Study Coordinating Centre
Item
Centre
text
C2825181 (UMLS CUI [1])
Item
In addition to the use of samples for the tests described in the protocol, samples might be used for other research by GSK (see protocol). Please tick what is also covered by the subject Informed Consent form of your center.
text
C0022885 (UMLS CUI [1,1])
C0457083 (UMLS CUI [1,2])
Code List
In addition to the use of samples for the tests described in the protocol, samples might be used for other research by GSK (see protocol). Please tick what is also covered by the subject Informed Consent form of your center.
CL Item
Quality Assurance of tests described in the protocol. This may include the management of the quality of these current tests, the maintenance or improvement of these current tests, the development of new test methods for the markers described in the protocol as well as making sure that new tests are comparable to previous methods and work reliably. (1)
CL Item
Further investigation by GSK Biologicals into the ability of Fluviral vaccine to protect people if any findings from related studies require it and further research in Influenza disease under study. These investigations excludes genetics and HIV testing. (2)
CL Item
Further investigation by GSK Biologicals into the ability of Fluviral vaccine to protect people if any findings from related studies require it and further research in Influenza disease under study. These investigations excludes genetics and HIV testing. (3)
CL Item
Further research by GSK Biologicals that is NOT RELATED to Fluviral vaccine or Influenza disease under study done on an anonymous basis (meaning that any identification linking (4)
CL Item
he subject to the sample is destroyed). This research excludes genetic and HIV testing and does not affect subject participation in the study. (he subject to the sample is destroyed). This research excludes genetic and HIV testing and does not affect subject participation in the study.)
Item
Please tick below box if a 15 years GSK storage period is covered by the subjectís Informed Consent form of your center.
text
C0022885 (UMLS CUI [1,1])
C1698986 (UMLS CUI [1,2])
C0449238 (UMLS CUI [1,3])
Code List
Please tick below box if a 15 years GSK storage period is covered by the subjectís Informed Consent form of your center.
CL Item
At least 15 years storage period by GSK Biologicals (1)
CL Item
Other, specify (2)
Pharmaceutical Procedures, Usage, Informed Consent, Date in time
Item
ICF Effective date
date
C0022885 (UMLS CUI [1,1])
C0457083 (UMLS CUI [1,2])
C0021430 (UMLS CUI [1,3])
C0011008 (UMLS CUI [1,4])
Investigator Signature
Item
Investigator's signature
text
C2346576 (UMLS CUI [1])
Investigator Signature, Date in time
Item
Date
date
C2346576 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Investigator Name
Item
Printed Investigator's name
text
C2826892 (UMLS CUI [1])