Febrile Convulsions AE Form

Administrative data
Descripción

Administrative data

Subject Number
Descripción

Subject Number

Tipo de datos

integer

Febrile Convulsions - Suspected Signs of Meningitis
Descripción

Febrile Convulsions - Suspected Signs of Meningitis

Event Number
Descripción

Please report any febrile convulsion and any suspected signs of meningitis occurring during the study period

Tipo de datos

integer

Description
Descripción

Description

Tipo de datos

text

Further Details (For GSK)
Descripción

Further Details (For GSK)

Event Number
Descripción

Event Number

Tipo de datos

text

Date started
Descripción

Date started

Tipo de datos

date

Date stopped
Descripción

Date stopped

Tipo de datos

date

Intensity
Descripción

Intensity

Tipo de datos

text

Was a neurological examination performed?
Descripción

Was a neurological examination performed?

Tipo de datos

boolean

If Yes, was a lumbar puncture performed?
Descripción

If Yes, was a lumbar puncture performed?

Tipo de datos

boolean

If Yes, date of exam
Descripción

If Yes, date of exam

Tipo de datos

date

Relationship to investigational products
Descripción

Relationship to investigational products

Tipo de datos

boolean

Outcome
Descripción

Outcome

Tipo de datos

text

Similar models

Febrile Convulsions AE Form

Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
Administrative data
Subject Number
Item
Subject Number
integer
Item Group
Febrile Convulsions - Suspected Signs of Meningitis
Item
Event Number
integer
Code List
Event Number
CL Item
FC. 1 (1)
CL Item
FC. 2 (2)
Description
Item
Description
text
Item Group
Further Details (For GSK)
Item
Event Number
text
Code List
Event Number
CL Item
FC. 1 (1)
CL Item
FC. 2 (2)
Date started
Item
Date started
date
Date stopped
Item
Date stopped
date
Item
Intensity
text
Code List
Intensity
CL Item
Mild (1)
CL Item
Moderate (2)
CL Item
Severe (3)
Was a neurological examination performed?
Item
Was a neurological examination performed?
boolean
If Yes, was a lumbar puncture performed?
Item
If Yes, was a lumbar puncture performed?
boolean
If Yes, date of exam
Item
If Yes, date of exam
date
Relationship to investigational products
Item
Relationship to investigational products
boolean
Item
Outcome
text
Code List
Outcome
CL Item
Recovered/resolved (1)
CL Item
Recovering/resolving (2)
CL Item
Not recovered/not resolved (3)
CL Item
Recovered with sequelae/resolved with sequelae (4)