ID

33348

Beschrijving

Study ID: 104065 Clinical Study ID: 104065 Study Title: Immune memory of GSK's DTPw-HBV/Hib vaccine by giving Plain PRP polysaccharide at 10 mths. Immuno & reacto of a booster dose of DTPw-HBV/Hib or DTPw-HBV or DTPw-HBV+Hib at 15-18 mths in infants previously primed with DTPw-HBV/Hib Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00169442  Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 3 Study Recruitment Status: Completet Generic Name: Combined Diphtheria, Tetanus, Whole Cell Pertussis, Hepatitis B, Haemophilus influenzae Type b Vaccine (KFT) Trade Name: Zilbrix/Hib Study Indication: Diphtheria; Haemophilus influenzae type b; Hepatitis B; Tetanus; Whole Cell Pertussis

Trefwoorden

  1. 06-12-18 06-12-18 -
Houder van rechten

GSK group of companies

Geüploaded op

6 december 2018

DOI

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Licentie

Creative Commons BY-NC 3.0

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Immune memory of Combined Diphtheria, Tetanus, Whole Cell Pertussis, Hepatitis B, Haemophilus influenzae Type b Vaccine at infants (15 to 18 mths) - 104065

Large Swelling Reaction

Administrative data
Beschrijving

Administrative data

Subject Number
Beschrijving

Subject Number

Datatype

integer

Protocol Number
Beschrijving

Protocol Number

Datatype

integer

Date of Birth
Beschrijving

Date of Birth

Datatype

date

Vaccine - possible cause of swelling reaction
Beschrijving

Vaccine - possible cause of swelling reaction

Datatype

text

Report of Physical Examination
Beschrijving

Report of Physical Examination

Date of physical examination
Beschrijving

Please complete this section for: any local swelling with diameter >50mm, any noticeable diffuse injection site swelling (diameter not measurable), any noticeable increased circumference of the injected limb.

Datatype

date

Was the examination performed by a member of study personnel during the large swelling reaction period?
Beschrijving

Was the examination performed by a member of study personnel during the large swelling reaction period?

Datatype

boolean

Date when the swelling was first considered to be a large swelling reaction
Beschrijving

Date when the swelling was first considered to be a large swelling reaction

Datatype

date

If occurring within 24 hrs after vaccination, please specify how long after vaccination
Beschrijving

If occurring within 24 hrs after vaccination, please specify how long after vaccination

Datatype

integer

Maateenheden
  • hrs
hrs
Size of swelling
Beschrijving

measurement of the greatest diameter

Datatype

integer

Maateenheden
  • mm
mm
Type of swelling
Beschrijving

please specify in section "clinical case description"

Datatype

text

Circumference of swollen limb (at the site of maximum swelling)
Beschrijving

Circumference of swollen limb (at the site of maximum swelling)

Datatype

integer

Maateenheden
  • mm
mm
Circumference of the opposite limb (at the same level)
Beschrijving

Circumference of the opposite limb (at the same level)

Datatype

integer

Maateenheden
  • mm
mm
Associated signs
Beschrijving

Associated signs

Temperature
Beschrijving

Please report t°; if the t° has been taken more than once a day, please report the highest value.

Datatype

integer

Maateenheden
  • °C
°C
Route
Beschrijving

Route

Datatype

text

Redness
Beschrijving

Redness

Datatype

boolean

Redness - largest diameter
Beschrijving

Redness - largest diameter

Datatype

integer

Maateenheden
  • mm
mm
Induration
Beschrijving

Induration

Datatype

boolean

Induration - largest diameter
Beschrijving

Induration - largest diameter

Datatype

integer

Maateenheden
  • mm
mm
Pain
Beschrijving

at administration site

Datatype

boolean

Pain intensity
Beschrijving

Pain intensity

Datatype

text

Functional impairment
Beschrijving

Functional impairment

Datatype

boolean

Functional impairment intensity
Beschrijving

Functional impairment intensity

Datatype

text

If hospitalisation is required, please also complete a Serious Adverse Event Form
Beschrijving

If hospitalisation is required, please also complete a Serious Adverse Event Form

Clinical Case Description
Beschrijving

Clinical Case Description

Please give a clinical description of the observed large swelling reaction.
Beschrijving

Includes a description of the joint involved and specific associated symptoms. Please mention also eventual diagnostic(s) procedures and therapeutic interventions.

Datatype

text

Last date when the swelling was still considered to be a large swelling reaction
Beschrijving

Last date when the swelling was still considered to be a large swelling reaction

Datatype

date

Outcome of the large swelling reaction
Beschrijving

Outcome of the large swelling reaction

Datatype

text

Follow-up information
Beschrijving

Follow-up information

Datatype

text

Is there an alternative explanation for the swelling?
Beschrijving

e.g., allergy, infection, trauma, underlying conditions

Datatype

boolean

If Yes, please specify below
Beschrijving

If Yes, please specify below

Datatype

text

Similar models

Large Swelling Reaction

Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
Administrative data
Subject Number
Item
Subject Number
integer
Protocol Number
Item
Protocol Number
integer
Date of Birth
Item
Date of Birth
date
Item
Vaccine - possible cause of swelling reaction
text
Code List
Vaccine - possible cause of swelling reaction
CL Item
Plain PRP Vaccine (1)
CL Item
DTPw-HBV Kft Vaccine (2)
Item Group
Report of Physical Examination
Date of physical examination
Item
Date of physical examination
date
Was the examination performed by a member of study personnel during the large swelling reaction period?
Item
Was the examination performed by a member of study personnel during the large swelling reaction period?
boolean
Date when the swelling was first considered to be a large swelling reaction
Item
Date when the swelling was first considered to be a large swelling reaction
date
If occurring within 24 hrs after vaccination, please specify how long after vaccination
Item
If occurring within 24 hrs after vaccination, please specify how long after vaccination
integer
Size of swelling
Item
Size of swelling
integer
Item
Type of swelling
text
Code List
Type of swelling
CL Item
Local swelling around injection site, not involving adjacent joint (1)
CL Item
Diffuse swelling, not involving adjacent joint (2)
CL Item
Swelling, involving adjacent joint (3)
Circumference of swollen limb (at the site of maximum swelling)
Item
Circumference of swollen limb (at the site of maximum swelling)
integer
Circumference of the opposite limb (at the same level)
Item
Circumference of the opposite limb (at the same level)
integer
Item Group
Associated signs
Temperature
Item
Temperature
integer
Item
Route
text
Code List
Route
CL Item
Axillary (1)
CL Item
Oral (2)
CL Item
Tympanic oral (3)
CL Item
Tympanic rectal (4)
CL Item
Rectal (5)
Redness
Item
Redness
boolean
Redness - largest diameter
Item
Redness - largest diameter
integer
Induration
Item
Induration
boolean
Induration - largest diameter
Item
Induration - largest diameter
integer
Pain
Item
Pain
boolean
Item
Pain intensity
text
Code List
Pain intensity
CL Item
Minor reaction to touch (1)
CL Item
Cries/protest on touch (2)
CL Item
Cries when limb is moved/spontaneously painful (3)
Functional impairment
Item
Functional impairment
boolean
Item
Functional impairment intensity
text
Code List
Functional impairment intensity
CL Item
grade 1 (easily tolerated, causing minimal discomfort and not interfering with everyday activities) (1)
CL Item
grade 2 (sufficiently discomforting to interfere with normal everyday activities) (2)
CL Item
grade 3 (prevents normal everyday activities) (3)
Item Group
If hospitalisation is required, please also complete a Serious Adverse Event Form
Item Group
Clinical Case Description
Please give a clinical description of the observed large swelling reaction.
Item
Please give a clinical description of the observed large swelling reaction.
text
Last date when the swelling was still considered to be a large swelling reaction
Item
Last date when the swelling was still considered to be a large swelling reaction
date
Item
Outcome of the large swelling reaction
text
Code List
Outcome of the large swelling reaction
CL Item
Recovered/resolved (1)
CL Item
Recovering/resolving (2)
CL Item
Not recovered/not resolved (please provide further follow-up data) (3)
CL Item
Recovered with sequelae/resolved with sequelae (please specify under section "clinical case description") (4)
Follow-up information
Item
Follow-up information
text
Is there an alternative explanation for the swelling?
Item
Is there an alternative explanation for the swelling?
boolean
If Yes, please specify below
Item
If Yes, please specify below
text

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