ID

36822

Beschrijving

Study ID: 104297 Clinical Study ID: 104297 Study Title: An open study for a 2-year period to confirm the safety and immunogenicity of the candidate malaria vaccine RTS,S/AS02A in Mozambican children aged 1 to 4 years at the time of first vaccine dose. Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00323622 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 2 Study Recruitment Status: Completed Generic Name: SB257049 Trade Name: SB257049 Study Indication: Malaria This study (Malaria-039 / NCT00323622 / GlaxoSmithKline Study ID 104297) is a two-year follow-up to Malaria-026 and consists of three clinic visits: Visit 1 / Informed Consent Visit at Visit 7 of Malaria-026 (i.e. 21 months post vaccine dose 1 in Malaria-026). Visit 2 / Interim Analysis 12 months +/- 1 month after Visit 1. Visit 3 / Final Analysis 24 months +/- 1 month after Visit 1. See https://clinicaltrials.gov/ct2/show/NCT00323622 This form is to be completed at/after Visit 3.

Link

https://clinicaltrials.gov/ct2/show/NCT00323622

Trefwoorden

Versies (4)
  1. 12-12-18 12-12-18 -
  2. 06-06-19 06-06-19 -
  3. 12-06-19 12-06-19 -
  4. 27-09-21 27-09-21 -
Houder van rechten

GSK group of companies

Geüploaded op

12 juni 2019

DOI

Voor een aanvraag inloggen.

Licentie

Creative Commons BY-NC 3.0
Model Commentaren :

Hier kunt u commentaar leveren op het model. U kunt de tekstballonnen bij de itemgroepen en items gebruiken om er specifiek commentaar op te geven.

Terug naar het model Commentaren
Itemgroep Commentaren voor :

Item Commentaren voor :

U moet ingelogd zijn om formulieren te downloaden. AUB inloggen of schrijf u gratis in.

Immunogenicity of malaria vaccine candidate - NCT00323622 / Malaria-039

Engels

Visit 3: Laboratory Tests

1 Formulieren  
Administrative data
Beschrijving

Administrative data

Alias
UMLS CUI-1
C1320722
Subject Number
Beschrijving

Subject Number

Datatype

integer

Alias
UMLS CUI [1]
C2348585
Date of Visit
Beschrijving

Date of Visit

Datatype

date

Alias
UMLS CUI [1]
C1320303
Blood Sample for Antibodies to CS
Beschrijving

Blood Sample for Antibodies to CS

Alias
UMLS CUI-1
C0005834
UMLS CUI-2
C3833453
UMLS CUI-3
C0525913
Has a blood sample been taken for antibodies to CS?
Beschrijving

For Cohorts 1 and 2 from Malaria-026

Datatype

boolean

Alias
UMLS CUI [1,1]
C1277698
UMLS CUI [1,2]
C3833453
UMLS CUI [1,3]
C0525913
Date CS antibody sample taken
Beschrijving

if applicable; please complete only if different from visit date

Datatype

date

Alias
UMLS CUI [1]
C1302413
UMLS CUI [2,1]
C3833453
UMLS CUI [2,2]
C0525913
Blood Sample for Antibodies to HBs
Beschrijving

Blood Sample for Antibodies to HBs

Alias
UMLS CUI-1
C0005834
UMLS CUI-2
C0948254
Has a blood sample been taken for antibodies to HBs?
Beschrijving

For Cohort 2 only from Malaria-026

Datatype

integer

Alias
UMLS CUI [1,1]
C1277698
UMLS CUI [1,2]
C0948254
Date anti-HBs sample taken
Beschrijving

if applicable; please complete only if different from visit date

Datatype

date

Alias
UMLS CUI [1,1]
C1302413
UMLS CUI [1,2]
C0948254
Blood Sample for Hematocrit
Beschrijving

Blood Sample for Hematocrit

Alias
UMLS CUI-1
C0005834
UMLS CUI-2
C0518014
Has a blood sample been taken for hematocrit?
Beschrijving

blood sample taken for hematocrit

Datatype

boolean

Alias
UMLS CUI [1,1]
C1277698
UMLS CUI [1,2]
C0518014
Date hematocrit sample taken
Beschrijving

if applicable, please complete only if different from visit date

Datatype

date

Alias
UMLS CUI [1,1]
C1302413
UMLS CUI [1,2]
C0518014
Has PCV (Packed cell volume) / Hematocrit test been done?
Beschrijving

Hematocrit test done

Datatype

boolean

Alias
UMLS CUI [1,1]
C0518014
UMLS CUI [1,2]
C0884358
PCV (Packed cell volume) / Hematocrit Results
Beschrijving

if test was done

Datatype

float

Maateenheden
  • %
Alias
UMLS CUI [1]
C0518014
%
Out of range values
Beschrijving

if applicable; please enter ONE code

Datatype

integer

Alias
UMLS CUI [1,1]
C0438215
UMLS CUI [1,2]
C0600091
specify out of range values
Beschrijving

specification of out of range values

Datatype

text

Alias
UMLS CUI [1,1]
C2348235
UMLS CUI [1,2]
C0438215
Terug naar het begin van de pagina

Similar models

Visit 3: Laboratory Tests

1 Formulieren
Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
Administrative data
C1320722 (UMLS CUI-1)
Subject Number
Item
Subject Number
integer
C2348585 (UMLS CUI [1])
Date of Visit
Item
Date of Visit
date
C1320303 (UMLS CUI [1])
Item Group
Blood Sample for Antibodies to CS
C0005834 (UMLS CUI-1)
C3833453 (UMLS CUI-2)
C0525913 (UMLS CUI-3)
blood sample taken for antibodies to CS
Item
Has a blood sample been taken for antibodies to CS?
boolean
C1277698 (UMLS CUI [1,1])
C3833453 (UMLS CUI [1,2])
C0525913 (UMLS CUI [1,3])
Date CS antibody sample taken
Item
Date CS antibody sample taken
date
C1302413 (UMLS CUI [1])
C3833453 (UMLS CUI [2,1])
C0525913 (UMLS CUI [2,2])
Item Group
Blood Sample for Antibodies to HBs
C0005834 (UMLS CUI-1)
C0948254 (UMLS CUI-2)
Item
Has a blood sample been taken for antibodies to HBs?
integer
C1277698 (UMLS CUI [1,1])
C0948254 (UMLS CUI [1,2])
Has a blood sample been taken for antibodies to HBs?
Code List
Has a blood sample been taken for antibodies to HBs?
CL Item
Yes (1)
CL Item
No (2)
CL Item
NA (for Cohort 1) (3)
Date anti-HBs sample taken
Item
Date anti-HBs sample taken
date
C1302413 (UMLS CUI [1,1])
C0948254 (UMLS CUI [1,2])
Item Group
Blood Sample for Hematocrit
C0005834 (UMLS CUI-1)
C0518014 (UMLS CUI-2)
blood sample taken for hematocrit
Item
Has a blood sample been taken for hematocrit?
boolean
C1277698 (UMLS CUI [1,1])
C0518014 (UMLS CUI [1,2])
Date hematocrit sample taken
Item
Date hematocrit sample taken
date
C1302413 (UMLS CUI [1,1])
C0518014 (UMLS CUI [1,2])
Hematocrit test done
Item
Has PCV (Packed cell volume) / Hematocrit test been done?
boolean
C0518014 (UMLS CUI [1,1])
C0884358 (UMLS CUI [1,2])
Hematocrit
Item
PCV (Packed cell volume) / Hematocrit Results
float
C0518014 (UMLS CUI [1])
Item
Out of range values
integer
C0438215 (UMLS CUI [1,1])
C0600091 (UMLS CUI [1,2])
Out of range values
Code List
Out of range values
CL Item
Laboratory error (1)
CL Item
Preexisting/concomitant medical condition, please specify (2)
CL Item
Prior/Concomitant Medication (3)
CL Item
Child is well - not investigated further (4)
CL Item
Other, please specify (5)
specification of out of range values
Item
specify out of range values
text
C2348235 (UMLS CUI [1,1])
C0438215 (UMLS CUI [1,2])
Terug naar het begin van de pagina 

Contact

Gebruik dit formulier voor feedback, vragen en verbeteringsvoorstellen.

Velden gemarkeerd met een * zijn verplicht.

Help

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