General medical history/ physical examination, risk factors, vaccination history

Administrative data
Descrição

Administrative data

Alias
UMLS CUI-1
C1320722
Subject number
Descrição

Subject number

Tipo de dados

integer

Alias
UMLS CUI [1]
C2348585
Date of visit
Descrição

Date of visit

Tipo de dados

date

Alias
UMLS CUI [1]
C1320303
Workbook number
Descrição

Workbook number

Tipo de dados

integer

general medical history/ physical examination, MedDRA System Organ Class
Descrição

general medical history/ physical examination, MedDRA System Organ Class

Alias
UMLS CUI-1
C0262926
UMLS CUI-2
C0031809
UMLS CUI-3
C2347091
Are you aware of any pre-existing conditions, signs or symptoms present prior to the start of the study? If yes please give diagnosis and tick appropriate Past/Current box(es).
Descrição

Pre-existing conditions, signs or symptoms

Tipo de dados

boolean

Alias
UMLS CUI [1]
C0521987
UMLS CUI [2,1]
C1457887
UMLS CUI [2,2]
C2347662
MedDRA System Organ Class
Descrição

MedDRA System Organ Class

Tipo de dados

integer

Alias
UMLS CUI [1]
C2347091
Diagnosis
Descrição

Diagnosis

Tipo de dados

text

Alias
UMLS CUI [1]
C0011900
pre-existing conditions, signs or symptoms in past
Descrição

Disease in past

Tipo de dados

boolean

Alias
UMLS CUI [1,1]
C0012634
UMLS CUI [1,2]
C1444637
Current pre-existing conditions, signs or symptoms
Descrição

Current disease

Tipo de dados

boolean

Alias
UMLS CUI [1,1]
C0521116
UMLS CUI [1,2]
C0012634
Risk factors for participation in study
Descrição

Risk factors for participation in study

Alias
UMLS CUI-1
C0035648
Are there any risk factor(s) for Pneumococcal and/or H.influenzae infections?
Descrição

Risk factor(s) for Pneumococcal and/or H.influenzae infections

Tipo de dados

boolean

Alias
UMLS CUI [1,1]
C0035648
UMLS CUI [1,2]
C0032269
UMLS CUI [2,1]
C0035648
UMLS CUI [2,2]
C0018483
UMLS CUI [2,3]
C0009450
Risk factor: Agammaglobulinemia
Descrição

Risk factor: Agammaglobulinemia

Tipo de dados

boolean

Alias
UMLS CUI [1,1]
C0035648
UMLS CUI [1,2]
C0001768
Risk factor: HIV infection
Descrição

Risk factor: HIV infection

Tipo de dados

boolean

Alias
UMLS CUI [1,1]
C0035648
UMLS CUI [1,2]
C0019693
Risk factor: Sickle cell disease
Descrição

Risk factor: Sickle cell disease

Tipo de dados

boolean

Alias
UMLS CUI [1,1]
C0035648
UMLS CUI [1,2]
C0002895
Risk factor: Surgical asplenia
Descrição

Risk factor: splenectomy

Tipo de dados

boolean

Alias
UMLS CUI [1,1]
C0035648
UMLS CUI [1,2]
C0037995
Risk factor: Nephrotic syndrome
Descrição

Risk factor: Nephrotic syndrome

Tipo de dados

boolean

Alias
UMLS CUI [1,1]
C0035648
UMLS CUI [1,2]
C0027726
Risk factor: Chronic renal failure
Descrição

Risk factor: Chronic renal failure

Tipo de dados

boolean

Alias
UMLS CUI [1,1]
C0035648
UMLS CUI [1,2]
C0035078
UMLS CUI [1,3]
C0205191
Risk factor: Organ transplantation
Descrição

Risk factor: Organ transplantation

Tipo de dados

boolean

Alias
UMLS CUI [1,1]
C0035648
UMLS CUI [1,2]
C0029216
Risk factor: Diabetes mellitus
Descrição

Risk factor: Diabetes mellitus

Tipo de dados

boolean

Alias
UMLS CUI [1,1]
C0035648
UMLS CUI [1,2]
C0011849
Risk factor: Congestive heart failure
Descrição

Risk factor: Congestive heart failure

Tipo de dados

boolean

Alias
UMLS CUI [1,1]
C0035648
UMLS CUI [1,2]
C0018802
Risk factor: CSF leaks
Descrição

Risk factor: CSF leaks

Tipo de dados

boolean

Alias
UMLS CUI [1,1]
C0035648
UMLS CUI [1,2]
C0007806
UMLS CUI [1,3]
C0919691
Other risk factors
Descrição

Other risk factors

Tipo de dados

boolean

Alias
UMLS CUI [1,1]
C0035648
UMLS CUI [1,2]
C0205394
Sepcify the other risk factor
Descrição

Sepcify other risk factor

Tipo de dados

text

Alias
UMLS CUI [1,1]
C0035648
UMLS CUI [1,2]
C0205394
Does the child receive breast-feeding?
Descrição

Breast-feeding

Tipo de dados

boolean

Alias
UMLS CUI [1]
C0006147
Household number of less than 5 years old siblings?
Descrição

Household number of less than 5 years old siblings

Tipo de dados

integer

Alias
UMLS CUI [1,1]
C0020052
UMLS CUI [1,2]
C0449788
UMLS CUI [1,3]
C0037047
UMLS CUI [1,4]
C0001779
Vaccination history
Descrição

Vaccination history

Alias
UMLS CUI-1
C0042196
UMLS CUI-2
C0019664
Has the subject received any vaccination since birth? if yes please complete the following table
Descrição

Any vaccination since birth

Tipo de dados

integer

Alias
UMLS CUI [1,1]
C0042196
UMLS CUI [1,2]
C1711239
UMLS CUI [1,3]
C0005615
Trade / Generic Name of vaccines
Descrição

Trade / Generic Name

Tipo de dados

text

Alias
UMLS CUI [1,1]
C2360065
UMLS CUI [1,2]
C0042210
Route of vaccines
Descrição

Route of vaccines

Tipo de dados

text

Alias
UMLS CUI [1,1]
C0013153
UMLS CUI [1,2]
C0042210
Dose Number of vaccine
Descrição

Dose Number of vaccine

Tipo de dados

integer

Alias
UMLS CUI [1,1]
C1115464
UMLS CUI [1,2]
C0042210
Estimated date of vaccine.
Descrição

Enter approximate date in case the exact date is unknown. Reminder: Any vaccine should be administered at least 30 days before the date of study vaccine administration

Tipo de dados

partialDate

Alias
UMLS CUI [1,1]
C2368628
UMLS CUI [1,2]
C0011008

Similar models

General medical history/ physical examination, risk factors, vaccination history

Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de dados
Alias
Item Group
Administrative data
C1320722 (UMLS CUI-1)
Subject number
Item
Subject number
integer
C2348585 (UMLS CUI [1])
Date of visit
Item
Date of visit
date
C1320303 (UMLS CUI [1])
Item
Workbook number
integer
Code List
Workbook number
CL Item
Workbook 1 2=Workbook 2 3=Workbook 3 (1)
Item Group
general medical history/ physical examination, MedDRA System Organ Class
C0262926 (UMLS CUI-1)
C0031809 (UMLS CUI-2)
C2347091 (UMLS CUI-3)
Pre-existing conditions, signs or symptoms
Item
Are you aware of any pre-existing conditions, signs or symptoms present prior to the start of the study? If yes please give diagnosis and tick appropriate Past/Current box(es).
boolean
C0521987 (UMLS CUI [1])
C1457887 (UMLS CUI [2,1])
C2347662 (UMLS CUI [2,2])
Item
MedDRA System Organ Class
integer
C2347091 (UMLS CUI [1])
Code List
MedDRA System Organ Class
CL Item
Skin and subcutaneous tissue (1)
CL Item
Musculoskeletal and connective tissue (2)
CL Item
Cardiac  (3)
CL Item
Vascular (4)
CL Item
Respiratory, thoracic and mediastinal (5)
CL Item
Gastrointestinal (6)
CL Item
Hepatobiliary (7)
CL Item
Renal and urinary (8)
CL Item
Nervous system (9)
CL Item
Eye (10)
CL Item
Ear and labyrinth (11)
CL Item
Endocrine (12)
CL Item
Metabolism and nutrition (13)
CL Item
Blood and lymphatic system (14)
CL Item
Immune system (incl allergies, autoimmune disorders) (15)
CL Item
Infections and infestations  (16)
CL Item
Neoplasms benign, malignant and unspecified (incl cysts, polyps) (17)
CL Item
Surgical and medical procedures (18)
CL Item
Other (19)
Diagnosis
Item
Diagnosis
text
C0011900 (UMLS CUI [1])
Disease in past
Item
pre-existing conditions, signs or symptoms in past
boolean
C0012634 (UMLS CUI [1,1])
C1444637 (UMLS CUI [1,2])
Current disease
Item
Current pre-existing conditions, signs or symptoms
boolean
C0521116 (UMLS CUI [1,1])
C0012634 (UMLS CUI [1,2])
Item Group
Risk factors for participation in study
C0035648 (UMLS CUI-1)
Risk factor(s) for Pneumococcal and/or H.influenzae infections
Item
Are there any risk factor(s) for Pneumococcal and/or H.influenzae infections?
boolean
C0035648 (UMLS CUI [1,1])
C0032269 (UMLS CUI [1,2])
C0035648 (UMLS CUI [2,1])
C0018483 (UMLS CUI [2,2])
C0009450 (UMLS CUI [2,3])
Risk factor: Agammaglobulinemia
Item
Risk factor: Agammaglobulinemia
boolean
C0035648 (UMLS CUI [1,1])
C0001768 (UMLS CUI [1,2])
Risk factor: HIV infection
Item
Risk factor: HIV infection
boolean
C0035648 (UMLS CUI [1,1])
C0019693 (UMLS CUI [1,2])
Risk factor: Sickle cell disease
Item
Risk factor: Sickle cell disease
boolean
C0035648 (UMLS CUI [1,1])
C0002895 (UMLS CUI [1,2])
Risk factor: splenectomy
Item
Risk factor: Surgical asplenia
boolean
C0035648 (UMLS CUI [1,1])
C0037995 (UMLS CUI [1,2])
Risk factor: Nephrotic syndrome
Item
Risk factor: Nephrotic syndrome
boolean
C0035648 (UMLS CUI [1,1])
C0027726 (UMLS CUI [1,2])
Risk factor: Chronic renal failure
Item
Risk factor: Chronic renal failure
boolean
C0035648 (UMLS CUI [1,1])
C0035078 (UMLS CUI [1,2])
C0205191 (UMLS CUI [1,3])
Risk factor: Organ transplantation
Item
Risk factor: Organ transplantation
boolean
C0035648 (UMLS CUI [1,1])
C0029216 (UMLS CUI [1,2])
Risk factor: Diabetes mellitus
Item
Risk factor: Diabetes mellitus
boolean
C0035648 (UMLS CUI [1,1])
C0011849 (UMLS CUI [1,2])
Risk factor: Congestive heart failure
Item
Risk factor: Congestive heart failure
boolean
C0035648 (UMLS CUI [1,1])
C0018802 (UMLS CUI [1,2])
Risk factor: CSF leaks
Item
Risk factor: CSF leaks
boolean
C0035648 (UMLS CUI [1,1])
C0007806 (UMLS CUI [1,2])
C0919691 (UMLS CUI [1,3])
Other risk factors
Item
Other risk factors
boolean
C0035648 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
Sepcify other risk factor
Item
Sepcify the other risk factor
text
C0035648 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
Breast-feeding
Item
Does the child receive breast-feeding?
boolean
C0006147 (UMLS CUI [1])
Household number of less than 5 years old siblings
Item
Household number of less than 5 years old siblings?
integer
C0020052 (UMLS CUI [1,1])
C0449788 (UMLS CUI [1,2])
C0037047 (UMLS CUI [1,3])
C0001779 (UMLS CUI [1,4])
Item Group
Vaccination history
C0042196 (UMLS CUI-1)
C0019664 (UMLS CUI-2)
Item
Has the subject received any vaccination since birth? if yes please complete the following table
integer
C0042196 (UMLS CUI [1,1])
C1711239 (UMLS CUI [1,2])
C0005615 (UMLS CUI [1,3])
Code List
Has the subject received any vaccination since birth? if yes please complete the following table
CL Item
No (1)
CL Item
Unknown (2)
CL Item
Yes (3)
Trade / Generic Name
Item
Trade / Generic Name of vaccines
text
C2360065 (UMLS CUI [1,1])
C0042210 (UMLS CUI [1,2])
Route of vaccines
Item
Route of vaccines
text
C0013153 (UMLS CUI [1,1])
C0042210 (UMLS CUI [1,2])
Dose Number of vaccine
Item
Dose Number of vaccine
integer
C1115464 (UMLS CUI [1,1])
C0042210 (UMLS CUI [1,2])
Estimated date of vaccine
Item
Estimated date of vaccine.
partialDate
C2368628 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])