ID

28944

Description

Study part: Medical and Surgical History Screening . A Phase III, Multicenter, Randomized, Double-Masked, Sham Injection-Controlled Study Of The Efficacy And Safety Of rhuFab V2 (Ranibizumab) In Subjects With Minimally Classic Or Occult Subfoveal Neovascular Age-Related Macular Degeneration.

Keywords

Versions (1)
  1. 2/18/18 2/18/18 -
Copyright Holder

Roche

Uploaded on

February 18, 2018

DOI

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License

Creative Commons BY-NC 3.0
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Medical and Surgical History Screening rhuFab V2 Neovascular Age-Related Macular Degeneration FVF2598g

English

Medical and Surgical History Screening

1 forms  
MEDICAL AND SURGICAL HISTORY (SCREENING)
Description

MEDICAL AND SURGICAL HISTORY (SCREENING)

Alias
UMLS CUI-1
C0262926
Subject Number:
Description

Subject Number

Data type

text

Alias
UMLS CUI [1]
C2348585
Subject Initials:
Description

Subject Initials

Data type

text

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

Visit Date

Data type

date

Alias
UMLS CUI [1]
C1320303
Does subject have history of conditions or procedures?
Description

Medical History

Data type

boolean

Alias
UMLS CUI [1]
C0262926
Description of Condition or Procedure:
Description

Medical History

Data type

text

Alias
UMLS CUI [1]
C0262926
System Code
Description

Organ system code

Data type

text

Alias
UMLS CUI [1,1]
C0678852
UMLS CUI [1,2]
C0805701
Event Type
Description

Medical history

Data type

text

Alias
UMLS CUI [1]
C0262926
Condition Currently Active?
Description

Medical condition ongoing

Data type

boolean

Alias
UMLS CUI [1,1]
C0012634
UMLS CUI [1,2]
C0549178
Onset Date / Procedure Date
Description

Onset Date

Data type

date

Alias
UMLS CUI [1]
C0574845
Date Unknown
Description

Date unknown

Data type

boolean

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C0439673
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Similar models

Medical and Surgical History Screening

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
MEDICAL AND SURGICAL HISTORY (SCREENING)
C0262926 (UMLS CUI-1)
Subject Number
Item
Subject Number:
text
C2348585 (UMLS CUI [1])
Subject Initials
Item
Subject Initials:
text
C1997894 (UMLS CUI [1,1])
C2986440 (UMLS CUI [1,2])
Visit Date
Item
Visit Date:
date
C1320303 (UMLS CUI [1])
Medical History
Item
Does subject have history of conditions or procedures?
boolean
C0262926 (UMLS CUI [1])
Medical History
Item
Description of Condition or Procedure:
text
C0262926 (UMLS CUI [1])
Item
System Code
text
C0678852 (UMLS CUI [1,1])
C0805701 (UMLS CUI [1,2])
Organ system code
Code List
System Code
CL Item
HEENT (1)
C1512338 (UMLS CUI-1)
(Comment:en)
CL Item
Endocrine (2)
C0014136 (UMLS CUI-1)
(Comment:en)
CL Item
Respiratory (3)
C0035237 (UMLS CUI-1)
(Comment:en)
CL Item
Cardiovascular (4)
C0007226 (UMLS CUI-1)
(Comment:en)
CL Item
Breast (5)
C0006141 (UMLS CUI-1)
(Comment:en)
CL Item
Gastrointestinal (6)
C0012240 (UMLS CUI-1)
(Comment:en)
CL Item
Genitourinary/Reproductive (7)
C0042066 (UMLS CUI-1)
(Comment:en)
CL Item
Musculoskeletal/Rheumatic (8)
C0026860 (UMLS CUI-1)
(Comment:en)
CL Item
Neurologic/Psychiatric (9)
C0027763 (UMLS CUI-1)
(Comment:en)
CL Item
Dermatologic (10)
C0205489 (UMLS CUI-1)
(Comment:en)
CL Item
Ophthalmologic (11)
CL Item
Other (99)
Item
Event Type
text
C0262926 (UMLS CUI [1])
Medical history
Code List
Event Type
CL Item
Condition (Condition)
C0012634 (UMLS CUI-1)
(Comment:en)
CL Item
Procedure (Procedure)
C0087111 (UMLS CUI-1)
(Comment:en)
Medical condition ongoing
Item
Condition Currently Active?
boolean
C0012634 (UMLS CUI [1,1])
C0549178 (UMLS CUI [1,2])
Onset Date
Item
Onset Date / Procedure Date
date
C0574845 (UMLS CUI [1])
Date unknown
Item
Date Unknown
boolean
C0011008 (UMLS CUI [1,1])
C0439673 (UMLS CUI [1,2])
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