Date of first Tecfidera® administration:
Item
Date of first Tecfidera® administration:
date
C0808070 (UMLS CUI [1,1])
C3556178 (UMLS CUI [1,2])
Date of last Tecfidera® administration:
Item
Date of last Tecfidera® administration:
date
C0806020 (UMLS CUI [1,1])
C3556178 (UMLS CUI [1,2])
No. of dose adjustment
Item
No. of dose adjustment
integer
C2826232 (UMLS CUI [1,1])
C0449788 (UMLS CUI [1,2])
Adjusted daily dose
Item
Adjusted daily dose
integer
C2348070 (UMLS CUI [1,1])
C0456081 (UMLS CUI [1,2])
or interruption
Item
or interruption
boolean
C1512900 (UMLS CUI [1])
Start date
Item
Start date
date
C0808070 (UMLS CUI [1])
End date
Item
End date
date
C0806020 (UMLS CUI [1])
Item
Reason for adjustment/interruption
text
C0392360 (UMLS CUI [1,1])
C2826232 (UMLS CUI [1,2])
C0392360 (UMLS CUI [2,1])
C1512900 (UMLS CUI [2,2])
Code List
Reason for adjustment/interruption
CL Item
Adverse event (1)
C0877248 (UMLS CUI-1)
CL Item
Serious adverse event (2)
C1519255 (UMLS CUI-1)
CL Item
MS relapse (3)
C0856120 (UMLS CUI-1)
CL Item
Suspicion of pregnancy (4)
C0032961 (UMLS CUI-1)
CL Item
Use of prohibited concomitant medication (5)
C2347852 (UMLS CUI-1)
CL Item
Other (9)
C0205394 (UMLS CUI-1)
Other
Item
If other, please specify
text
C0205394 (UMLS CUI [1])
Investigator Signature Date
Item
Date
date
C2346576 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Signature Investigator
Item
Signature Investigator
text
C2346576 (UMLS CUI [1])