English

Concomitant Medication

1 forms  
  1. StudyEvent: ODM
    1. Concomitant Medication
Administrative data
Description

Administrative data

Alias
UMLS CUI-1
C1320722
Subject Number
Description

Subject Number

Data type

integer

Alias
UMLS CUI [1]
C2348585
Workbook number
Description

Workbook number

Data type

integer

Alias
UMLS CUI [1]
C2986015
Visit type
Description

Check/update for each study visit

Data type

integer

Alias
UMLS CUI [1,1]
C0332307
UMLS CUI [1,2]
C0545082
Concomitant medication
Description

Concomitant medication

Alias
UMLS CUI-1
C2347852
Collection Date
Description

day month year

Data type

date

Alias
UMLS CUI [1]
C1317250
Have any medications/treatments been administered during the timeframe as specified by the protocol?
Description

If you tick "yes" please fill in following items. At each study visit/contact, the investigator should question the subject about any medication(s) taken.

Data type

text

Alias
UMLS CUI [1]
C2347852
Trade/ (Generic) Name
Description

Trade/ (Generic) Name

Data type

text

Alias
UMLS CUI [1,1]
C0027365
UMLS CUI [1,2]
C2347852
Medical Indication: prophylactic
Description

A prophylactic medication is a medication administered in the absence of ANY symptom and in anticipation of a reaction to the vaccination (e.g. an anti-pyretic is considered to be prophylactic when it is given in the absence of fever [rectal temperature < 38°C] and any other symptom, to prevent fever from occurring). Any concomitant medication administered prophylactically in anticipation of reaction to the vaccination must be recorded in the CRF with generic name of the medication (trade names are allowed for combination drugs only), total daily dose, route of administration, start and end dates of treatment and coded as ‘Prophylactic’.

Data type

boolean

Alias
UMLS CUI [1,1]
C3146298
UMLS CUI [1,2]
C2347852
UMLS CUI [1,3]
C0199176
Medical Indication
Description

Medical Indication

Data type

text

Alias
UMLS CUI [1,1]
C3146298
UMLS CUI [1,2]
C2347852
Total daily dose
Description

Total daily dose

Data type

text

Alias
UMLS CUI [1]
C2826638
Route of administration
Description

Route of administration

Data type

text

Alias
UMLS CUI [1,1]
C0013153
UMLS CUI [1,2]
C2347852
Start date of medication
Description

day month year

Data type

date

Alias
UMLS CUI [1]
C2826734
End date of medication
Description

day month year

Data type

date

Alias
UMLS CUI [1]
C2826744
Continuation of medication
Description

Tick if medication is continuing

Data type

boolean

Alias
UMLS CUI [1]
C2826666
Comment
Description

For GSK

Data type

text

Alias
UMLS CUI [1]
C0947611
Back to the top of the page

Similar models

Concomitant Medication

1 forms
  1. StudyEvent: ODM
    1. Concomitant Medication
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Administrative data
C1320722 (UMLS CUI-1)
Subject Number
Item
Subject Number
integer
C2348585 (UMLS CUI [1])
Item
Workbook number
integer
C2986015 (UMLS CUI [1])
Workbook number
Code List
Workbook number
CL Item
WB 1 (1)
CL Item
WB 2 (2)
CL Item
WB 3 (3)
CL Item
WB 4 (4)
Item
Visit type
integer
C0332307 (UMLS CUI [1,1])
C0545082 (UMLS CUI [1,2])
Visit type
Code List
Visit type
CL Item
Core Analysis 1 (1)
CL Item
Core Analysis 2 (2)
CL Item
Study conclusion  (3)
Item Group
Concomitant medication
C2347852 (UMLS CUI-1)
Collection Date
Item
Collection Date
date
C1317250 (UMLS CUI [1])
Item
Have any medications/treatments been administered during the timeframe as specified by the protocol?
text
C2347852 (UMLS CUI [1])
Administration of other vaccines
Code List
Have any medications/treatments been administered during the timeframe as specified by the protocol?
CL Item
Yes (Y)
CL Item
No (N)
Trade/ (Generic) Name
Item
Trade/ (Generic) Name
text
C0027365 (UMLS CUI [1,1])
C2347852 (UMLS CUI [1,2])
Medical Indication: prophylactic
Item
Medical Indication: prophylactic
boolean
C3146298 (UMLS CUI [1,1])
C2347852 (UMLS CUI [1,2])
C0199176 (UMLS CUI [1,3])
Medical Indication
Item
Medical Indication
text
C3146298 (UMLS CUI [1,1])
C2347852 (UMLS CUI [1,2])
Total daily dose
Item
Total daily dose
text
C2826638 (UMLS CUI [1])
Item
Route of administration
text
C0013153 (UMLS CUI [1,1])
C2347852 (UMLS CUI [1,2])
Route of administration
Code List
Route of administration
CL Item
Intradermal (ID)
CL Item
Inhalation (IH)
CL Item
Intramuscular (IM)
CL Item
Intravenous (IV)
CL Item
Intranasal (NA)
CL Item
Parenteral (PE)
CL Item
Oral (PO)
CL Item
Subcutaneous (SC)
CL Item
Sublingual (SL)
CL Item
Transdermal (TD)
CL Item
Other (OTH)
CL Item
Unknown (UNK)
CL Item
External (EXT)
CL Item
Intraarticular (IR)
CL Item
Intrathecal (IT)
CL Item
Rectal (PR)
CL Item
Topical (TO)
CL Item
Vaginal (VA)
Start date
Item
Start date of medication
date
C2826734 (UMLS CUI [1])
End date
Item
End date of medication
date
C2826744 (UMLS CUI [1])
Continuation of medication
Item
Continuation of medication
boolean
C2826666 (UMLS CUI [1])
Comment
Item
Comment
text
C0947611 (UMLS CUI [1])
Back to the top of the page