ID

34848

Beskrivning

Study ID: 104951 Clinical Study ID: 104951 Study Title: A Phase III, double-blind, randomized, controlled study to evaluate the immunogenicity and safety of GlaxoSmithKline (GSK) Biologicals' HPV-16/18 L1 VLP AS04 vaccine administered intramuscularly according to a 0_ 1_ 6 month schedule in healthy female subjects aged 10 - 14 years. Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00290277 https://clinicaltrials.gov/ct2/show/NCT00290277 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 3 Study Recruitment Status: Completed Generic Name: HPV-16/18 L1/AS04 Vaccine Trade Name: N/A Study Indication: Infections, Papillomavirus This form contains information about labotratory tests and should be filled in at visit 1 and at visit 4.

Länk

https://clinicaltrials.gov/ct2/show/NCT00290277

Nyckelord

  1. 2019-01-31 2019-01-31 -
  2. 2019-01-31 2019-01-31 -
Rättsinnehavare

GlaxoSmithKline

Uppladdad den

31 januari 2019

DOI

För en begäran logga in.

Licens

Creative Commons BY-NC 3.0

Modellkommentarer :

Här kan du kommentera modellen. Med hjälp av pratbubblor i Item-grupperna och Item kan du lägga in specifika kommentarer.

Itemgroup-kommentar för :

Item-kommentar för :

Du måste vara inloggad för att kunna ladda ner formulär. Var vänlig logga in eller registrera dig utan kostnad.

Evaluation of immunogenicity and safety of GSK Biologicals' HPV-16/18 L1 VLP AS04 vaccine in healthy females NCT00290277

Laboratory Tests (Blood Sample)

Administrative data
Beskrivning

Administrative data

Alias
UMLS CUI-1
C1320722
Subject number
Beskrivning

Subject number

Datatyp

text

Alias
UMLS CUI [1]
C2348585
Date of visit
Beskrivning

Date of visit

Datatyp

date

Alias
UMLS CUI [1]
C1320303
Visit number
Beskrivning

This form should be filled in at visit 1 and at visit 4.

Datatyp

text

Alias
UMLS CUI [1]
C1549755
Laboratory Name
Beskrivning

Laboratory Name

Datatyp

text

Alias
UMLS CUI [1]
C3258037
Has a blood sample been taken for biochemical and haematological analysis?
Beskrivning

If YES, complete date of blood sample taking below (if different from visit date) and complete test results below. 5ml for biochemical and haematological analysis. 5 ml for HPV antibody determination.

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0005834
UMLS CUI [1,2]
C0205474
UMLS CUI [2,1]
C0005834
UMLS CUI [2,2]
C0018941
Results of biochemical analysis
Beskrivning

Results of biochemical analysis

Alias
UMLS CUI-1
C1254595
UMLS CUI-2
C0205474
Creatinine
Beskrivning

Fill in results of creatinine testing. Answer 'ND' for not done, 'BSI' for blood sample inadequate for testing.

Datatyp

text

Alias
UMLS CUI [1,1]
C1254595
UMLS CUI [1,2]
C0201976
Alanine amino-transferase
Beskrivning

Fill in results of alanine amino-transferase testing. Answer 'ND' for not done, 'BSI' for blood sample inadequate for testing.

Datatyp

text

Alias
UMLS CUI [1,1]
C1254595
UMLS CUI [1,2]
C0201836
Results of haematology analysis
Beskrivning

Results of haematology analysis

Alias
UMLS CUI-1
C1254595
UMLS CUI-2
C0474523
White blood cells: Lymphocytes
Beskrivning

Fill in results of lymphocytes testing. Answer 'ND' for not done, 'BSI' for blood sample inadequate for testing.

Datatyp

text

Alias
UMLS CUI [1,1]
C1254595
UMLS CUI [1,2]
C0200635
White blood cells: Eosinophils
Beskrivning

Fill in results of eosinophils testing. Answer 'ND' for not done, 'BSI' for blood sample inadequate for testing.

Datatyp

text

Alias
UMLS CUI [1,1]
C1254595
UMLS CUI [1,2]
C0200638
White blood cells: Neurophils
Beskrivning

Fill in results of neutrophils testing. Answer 'ND' for not done, 'BSI' for blood sample inadequate for testing.

Datatyp

text

Alias
UMLS CUI [1,1]
C1254595
UMLS CUI [1,2]
C0948762
White blood cellls: Monocytes
Beskrivning

Fill in results of monocytes testing. Answer 'ND' for not done, 'BSI' for blood sample inadequate for testing.

Datatyp

text

Alias
UMLS CUI [1,1]
C1254595
UMLS CUI [1,2]
C0200637
White blood cells: Basophils
Beskrivning

Fill in results of basophils testing. Answer 'ND' for not done, 'BSI' for blood sample inadequate for testing.

Datatyp

text

Alias
UMLS CUI [1,1]
C1254595
UMLS CUI [1,2]
C0200641
Red blood cells
Beskrivning

Fill in results of red blood cells testing. Answer 'ND' for not done, 'BSI' for blood sample inadequate for testing.

Datatyp

text

Alias
UMLS CUI [1,1]
C1254595
UMLS CUI [1,2]
C0014772
Haematocrit
Beskrivning

Fill in results of haematocrit testing. Answer 'ND' for not done, 'BSI' for blood sample inadequate for testing.

Datatyp

text

Alias
UMLS CUI [1,1]
C1254595
UMLS CUI [1,2]
C0018935
Platelets
Beskrivning

Fill in results of platelets testing. Answer 'ND' for not done, 'BSI' for blood sample inadequate for testing.

Datatyp

text

Alias
UMLS CUI [1,1]
C1254595
UMLS CUI [1,2]
C0005821
Antibody determination
Beskrivning

Antibody determination

Alias
UMLS CUI-1
C3833453
Has a blood sample been taken for antibody determination?
Beskrivning

If YES, please complete date of blood sample taking below (if different from visit date). 5ml for biochemical and haematological analysis. 5 ml for HPV antibody determination.

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0005834
UMLS CUI [1,2]
C3833453
Date of blood sample taking for antibody determination
Beskrivning

Please fill in, only if the date of blood sample taking for antibody determination is different from visit date.

Datatyp

date

Alias
UMLS CUI [1,1]
C0005834
UMLS CUI [1,2]
C3833453
UMLS CUI [1,3]
C0011008

Similar models

Laboratory Tests (Blood Sample)

Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Administrative data
C1320722 (UMLS CUI-1)
Subject number
Item
Subject number
text
C2348585 (UMLS CUI [1])
Date of visit
Item
Date of visit
date
C1320303 (UMLS CUI [1])
Item
Visit number
text
C1549755 (UMLS CUI [1])
Code List
Visit number
CL Item
Visit 1 (month 0, pre-vacc) (Visit 1)
CL Item
Visit 4 (month 7, post vacc III) (Visit 4)
Laboratory Name
Item
Laboratory Name
text
C3258037 (UMLS CUI [1])
Blood sample
Item
Has a blood sample been taken for biochemical and haematological analysis?
boolean
C0005834 (UMLS CUI [1,1])
C0205474 (UMLS CUI [1,2])
C0005834 (UMLS CUI [2,1])
C0018941 (UMLS CUI [2,2])
Item Group
Results of biochemical analysis
C1254595 (UMLS CUI-1)
C0205474 (UMLS CUI-2)
Creatinine
Item
Creatinine
text
C1254595 (UMLS CUI [1,1])
C0201976 (UMLS CUI [1,2])
Alanine amino-transferase
Item
Alanine amino-transferase
text
C1254595 (UMLS CUI [1,1])
C0201836 (UMLS CUI [1,2])
Item Group
Results of haematology analysis
C1254595 (UMLS CUI-1)
C0474523 (UMLS CUI-2)
White blood cells: Lymphocytes
Item
White blood cells: Lymphocytes
text
C1254595 (UMLS CUI [1,1])
C0200635 (UMLS CUI [1,2])
White blood cells: Eosinophils
Item
White blood cells: Eosinophils
text
C1254595 (UMLS CUI [1,1])
C0200638 (UMLS CUI [1,2])
White blood cells: Neurophils
Item
White blood cells: Neurophils
text
C1254595 (UMLS CUI [1,1])
C0948762 (UMLS CUI [1,2])
White blood cells: Monocytes
Item
White blood cellls: Monocytes
text
C1254595 (UMLS CUI [1,1])
C0200637 (UMLS CUI [1,2])
White blood cells: Basophils
Item
White blood cells: Basophils
text
C1254595 (UMLS CUI [1,1])
C0200641 (UMLS CUI [1,2])
Red blood cells
Item
Red blood cells
text
C1254595 (UMLS CUI [1,1])
C0014772 (UMLS CUI [1,2])
Haematocrit
Item
Haematocrit
text
C1254595 (UMLS CUI [1,1])
C0018935 (UMLS CUI [1,2])
Platelets
Item
Platelets
text
C1254595 (UMLS CUI [1,1])
C0005821 (UMLS CUI [1,2])
Item Group
Antibody determination
C3833453 (UMLS CUI-1)
Antibody determination
Item
Has a blood sample been taken for antibody determination?
boolean
C0005834 (UMLS CUI [1,1])
C3833453 (UMLS CUI [1,2])
Date of blood sample taking for antibody determination
Item
Date of blood sample taking for antibody determination
date
C0005834 (UMLS CUI [1,1])
C3833453 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])

Använd detta formulär för feedback, frågor och förslag på förbättringar.

Fält markerade med * är obligatoriska.

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial