ID

33243

Descripción

Study ID: 104021 Clinical Study ID: 104021 Study Title: A phase III, partially blind, randomized study to evaluate the immunogenicity, safety and reactogenicity of GlaxoSmithKline (GSK) Biologicals’ Tritanrix™-HepB and GSK Biologicals Kft’s DTPw-HBV vaccines as compared to concomitant administration of Commonwealth Serum Laboratory’s (CSL’s) DTPw (Triple Antigen™) and GSK Biologicals’ HBV (Engerix™-B), when co-administered with GSK Biologicals’ oral live attenuated human rotavirus (HRV) vaccine, to healthy infants at 3, 4½ and 6 months of age, after a birth dose of hepatitis B vaccine. Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00158756 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 3 Study Recruitment Status: Completed Generic Name: Hepatitis B Vaccine, Recombinant Trade Name: Engerix B Study Indication: Hepatitis B

Palabras clave

Versiones (1)
  1. 3/12/18 3/12/18 -
Titular de derechos de autor

GSK group of companies

Subido en

3 de diciembre de 2018

DOI

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Licencia

Creative Commons BY-NC 3.0
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Immunogenicity of co-administration of Tritanrix™-HepB and DTPw-HBV vaccines or Triple Antigen™ and Engerix™-B with HRV vaccine to infants (3, 4½ and 6 month) - 104021

Inglés

Diary Card 3: Local Symptoms (Triple AntigenTM+EngerixTM-B Group)

1 formularios  
Administrative data
Descripción

Administrative data

Subject Number
Descripción

Subject Number

Tipo de datos

integer

Dose
Descripción

Dose

Tipo de datos

text

Local Symptoms (at injection site) Triple AntigenTM Vaccine
Descripción

Local Symptoms (at injection site) Triple AntigenTM Vaccine

Day
Descripción

Day

Tipo de datos

text

1. Redness
Descripción

size; please measure the greatest diameter

Tipo de datos

integer

Unidades de medida
  • mm
mm
Ongoing after Day 7?
Descripción

Ongoing after Day 7?

Tipo de datos

boolean

If yes, record the date of last day of symptoms
Descripción

If yes, record the date of last day of symptoms

Tipo de datos

date

Medically attended visit
Descripción

Medically attended visit

Tipo de datos

boolean

2. Swelling
Descripción

size; please measure the greatest diameter

Tipo de datos

integer

Unidades de medida
  • mm
mm
Ongoing after Day 7?
Descripción

Ongoing after Day 7?

Tipo de datos

boolean

if Yes, record, day of the last day of symptoms
Descripción

if Yes, record, day of the last day of symptoms

Tipo de datos

date

Medically attended visit?
Descripción

Medically attended visit?

Tipo de datos

boolean

3. Pain
Descripción

intensity

Tipo de datos

text

Ongoing after Day 7?
Descripción

Ongoing after Day 7?

Tipo de datos

boolean

If Yes, record date of the last day of symptoms
Descripción

If Yes, record date of the last day of symptoms

Tipo de datos

date

Medically attended visit?
Descripción

Medically attended visit?

Tipo de datos

boolean

for investigator only
Descripción

for investigator only

Side of Injection
Descripción

Side of Injection

Tipo de datos

text

Site of Injection
Descripción

Site of Injection

Tipo de datos

text

Local Symptoms (at injection site) EngerixTM Vaccine
Descripción

Local Symptoms (at injection site) EngerixTM Vaccine

Day
Descripción

Day

Tipo de datos

integer

Redness
Descripción

size; please measure the greatest diameter

Tipo de datos

integer

Unidades de medida
  • mm
mm
Ongoing after Day 7?
Descripción

Ongoing after Day 7?

Tipo de datos

boolean

if Yes, record, day of the last day of symptoms
Descripción

if Yes, record, day of the last day of symptoms

Tipo de datos

date

Medically attended visit?
Descripción

Medically attended visit?

Tipo de datos

boolean

Swelling
Descripción

size; please measure the greatest diameter

Tipo de datos

integer

Unidades de medida
  • mm
mm
Ongoing after Day 7?
Descripción

Ongoing after Day 7?

Tipo de datos

boolean

if Yes, record, day of the last day of symptoms
Descripción

if Yes, record, day of the last day of symptoms

Tipo de datos

date

Medically attended visit?
Descripción

Medically attended visit?

Tipo de datos

boolean

Pain
Descripción

intensity

Tipo de datos

text

Ongoing after Day 7?
Descripción

Ongoing after Day 7?

Tipo de datos

boolean

if Yes, record, day of the last day of symptoms
Descripción

if Yes, record, day of the last day of symptoms

Tipo de datos

text

Medically attended visit?
Descripción

Medically attended visit?

Tipo de datos

boolean

for investigator only
Descripción

for investigator only

Side of Injection
Descripción

Side of Injection

Tipo de datos

text

Site of Injection
Descripción

Site of Injection

Tipo de datos

text

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Similar models

Diary Card 3: Local Symptoms (Triple AntigenTM+EngerixTM-B Group)

1 formularios
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
Administrative data
Subject Number
Item
Subject Number
integer
Item
Dose
text
Dose
Code List
Dose
CL Item
Dose 3 (1)
Item Group
Local Symptoms (at injection site) Triple AntigenTM Vaccine
Item
Day
text
Day
Code List
Day
CL Item
Day 0 (1)
CL Item
Day 1 (2)
CL Item
Day 2 (3)
CL Item
Day 3 (4)
CL Item
Day 4 (5)
CL Item
Day 5 (6)
CL Item
Day 6 (7)
CL Item
Day 7 (8)
1. Redness
Item
1. Redness
integer
Ongoing after Day 7?
Item
Ongoing after Day 7?
boolean
If yes, record the date of last day of symptoms
Item
If yes, record the date of last day of symptoms
date
Medically attended visit
Item
Medically attended visit
boolean
2. Swelling
Item
2. Swelling
integer
Ongoing after Day 7?
Item
Ongoing after Day 7?
boolean
if Yes, record, day of the last day of symptoms
Item
if Yes, record, day of the last day of symptoms
date
Medically attended visit?
Item
Medically attended visit?
boolean
Item
3. Pain
text
3. Pain
Code List
3. Pain
CL Item
Absent (1)
CL Item
Minor reaction to touch (2)
CL Item
Cries/protests to touch (3)
CL Item
Cries when limb is moved/spontaneously painful (4)
Ongoing after Day 7?
Item
Ongoing after Day 7?
boolean
If Yes, record date of the last day of symptoms
Item
If Yes, record date of the last day of symptoms
date
Medically attended visit?
Item
Medically attended visit?
boolean
Item Group
for investigator only
Item
Side of Injection
text
Side
Code List
Side of Injection
CL Item
Left (1)
CL Item
Right (2)
Item
Site of Injection
text
Site of Injection
Code List
Site of Injection
CL Item
Arm (1)
CL Item
Thigh (2)
CL Item
Buttock (3)
Item Group
Local Symptoms (at injection site) EngerixTM Vaccine
Item
Day
integer
Day
Code List
Day
CL Item
Day 0 (1)
CL Item
Day 1 (2)
CL Item
Day 2 (3)
CL Item
Day 3 (4)
CL Item
Day 4 (5)
CL Item
Day 5 (6)
CL Item
Day 6 (7)
CL Item
Day 7 (8)
Redness
Item
Redness
integer
Ongoing after Day 7?
Item
Ongoing after Day 7?
boolean
if Yes, record, day of the last day of symptoms
Item
if Yes, record, day of the last day of symptoms
date
Medically attended visit?
Item
Medically attended visit?
boolean
Swelling
Item
Swelling
integer
Ongoing after Day 7?
Item
Ongoing after Day 7?
boolean
if Yes, record, day of the last day of symptoms
Item
if Yes, record, day of the last day of symptoms
date
Medically attended visit?
Item
Medically attended visit?
boolean
Item
Pain
text
Pain
Code List
Pain
CL Item
Absent (1)
CL Item
Minor reaction to touch (2)
CL Item
Cries/protests to touch (3)
CL Item
Cries when limb is moved/spontaneously painful (4)
Ongoing after Day 7?
Item
Ongoing after Day 7?
boolean
if Yes, record, day of the last day of symptoms
Item
if Yes, record, day of the last day of symptoms
text
Medically attended visit?
Item
Medically attended visit?
boolean
Item Group
for investigator only
Item
Side of Injection
text
Side of Injection
Code List
Side of Injection
CL Item
Left (1)
CL Item
Right (2)
Item
Site of Injection
text
Site of Injection
Code List
Site of Injection
CL Item
Arm (1)
CL Item
Thigh (2)
CL Item
Buttock (3)
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