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22621

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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

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  1. 2017-06-08 2017-06-08 -
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Genentech, Inc.

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8 juni 2017

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INDIRECT OPHTHALMOSCOPY (DAY 0) CRFs Roche FVF4168G Macular Edema NCT00473330

Engelsk

INDIRECT OPHTHALMOSCOPY (DAY 0) CRFs Roche FVF4168G Macular Edema NCT00473330

1 Formulär  
Patient administration
Beskrivning

Patient administration

Subject Number
Beskrivning

PT

Datatyp

integer

Alias
UMLS CUI [1]
C2348585
Subject Initials:
Beskrivning

PTINIT

Datatyp

text

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

VDT

Datatyp

date

Alias
UMLS CUI [1,1]
C1302584
INDIRECT OPHTHALMOSCOPY (DAY 0) Right Eye
Beskrivning

INDIRECT OPHTHALMOSCOPY (DAY 0) Right Eye

Date of Exam:
Beskrivning

EXAM_DT [EXMDT]

Datatyp

date

Måttenheter
  • DD/MMM/YY
Alias
UMLS CUI [1,1]
C1444582
UMLS CUI [1,2]
C0011008
DD/MMM/YY
Clinically Significant Macular Edema (CSME) Present?
Beskrivning

MACULAR_EDEMA [MACEDM]

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0271051
UMLS CUI [1,2]
C0229089
Neovascularization of the Disc (NVD)?
Beskrivning

OPHTHALMO_NEOV_DISC [OPHNVD]

Datatyp

boolean

Alias
UMLS CUI [1,1]
C1112634
UMLS CUI [1,2]
C0229089
Neovascularization (NVE) of the Retina elsewhere?
Beskrivning

OPHTHALMO_NVE [OPHNVE]

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0035320
UMLS CUI [1,2]
C0229089
Neovascularization of the Iris?
Beskrivning

OPHTHALMO_NV_IRIS [OPHIRIS]

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0271110
UMLS CUI [1,2]
C0229089
Posterior Vitreal Detachment (PVD)?
Beskrivning

IND_OPHT_VIT_DETACH [IODET]

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0423361
UMLS CUI [1,2]
C0229089
Retinal Hemorrhages
Beskrivning

OPHTHALMO_RET_HEM [OPHEM]

Datatyp

integer

Alias
UMLS CUI [1,1]
C0035317
UMLS CUI [1,2]
C0229089
Cotton Wool Spots
Beskrivning

OPHTHALMO_COTTON [OPHCOT]

Datatyp

integer

Alias
UMLS CUI [1,1]
C0271053
UMLS CUI [1,2]
C0229089
Is there a new or worsened retinal break or detachment?
Beskrivning

OPHTHALMO_RET_BRK_DH [OPHBD]

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0035321
UMLS CUI [1,2]
C0035305
UMLS CUI [1,3]
C0229089
INDIRECT OPHTHALMOSCOPY (DAY 0) Left Eye
Beskrivning

INDIRECT OPHTHALMOSCOPY (DAY 0) Left Eye

Date of Exam:
Beskrivning

EXAM_DT [EXMDT]

Datatyp

date

Måttenheter
  • DD/MMM/YY
Alias
UMLS CUI [1,1]
C1444582
UMLS CUI [1,2]
C0011008
DD/MMM/YY
Clinically Significant Macular Edema (CSME) Present?
Beskrivning

MACULAR_EDEMA [MACEDM]

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0271051
UMLS CUI [1,2]
C0229090
Neovascularization of the Disc (NVD)?
Beskrivning

OPHTHALMO_NEOV_DISC [OPHNVD]

Datatyp

boolean

Alias
UMLS CUI [1,1]
C1112634
UMLS CUI [1,2]
C0229090
Neovascularization (NVE) of the Retina elsewhere?
Beskrivning

OPHTHALMO_NVE [OPHNVE]

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0035320
UMLS CUI [1,2]
C0229090
Neovascularization of the Iris?
Beskrivning

OPHTHALMO_NV_IRIS [OPHIRIS]

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0271110
UMLS CUI [1,2]
C0229090
Posterior Vitreal Detachment (PVD)?
Beskrivning

IND_OPHT_VIT_DETACH [IODET]

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0423361
UMLS CUI [1,2]
C0229090
Retinal Hemorrhages
Beskrivning

OPHTHALMO_RET_HEM [OPHEM]

Datatyp

integer

Alias
UMLS CUI [1,1]
C0035317
UMLS CUI [1,2]
C0229090
Cotton Wool Spots
Beskrivning

OPHTHALMO_COTTON [OPHCOT]

Datatyp

integer

Alias
UMLS CUI [1,1]
C0271053
UMLS CUI [1,2]
C0229090
Is there a new or worsened retinal break or detachment?
Beskrivning

OPHTHALMO_RET_BRK_DH [OPHBD]

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0035321
UMLS CUI [1,2]
C0035305
UMLS CUI [1,3]
C0229090
Tillbaka till toppen

Similar models

INDIRECT OPHTHALMOSCOPY (DAY 0) CRFs Roche FVF4168G Macular Edema NCT00473330

1 Formulär
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
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
INDIRECT OPHTHALMOSCOPY (DAY 0) Right Eye
EXAM_DT [EXMDT]
Item
Date of Exam:
date
C1444582 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
MACULAR_EDEMA [MACEDM]
Item
Clinically Significant Macular Edema (CSME) Present?
boolean
C0271051 (UMLS CUI [1,1])
C0229089 (UMLS CUI [1,2])
OPHTHALMO_NEOV_DISC [OPHNVD]
Item
Neovascularization of the Disc (NVD)?
boolean
C1112634 (UMLS CUI [1,1])
C0229089 (UMLS CUI [1,2])
OPHTHALMO_NVE [OPHNVE]
Item
Neovascularization (NVE) of the Retina elsewhere?
boolean
C0035320 (UMLS CUI [1,1])
C0229089 (UMLS CUI [1,2])
OPHTHALMO_NV_IRIS [OPHIRIS]
Item
Neovascularization of the Iris?
boolean
C0271110 (UMLS CUI [1,1])
C0229089 (UMLS CUI [1,2])
IND_OPHT_VIT_DETACH [IODET]
Item
Posterior Vitreal Detachment (PVD)?
boolean
C0423361 (UMLS CUI [1,1])
C0229089 (UMLS CUI [1,2])
OPHTHALMO_RET_HEM [OPHEM]
Item
Retinal Hemorrhages
integer
C0035317 (UMLS CUI [1,1])
C0229089 (UMLS CUI [1,2])
Item
Cotton Wool Spots
integer
C0271053 (UMLS CUI [1,1])
C0229089 (UMLS CUI [1,2])
OPHTHALMO_COTTON [OPHCOT]
Code List
Cotton Wool Spots
CL Item
0 (1)
CL Item
1-10 (2)
CL Item
>10 (3)
OPHTHALMO_RET_BRK_DH [OPHBD]
Item
Is there a new or worsened retinal break or detachment?
boolean
C0035321 (UMLS CUI [1,1])
C0035305 (UMLS CUI [1,2])
C0229089 (UMLS CUI [1,3])
Item Group
INDIRECT OPHTHALMOSCOPY (DAY 0) Left Eye
EXAM_DT [EXMDT]
Item
Date of Exam:
date
C1444582 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
MACULAR_EDEMA [MACEDM]
Item
Clinically Significant Macular Edema (CSME) Present?
boolean
C0271051 (UMLS CUI [1,1])
C0229090 (UMLS CUI [1,2])
OPHTHALMO_NEOV_DISC [OPHNVD]
Item
Neovascularization of the Disc (NVD)?
boolean
C1112634 (UMLS CUI [1,1])
C0229090 (UMLS CUI [1,2])
OPHTHALMO_NVE [OPHNVE]
Item
Neovascularization (NVE) of the Retina elsewhere?
boolean
C0035320 (UMLS CUI [1,1])
C0229090 (UMLS CUI [1,2])
OPHTHALMO_NV_IRIS [OPHIRIS]
Item
Neovascularization of the Iris?
boolean
C0271110 (UMLS CUI [1,1])
C0229090 (UMLS CUI [1,2])
IND_OPHT_VIT_DETACH [IODET]
Item
Posterior Vitreal Detachment (PVD)?
boolean
C0423361 (UMLS CUI [1,1])
C0229090 (UMLS CUI [1,2])
OPHTHALMO_RET_HEM [OPHEM]
Item
Retinal Hemorrhages
integer
C0035317 (UMLS CUI [1,1])
C0229090 (UMLS CUI [1,2])
Item
Cotton Wool Spots
integer
C0271053 (UMLS CUI [1,1])
C0229090 (UMLS CUI [1,2])
OPHTHALMO_COTTON [OPHCOT]
Code List
Cotton Wool Spots
CL Item
0 (1)
CL Item
1-10 (2)
CL Item
>10 (3)
OPHTHALMO_RET_BRK_DH [OPHBD]
Item
Is there a new or worsened retinal break or detachment?
boolean
C0035321 (UMLS CUI [1,1])
C0035305 (UMLS CUI [1,2])
C0229090 (UMLS CUI [1,3])
Tillbaka till toppen 

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