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ID

33080

Beschrijving

Study ID: 104020 Clinical Study ID: 104020 Study Title: Blinded, randomised study to assess the immunogenicity and safety of GlaxoSmithKline (GSK) Biologicals’ live attenuated measles-mumps-rubella-varicella candidate vaccine when given to healthy children in their second year of life Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00126997 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 4 Study Recruitment Status: Completed Generic Name: Combined Measles, Mumps, Rubella, Varicella Vaccine Trade Name: Priorix Tetra Study Indication: Measles; Mumps; Rubella; Varicella

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Versies (1)
  1. 26-11-18 26-11-18 -
Houder van rechten

GSK group of companies

Geüploaded op

26 november 2018

DOI

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Licentie

Creative Commons BY-NC 3.0
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    Immunogenicity of Combined Measles, Mumps, Rubella, Varicella Vaccine for healthy 2 y.o children - 104020

    Engels

    Concomitant Medication Form

    1 Formulieren  
    Administrative data
    Beschrijving

    Administrative data

    Subject Number
    Beschrijving

    Subject Number

    Datatype

    integer

    Concomitant Medication
    Beschrijving

    Concomitant Medication

    Have any medications/treatments been administered during study period?
    Beschrijving

    Have any medications/treatments been administered during study period?

    Datatype

    boolean

    If Yes, please complete the following table
    Beschrijving

    If Yes, please complete the following table

    Datatype

    text

    List of Medications
    Beschrijving

    List of Medications

    Trade/Generic Name
    Beschrijving

    Trade/Generic Name

    Datatype

    text

    Medical Indication
    Beschrijving

    Medical Indication

    Datatype

    text

    Total daily dose
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    Total daily dose

    Datatype

    text

    Route
    Beschrijving

    Route

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    text

    Start date
    Beschrijving

    Start date

    Datatype

    date

    End date
    Beschrijving

    End date

    Datatype

    date

    Ongoing at the end of study?
    Beschrijving

    Ongoing at the end of study?

    Datatype

    boolean

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    Concomitant Medication Form

    1 Formulieren
    Name
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    Description | Question | Decode (Coded Value)
    Datatype
    Alias
    Item Group
    Administrative data
    Subject Number
    Item
    Subject Number
    integer
    Item Group
    Concomitant Medication
    Have any medications/treatments been administered during study period?
    Item
    Have any medications/treatments been administered during study period?
    boolean
    If Yes, please complete the following table
    Item
    If Yes, please complete the following table
    text
    Item Group
    List of Medications
    Trade/Generic Name
    Item
    Trade/Generic Name
    text
    Item
    Medical Indication
    text
    Medical Indication
    Code List
    Medical Indication
    CL Item
    Prophylactic (1)
    Total daily dose
    Item
    Total daily dose
    text
    Route
    Item
    Route
    text
    Start date
    Item
    Start date
    date
    End date
    Item
    End date
    date
    Ongoing at the end of study?
    Item
    Ongoing at the end of study?
    boolean
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