Engelsk

Concomitant Vaccination

1 Formulär  
Administrative Documentation
Beskrivning

Administrative Documentation

Alias
UMLS CUI-1
C1320722
Subject number
Beskrivning

Subject number

Datatyp

integer

Alias
UMLS CUI [1]
C2348585
Concomitant Vaccination
Beskrivning

Concomitant Vaccination

Alias
UMLS CUI-1
C0042196
UMLS CUI-2
C2347852
Has any vaccine other than the study vaccine(s) been administered during the timeframe as specified in the protocol?
Beskrivning

If yes, please record concomitant vaccination with trade name and/or generic name, route and vaccine administration date in the following item group.

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0042196
UMLS CUI [1,2]
C2347852
UMLS CUI [1,3]
C0347984
UMLS CUI [1,4]
C1948053
UMLS CUI [1,5]
C2348563
UMLS CUI [2,1]
C1705847
UMLS CUI [2,2]
C0042196
UMLS CUI [2,3]
C3854006
Concomitant Vaccination
Beskrivning

Concomitant Vaccination

Alias
UMLS CUI-1
C0042196
UMLS CUI-2
C2347852
Please record the trade name and/or generic name of the concomitant vaccination.
Beskrivning

Trade name | generic name concomitant vaccination

Datatyp

text

Alias
UMLS CUI [1,1]
C2360065
UMLS CUI [1,2]
C0042196
UMLS CUI [1,3]
C2347852
UMLS CUI [2,1]
C0592502
UMLS CUI [2,2]
C0042196
UMLS CUI [2,3]
C2347852
Please record the route of administration of the concomitant vaccination.
Beskrivning

Drug administration route concomitant vaccination

Datatyp

text

Alias
UMLS CUI [1,1]
C0013153
UMLS CUI [1,2]
C0042196
UMLS CUI [1,3]
C2347852
Please record the vaccine administration date of the concomitant vaccination.
Beskrivning

Date of administration concomitant vaccination

Datatyp

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C0042196
UMLS CUI [1,3]
C2347852
For GSK
Beskrivning

Clinical study sponsor comment

Datatyp

text

Alias
UMLS CUI [1,1]
C2347796
UMLS CUI [1,2]
C0947611
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Similar models

Concomitant Vaccination

1 Formulär
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Administrative Documentation
C1320722 (UMLS CUI-1)
Subject number
Item
Subject number
integer
C2348585 (UMLS CUI [1])
Item Group
Concomitant Vaccination
C0042196 (UMLS CUI-1)
C2347852 (UMLS CUI-2)
Concomitant vaccination during during study protocol period | except for study vaccination
Item
Has any vaccine other than the study vaccine(s) been administered during the timeframe as specified in the protocol?
boolean
C0042196 (UMLS CUI [1,1])
C2347852 (UMLS CUI [1,2])
C0347984 (UMLS CUI [1,3])
C1948053 (UMLS CUI [1,4])
C2348563 (UMLS CUI [1,5])
C1705847 (UMLS CUI [2,1])
C0042196 (UMLS CUI [2,2])
C3854006 (UMLS CUI [2,3])
Item Group
Concomitant Vaccination
C0042196 (UMLS CUI-1)
C2347852 (UMLS CUI-2)
Trade name | generic name concomitant vaccination
Item
Please record the trade name and/or generic name of the concomitant vaccination.
text
C2360065 (UMLS CUI [1,1])
C0042196 (UMLS CUI [1,2])
C2347852 (UMLS CUI [1,3])
C0592502 (UMLS CUI [2,1])
C0042196 (UMLS CUI [2,2])
C2347852 (UMLS CUI [2,3])
Item
Please record the route of administration of the concomitant vaccination.
text
C0013153 (UMLS CUI [1,1])
C0042196 (UMLS CUI [1,2])
C2347852 (UMLS CUI [1,3])
Route of administration concomitant vaccination
Code List
Please record the route of administration of the concomitant vaccination.
CL Item
Intradermal (ID)
CL Item
Inhalation (IH)
CL Item
Intramuscular (IM)
CL Item
Intravenous (IV)
CL Item
Intranasal (NA)
CL Item
Other (OTH)
CL Item
Parenteral (PE)
CL Item
Oral (PO)
CL Item
Subcutaneous (SC)
CL Item
Sublingual (SL)
CL Item
Transdermal (TD)
CL Item
Unknown (UNK)
Date of administration concomitant vaccination
Item
Please record the vaccine administration date of the concomitant vaccination.
date
C0011008 (UMLS CUI [1,1])
C0042196 (UMLS CUI [1,2])
C2347852 (UMLS CUI [1,3])
Clinical study sponsor comment
Item
For GSK
text
C2347796 (UMLS CUI [1,1])
C0947611 (UMLS CUI [1,2])
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