ID

29330

Beskrivning

Study part: Indirect Ophthalmoscopy Screening. A Phase III, Multicenter, Randomized, Sham Injection-Controlled Study Of The Efficacy And Safety Of Ranibizumab Injection Compared With Sham In Subjects with Macular Edema Secondary To Branch Retinal Vein Occlusion.

Nyckelord

Versioner (1)
  1. 2018-03-18 2018-03-18 -
Rättsinnehavare

Roche

Uppladdad den

18 mars 2018

DOI

För en begäran logga in.

Licens

Creative Commons BY-NC 3.0
Modellkommentarer :

Här kan du kommentera modellen. Med hjälp av pratbubblor i Item-grupperna och Item kan du lägga in specifika kommentarer.

Tillbaka till modellkommentarer
Itemgroup-kommentar för :

Item-kommentar för :

Du måste vara inloggad för att kunna ladda ner formulär. Var vänlig logga in eller registrera dig utan kostnad.

Indirect Ophthalmoscopy Screening Ranibizumab Macular Edema Secondary To Branch Retinal Vein Occlusion FVF4165g

Engelsk

Indirect Ophthalmoscopy Screening

1 Formulär  
INDIRECT OPHTHALMOSCOPY (SCREENING) RIGHT EYE
Beskrivning

INDIRECT OPHTHALMOSCOPY (SCREENING) RIGHT EYE

Alias
UMLS CUI-1
C1444582
UMLS CUI-2
C0229089
Subject Number:
Beskrivning

Subject Number

Datatyp

text

Alias
UMLS CUI [1]
C2348585
Subject Initials:
Beskrivning

Subject Initials

Datatyp

text

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

Date of visit

Datatyp

date

Alias
UMLS CUI [1]
C1320303
Date Examined:
Beskrivning

Date Examined

Datatyp

date

Alias
UMLS CUI [1]
C2826643
Retina/ Retinal vessels
Beskrivning

Retina

Datatyp

text

Alias
UMLS CUI [1]
C0035298
Describe Abnormality
Beskrivning

Abnormality

Datatyp

text

Alias
UMLS CUI [1]
C1704258
Optic disc
Beskrivning

Optic disc

Datatyp

text

Alias
UMLS CUI [1]
C0029127
Describe Abnormality
Beskrivning

Abnormality

Datatyp

text

Alias
UMLS CUI [1]
C1704258
Macula
Beskrivning

Macula

Datatyp

text

Alias
UMLS CUI [1]
C0423419
Describe Abnormality
Beskrivning

Abnormality

Datatyp

text

Alias
UMLS CUI [1]
C1704258
Evidence of collateral vessels crossing horizontal raphe?
Beskrivning

Retinal collateral vessels

Datatyp

boolean

Alias
UMLS CUI [1]
C1720272
Describe Abnormality
Beskrivning

Abnormality

Datatyp

text

Alias
UMLS CUI [1]
C1704258
Neovascularization of the Disc (NVD)?
Beskrivning

Disc neovascularization

Datatyp

boolean

Alias
UMLS CUI [1]
C1112634
Describe Abnormality
Beskrivning

Abnormality

Datatyp

text

Alias
UMLS CUI [1]
C1704258
Neovascularization elsewhere?
Beskrivning

Neovascularization

Datatyp

boolean

Alias
UMLS CUI [1]
C0027686
Describe Abnormality
Beskrivning

Abnormality

Datatyp

text

Alias
UMLS CUI [1]
C1704258
Hyperpigmentation involving the fovea?
Beskrivning

Foveal hyperpigmentation

Datatyp

boolean

Alias
UMLS CUI [1]
C3809301
Describe Abnormality
Beskrivning

Abnormality

Datatyp

text

Alias
UMLS CUI [1]
C1704258
Hypopigmentation?
Beskrivning

Hypopigmentation

Datatyp

boolean

Alias
UMLS CUI [1]
C0151891
Describe Abnormality
Beskrivning

Abnormality

Datatyp

text

Alias
UMLS CUI [1]
C1704258
Tortuosity of vessels?
Beskrivning

Tortuosity of vessels

Datatyp

boolean

Alias
UMLS CUI [1]
C4021569
Describe Abnormality
Beskrivning

Abnormality

Datatyp

text

Alias
UMLS CUI [1]
C1704258
Retinal Hemorrhages
Beskrivning

Retinal Hemorrhages

Datatyp

text

Alias
UMLS CUI [1]
C0035317
Cotton Wool Spots
Beskrivning

Cotton Wool Spots

Datatyp

text

Alias
UMLS CUI [1]
C0271053
INDIRECT OPHTHALMOSCOPY (SCREENING) LEFT EYE
Beskrivning

INDIRECT OPHTHALMOSCOPY (SCREENING) LEFT EYE

Alias
UMLS CUI-1
C1444582
UMLS CUI-2
C0229090
Retina/ Retinal vessels
Beskrivning

Retina

Datatyp

text

Alias
UMLS CUI [1]
C0035298
Describe Abnormality
Beskrivning

Abnormality

Datatyp

text

Alias
UMLS CUI [1]
C1704258
Optic disc
Beskrivning

Optic disc

Datatyp

text

Alias
UMLS CUI [1]
C0029127
Describe Abnormality
Beskrivning

Abnormality

Datatyp

text

Alias
UMLS CUI [1]
C1704258
Macula
Beskrivning

Macula

Datatyp

text

Alias
UMLS CUI [1]
C0423419
Describe Abnormality
Beskrivning

Abnormality

Datatyp

text

Alias
UMLS CUI [1]
C1704258
Evidence of collateral vessels crossing horizontal raphe?
Beskrivning

Retinal collateral vessels

Datatyp

boolean

Alias
UMLS CUI [1]
C1720272
Describe Abnormality
Beskrivning

Abnormality

Datatyp

text

Alias
UMLS CUI [1]
C1704258
Neovascularization of the Disc (NVD)?
Beskrivning

Disc neovascularization

Datatyp

boolean

Alias
UMLS CUI [1]
C1112634
Describe Abnormality
Beskrivning

Abnormality

Datatyp

text

Alias
UMLS CUI [1]
C1704258
Neovascularization elsewhere?
Beskrivning

Neovascularization

Datatyp

boolean

Alias
UMLS CUI [1]
C0027686
Describe Abnormality
Beskrivning

Abnormality

Datatyp

text

Alias
UMLS CUI [1]
C1704258
Hyperpigmentation involving the fovea?
Beskrivning

Foveal hyperpigmentation

Datatyp

boolean

Alias
UMLS CUI [1]
C3809301
Describe Abnormality
Beskrivning

Abnormality

Datatyp

text

Alias
UMLS CUI [1]
C1704258
Hypopigmentation?
Beskrivning

Hypopigmentation

Datatyp

boolean

Alias
UMLS CUI [1]
C0151891
Describe Abnormality
Beskrivning

Abnormality

Datatyp

text

Alias
UMLS CUI [1]
C1704258
Tortuosity of vessels?
Beskrivning

Tortuosity of vessels

Datatyp

boolean

Alias
UMLS CUI [1]
C4021569
Describe Abnormality
Beskrivning

Abnormality

Datatyp

text

Alias
UMLS CUI [1]
C1704258
Retinal Hemorrhages
Beskrivning

Retinal Hemorrhages

Datatyp

text

Alias
UMLS CUI [1]
C0035317
Cotton Wool Spots
Beskrivning

Cotton Wool Spots

Datatyp

text

Alias
UMLS CUI [1]
C0271053
RETINAL BREAK OR DETACHMENT RIGHT EYE
Beskrivning

RETINAL BREAK OR DETACHMENT RIGHT EYE

Alias
UMLS CUI-1
C0035305
UMLS CUI-2
C0229089
Is a retinal break present?
Beskrivning

retinal break

Datatyp

text

Alias
UMLS CUI [1]
C0035321
Is a retinal detachment present?
Beskrivning

retinal detachment

Datatyp

text

Alias
UMLS CUI [1]
C0035305
If retinal detachment present, specify type:
Beskrivning

retinal detachment

Datatyp

text

Alias
UMLS CUI [1]
C0035305
If Yes, Serous detachment of macula only?
Beskrivning

Serous detachment of the macula

Datatyp

boolean

Alias
UMLS CUI [1]
C1328517
RETINAL BREAK OR DETACHMENT LEFT EYE
Beskrivning

RETINAL BREAK OR DETACHMENT LEFT EYE

Alias
UMLS CUI-1
C0035305
UMLS CUI-2
C0229090
Is a retinal break present?
Beskrivning

retinal break

Datatyp

text

Alias
UMLS CUI [1]
C0035321
Is a retinal detachment present?
Beskrivning

retinal detachment

Datatyp

text

Alias
UMLS CUI [1]
C0035305
If retinal detachment present, specify type:
Beskrivning

retinal detachment

Datatyp

text

Alias
UMLS CUI [1]
C0035305
If Yes, Serous detachment of macula only?
Beskrivning

Serous detachment of the macula

Datatyp

boolean

Alias
UMLS CUI [1]
C1328517
Tillbaka till toppen

Similar models

Indirect Ophthalmoscopy Screening

1 Formulär
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
INDIRECT OPHTHALMOSCOPY (SCREENING) RIGHT EYE
C1444582 (UMLS CUI-1)
C0229089 (UMLS CUI-2)
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])
Date of visit
Item
Visit Date:
date
C1320303 (UMLS CUI [1])
Date Examined
Item
Date Examined:
date
C2826643 (UMLS CUI [1])
Item
Retina/ Retinal vessels
text
C0035298 (UMLS CUI [1])
Lid
Code List
Retina/ Retinal vessels
CL Item
Normal (Normal)
CL Item
Abnormal (Abnormal)
Abnormality
Item
Describe Abnormality
text
C1704258 (UMLS CUI [1])
Item
Optic disc
text
C0029127 (UMLS CUI [1])
Lid
Code List
Optic disc
CL Item
Normal (Normal)
CL Item
Abnormal (Abnormal)
Abnormality
Item
Describe Abnormality
text
C1704258 (UMLS CUI [1])
Item
Macula
text
C0423419 (UMLS CUI [1])
Lid
Code List
Macula
CL Item
Normal (Normal)
CL Item
Abnormal (Abnormal)
Abnormality
Item
Describe Abnormality
text
C1704258 (UMLS CUI [1])
Retinal collateral vessels
Item
Evidence of collateral vessels crossing horizontal raphe?
boolean
C1720272 (UMLS CUI [1])
Abnormality
Item
Describe Abnormality
text
C1704258 (UMLS CUI [1])
Disc neovascularization
Item
Neovascularization of the Disc (NVD)?
boolean
C1112634 (UMLS CUI [1])
Abnormality
Item
Describe Abnormality
text
C1704258 (UMLS CUI [1])
Neovascularization
Item
Neovascularization elsewhere?
boolean
C0027686 (UMLS CUI [1])
Abnormality
Item
Describe Abnormality
text
C1704258 (UMLS CUI [1])
Foveal hyperpigmentation
Item
Hyperpigmentation involving the fovea?
boolean
C3809301 (UMLS CUI [1])
Abnormality
Item
Describe Abnormality
text
C1704258 (UMLS CUI [1])
Hypopigmentation
Item
Hypopigmentation?
boolean
C0151891 (UMLS CUI [1])
Abnormality
Item
Describe Abnormality
text
C1704258 (UMLS CUI [1])
Tortuosity of vessels
Item
Tortuosity of vessels?
boolean
C4021569 (UMLS CUI [1])
Abnormality
Item
Describe Abnormality
text
C1704258 (UMLS CUI [1])
Item
Retinal Hemorrhages
text
C0035317 (UMLS CUI [1])
Retinal Hemorrhages
Code List
Retinal Hemorrhages
CL Item
0 (0)
CL Item
1-10 (1-10)
CL Item
>10 (>10)
Item
Cotton Wool Spots
text
C0271053 (UMLS CUI [1])
Retinal Hemorrhages
Code List
Cotton Wool Spots
CL Item
0 (0)
CL Item
1-10 (1-10)
CL Item
>10 (>10)
Item Group
INDIRECT OPHTHALMOSCOPY (SCREENING) LEFT EYE
C1444582 (UMLS CUI-1)
C0229090 (UMLS CUI-2)
Item
Retina/ Retinal vessels
text
C0035298 (UMLS CUI [1])
Lid
Code List
Retina/ Retinal vessels
CL Item
Normal (Normal)
CL Item
Abnormal (Abnormal)
Abnormality
Item
Describe Abnormality
text
C1704258 (UMLS CUI [1])
Item
Optic disc
text
C0029127 (UMLS CUI [1])
Lid
Code List
Optic disc
CL Item
Normal (Normal)
CL Item
Abnormal (Abnormal)
Abnormality
Item
Describe Abnormality
text
C1704258 (UMLS CUI [1])
Item
Macula
text
C0423419 (UMLS CUI [1])
Lid
Code List
Macula
CL Item
Normal (Normal)
CL Item
Abnormal (Abnormal)
Abnormality
Item
Describe Abnormality
text
C1704258 (UMLS CUI [1])
Retinal collateral vessels
Item
Evidence of collateral vessels crossing horizontal raphe?
boolean
C1720272 (UMLS CUI [1])
Abnormality
Item
Describe Abnormality
text
C1704258 (UMLS CUI [1])
Disc neovascularization
Item
Neovascularization of the Disc (NVD)?
boolean
C1112634 (UMLS CUI [1])
Abnormality
Item
Describe Abnormality
text
C1704258 (UMLS CUI [1])
Neovascularization
Item
Neovascularization elsewhere?
boolean
C0027686 (UMLS CUI [1])
Abnormality
Item
Describe Abnormality
text
C1704258 (UMLS CUI [1])
Foveal hyperpigmentation
Item
Hyperpigmentation involving the fovea?
boolean
C3809301 (UMLS CUI [1])
Abnormality
Item
Describe Abnormality
text
C1704258 (UMLS CUI [1])
Hypopigmentation
Item
Hypopigmentation?
boolean
C0151891 (UMLS CUI [1])
Abnormality
Item
Describe Abnormality
text
C1704258 (UMLS CUI [1])
Tortuosity of vessels
Item
Tortuosity of vessels?
boolean
C4021569 (UMLS CUI [1])
Abnormality
Item
Describe Abnormality
text
C1704258 (UMLS CUI [1])
Item
Retinal Hemorrhages
text
C0035317 (UMLS CUI [1])
Retinal Hemorrhages
Code List
Retinal Hemorrhages
CL Item
0 (0)
CL Item
1-10 (1-10)
CL Item
>10 (>10)
Item
Cotton Wool Spots
text
C0271053 (UMLS CUI [1])
Retinal Hemorrhages
Code List
Cotton Wool Spots
CL Item
0 (0)
CL Item
1-10 (1-10)
CL Item
>10 (>10)
Item Group
RETINAL BREAK OR DETACHMENT RIGHT EYE
C0035305 (UMLS CUI-1)
C0229089 (UMLS CUI-2)
Item
Is a retinal break present?
text
C0035321 (UMLS CUI [1])
retinal break
Code List
Is a retinal break present?
CL Item
Yes (Yes)
CL Item
No (No)
CL Item
Not Done (Not Done)
Item
Is a retinal detachment present?
text
C0035305 (UMLS CUI [1])
retinal break
Code List
Is a retinal detachment present?
CL Item
Yes (Yes)
CL Item
No (No)
CL Item
Not Done (Not Done)
Item
If retinal detachment present, specify type:
text
C0035305 (UMLS CUI [1])
retinal detachment
Code List
If retinal detachment present, specify type:
CL Item
Serous (Serous)
C0154822 (UMLS CUI-1)
(Comment:en)
CL Item
Rhegmatogenous (Rhegmatogenous)
C0271055 (UMLS CUI-1)
(Comment:en)
CL Item
Tractional (Tractional)
C0154828 (UMLS CUI-1)
(Comment:en)
Serous detachment of the macula
Item
If Yes, Serous detachment of macula only?
boolean
C1328517 (UMLS CUI [1])
Item Group
RETINAL BREAK OR DETACHMENT LEFT EYE
C0035305 (UMLS CUI-1)
C0229090 (UMLS CUI-2)
Item
Is a retinal break present?
text
C0035321 (UMLS CUI [1])
retinal break
Code List
Is a retinal break present?
CL Item
Yes (Yes)
CL Item
No (No)
CL Item
Not Done (Not Done)
Item
Is a retinal detachment present?
text
C0035305 (UMLS CUI [1])
retinal break
Code List
Is a retinal detachment present?
CL Item
Yes (Yes)
CL Item
No (No)
CL Item
Not Done (Not Done)
Item
If retinal detachment present, specify type:
text
C0035305 (UMLS CUI [1])
retinal detachment
Code List
If retinal detachment present, specify type:
CL Item
Serous (Serous)
C0154822 (UMLS CUI-1)
(Comment:en)
CL Item
Rhegmatogenous (Rhegmatogenous)
C0271055 (UMLS CUI-1)
(Comment:en)
CL Item
Tractional (Tractional)
C0154828 (UMLS CUI-1)
(Comment:en)
Serous detachment of the macula
Item
If Yes, Serous detachment of macula only?
boolean
C1328517 (UMLS CUI [1])
Tillbaka till toppen 

Kontakt

Använd detta formulär för feedback, frågor och förslag på förbättringar.

Fält markerade med * är obligatoriska.

Hjälp

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial