 (UMLS CUI [1])
C0422727 (UMLS CUI [2])
Item
Please tick the ONE most appropriate category for withdrawal.
text
C2348568 (UMLS CUI [1])
C0422727 (UMLS CUI [2])
Code List
Please tick the ONE most appropriate category for withdrawal.
CL Item
Serious adverse event(complete the Serious Adverse Event form) Please specify SAE N°: |__|__| ((SAE))
CL Item
Non-Serious adverse event (complete the Non-serious Adverse Event section) ((AEX))
CL Item
Protocol violation, please specify:_________________________________________  ((PTV))
CL Item
Consent withdrawal, not due to an adverse event. ((CWS))
CL Item
Migrated / moved from the study area ((MIG))
CL Item
Lost to follow-up. ((LFU))
CL Item
Other, please specify: ____________________________________________ ((OTH))
CL Item
Please specify unsolicited AE N° (Unsol.): |__|__| or solicited AE code :|__|__| (Please specify unsolicited AE N° (Unsol.): |__|__| or solicited AE code :|__|__|)
Item
Please tick who took decision:
text
C0422727 (UMLS CUI [1,1])
C0679006 (UMLS CUI [1,2])
Code List
Please tick who took decision:
CL Item
Investigator  ([I])
CL Item
Parents/Guardians ([P])
Date of last contact
Item
Date of last contact
date
C0805839 (UMLS CUI [1])
Item
Was the subject in good condition at date of last contact?
text
C1142435 (UMLS CUI [1,1])
C0681850 (UMLS CUI [1,2])
Code List
Was the subject in good condition at date of last contact?
CL Item
No, please give details within the Adverse Events section. (1)
CL Item
Yes (2)
Investigators signature date
Item
Investigators signature date
date
C0011008 (UMLS CUI [1,1])
C2346576 (UMLS CUI [1,2])
Investigators signature
Item
Investigators signature
text
C2346576 (UMLS CUI [1])

Utilisez ce formulaire pour les retours, les questions et les améliorations suggérées.

Les champs marqués d’un * sont obligatoires.

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial