ID

42496

Description

Study ID: 106464 Clinical Study ID: 106464 Study Title: A Study of the Efficacy Against Episodes of Clinical Malaria Due to P. Falciparum Infection of GSK Biologicals Candidate Vaccine RTS, S/AS01, Administered According to a 0,1,2-months Schedule in Children Aged 5 to 17 Months Living in Tanzania & Kenya Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00380393 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 2 Study Recruitment Status: Completed Generic Name: GSK malaria vaccine 257049 Vaccine, Sanofi-Pasteur's Human Diploid Cell Rabies Vaccine Trade Name: N/A Study Indication: Malaria ODM derived from https://clinicaltrials.gov/ct2/show/study/NCT00380393. This Phase IIb randomized, double-blind, controlled study of the efficacy against episodes of clinical malaria due to Plasmodium falciparum infection of GlaxoSmithKline Biologicals’ candidate vaccine RTS, S/AS01E, administered IM according to a 0, 1, 2-month vaccination schedule in children aged 5 months to 17 months living in Tanzania and Kenya. This study includes the following 7 clinical study visits (3 different visit types) during a double-blind phase (Day -60 to Month 6 1/2) and a single-blind phase including an extension for a subset of patients (month 7 to month 14). Clinical visit 1: Baseline visit, screening, and randomisation (DAY -60 to 0) Clinical visit 2: Vaccination I (MONTH 0, DAY 0 | DOSE 1 | 0 - 60 DAYS AFTER VISIT 1) Clinical visit 3: Vaccination II (MONTH 1, DAY 30 | DOSE 2 | 21 - 35 DAYS AFTER VISIT 2) Clinical visit 4: Vaccination III (MONTH 2, DAY 60 | DOSE 3 | 21 - 35 DAYS AFTER VISIT 3) Clinical visit 5: Blood Sample, ACD (MONTH 3, DAY 90 | 21 - 42 DAYS AFTER VISIT 4) Clinical visit 6: Blood Sample, ACD (MONTH 6 1/2 | CROSS-SECTIONAL VISIT FOR ACD | FINAL STUDY VISIT FOR DOUBLE-BLIND PHASE) Clinical visit 7: Blood Sample, ACD (MONTH 14 | FINAL STUDY VISIT SINGLE-BLIND PHASE) Field-worker home visits: During the vaccination period, clinical visits are accompanied by daily field-worker visits for a one-week period subsequent to each vaccine administration at clinical visits 2, 3, and 4 (visit code 21-26 following clinical visit 2; visit code 27-32 following clinical visit 3; visit code 33-38 following clinical visit 4). After completion of the vaccination period, clinical visits are then accompanied by weekly field-worker home visits (visit code 39-40 following clinical visit 4/dose 3; visit code 41-55 following clinical visit 5; visit code 56-86 following clinical visit 6). These visits serve the additional purpose of Active Case Detection (ACD). Passive Case Detection (PCD) for clinical malaria disease is performed both during the course of the double-blind (day -60 to month 6 1/2) and the single-blind phase (month 7 to month 14). For all subjects enrolled, please complete the screening conclusion form. Screening conclusion should be documented at clinical visit 1 (screening). Note that informed consent has to be obtained prior to any study procedure.

Link

https://clinicaltrials.gov/ct2/show/study/NCT00380393

Keywords

  1. 8/1/21 8/1/21 -
Copyright Holder

GlaxoSmithKline

Uploaded on

August 1, 2021

DOI

To request one please log in.

License

Creative Commons BY-NC 4.0

Model comments :

You can comment on the data model here. Via the speech bubbles at the itemgroups and items you can add comments to those specificially.

Itemgroup comments for :

Item comments for :

In order to download data models you must be logged in. Please log in or register for free.

Efficacy of P. Falciparum Vaccine Against Malaria in Children NCT00380393

Screening Conclusion

  1. StudyEvent: ODM
    1. Screening Conclusion
Administrative Documentation
Description

Administrative Documentation

Alias
UMLS CUI-1
C1320722
Date of visit
Description

Date of visit

Data type

date

Alias
UMLS CUI [1]
C1320303
Subject number
Description

Subject number

Data type

integer

Alias
UMLS CUI [1]
C2348585
Screening Conclusion
Description

Screening Conclusion

Alias
UMLS CUI-1
C1707478
UMLS CUI-2
C1710477
Did the subject experience any Serious Adverse Event during screening?
Description

(only SAEs related to study participation or to a concurrent medication need to be considered and reported)

Data type

boolean

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0347984
UMLS CUI [1,3]
C1710477
If yes, specify total number of SAEs.
Description

Serious adverse event during trial screening count specification

Data type

integer

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0347984
UMLS CUI [1,3]
C1710477
UMLS CUI [1,4]
C0750480
UMLS CUI [1,5]
C1521902
Is the subject a screening failure?
Description

(Was the subject withdrawn prior to randomisation or first vaccination?)

Data type

boolean

Alias
UMLS CUI [1]
C1710476
UMLS CUI [2,1]
C2349954
UMLS CUI [2,2]
C0332152
UMLS CUI [2,3]
C0034656
UMLS CUI [3,1]
C2349954
UMLS CUI [3,2]
C0332152
UMLS CUI [3,3]
C0042196
If yes, indicate the major reason for failure.
Description

Please tick one box only. If eligibility criteria not fulfilled, please tick failing criteria on Eligibility form. If serious adverse event, please complete and submit SAE report.

Data type

text

Alias
UMLS CUI [1,1]
C1710476
UMLS CUI [1,2]
C0566251
UMLS CUI [1,3]
C0205225
If protocol violation [PTV], please specify.
Description

Trial screen failure protocol violation specification

Data type

text

Alias
UMLS CUI [1,1]
C1710476
UMLS CUI [1,2]
C1709750
UMLS CUI [1,3]
C1521902
If serious adverse event [SAE], please specify SAE number.
Description

Trial screen failure serious adverse event number

Data type

integer

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0237753
UMLS CUI [1,3]
C1521902
If other [OTH], please specify.
Description

Trial screen failure reason and justification specification

Data type

text

Alias
UMLS CUI [1,1]
C1710476
UMLS CUI [1,2]
C0566251
UMLS CUI [1,3]
C0205225
UMLS CUI [1,4]
C1521902
If yes, indicate who made the decision.
Description

Trial screen failure decision

Data type

text

Alias
UMLS CUI [1,1]
C1710476
UMLS CUI [1,2]
C0679006
I confirm that I have reviewed the data in this Case Report Form for this subject. All information entered by myself or my colleagues is, to the best of my knowledge, complete and accurate, as of the date below.
Description

I confirm that I have reviewed the data in this Case Report Form for this subject. All information entered by myself or my colleagues is, to the best of my knowledge, complete and accurate, as of the date below.

Alias
UMLS CUI-1
C2346576
Investigator's signature
Description

Investigator signature

Data type

text

Alias
UMLS CUI [1]
C2346576
Printed investigator's name
Description

Investigator name

Data type

text

Alias
UMLS CUI [1]
C2826892
Date
Description

Investigator signature date

Data type

date

Alias
UMLS CUI [1,1]
C2346576
UMLS CUI [1,2]
C0011008

Similar models

Screening Conclusion

  1. StudyEvent: ODM
    1. Screening Conclusion
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Administrative Documentation
C1320722 (UMLS CUI-1)
Date of visit
Item
Date of visit
date
C1320303 (UMLS CUI [1])
Subject number
Item
Subject number
integer
C2348585 (UMLS CUI [1])
Item Group
Screening Conclusion
C1707478 (UMLS CUI-1)
C1710477 (UMLS CUI-2)
Serious adverse event during trial screening
Item
Did the subject experience any Serious Adverse Event during screening?
boolean
C1519255 (UMLS CUI [1,1])
C0347984 (UMLS CUI [1,2])
C1710477 (UMLS CUI [1,3])
Serious adverse event during trial screening count specification
Item
If yes, specify total number of SAEs.
integer
C1519255 (UMLS CUI [1,1])
C0347984 (UMLS CUI [1,2])
C1710477 (UMLS CUI [1,3])
C0750480 (UMLS CUI [1,4])
C1521902 (UMLS CUI [1,5])
Trial screen failure | withdrawal before randomization | withdrawal before vaccination
Item
Is the subject a screening failure?
boolean
C1710476 (UMLS CUI [1])
C2349954 (UMLS CUI [2,1])
C0332152 (UMLS CUI [2,2])
C0034656 (UMLS CUI [2,3])
C2349954 (UMLS CUI [3,1])
C0332152 (UMLS CUI [3,2])
C0042196 (UMLS CUI [3,3])
Item
If yes, indicate the major reason for failure.
text
C1710476 (UMLS CUI [1,1])
C0566251 (UMLS CUI [1,2])
C0205225 (UMLS CUI [1,3])
CL Item
Eligibility criteria not fulfilled (inclusion and exclusion criteria) ([ELI])
CL Item
Protocol violation ([PTV])
CL Item
Serious adverse event ([SAE])
CL Item
Consent withdrawal / not willing to participate, not due to a serious adverse event ([CWS])
CL Item
Migrated / moved from the study area ([MIG])
CL Item
Lost to follow-up ([LFU])
CL Item
Other ([OTH])
Trial screen failure protocol violation specification
Item
If protocol violation [PTV], please specify.
text
C1710476 (UMLS CUI [1,1])
C1709750 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,3])
Trial screen failure serious adverse event number
Item
If serious adverse event [SAE], please specify SAE number.
integer
C1519255 (UMLS CUI [1,1])
C0237753 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,3])
Trial screen failure reason and justification specification
Item
If other [OTH], please specify.
text
C1710476 (UMLS CUI [1,1])
C0566251 (UMLS CUI [1,2])
C0205225 (UMLS CUI [1,3])
C1521902 (UMLS CUI [1,4])
Item
If yes, indicate who made the decision.
text
C1710476 (UMLS CUI [1,1])
C0679006 (UMLS CUI [1,2])
CL Item
Investigator ([I])
CL Item
Subject/Parents/Guardians ([S]/[P])
Item Group
I confirm that I have reviewed the data in this Case Report Form for this subject. All information entered by myself or my colleagues is, to the best of my knowledge, complete and accurate, as of the date below.
C2346576 (UMLS CUI-1)
Investigator signature
Item
Investigator's signature
text
C2346576 (UMLS CUI [1])
Investigator name
Item
Printed investigator's name
text
C2826892 (UMLS CUI [1])
Investigator signature date
Item
Date
date
C2346576 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])

Please use this form for feedback, questions and suggestions for improvements.

Fields marked with * are required.

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