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Date of Visit/Assessment

1 forms  
Administrative Data
Description

Administrative Data

Alias
UMLS CUI-1
C1320722
Subject Number
Description

Subject Number

Data type

integer

Alias
UMLS CUI [1]
C2348585
Visit type
Description

If you tick "P1W24/EW", "P3W24/EW" or "P3W31/EW", please check in the following item if this is an early withdrawal. Note: Please check each item that has to be filled in for the chosen visit.

Data type

integer

Alias
UMLS CUI [1,1]
C0545082
UMLS CUI [1,2]
C0332307
Early withdrawal
Description

Early withdrawal

Data type

boolean

Alias
UMLS CUI [1,1]
C1279919
UMLS CUI [1,2]
C2349954
Date of Visit/Assessment
Description

Date of Visit/Assessment

Alias
UMLS CUI-1
C1320303
UMLS CUI-2
C2985720
Date of visit/assessment
Description

day month year

Data type

date

Alias
UMLS CUI [1]
C1320303
UMLS CUI [2]
C2985720
Which part is subject participating?
Description

Only to be filled in for screening.

Data type

integer

Alias
UMLS CUI [1,1]
C0008976
UMLS CUI [1,2]
C0449719
Was a quality of life assessment done?
Description

If you tick yes, please note if subject is less than 6 years of age in the following item. Only to be filled in for Screening, Day 1, P1W1-7, P2W1-7, P1W8-23, P3W8-23 and P3W8-30.

Data type

text

Alias
UMLS CUI [1]
C0281588
Is subject less than 6 years of age?
Description

Only to be filled in for Screening, Day 1, P1W1-7, P2W1-7, P1W8-23, P3W8-23 and P3W8-30.

Data type

text

Alias
UMLS CUI [1]
C0001779
Were ophthalmic exams done?
Description

If you tick yes, please check which exam (complete, lens) has been done in the following item. Not for the weekly follow-up visits (FUW1-FUW4).

Data type

text

Alias
UMLS CUI [1]
C0200149
Ophthalmic exams type
Description

Not for the weekly follow-up visits (FUW1-FUW4).

Data type

text

Alias
UMLS CUI [1,1]
C0200149
UMLS CUI [1,2]
C0332307
Were additional renal assessments performed at this visit?
Description

Only to be filled in for Screening, Day 1, P1W1-5, P1W7, P2W1-5, P2W7, P1W8-23, P3W8-23 and P3W8-30.

Data type

text

Alias
UMLS CUI [1,1]
C0022646
UMLS CUI [1,2]
C0431080
UMLS CUI [1,3]
C0884358
Was a blood smear performed?
Description

Only to be filled in for Screening, Day 1, P1W1-7, P2W1-7, P1W8-23, P3W8-23 and P3W8-30.

Data type

text

Alias
UMLS CUI [1,1]
C0884358
UMLS CUI [1,2]
C2238079
Were coagulation parameters calculated?
Description

Only to be filled in for P1W1-5, P1W7, P2W1-5, P2W7, P1W8-23, P3W8-23 and P3W8-30.

Data type

text

Alias
UMLS CUI [1,1]
C1441506
UMLS CUI [1,2]
C0005778
UMLS CUI [1,3]
C0449381
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Similar models

Date of Visit/Assessment

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Administrative Data
C1320722 (UMLS CUI-1)
Subject Number
Item
Subject Number
integer
C2348585 (UMLS CUI [1])
Item
Visit type
integer
C0545082 (UMLS CUI [1,1])
C0332307 (UMLS CUI [1,2])
Visit type
Code List
Visit type
CL Item
Screening (0)
CL Item
Day 1 (1)
CL Item
P1W1 (2)
CL Item
P1W2 (3)
CL Item
P1W3 (4)
CL Item
P1W4 (5)
CL Item
P1W5 (6)
CL Item
P1W6 (7)
CL Item
P1W7 (8)
CL Item
P1W8-23 (9)
CL Item
P1W24/EW (10)
CL Item
P2W1 (11)
CL Item
P2W2 (12)
CL Item
P2W3 (13)
CL Item
P2W4 (14)
CL Item
P2W5 (15)
CL Item
P2W6 (16)
CL Item
P2W7 (17)
CL Item
P3W8-23 (18)
CL Item
P3W8-30 (19)
CL Item
P3W24/EW (20)
CL Item
P3W31/EW (21)
CL Item
FUW1 (22)
CL Item
FUW2 (23)
CL Item
FUW3 (24)
CL Item
FUW4 (25)
CL Item
FUM3 (26)
CL Item
FUM6 (27)
Early withdrawal
Item
Early withdrawal
boolean
C1279919 (UMLS CUI [1,1])
C2349954 (UMLS CUI [1,2])
Item Group
Date of Visit/Assessment
C1320303 (UMLS CUI-1)
C2985720 (UMLS CUI-2)
Date of visit/assessment
Item
Date of visit/assessment
date
C1320303 (UMLS CUI [1])
C2985720 (UMLS CUI [2])
Item
Which part is subject participating?
integer
C0008976 (UMLS CUI [1,1])
C0449719 (UMLS CUI [1,2])
Study part
Code List
Which part is subject participating?
CL Item
Part 1 (1)
CL Item
Part 2 (2)
Item
Was a quality of life assessment done?
text
C0281588 (UMLS CUI [1])
Quality of life assessment
Code List
Was a quality of life assessment done?
CL Item
Yes (Y)
CL Item
No (N)
Item
Is subject less than 6 years of age?
text
C0001779 (UMLS CUI [1])
Quality of life assessment
Code List
Is subject less than 6 years of age?
CL Item
Yes (Y)
CL Item
No (N)
Item
Were ophthalmic exams done?
text
C0200149 (UMLS CUI [1])
Quality of life assessment
Code List
Were ophthalmic exams done?
CL Item
Yes (Y)
CL Item
No (N)
Item
Ophthalmic exams type
text
C0200149 (UMLS CUI [1,1])
C0332307 (UMLS CUI [1,2])
Quality of life assessment
Code List
Ophthalmic exams type
CL Item
Complete (C)
CL Item
Lens (L)
Item
Were additional renal assessments performed at this visit?
text
C0022646 (UMLS CUI [1,1])
C0431080 (UMLS CUI [1,2])
C0884358 (UMLS CUI [1,3])
Quality of life assessment
Code List
Were additional renal assessments performed at this visit?
CL Item
Yes (Y)
CL Item
No (N)
Item
Was a blood smear performed?
text
C0884358 (UMLS CUI [1,1])
C2238079 (UMLS CUI [1,2])
Quality of life assessment
Code List
Was a blood smear performed?
CL Item
Yes (Y)
CL Item
No (N)
Item
Were coagulation parameters calculated?
text
C1441506 (UMLS CUI [1,1])
C0005778 (UMLS CUI [1,2])
C0449381 (UMLS CUI [1,3])
Quality of life assessment
Code List
Were coagulation parameters calculated?
CL Item
Yes (Y)
CL Item
No (N)
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