ID

33348

Beskrivning

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

Nyckelord

  1. 2018-12-06 2018-12-06 -
Rättsinnehavare

GSK group of companies

Uppladdad den

6 december 2018

DOI

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Licens

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
Beskrivning

Administrative data

Subject Number
Beskrivning

Subject Number

Datatyp

integer

Protocol Number
Beskrivning

Protocol Number

Datatyp

integer

Date of Birth
Beskrivning

Date of Birth

Datatyp

date

Vaccine - possible cause of swelling reaction
Beskrivning

Vaccine - possible cause of swelling reaction

Datatyp

text

Report of Physical Examination
Beskrivning

Report of Physical Examination

Date of physical examination
Beskrivning

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.

Datatyp

date

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

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

Datatyp

boolean

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

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

Datatyp

date

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

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

Datatyp

integer

Måttenheter
  • hrs
hrs
Size of swelling
Beskrivning

measurement of the greatest diameter

Datatyp

integer

Måttenheter
  • mm
mm
Type of swelling
Beskrivning

please specify in section "clinical case description"

Datatyp

text

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

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

Datatyp

integer

Måttenheter
  • mm
mm
Circumference of the opposite limb (at the same level)
Beskrivning

Circumference of the opposite limb (at the same level)

Datatyp

integer

Måttenheter
  • mm
mm
Associated signs
Beskrivning

Associated signs

Temperature
Beskrivning

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

Datatyp

integer

Måttenheter
  • °C
°C
Route
Beskrivning

Route

Datatyp

text

Redness
Beskrivning

Redness

Datatyp

boolean

Redness - largest diameter
Beskrivning

Redness - largest diameter

Datatyp

integer

Måttenheter
  • mm
mm
Induration
Beskrivning

Induration

Datatyp

boolean

Induration - largest diameter
Beskrivning

Induration - largest diameter

Datatyp

integer

Måttenheter
  • mm
mm
Pain
Beskrivning

at administration site

Datatyp

boolean

Pain intensity
Beskrivning

Pain intensity

Datatyp

text

Functional impairment
Beskrivning

Functional impairment

Datatyp

boolean

Functional impairment intensity
Beskrivning

Functional impairment intensity

Datatyp

text

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

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

Clinical Case Description
Beskrivning

Clinical Case Description

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

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

Datatyp

text

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

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

Datatyp

date

Outcome of the large swelling reaction
Beskrivning

Outcome of the large swelling reaction

Datatyp

text

Follow-up information
Beskrivning

Follow-up information

Datatyp

text

Is there an alternative explanation for the swelling?
Beskrivning

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

Datatyp

boolean

If Yes, please specify below
Beskrivning

If Yes, please specify below

Datatyp

text

Similar models

Large Swelling Reaction

Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
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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