ID

29403

Description

Study part: General Medical History and Baseline Conditions Screening. 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.

Keywords

  1. 3/21/18 3/21/18 -
Copyright Holder

Roche

Uploaded on

March 21, 2018

DOI

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License

Creative Commons BY-NC 3.0

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General Medical History and Baseline Conditions Screening Ranibizumab Macular Edema Diabetes Mellitus FVF4170g

General Medical History and Baseline Conditions Screening

GENERAL MEDICAL HISTORY AND BASELINE CONDITIONS (SCREENING)
Description

GENERAL MEDICAL HISTORY AND BASELINE CONDITIONS (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 the subject have any other medical history or baseline conditions, not specified on a Targeted Medical History CRF?
Description

Medical History

Data type

boolean

Alias
UMLS CUI [1]
C0262926
Diagnosis
Description

Diagnosis

Data type

text

Alias
UMLS CUI [1]
C0011900
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

Similar models

General Medical History and Baseline Conditions Screening

Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
GENERAL MEDICAL HISTORY AND BASELINE CONDITIONS (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 the subject have any other medical history or baseline conditions, not specified on a Targeted Medical History CRF?
boolean
C0262926 (UMLS CUI [1])
Item
Diagnosis
text
C0011900 (UMLS CUI [1])
Code List
Diagnosis
CL Item
Neurologic/Psychiatric (Neurologic/Psychiatric)
C0027765 (UMLS CUI-1)
(Comment:en)
CL Item
Ophthalmologic (Ophthalmologic)
C0015397 (UMLS CUI-1)
(Comment:en)
CL Item
Ears, Nose, Throat (Ears, Nose, Throat)
C0150934 (UMLS CUI-1)
(Comment:en)
CL Item
Cardiovascular (Cardiovascular)
C0007222 (UMLS CUI-1)
(Comment:en)
CL Item
Respiratory (Respiratory)
C0035204 (UMLS CUI-1)
(Comment:en)
CL Item
Gastrointestinal (Gastrointestinal)
C0017178 (UMLS CUI-1)
(Comment:en)
CL Item
Genitourinary/Reproductive (Genitourinary/Reproductive)
C0080276 (UMLS CUI-1)
(Comment:en)
CL Item
Musculoskeletal (Musculoskeletal)
C0026857 (UMLS CUI-1)
(Comment:en)
CL Item
Dermatologic (Dermatologic)
C0037274 (UMLS CUI-1)
(Comment:en)
CL Item
Endocrine (Endocrine)
C0014130 (UMLS CUI-1)
(Comment:en)
CL Item
Hematologic (Hematologic)
C0018939 (UMLS CUI-1)
(Comment:en)
CL Item
Allergies / Drug Sensitivities (Allergies / Drug Sensitivities)
C0020517 (UMLS CUI-1)
(Comment:en)
CL Item
Malignancy (Malignancy)
C0006826 (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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