Inglês

Non-Serious Adverse Events (AE)

1 Formulários  
Administrative data
Descrição

Administrative data

Alias
UMLS CUI-1
C1320722
Subject Number
Descrição

Subject Number

Tipo de dados

text

Alias
UMLS CUI [1]
C2348585
Workbook Number
Descrição

Workbook Number

Tipo de dados

integer

Alias
UMLS CUI [1]
C2986015
Non-Serious Adverse Events
Descrição

Non-Serious Adverse Events

Alias
UMLS CUI-1
C1518404
Has any non-serious adverse events occurred within one month (minimum 30 days) post-vaccination, excluding those recorded on the Solicited Adverse Events pages?
Descrição

If you tick yes, please complete the following items.

Tipo de dados

text

Alias
UMLS CUI [1,1]
C1518404
UMLS CUI [1,2]
C0332282
UMLS CUI [1,3]
C0042196
AE Number
Descrição

AE Number

Tipo de dados

integer

Alias
UMLS CUI [1,1]
C1518404
UMLS CUI [1,2]
C0237753
AE Description
Descrição

AE Description

Tipo de dados

text

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C0678257
AE Site
Descrição

AE Site

Tipo de dados

text

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C0450429
Vaccine administered
Descrição

IPV vaccine: Only to fill in for WB 2

Tipo de dados

integer

Alias
UMLS CUI [1]
C2368628
Comment for GSK
Descrição

Comment for GSK

Tipo de dados

text

Alias
UMLS CUI [1,1]
C0947611
UMLS CUI [1,2]
C0008961
Start Date of AE
Descrição

day month year

Tipo de dados

date

Alias
UMLS CUI [1]
C2697888
Tick if AE start during immediate post-vaccination period (30 minutes)
Descrição

AE start immediate post-vaccination period

Tipo de dados

boolean

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C0205253
UMLS CUI [1,3]
C0687676
UMLS CUI [1,4]
C0042196
Stop Date of AE
Descrição

day month year

Tipo de dados

date

Alias
UMLS CUI [1,1]
C0806020
UMLS CUI [1,2]
C0877248
AE Maximum Intensity
Descrição

Definition: Mild: An adverse event which is easily tolerated by the subject, causing minimal discomfort and not interfering with everyday activities. Moderate: An adverse event which is sufficiently discomforting to interfere with normal everyday activities. Severe: An adverse event which prevents normal, everyday activities (In a young child, such an adverse event would, for example, prevent attendance at school/kindergarten/a day-care center and would cause the parents/guardians to seek medical advice).

Tipo de dados

integer

Alias
UMLS CUI [1,1]
C0806909
UMLS CUI [1,2]
C0518690
UMLS CUI [1,3]
C0877248
Is there a reasonable possibility that the AE may have been caused by the investigational product?
Descrição

NO: The adverse event is not causally related to administration of the study vaccine(s). There are other, more likely causes and administration of the study vaccine(s) is not suspected to have contributed to the adverse event. YES: There is a reasonable possibility that the vaccine contributed to the adverse event.

Tipo de dados

text

Alias
UMLS CUI [1,1]
C1518404
UMLS CUI [1,2]
C0304229
UMLS CUI [1,3]
C0439849
Outcome of AE
Descrição

Definition: 1: Recovered / resolved. 2:Recovering / Resolving: Subject is recovering at the time she/he completes the study or at the time she/he withdraws from study. 3: Not recovered / Not resolved: AE is ongoing at the time the subject completes the study or becomes lost to follow-up; in case of death AEs that are not the cause of death. 4: Recovered with sequelae / Resolved with sequelae

Tipo de dados

integer

Alias
UMLS CUI [1]
C1705586
Medically attended visit
Descrição

Medically attended visit

Tipo de dados

text

Alias
UMLS CUI [1,1]
C0545082
UMLS CUI [1,2]
C1386497
UMLS CUI [1,3]
C1518404
If medically attended visit, please specify type
Descrição

Type of medically attended visit

Tipo de dados

text

Alias
UMLS CUI [1,1]
C0545082
UMLS CUI [1,2]
C0332307
UMLS CUI [1,3]
C1386497
UMLS CUI [1,4]
C1518404
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Similar models

Non-Serious Adverse Events (AE)

1 Formulários
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de dados
Alias
Item Group
Administrative data
C1320722 (UMLS CUI-1)
Subject Number
Item
Subject Number
text
C2348585 (UMLS CUI [1])
Item
Workbook Number
integer
C2986015 (UMLS CUI [1])
Visit type
Code List
Workbook Number
CL Item
WB 1 (1)
CL Item
WB 2 (2)
Item Group
Non-Serious Adverse Events
C1518404 (UMLS CUI-1)
Item
Has any non-serious adverse events occurred within one month (minimum 30 days) post-vaccination, excluding those recorded on the Solicited Adverse Events pages?
text
C1518404 (UMLS CUI [1,1])
C0332282 (UMLS CUI [1,2])
C0042196 (UMLS CUI [1,3])
Non-serious AE after vaccine dose
Code List
Has any non-serious adverse events occurred within one month (minimum 30 days) post-vaccination, excluding those recorded on the Solicited Adverse Events pages?
CL Item
No (N)
CL Item
Yes (Y)
AE Number
Item
AE Number
integer
C1518404 (UMLS CUI [1,1])
C0237753 (UMLS CUI [1,2])
AE Description
Item
AE Description
text
C0877248 (UMLS CUI [1,1])
C0678257 (UMLS CUI [1,2])
Item
AE Site
text
C0877248 (UMLS CUI [1,1])
C0450429 (UMLS CUI [1,2])
AE Site
Code List
AE Site
CL Item
Administration site (L)
CL Item
Non-administration site (G)
Item
Vaccine administered
integer
C2368628 (UMLS CUI [1])
AE Site
Code List
Vaccine administered
CL Item
10Pn-PD-DiT or Prevenar vaccine (901)
CL Item
DTPw-HBV/Hib vaccine (94)
CL Item
IPV vaccine (10)
Comment for GSK
Item
Comment for GSK
text
C0947611 (UMLS CUI [1,1])
C0008961 (UMLS CUI [1,2])
Start Date of AE
Item
Start Date of AE
date
C2697888 (UMLS CUI [1])
AE start immediate post-vaccination period
Item
Tick if AE start during immediate post-vaccination period (30 minutes)
boolean
C0877248 (UMLS CUI [1,1])
C0205253 (UMLS CUI [1,2])
C0687676 (UMLS CUI [1,3])
C0042196 (UMLS CUI [1,4])
Stop Date of AE
Item
Stop Date of AE
date
C0806020 (UMLS CUI [1,1])
C0877248 (UMLS CUI [1,2])
Item
AE Maximum Intensity
integer
C0806909 (UMLS CUI [1,1])
C0518690 (UMLS CUI [1,2])
C0877248 (UMLS CUI [1,3])
AE Maximum Intensity
Code List
AE Maximum Intensity
CL Item
Mild (1)
CL Item
Moderate (2)
CL Item
Severe (3)
Item
Is there a reasonable possibility that the AE may have been caused by the investigational product?
text
C1518404 (UMLS CUI [1,1])
C0304229 (UMLS CUI [1,2])
C0439849 (UMLS CUI [1,3])
AE Relationship to investigational products
Code List
Is there a reasonable possibility that the AE may have been caused by the investigational product?
CL Item
No (N)
CL Item
Yes (Y)
Item
Outcome of AE
integer
C1705586 (UMLS CUI [1])
Outcome of AE
Code List
Outcome of AE
CL Item
Recovered / resolved (1)
CL Item
Recovering / resolving (2)
CL Item
Not recovered / not resolved (3)
CL Item
Recovered with sequelae / resolved with sequelae (4)
Item
Medically attended visit
text
C0545082 (UMLS CUI [1,1])
C1386497 (UMLS CUI [1,2])
C1518404 (UMLS CUI [1,3])
Medically attended visit
Code List
Medically attended visit
CL Item
No (N)
CL Item
Yes (Y)
Item
If medically attended visit, please specify type
text
C0545082 (UMLS CUI [1,1])
C0332307 (UMLS CUI [1,2])
C1386497 (UMLS CUI [1,3])
C1518404 (UMLS CUI [1,4])
Medically attended visit
Code List
If medically attended visit, please specify type
CL Item
Hospitalisation (HO)
CL Item
Emergency Room (ER)
CL Item
Medical Personnel (MD)
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