ID
37458
Description
ICHOM Macular Degeneration data collection Version 3.0.1 Revised: April 10th, 2017 International Consortium for Health Outcomes Measurement (ICHOM), Source: http://www.ichom.org/ For Macular Degeneration, the following conditions and treatment approaches (or interventions) are covered by our Standard Set. Conditions: Neovascular Macular Degeneration Neovascular Age Related Macular Degeneration | Polypoidal Choroidal Vasculopathy | Myopic Neovascular Macular Degeneration | Other Forms of Neovascular Macular Degeneration (includes Post-Traumatic, Inflammatory, Idiopathic, Macular Telangiectasia Type 2) Non-Neovascular Age Related Macular Degeneration Treatment approaches: Intravitreal anti-VEGF treatment | Other intravitreal treatment | Photodynamic therapy | Thermal laser photocoagulation | Retinal radiation therapy | Transpupillary thermotherapy | Retinal surgical treatment This document contains the Each Clinical Visit - Clinical Form. Collecting Patient-Reported Outcome Measure: Brief Impact of Vision Impairment Questionnaire (Brief IVI): The Brief IVI includes costs for commercial use, and requires an agreement license. Therefore this questionnaire is not included in this Version of the standard set. Reference: Rodrigues IA, Sprinkhuizen SM, Barthelmes D, et al. Defining a Minimum Set of Standardized Patient-centered Outcome Measures for Macular Degeneration. American Journal of Opthalmology. 2016;168:1–12. doi: 10.1016/j.ajo.2016.04.012 The Standard set of ICHOM was supported by the WillsEye Hospital (America’s First World’s Best), Retina Suisse, St. Erik Eye Hospital, Macular Society, The Retina Society, Save sight Institute and The Macula Foundation (Preserving and Restoring Vision).
Link
Keywords
Versions (4)
- 7/24/19 7/24/19 -
- 7/30/19 7/30/19 -
- 8/2/19 8/2/19 - Sarah Riepenhausen
- 4/30/20 4/30/20 - Sarah Riepenhausen
Copyright Holder
ICHOM
Uploaded on
July 30, 2019
DOI
To request one please log in.
License
Creative Commons BY-NC 3.0
Model comments :
You can comment on the data model here. Via the speech bubbles at the itemgroups and items you can add comments to those specificially.
Itemgroup comments for :
Item comments for :
In order to download data models you must be logged in. Please log in or register for free.
ICHOM Macular Degeneration
Each Clinical Visit - Clinical Form
- StudyEvent: ODM
Description
Clinical status
Alias
- UMLS CUI-1
- C0449440
Description
INCLUSION CRITERIA: ALl patients TIMING: Baseline, Each clinical visit to check for change REPORTING SOURCE: Clinical TYPE: Single answer
Data type
integer
Alias
- UMLS CUI [1,1]
- C0024437
- UMLS CUI [1,2]
- C0332307
Description
SUPPORTING DEFINITION: Geographic atrophy is defined as an area of hypopigmentation or hyperfluorescence of at least 250 μm in its minimum linear dimension with 2 of the 3 following characteristics: (i) circular shape, (ii) sharp borders, or (iii) visibility of choroidal vessels within the area of geographic atrophy INCLUSION CRITERIA: ALl patients TIMING: Baseline, Each clinical visit to check for change REPORTING SOURCE: Clinical TYPE: Single answer
Data type
integer
Alias
- UMLS CUI [1]
- C1536085
Description
SUPPORTING DEFINITION: Abnormal thickening of the subretinal tissue complex (material between Bruch's membrane and outer retina) anywhere in the macular area INCLUSION CRITERIA: ALl patients TIMING: Baseline, Each clinical visit to check for change REPORTING SOURCE: Clinical TYPE: Single answer
Data type
integer
Alias
- UMLS CUI [1]
- C0423434
Description
SUPPORTING DEFINITION: Discrete elevations of the retinal pigment epithelium (RPE) anywhere in the macular area with solid (fibrovascular or haemorrhagic PED) or fluid (serous PED) matter below the corresponding retinal pigment epithelium INCLUSION CRITERIA: ALl patients TIMING: Baseline, Each clinical visit to check for change REPORTING SOURCE: Clinical TYPE: Single answer
Data type
integer
Alias
- UMLS CUI [1]
- C0339546
Description
SUPPORTING DEFINITION: Solid (fibrovascular or haemorrhagic) or fluid (Serous) PED below the corresponding retinal pigment epithelium INCLUSION CRITERIA: All patients If answered '1' or '2' on Pigment epithelial detachment (PED) TIMING: Baseline, Each clinical visit to check for change REPORTING SOURCE: Clinical TYPE: Single answer
Data type
integer
Alias
- UMLS CUI [1,1]
- C0339546
- UMLS CUI [1,2]
- C0332307
Description
Other ocular treatments
Alias
- UMLS CUI-1
- C0087111
- UMLS CUI-2
- C0015392
Description
INCLUSION CRITERIA: ALl patients TIMING: Each clinical visit to check for change REPORTING SOURCE: Clinical TYPE: Single answer
Data type
integer
Alias
- UMLS CUI [1]
- C2939459
Description
INCLUSION CRITERIA: All patients If answered 'yes' on cataract surgery (CATSURGTX) TIMING: Each clinical visit to check for change REPORTING SOURCE: Clinical TYPE: Date by DD/MM/YYYY
Data type
date
Measurement units
- DD/MM/YYYY
Alias
- UMLS CUI [1,1]
- C0011008
- UMLS CUI [1,2]
- C2939459
Description
INCLUSION CRITERIA: All patients TIMING: Each clinical visit to check for change REPORTING SOURCE: Clinical TYPE: Single answer
Data type
integer
Alias
- UMLS CUI [1]
- C0579255
Description
INCLUSION CRITERIA: All patients If answered 'yes' on YAG laser capsulotomy (YAGLASERTX) TIMING: Each clinical visit to check for change REPORTING SOURCE: Clinical TYPE: Date by DD/MM/YYYY
Data type
date
Measurement units
- DD/MM/YYYY
Alias
- UMLS CUI [1,1]
- C0011008
- UMLS CUI [1,2]
- C0579255
Description
SUPPORTING DEFINITION: i.e. for macular edema or diabetic retinopathy INCLUSION CRITERIA: All patients TIMING: Each clinical visit to check for change REPORTING SOURCE: Clinical TYPE: Single answer
Data type
integer
Alias
- UMLS CUI [1]
- C0438670
Description
INCLUSION CRITERIA: All patients If answered 'yes' on retinal laser (RETLASERTX) TIMING: Each clinical visit to check for change REPORTING SOURCE: Clinical TYPE: Date by DD/MM/YYYY
Data type
date
Measurement units
- DD/MM/YYYY
Alias
- UMLS CUI [1,1]
- C0011008
- UMLS CUI [1,2]
- C0438670
Description
INCLUSION CRITERIA: All patients TIMING: Each clinical visit to check for change REPORTING SOURCE: Clinical TYPE: Single Answer
Data type
integer
Alias
- UMLS CUI [1]
- C0042903
Description
INCLUSION CRITERIA: All patients If answered 'yes' on vitrectomy (VITRTX) TIMING: Each clinical visit to check for change REPORTING SOURCE: Clinical TYPE: Date by DD/MM/YYYY
Data type
date
Measurement units
- DD/MM/YYYY
Alias
- UMLS CUI [1,1]
- C0011008
- UMLS CUI [1,2]
- C0042903
Description
SUPPORTING DEFINITION: i.e. graft, pterygium INCLUSION CRITERIA: All patients TIMING: Each clinical visit to check for change REPORTING SOURCE: Clinical TYPE: Single Answer
Data type
integer
Alias
- UMLS CUI [1]
- C0197402
Description
INCLUSION CRITERIA: All patients If answered 'yes' on corneal surgery (CORNSURGTX) TIMING: Each clinical visit to check for change REPORTING SOURCE: Clinical TYPE: Date by DD/MM/YYYY
Data type
date
Measurement units
- DD/MM/YYYY
Alias
- UMLS CUI [1,1]
- C0011008
- UMLS CUI [1,2]
- C0197402
Description
Treatment variables
Alias
- UMLS CUI-1
- C0087111
Description
INCLUSION CRITERIA: All patients TIMING: Each clinical visit REPORTING SOURCE: Clinical or administrative data TYPE: Multiple answers Separate multiple entries with "";""
Data type
boolean
Alias
- UMLS CUI [1,1]
- C0549184
- UMLS CUI [1,2]
- C0087111
Description
INCLUSION CRITERIA: All patients TIMING: Each clinical visit REPORTING SOURCE: Clinical or administrative data TYPE: Multiple answers Separate multiple entries with "";""
Data type
boolean
Alias
- UMLS CUI [1]
- C0087111
- UMLS CUI [2,1]
- C0013216
- UMLS CUI [2,2]
- C1566537
Description
INCLUSION CRITERIA: All patients TIMING: Each clinical visit REPORTING SOURCE: Clinical or administrative data TYPE: Multiple answers Separate multiple entries with "";""
Data type
boolean
Alias
- UMLS CUI [1]
- C0087111
- UMLS CUI [2,1]
- C0013216
- UMLS CUI [2,2]
- C0796392
Description
INCLUSION CRITERIA: All patients TIMING: Each clinical visit REPORTING SOURCE: Clinical or administrative data TYPE: Multiple answers Separate multiple entries with "";""
Data type
boolean
Alias
- UMLS CUI [1]
- C0087111
- UMLS CUI [2,1]
- C0013216
- UMLS CUI [2,2]
- C1531015
Description
INCLUSION CRITERIA: All patients TIMING: Each clinical visit REPORTING SOURCE: Clinical or administrative data TYPE: Multiple answers Separate multiple entries with "";""
Data type
boolean
Alias
- UMLS CUI [1]
- C0087111
- UMLS CUI [2,1]
- C0013216
- UMLS CUI [2,2]
- C1134659
Description
INCLUSION CRITERIA: All patients TIMING: Each clinical visit REPORTING SOURCE: Clinical or administrative data TYPE: Multiple answers Separate multiple entries with "";""
Data type
boolean
Alias
- UMLS CUI [1]
- C0087111
- UMLS CUI [2]
- C1444685
Description
INCLUSION CRITERIA: All patients TIMING: Each clinical visit REPORTING SOURCE: Clinical or administrative data TYPE: Multiple answers Separate multiple entries with "";""
Data type
boolean
Alias
- UMLS CUI [1]
- C0087111
- UMLS CUI [2]
- C0940918
Description
INCLUSION CRITERIA: All patients TIMING: Each clinical visit REPORTING SOURCE: Clinical or administrative data TYPE: Multiple answers Separate multiple entries with "";""
Data type
boolean
Alias
- UMLS CUI [1]
- C0087111
- UMLS CUI [2]
- C0441510
Description
INCLUSION CRITERIA: All patients TIMING: Each clinical visit REPORTING SOURCE: Clinical or administrative data TYPE: Multiple answers Separate multiple entries with "";""
Data type
boolean
Alias
- UMLS CUI [1]
- C0087111
- UMLS CUI [2,1]
- C0035331
- UMLS CUI [2,2]
- C1522449
Description
INCLUSION CRITERIA: All patients TIMING: Each clinical visit REPORTING SOURCE: Clinical or administrative data TYPE: Multiple answers Separate multiple entries with "";""
Data type
boolean
Alias
- UMLS CUI [1]
- C0087111
- UMLS CUI [2,1]
- C0442379
- UMLS CUI [2,2]
- C0879037
Description
INCLUSION CRITERIA: All patients TIMING: Each clinical visit REPORTING SOURCE: Clinical or administrative data TYPE: Multiple answers Separate multiple entries with "";""
Data type
boolean
Alias
- UMLS CUI [1]
- C0087111
- UMLS CUI [2]
- C0197770
Description
INCLUSION CRITERIA: All patients TIMING: Each clinical visit REPORTING SOURCE: Clinical or administrative data TYPE: Multiple answers Separate multiple entries with "";""
Data type
boolean
Alias
- UMLS CUI [1,1]
- C0205394
- UMLS CUI [1,2]
- C0087111
Description
INCLUSION CRITERIA: All patients TIMING: Each clinical visit REPORTING SOURCE: Clinical or administrative data TYPE: Multiple answers Separate multiple entries with "";""
Data type
boolean
Alias
- UMLS CUI [1,1]
- C0439673
- UMLS CUI [1,2]
- C0087111
Description
Burden of treatment
Alias
- UMLS CUI-1
- C0087111
- UMLS CUI-2
- C2828008
Description
Complications of treatment
Alias
- UMLS CUI-1
- C0087111
- UMLS CUI-2
- C0009566
Description
Severe intra-ocular inflammation within 3 months of last intra-ocular treatment, due to infectious or non-infectious causes INCLUSION CRITERIA: Neovascular macular disease patients receiving treatment TIMING: Each clinical visit REPORTING SOURCE: Clinical TYPE: Single answer
Data type
integer
Alias
- UMLS CUI [1]
- C0014236
Description
Disease activity
Alias
- UMLS CUI-1
- C0544450
Description
SUPPORTING DEFINITION: Presence of intraretinal or subretinal fluid or hemorrhage that is attributable to activity of the neovascular lesion as determined by the treating ophthalmologist. This could be based on clinical examination or imaging INCLUSION CRITERIA: Neovascular macular disease patients receiving treatment TIMING: Each clinical visit REPORTING SOURCE: Clinical TYPE: Single answer
Data type
integer
Alias
- UMLS CUI [1]
- C0242420
- UMLS CUI [2]
- C0035317
Description
Visual functioning and health related quality of life
Alias
- UMLS CUI-1
- C4279947
- UMLS CUI-2
- C0042792
Description
SUPPORTING DEFINITION: Distance visual acuity (best of uncorrected, corrected using glasses or contact lenses, or pinhole) in the affected eye INCLUSION CRITERIA: All patients TIMING: Each clinical visit REPORTING SOURCE: Clinical TYPE: Numerical value RESPONSE OPTIONS: Numerical value preferably reported in LogMAR. Snellen may be used but needs to be converted to LogMAR. Please refer to page 13 for a Snellen to LogMAR conversion table. Change in distance visual acuity should be calculated from baseline and previous visual acuity assessments.
Data type
integer
Alias
- UMLS CUI [1,1]
- C0429537
- UMLS CUI [1,2]
- C0012751
Description
SUPPORTING DEFINITION: Results preferably reported in LogMAR. Snellen may be used but needs to be converted to LogMAR. INCLUSION CRITERIA: All patients TIMING: Each clinical visit REPORTING SOURCE: Clinical TYPE: Numerical value RESPONSE OPTIONS: Numerical value preferably reported in LogMAR. Snellen may be used but needs to be converted to LogMAR. Please refer to page 13 for a Snellen to LogMAR conversion table. Change in distance visual acuity should be calculated from baseline and previous visual acuity assessments.
Data type
integer
Alias
- UMLS CUI [1]
- C1302978
Description
INCLUSION CRITERIA: All patients TIMING: Each clinical visit REPORTING SOURCE: Clinical TYPE: Numerical value RESPONSE OPTIONS: Record details of the distance at which visual acuity is measured
Data type
integer
Alias
- UMLS CUI [1]
- C0429537
Similar models
Each Clinical Visit - Clinical Form
- StudyEvent: ODM
C0332307 (UMLS CUI [1,2])
(Comment:en)
(Comment:en)
(Comment:en)
(Comment:en)
(Comment:en)
(Comment:en)
(Comment:en)
C0442185 (UMLS CUI-2)
(Comment:en)
(Comment:en)
(Comment:en)
C0442185 (UMLS CUI-2)
(Comment:en)
(Comment:en)
(Comment:en)
C0442185 (UMLS CUI-2)
(Comment:en)
C0332307 (UMLS CUI [1,2])
C0154846 (UMLS CUI-2)
(Comment:en)
(Comment:en)
C0015392 (UMLS CUI-2)
(Comment:en)
(Comment:en)
C2939459 (UMLS CUI [1,2])
(Comment:en)
(Comment:en)
C0579255 (UMLS CUI [1,2])
(Comment:en)
(Comment:en)
C0438670 (UMLS CUI [1,2])
(Comment:en)
(Comment:en)
C0042903 (UMLS CUI [1,2])
(Comment:en)
(Comment:en)
C0197402 (UMLS CUI [1,2])
C0087111 (UMLS CUI [1,2])
C0013216 (UMLS CUI [2,1])
C1566537 (UMLS CUI [2,2])
C0013216 (UMLS CUI [2,1])
C0796392 (UMLS CUI [2,2])
C0013216 (UMLS CUI [2,1])
C1531015 (UMLS CUI [2,2])
C0013216 (UMLS CUI [2,1])
C1134659 (UMLS CUI [2,2])
C1444685 (UMLS CUI [2])
C0940918 (UMLS CUI [2])
C0441510 (UMLS CUI [2])
C0035331 (UMLS CUI [2,1])
C1522449 (UMLS CUI [2,2])
C0442379 (UMLS CUI [2,1])
C0879037 (UMLS CUI [2,2])
C0197770 (UMLS CUI [2])
C0087111 (UMLS CUI [1,2])
C0087111 (UMLS CUI [1,2])
C2828008 (UMLS CUI [1,2])
C0009566 (UMLS CUI-2)
(Comment:en)
C1532322 (UMLS CUI-2)
C0456369 (UMLS CUI-3)
C1532322 (UMLS CUI-4)
(Comment:en)
(Comment:en)
C0035317 (UMLS CUI [2])
C2721564 (UMLS CUI-2)
C0035317 (UMLS CUI-3)
C0271049 (UMLS CUI-4)
(Comment:en)
(Comment:en)
C0042792 (UMLS CUI-2)
C0012751 (UMLS CUI [1,2])
C1446199 (UMLS CUI-2)
(Comment:en)
(Comment:en)