ID

24093

Description

Terms of use: You may not use this document or the information contained herein to a regulatory authority in connection with an application for a marketing authorization or any other regulatory submission without the express written consent of Roche Study #: FVF4168g Drug: Ranibizumab Study Title: A Phase III, Double-Masked, Multicenter, Randomized, Sham-Controlled Study Of The Efficacy And Safety Of Ranibizumab Injection In Subjects With Clinically Significant Macular Edema With Center Involvement Secondary To Diabetes Mellitus

Mots-clés

Versions (3)
  1. 01/07/2017 01/07/2017 -
  2. 01/07/2017 01/07/2017 -
  3. 25/07/2017 25/07/2017 -
Détendeur de droits

Genentech, Inc.

Téléchargé le

25 juillet 2017

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Creative Commons BY-NC 3.0
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RESCUE LASER ADMINISTRATION AND CRITERIA STUDY EYE (MONTH 3) CRFs Roche FVF4168G Macular Edema NCT00473330

Anglais

RESCUE LASER ADMINISTRATION AND CRITERIA STUDY EYE (MONTH 3) CRFs Roche FVF4168G Macular Edema NCT00473330

1 Formulaires  
Patient administration
Description

Patient administration

Subject Number
Description

PT

Type de données

integer

Alias
UMLS CUI [1]
C2348585
Subject Initials:
Description

PTINIT

Type de données

text

Alias
UMLS CUI [1,1]
C1997894
UMLS CUI [1,2]
C2986440
Report Date:
Description

VDT

Type de données

date

Alias
UMLS CUI [1,1]
C1302584
RESCUE LASER ADMINISTRATION AND CRITERIA STUDY EYE (MONTH 3)
Description

RESCUE LASER ADMINISTRATION AND CRITERIA STUDY EYE (MONTH 3)

Were protocol-specified anatomical and timeframe criteria met for the rescue laser administration in the study eye?
Description

[Central foveal thickness (CFT) is 250 μm with < 50 μm reduction from the prior month’s measurement, and laser treatment not received by the subject in the past 3 months.]

Type de données

boolean

Alias
UMLS CUI [1,1]
C0743733
UMLS CUI [1,2]
C1512693
Was rescue laser treatment administered to the study eye?
Description

TX_RECEIVED (TXREC)

Type de données

boolean

Alias
UMLS CUI [1]
C0743733
Date Administered:
Description

If Yes (Administered):

Type de données

date

Unités de mesure
  • DD/MMM/YY
Alias
UMLS CUI [1,1]
C0743733
UMLS CUI [1,2]
C4255413
DD/MMM/YY
Time Administered:
Description

TREATMENT_TIME (TXTM)

Type de données

time

Unités de mesure
  • 24 hr clock
Alias
UMLS CUI [1,1]
C0743733
UMLS CUI [1,2]
C4255413
24 hr clock
Type of Laser:
Description

TREATMENT_TYPE (TXTYP)

Type de données

integer

Alias
UMLS CUI [1]
C1275681
UMLS CUI [2]
C1275682
# of Laser Burns:
Description

LASER_BURNS (LSRBRN)

Type de données

integer

Alias
UMLS CUI [1,1]
C0332708
UMLS CUI [1,2]
C0449788
Power of the Laser:
Description

LASER_POWER (LSRPWR)

Type de données

integer

Unités de mesure
  • mW
Alias
UMLS CUI [1,1]
C0023089
UMLS CUI [1,2]
C3854080
mW
Duration of Laser:
Description

LASER_DURATION (LSRDUR)

Type de données

integer

Unités de mesure
  • seconds
Alias
UMLS CUI [1,1]
C0023089
UMLS CUI [1,2]
C0449238
seconds
undefined item
Description

If No (Not Administered): If protocol specified anatomical and timeframe criteria for the rescue laser treatment were met but the rescue laser was NOT administered, select one or more reasons below and / or provide other reasons, if applicable:

Type de données

text

Treatment required is too close to the edge of the foveal avascular zone
Description

INDICATE_REASON (NDRSN1)

Type de données

boolean

Alias
UMLS CUI [1,1]
C0522473
UMLS CUI [1,2]
C1275950
Subject had extensive, adequate prior laser and all leaking microaneurysms associated with edema seen on FA have been laser treated
Description

INDICATE_REASON (NDRSN2)

Type de données

boolean

Alias
UMLS CUI [1,1]
C0522473
UMLS CUI [1,2]
C0333101
Component of traction on OCT
Description

INDICATE_REASON (NDRSN3)

Type de données

boolean

Alias
UMLS CUI [1]
C0154828
Significant non-perfusion on FA
Description

INDICATE_REASON (NDRSN4)

Type de données

boolean

Alias
UMLS CUI [1,1]
C0522473
UMLS CUI [1,2]
C4049512
Subject refused laser treatment
Description

INDICATE_REASON (NDRSN5)

Type de données

boolean

Alias
UMLS CUI [1,1]
C0522473
UMLS CUI [1,2]
C0749657
Other (specify):
Description

INDICATE_REASON (NDRSN6)

Type de données

boolean

Alias
UMLS CUI [1,1]
C0522473
UMLS CUI [1,2]
C3840932
Other (specify):
Description

OTHER_SPECIFY [OTHSP]

Type de données

text

Alias
UMLS CUI [1,1]
C0522473
UMLS CUI [1,2]
C3840932
Retour au début de la page

Similar models

RESCUE LASER ADMINISTRATION AND CRITERIA STUDY EYE (MONTH 3) CRFs Roche FVF4168G Macular Edema NCT00473330

1 Formulaires
Name
Type
Description | Question | Decode (Coded Value)
Type de données
Alias
Item Group
Patient administration
PT
Item
Subject Number
integer
C2348585 (UMLS CUI [1])
PTINIT
Item
Subject Initials:
text
C1997894 (UMLS CUI [1,1])
C2986440 (UMLS CUI [1,2])
VDT
Item
Report Date:
date
C1302584 (UMLS CUI [1,1])
Item Group
RESCUE LASER ADMINISTRATION AND CRITERIA STUDY EYE (MONTH 3)
CRIT_NOTMET_CHAR (CRTNMC)
Item
Were protocol-specified anatomical and timeframe criteria met for the rescue laser administration in the study eye?
boolean
C0743733 (UMLS CUI [1,1])
C1512693 (UMLS CUI [1,2])
TX_RECEIVED (TXREC)
Item
Was rescue laser treatment administered to the study eye?
boolean
C0743733 (UMLS CUI [1])
TREATMENT_DATE (TXDT, TXDTF)
Item
Date Administered:
date
C0743733 (UMLS CUI [1,1])
C4255413 (UMLS CUI [1,2])
TREATMENT_TIME (TXTM)
Item
Time Administered:
time
C0743733 (UMLS CUI [1,1])
C4255413 (UMLS CUI [1,2])
Item
Type of Laser:
integer
C1275681 (UMLS CUI [1])
C1275682 (UMLS CUI [2])
TREATMENT_TYPE (TXTYP)
Code List
Type of Laser:
CL Item
Focal  (1)
CL Item
Grid (2)
LASER_BURNS (LSRBRN)
Item
# of Laser Burns:
integer
C0332708 (UMLS CUI [1,1])
C0449788 (UMLS CUI [1,2])
LASER_POWER (LSRPWR)
Item
Power of the Laser:
integer
C0023089 (UMLS CUI [1,1])
C3854080 (UMLS CUI [1,2])
LASER_DURATION (LSRDUR)
Item
Duration of Laser:
integer
C0023089 (UMLS CUI [1,1])
C0449238 (UMLS CUI [1,2])
undefined item
Item
text
INDICATE_REASON (NDRSN1)
Item
Treatment required is too close to the edge of the foveal avascular zone
boolean
C0522473 (UMLS CUI [1,1])
C1275950 (UMLS CUI [1,2])
INDICATE_REASON (NDRSN2)
Item
Subject had extensive, adequate prior laser and all leaking microaneurysms associated with edema seen on FA have been laser treated
boolean
C0522473 (UMLS CUI [1,1])
C0333101 (UMLS CUI [1,2])
INDICATE_REASON (NDRSN3)
Item
Component of traction on OCT
boolean
C0154828 (UMLS CUI [1])
INDICATE_REASON (NDRSN4)
Item
Significant non-perfusion on FA
boolean
C0522473 (UMLS CUI [1,1])
C4049512 (UMLS CUI [1,2])
INDICATE_REASON (NDRSN5)
Item
Subject refused laser treatment
boolean
C0522473 (UMLS CUI [1,1])
C0749657 (UMLS CUI [1,2])
INDICATE_REASON (NDRSN6)
Item
Other (specify):
boolean
C0522473 (UMLS CUI [1,1])
C3840932 (UMLS CUI [1,2])
OTHER_SPECIFY [OTHSP]
Item
Other (specify):
text
C0522473 (UMLS CUI [1,1])
C3840932 (UMLS CUI [1,2])
Retour au début de la page 

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