ID
37466
Descrizione
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 Baseline - Clinical Form. It has to be filled in at Patient's entrance into outcome tracking system for Macular Degeneration. 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).
collegamento
Keywords
versioni (2)
- 30/07/19 30/07/19 -
- 30/04/20 30/04/20 - Sarah Riepenhausen
Titolare del copyright
ICHOM
Caricato su
30 luglio 2019
DOI
Per favore, per richiedere un accesso.
Licenza
Creative Commons BY-NC 3.0
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ICHOM Macular Degeneration
Baseline - Clinical Form
- StudyEvent: ODM
Descrizione
Demographic factors
Alias
- UMLS CUI-1
- C1704791
Descrizione
Age in years, calculated from birth date at commencement of therapy INCLUSION CRITERIA: ALl patients TIMING: Baseline REPORTING SOURCE: Clinical or administrative data
Tipo di dati
date
Unità di misura
- DD/MM/YYYY
Alias
- UMLS CUI [1]
- C0421451
Descrizione
INCLUSION CRITERIA: ALl patients TIMING: Baseline REPORTING SOURCE: Clinical or administrative data
Tipo di dati
integer
Alias
- UMLS CUI [1]
- C0079399
Descrizione
Baseline Functional Status
Alias
- UMLS CUI-1
- C0598463
- UMLS CUI-2
- C1442488
Descrizione
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: Baseline REPORTING SOURCE: Clinical RESPONSE OPTIONS: Numerical value preferably reported in LogMAR. Snellen may be used but needs to be converted to LogMAR. Please refer to page 13 of the reference guide for a Snellen to LogMAR conversion table.
Tipo di dati
integer
Alias
- UMLS CUI [1]
- C0429537
Descrizione
SUPPORTING DEFINITION: Distance visual acuity (best of uncorrected, corrected using glasses or contact lenses, or pinhole) in the fellow eye INCLUSION CRITERIA: ALl patients TIMING: Baseline REPORTING SOURCE: Clinical 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.
Tipo di dati
integer
Alias
- UMLS CUI [1,1]
- C0429537
- UMLS CUI [1,2]
- C0205394
- UMLS CUI [1,3]
- C0015392
Descrizione
SUPPORTING DEFINITION: Results preferably reported in LogMAR. Snellen may be used but needs to be converted to LogMAR. INCLUSION CRITERIA: ALl patients TIMING: Baseline REPORTING SOURCE: Clinical
Tipo di dati
integer
Alias
- UMLS CUI [1]
- C1302978
Descrizione
INCLUSION CRITERIA: ALl patients TIMING: Baseline REPORTING SOURCE: Clinical RESPONSE OPTIONS: Record details of the distance at which visual acuity is measured
Tipo di dati
integer
Alias
- UMLS CUI [1,1]
- C0429537
- UMLS CUI [1,2]
- C0012751
Descrizione
Baseline clinical status
Alias
- UMLS CUI-1
- C0449440
- UMLS CUI-2
- C1442488
Descrizione
INCLUSION CRITERIA: ALl patients TIMING: Baseline, Each clinical visit to check for change REPORTING SOURCE: Clinical TYPE: Single answer
Tipo di dati
integer
Alias
- UMLS CUI [1,1]
- C0024437
- UMLS CUI [1,2]
- C0332307
Descrizione
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
Tipo di dati
integer
Alias
- UMLS CUI [1]
- C1536085
Descrizione
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
Tipo di dati
integer
Alias
- UMLS CUI [1]
- C0423434
Descrizione
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
Tipo di dati
integer
Alias
- UMLS CUI [1]
- C0339546
Descrizione
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
Tipo di dati
integer
Alias
- UMLS CUI [1,1]
- C0339546
- UMLS CUI [1,2]
- C0332307
Descrizione
Associated clinical history
Alias
- UMLS CUI-1
- C0262926
- UMLS CUI-2
- C0332281
Descrizione
SUPPORTING DEFINITION: Select all that apply INCLUSION CRITERIA: All patients TIMING: Baseline, Annually from baseline REPORTING SOURCE: Clinical TYPE: Multiple answers. Separate multiple entries with "";""
Tipo di dati
boolean
Alias
- UMLS CUI [1,1]
- C0009488
- UMLS CUI [1,2]
- C1299003
- UMLS CUI [1,3]
- C0154833
- UMLS CUI [2]
- C0011884
- UMLS CUI [3]
- C0035328
- UMLS CUI [4]
- C0035302
Descrizione
SUPPORTING DEFINITION: Select all that apply INCLUSION CRITERIA: All patients TIMING: Baseline, Annually from baseline REPORTING SOURCE: Clinical TYPE: Multiple answers. Separate multiple entries with "";""
Tipo di dati
boolean
Alias
- UMLS CUI [1,1]
- C0009488
- UMLS CUI [1,2]
- C1299003
- UMLS CUI [1,3]
- C0730362
- UMLS CUI [1,4]
- C1518912
- UMLS CUI [2]
- C0730285
- UMLS CUI [3]
- C0339543
- UMLS CUI [4]
- C0024441
- UMLS CUI [5]
- C0026850
Descrizione
SUPPORTING DEFINITION: Select all that apply INCLUSION CRITERIA: All patients TIMING: Baseline, Annually from baseline REPORTING SOURCE: Clinical TYPE: Multiple answers. Separate multiple entries with "";""
Tipo di dati
boolean
Alias
- UMLS CUI [1,1]
- C0009488
- UMLS CUI [1,2]
- C1299003
- UMLS CUI [2]
- C0017601
- UMLS CUI [3,1]
- C3887709
- UMLS CUI [3,2]
- C0205394
Descrizione
SUPPORTING DEFINITION: Select all that apply INCLUSION CRITERIA: All patients TIMING: Baseline, Annually from baseline REPORTING SOURCE: Clinical TYPE: Multiple answers. Separate multiple entries with "";""
Tipo di dati
boolean
Alias
- UMLS CUI [1,1]
- C0009488
- UMLS CUI [1,2]
- C1299003
- UMLS CUI [2]
- C0002418
Descrizione
SUPPORTING DEFINITION: Select all that apply INCLUSION CRITERIA: All patients TIMING: Baseline, Annually from baseline REPORTING SOURCE: Clinical TYPE: Multiple answers. Separate multiple entries with "";""
Tipo di dati
boolean
Alias
- UMLS CUI [1,1]
- C0009488
- UMLS CUI [1,2]
- C1299003
- UMLS CUI [2]
- C0086543
- UMLS CUI [3]
- C0010038
Descrizione
SUPPORTING DEFINITION: Select all that apply INCLUSION CRITERIA: All patients TIMING: Baseline, Annually from baseline REPORTING SOURCE: Clinical TYPE: Multiple answers. Separate multiple entries with "";""
Tipo di dati
boolean
Alias
- UMLS CUI [1,1]
- C0009488
- UMLS CUI [1,2]
- C1299003
- UMLS CUI [1,3]
- C0205394
Descrizione
SUPPORTING DEFINITION: Select all that apply INCLUSION CRITERIA: All patients TIMING: Baseline REPORTING SOURCE: Clinical TYPE: "Multiple answers. Separate multiple entries with "";"""
Tipo di dati
boolean
Alias
- UMLS CUI [1,1]
- C0549184
- UMLS CUI [1,2]
- C0205156
- UMLS CUI [1,3]
- C0024437
- UMLS CUI [1,4]
- C0087111
Descrizione
SUPPORTING DEFINITION: Select all that apply INCLUSION CRITERIA: All patients TIMING: Baseline REPORTING SOURCE: Clinical TYPE: "Multiple answers. Separate multiple entries with "";"""
Tipo di dati
boolean
Alias
- UMLS CUI [1,1]
- C0205156
- UMLS CUI [1,2]
- C0024437
- UMLS CUI [1,3]
- C0087111
- UMLS CUI [2,1]
- C1554888
- UMLS CUI [2,2]
- C3895948
Descrizione
SUPPORTING DEFINITION: Select all that apply INCLUSION CRITERIA: All patients TIMING: Baseline REPORTING SOURCE: Clinical TYPE: "Multiple answers. Separate multiple entries with "";"""
Tipo di dati
boolean
Alias
- UMLS CUI [1,1]
- C0205156
- UMLS CUI [1,2]
- C0024437
- UMLS CUI [1,3]
- C0087111
- UMLS CUI [2]
- C1444685
Descrizione
SUPPORTING DEFINITION: Select all that apply INCLUSION CRITERIA: All patients TIMING: Baseline REPORTING SOURCE: Clinical TYPE: "Multiple answers. Separate multiple entries with "";"""
Tipo di dati
boolean
Alias
- UMLS CUI [1,1]
- C0205156
- UMLS CUI [1,2]
- C0024437
- UMLS CUI [1,3]
- C0087111
- UMLS CUI [2]
- C0940918
Descrizione
SUPPORTING DEFINITION: Select all that apply INCLUSION CRITERIA: All patients TIMING: Baseline REPORTING SOURCE: Clinical TYPE: "Multiple answers. Separate multiple entries with "";"""
Tipo di dati
boolean
Alias
- UMLS CUI [1,1]
- C0205156
- UMLS CUI [1,2]
- C0024437
- UMLS CUI [1,3]
- C0087111
- UMLS CUI [2]
- C0441510
Descrizione
SUPPORTING DEFINITION: Select all that apply INCLUSION CRITERIA: All patients TIMING: Baseline REPORTING SOURCE: Clinical TYPE: "Multiple answers. Separate multiple entries with "";"""
Tipo di dati
boolean
Alias
- UMLS CUI [1,1]
- C0205156
- UMLS CUI [1,2]
- C0024437
- UMLS CUI [1,3]
- C0087111
- UMLS CUI [2,1]
- C1522449
- UMLS CUI [2,2]
- C0035331
Descrizione
SUPPORTING DEFINITION: Select all that apply INCLUSION CRITERIA: All patients TIMING: Baseline REPORTING SOURCE: Clinical TYPE: "Multiple answers. Separate multiple entries with "";"""
Tipo di dati
boolean
Alias
- UMLS CUI [1,1]
- C0205156
- UMLS CUI [1,2]
- C0024437
- UMLS CUI [1,3]
- C0087111
- UMLS CUI [2,1]
- C0442379
- UMLS CUI [2,2]
- C0879037
Descrizione
SUPPORTING DEFINITION: Select all that apply INCLUSION CRITERIA: All patients TIMING: Baseline REPORTING SOURCE: Clinical TYPE: "Multiple answers. Separate multiple entries with "";"""
Tipo di dati
boolean
Alias
- UMLS CUI [1,1]
- C0205156
- UMLS CUI [1,2]
- C0024437
- UMLS CUI [1,3]
- C0087111
- UMLS CUI [2]
- C0197770
Descrizione
SUPPORTING DEFINITION: Select all that apply INCLUSION CRITERIA: All patients TIMING: Baseline REPORTING SOURCE: Clinical TYPE: "Multiple answers. Separate multiple entries with "";"""
Tipo di dati
boolean
Alias
- UMLS CUI [1,1]
- C0205156
- UMLS CUI [1,2]
- C0024437
- UMLS CUI [1,3]
- C0087111
- UMLS CUI [2]
- C0205394
Descrizione
SUPPORTING DEFINITION: Select all that apply INCLUSION CRITERIA: All patients TIMING: Baseline REPORTING SOURCE: Clinical TYPE: "Multiple answers. Separate multiple entries with "";"""
Tipo di dati
boolean
Alias
- UMLS CUI [1,1]
- C0205156
- UMLS CUI [1,2]
- C0024437
- UMLS CUI [1,3]
- C0087111
- UMLS CUI [2]
- C0439673
Similar models
Baseline - Clinical Form
- StudyEvent: ODM
(Comment:en)
(Comment:en)
(Comment:en)
C1442488 (UMLS CUI-2)
C0205394 (UMLS CUI [1,2])
C0015392 (UMLS CUI [1,3])
(Comment:en)
(Comment:en)
C0012751 (UMLS CUI [1,2])
C1442488 (UMLS CUI-2)
C0332307 (UMLS CUI [1,2])
(Comment:en)
(Comment:en)
C0024437 (UMLS CUI-2)
(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)
C0332281 (UMLS CUI-2)
C1299003 (UMLS CUI [1,2])
C0154833 (UMLS CUI [1,3])
C0011884 (UMLS CUI [2])
C0035328 (UMLS CUI [3])
C0035302 (UMLS CUI [4])
C1299003 (UMLS CUI [1,2])
C0730362 (UMLS CUI [1,3])
C1518912 (UMLS CUI [1,4])
C0730285 (UMLS CUI [2])
C0339543 (UMLS CUI [3])
C0024441 (UMLS CUI [4])
C0026850 (UMLS CUI [5])
C1299003 (UMLS CUI [1,2])
C0017601 (UMLS CUI [2])
C3887709 (UMLS CUI [3,1])
C0205394 (UMLS CUI [3,2])
C1299003 (UMLS CUI [1,2])
C0002418 (UMLS CUI [2])
C1299003 (UMLS CUI [1,2])
C0086543 (UMLS CUI [2])
C0010038 (UMLS CUI [3])
C1299003 (UMLS CUI [1,2])
C0205394 (UMLS CUI [1,3])
C0205156 (UMLS CUI [1,2])
C0024437 (UMLS CUI [1,3])
C0087111 (UMLS CUI [1,4])
C0024437 (UMLS CUI [1,2])
C0087111 (UMLS CUI [1,3])
C1554888 (UMLS CUI [2,1])
C3895948 (UMLS CUI [2,2])
C0024437 (UMLS CUI [1,2])
C0087111 (UMLS CUI [1,3])
C1444685 (UMLS CUI [2])
C0024437 (UMLS CUI [1,2])
C0087111 (UMLS CUI [1,3])
C0940918 (UMLS CUI [2])
C0024437 (UMLS CUI [1,2])
C0087111 (UMLS CUI [1,3])
C0441510 (UMLS CUI [2])
C0024437 (UMLS CUI [1,2])
C0087111 (UMLS CUI [1,3])
C1522449 (UMLS CUI [2,1])
C0035331 (UMLS CUI [2,2])
C0024437 (UMLS CUI [1,2])
C0087111 (UMLS CUI [1,3])
C0442379 (UMLS CUI [2,1])
C0879037 (UMLS CUI [2,2])
C0024437 (UMLS CUI [1,2])
C0087111 (UMLS CUI [1,3])
C0197770 (UMLS CUI [2])
C0024437 (UMLS CUI [1,2])
C0087111 (UMLS CUI [1,3])
C0205394 (UMLS CUI [2])
C0024437 (UMLS CUI [1,2])
C0087111 (UMLS CUI [1,3])
C0439673 (UMLS CUI [2])