Engelsk

Protocol required concomitant vaccination, convulsion episode

1 Formulär  
Administrative data
Beskrivning

Administrative data

Alias
UMLS CUI-1
C1320722
Subject number
Beskrivning

Subject number

Datatyp

text

Alias
UMLS CUI [1]
C2348585
Visit number
Beskrivning

Visit number

Datatyp

integer

Alias
UMLS CUI [1]
C1549755
Date of Visit
Beskrivning

Date of Visit

Datatyp

date

Alias
UMLS CUI [1]
C1320303
Workbook number
Beskrivning

Workbook number

Datatyp

integer

Alias
UMLS CUI [1]
C2986015
PROTOCOL REQUIRED CONCOMITANT VACCINATION
Beskrivning

PROTOCOL REQUIRED CONCOMITANT VACCINATION

Alias
UMLS CUI-1
C2347852
UMLS CUI-2
C0042196
UMLS CUI-3
C1708545
Have the following protocol required concomitant vaccines been administered?
Beskrivning

If Yes is ticked, the applicable vaccine is not to be reported again in the Concomitant Vaccination section at the end of the CRF. Any other vaccines administered during the study period are to be recorded in the Concomitant Vaccination section at the end of the CRF. Reminder: Any vaccine should be administered at least 30 days before the date of study vaccine administration.

Datatyp

boolean

Alias
UMLS CUI [1,1]
C2347852
UMLS CUI [1,2]
C0042196
UMLS CUI [1,3]
C1708545
UMLS CUI [1,4]
C2368628
Vaccines
Beskrivning

In visit 8 only HAV vaccine

Datatyp

integer

Alias
UMLS CUI [1]
C0042210
Date if different from visit date
Beskrivning

Vaccine administration, Date

Datatyp

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C2368628
CONVULSION EPISODE
Beskrivning

CONVULSION EPISODE

Alias
UMLS CUI-1
C0332189
UMLS CUI-2
C4048158
Has the subject experienced any CONVULSION EPISODE occurring within 30 days after booster vaccination?
Beskrivning

If yes please complete the CONVULSION EPISODE section

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0332189
UMLS CUI [1,2]
C4048158
UMLS CUI [1,3]
C0332282
UMLS CUI [1,4]
C0042196
UMLS CUI [1,5]
C3259236
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Similar models

Protocol required concomitant vaccination, convulsion episode

1 Formulär
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Administrative data
C1320722 (UMLS CUI-1)
Subject number
Item
Subject number
text
C2348585 (UMLS CUI [1])
Item
Visit number
integer
C1549755 (UMLS CUI [1])
Visit number
Code List
Visit number
CL Item
Visit 2 (2)
CL Item
Visit 3 (3)
CL Item
Visit 4 (4)
CL Item
Visit 5 (5)
CL Item
Visit 6 (6)
CL Item
Visit 7 (7)
CL Item
Visit 8 (8)
CL Item
Visit 9 (9)
Date of Visit
Item
Date of Visit
date
C1320303 (UMLS CUI [1])
Item
Workbook number
integer
C2986015 (UMLS CUI [1])
Workbook number
Code List
Workbook number
CL Item
workbook 1 (1)
CL Item
workbook 2 (2)
CL Item
workbook 3 (3)
Item Group
PROTOCOL REQUIRED CONCOMITANT VACCINATION
C2347852 (UMLS CUI-1)
C0042196 (UMLS CUI-2)
C1708545 (UMLS CUI-3)
Administration of protocol required concomitant vaccines
Item
Have the following protocol required concomitant vaccines been administered?
boolean
C2347852 (UMLS CUI [1,1])
C0042196 (UMLS CUI [1,2])
C1708545 (UMLS CUI [1,3])
C2368628 (UMLS CUI [1,4])
Item
Vaccines
integer
C0042210 (UMLS CUI [1])
Vaccines
Code List
Vaccines
CL Item
HAV vaccine (1)
CL Item
MMR vaccine (2)
CL Item
Meningococcal C conjugated vaccine (3)
Vaccine administration, Date
Item
Date if different from visit date
date
C0011008 (UMLS CUI [1,1])
C2368628 (UMLS CUI [1,2])
Item Group
CONVULSION EPISODE
C0332189 (UMLS CUI-1)
C4048158 (UMLS CUI-2)
Convulsion episode following booster vaccination
Item
Has the subject experienced any CONVULSION EPISODE occurring within 30 days after booster vaccination?
boolean
C0332189 (UMLS CUI [1,1])
C4048158 (UMLS CUI [1,2])
C0332282 (UMLS CUI [1,3])
C0042196 (UMLS CUI [1,4])
C3259236 (UMLS CUI [1,5])
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