Diary Card: Rash/Exanthem + Parotid/Salivary gland swelling + Febrile Convulsions

Administrative data
Descrição

Administrative data

Dose Number
Descrição

Dose Number

Tipo de dados

text

Subject Number
Descrição

Subject Number

Tipo de dados

integer

Please do not forget to bring back the diary card on
Descrição

fill the date below

Tipo de dados

date

In case rash/exanthem or Parotid/Salivary gland swelling or Febrile convulsions (suspected signs of meningism) is observed, bring the child to visit the investigators for clinical examination.
Descrição

If rash occurs, please also record the event below

Tipo de dados

text

Rash Episode
Descrição

Rash Episode

Rash Episode Number
Descrição

Rash Episode Number

Tipo de dados

integer

Description
Descrição

Description

Tipo de dados

text

Vaccination site
Descrição

Vaccination site

Tipo de dados

text

Date Started
Descrição

Date Started

Tipo de dados

date

Date Stopped
Descrição

Date Stopped

Tipo de dados

date

Intensity
Descrição

Intensity

Tipo de dados

text

Temperature
Descrição

Temperature

Tipo de dados

text

Similar models

Diary Card: Rash/Exanthem + Parotid/Salivary gland swelling + Febrile Convulsions

Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de dados
Alias
Item Group
Administrative data
Item
Dose Number
text
Code List
Dose Number
CL Item
Dose 1 (1)
Subject Number
Item
Subject Number
integer
Please do not forget to bring back the diary card on
Item
Please do not forget to bring back the diary card on
date
In case rash/exanthem or Parotid/Salivary gland swelling or Febrile convulsions (suspected signs of meningism) is observed, bring the child to visit the investigators for clinical examination.
Item
In case rash/exanthem or Parotid/Salivary gland swelling or Febrile convulsions (suspected signs of meningism) is observed, bring the child to visit the investigators for clinical examination.
text
Item Group
Rash Episode
Item
Rash Episode Number
integer
Code List
Rash Episode Number
CL Item
RA 1 (1)
CL Item
RA 2 (2)
CL Item
RA 3 (3)
Description
Item
Description
text
Item
Vaccination site
text
Code List
Vaccination site
CL Item
Left arm (1)
CL Item
Right arm (2)
CL Item
Non-administration site (3)
Date Started
Item
Date Started
date
Date Stopped
Item
Date Stopped
date
Item
Intensity
text
Code List
Intensity
CL Item
1-50 lesions (1)
CL Item
51-150 lesions (2)
CL Item
>150 lesions (3)
Item
Temperature
text
Code List
Temperature
CL Item
Please complete the Temperature diary card (1)